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Grads

Hello!

We are Tiber and Frances, and we are the grad officers this year

While much work has been done to bring the graduate courses into alignment with the standard course, given the breadth of our cohort, this can sometimes be a challenge! Grads come from all walks of life (try chatting one up – they’re pretty cool), their motives and determination can be uniquely driven – an off the shelf approach is seldom fitting. That’s where we come in!

We’re here to listen to your ideas, concerns and expectations, and support you in your endeavours with the Clinical School. We work closely with the grad base at West Suffolk, Clinical School management and GradSoc.

If you are a prospective grad student who wants to know more about the course, don’t hesitate to get in touch. If you’re considering an MBPhD you might find reading Laith’s guide below helpful. You can reach us at (atb47@nullcam.ac.uk or fh357@nullcam.ac.uk).

 

Laith’s Guide to MBPhD

Hi, my name’s Laith, one of the ClinSoc grad reps for 2018-2019. Lots of students have asked me about the MBPhD programme — why you should do it, what the PhD journey is like and what the pluses and minuses are.

I’ve written this guide using my own perspective together with the opinions of several of my peers to give you a a better understanding of the whole process, from the application right through to completing the PhD. I hope you find it helpful!

If you are passionate about research, love getting your teeth sunk into a long-term project and want to be more involved in graduate life at university, then the MB/PhD course is definitely something you should consider.

Pre-PhD: decisions, decisions, decisions

I was fortunate to find a topic I was passionate about in my second year of medical school: neuroscience. I’m interested in how the brain goes wrong in psychiatric disorders. In my third year, I intercalated into a combined neuroscience and psychology degree.

A laboratory research project was a mandatory component of the third year course, and my project mentor – a postdoc at the time – was a skilled scientist and teacher, tenacious in his pursuit of scientific knowledge. He instilled in me an appreciation of science as a day-to-day pursuit: some successes scattered amongst many more failed projects and dead ends. But he always said that if you are passionate, the successes make all the failures worth it. It was his mentorship and my enjoyment of wet lab work that spurred me on to apply for the MB/PhD programme.

I filled out the application towards the end of my third year and was invited for interview just before preclinical finals. The interview itself was pretty daunting – I was faced with a panel of seven or eight (it’s a blur!) clinician-researchers from different backgrounds. They asked two types of questions in the interview: detailed, specific ones about the research I had undertaken; and more general questions about why I wanted to pursue a PhD, why now, and the steps I had taken to show I was serious, such as contacting potential supervisors.

After a month, I heard back – I had been offered a place! During the following year – the first year of clinical studies – I had to decide on a lab. I followed up discussions with several of the lecturers I had approached previously, and gradually whittled down the options to a shortlist of three potential labs. I investigated these more thoroughly: I spent a couple of days at each lab and attended lab meetings to get a feel of lab dynamics. I spoke to PhDs and postdocs about life in the lab, both academically and socially. The most important factor influencing my decision was how clearly the supervisor defined my project, and how the project fitted in to the overall direction of the lab.

I also wanted a supervisor who was experienced from two perspectives: first, from a publishing perspective – I wanted a lab with a record of publishing in high-impact journals. Second, from a supervision perspective – I wanted a PI who had supervised several PhD students before me.

PhD: there and back again

My PhD used animal models to investigate the physiological and behavioural functions of the ventromedial prefrontal cortex – a brain region heavily implicated in psychiatric disorders. Looking back, my PhD is a story in three parts, which broadly align with the first, second and third years.

The first year was about acquiring skills: learning how to plan experiments, lab skills and data analysis. I was fortunate to join onto the project of a final-year PhD student, so I could learn skills whilst also getting my name on a publication. Thanks to this, I hit the ground running with my own projects. By the final few months of the first year, I had my first complete dataset and plenty of things to talk about in the first-year report. Having someone’s project to join helped with my own work, providing me with the ideal opportunity to acquire skills relevant to my experiments.

The success of my first year was followed by the notorious ‘second-year slump.’ This year was the toughest for several reasons: my experiments were running into problems, the steady stream of results was running dry, and importantly my medic friends were graduating and moving on with their lives. They were preparing to be junior doctors, whereas I felt stuck.

Looking back, the reality couldn’t have been more different – my experiments were progressing (even though there were lots of negative results), I was learning advanced lab skills (including surgery and neuroimaging) and I spoke at national/international conferences. A post-doc commented that things often feel slower because I was becoming more efficient and completing my work in less time. A nice thought, with hopefully some truth! My supervisor was very supportive and made sure I had post-docs helping me with some of the most advanced experiments, including MRI and PET imaging.

The final year was a combination of tremendous excitement but also significant stress. The experiments were working, data were being generated and we had results to write papers. I realised that resting on your laurels is not a thing in science – if you’ve got results, you’ve got to write them up quickly to remain current. Writing up a manuscript is an immense task, and for most of my third year I was balancing writing manuscripts, completing experiments, writing my thesis and preparing for the return to clinical school.

The MB/PhD puts a significant time pressure on you as a student because you want to have written up your thesis (or at least most of it) by the time you return to clinical school, which gives you in total only two years and 10 months to complete all your experiments and have a thesis to boot. Fortunately, my supervisor carefully planned out my transition from a PhD student who was in experiment-mode to one who was in thesis-writing mode by gradually transferring experimental responsibility to students and post-docs.

Thanks to support from the lab, family and friends, I powered on and managed to submit my thesis in time for my return to clinical school. The papers inevitably lingered on (because of the lengthy peer-review process) but juggling clinical and academic commitments was manageable. My viva exam took place in October 2018, and I passed with minor corrections, ultimately graduating with my PhD in April 2019. The PhD journey, of course, doesn’t end there – and the reality is I am still involved in my lab, offering advice on experiments and helping to write up other papers.

I’m drawing on personal experience here, as well as discussions with other MBPhDs. We all had different experiences, but there are some common themes.

One: find something you are passionate about and embrace it.

By the time you’re in your third year and applying to the MB/PhD, you will probably have specialised into a preclinical field. Most people will choose a PhD within that specialisation, but even within one subject there are a myriad of projects you can choose from. For instance, with neuroscience you could do molecular, computational, animal or human work. Take some time to think about what you enjoy, and why you enjoy it. Come up with a research question, and how you want to answer it. Passion will come across in the interview for the programme and it is the most critical component to a successful PhD.

Two: get hands-on research experience.

Having some research experience is a prerequisite – an intercalated degree is essential – but try and get as much hands-on, lab-based experience under your belt. It shows that you’re committed and you have an appreciation of what research is really like. If you can, work in different labs so you can appreciate how the mechanics of labs differ (although this is by no means necessary, my only laboratory experience was during my final year project). I would recommend writing up some of your experiences in a report – even if it isn’t published – so you can demonstrate scientific writing skills. It’s also worth noting that doing a ‘pure’ literature-based dissertation rather than a hands-on project makes getting a place much more difficult.

Summer research placements are looked on favourably by the selection panel – they could be at your own university, closer to home or even international. You can get funding for a whole host of research charities or international organisations (like the Amgen Scholars’ Programme), and writing an application is excellent training for potential future academics. It’s best to try and contact the labs early on in the academic year – before Christmas, or at the latest early in the New Year.

I spoke to another MB/PhD student, Agata, about her tips for applying to the programme. She emphasised the differences between medical school and research, which highlights why getting real lab experience is so important:

Research is very different from passing medical exams, so don’t go for the MB/PhD just because you were “good at school” – only apply if you’re sure that research is your cup of tea. Otherwise there might be more frustration along the way.

Three: approach supervisors early, in several research areas.

Don’t be afraid to approach potential supervisors after lectures; in fact, that’s how I got my PhD project. It’s best to do this early on in your third year for two reasons: first, it gives you more time to understand if research in their lab is really for you; and second, it will demonstrate to interviewers that you are serious about the MB/PhD.

Ask yourself whether you’d like to be supervised by a new, up-and-coming supervisor or a well-established one. Newer supervisors may be working on the next big thing, but often have less experience supervising with PhD students. Established supervisors often have a substantial publication record and will have supervised several students so will understand some of the strains the doctorate will put you under. I’d also advocate speaking to supervisors whose fields are slightly outside of your direct area of interest – you might find a project that uses some exciting techniques you’d like to learn.

Four: ask PhDs and postdocs about their experiences in the lab.

Try and get an opportunity to speak with current students and postdocs about what life is like working in the lab you’re interested in. They might give you some honest insight into what the work is like, some of the stresses and strains, and time frames for turning around research papers. Most importantly, are they enjoying it? Many PhD students will become a bit jaded by the second year, so it’s normal to have positives balanced out by some negatives – in fact, it would be unusual to have a universally positive experience.

It was through speaking to PhD students that I was swayed towards my PhD lab. I spoke to three students who all seemed to love what they were doing. They also emphasised the importance and impact of the work the lab was doing. A postdoc told me how the supervisor was willing to listen to her PhD students’ perspectives and would take their experiences into account when deciding on experiments.

Five: brace yourself for a personal journey.

The PhD is as much a personal endeavour as it is a scientific one. Karim, another MB/PhD student, put it best:

There is a personal, experiential aspect – you will spend three years of your early twenties with one group of people every day and think about the same thing every day. That’s quite a formative and powerful experience, of the type most applicants have never chosen before and so aren’t necessarily mindful of. My view is that the MB/PhD is a big commitment, and that sincere dedication really immunises against the inevitable ups and downs across the months and years, whether those are scientific or personal.

During a PhD, it’s inevitable that there will be highs and lows, but you become resilient. Sometimes, the results of your hard work just don’t come to pass because in research, there isn’t always a linear relationship between effort and output. Sometimes, you hit a run of bad luck. If you invest all your worth in your work, it’d be easy to feel low. So you adapt, and develop other areas of interest which help you bounce back – for instance, I trained to be a gym instructor!  

Most importantly, the PhD teaches you to value your support networks more than ever, whether that’s your friends, family or mentors. The adage is very true – it’s a marathon not a sprint, and it’s perfectly natural to need a helping hand every once in a while. Your own passion together with the support of colleagues and friends is a winning combination when it comes to completing the PhD.

What attributes make me suited to an MB/PhD programme?

Three things. Number one is a passion for research. Number two is a willingness to learn about the scientific method. Finally, three: a commitment to develop as an excellent clinician.

I can’t emphasise the last point enough, because an excellent clinician-scientist is, first and foremost, an excellent clinician. In the future, you might be taking time out of clinical practice to pursue research. You’ll have to prove to your colleagues that despite this you are still a world-class doctor. Being a clinician will benefit your research, because you understand the problems that matter to patients. That means you can direct your research questions accordingly – a perspective that pure scientists will find harder to appreciate.  

Is there a disadvantage to doing a PhD early on, before you have all your clinical experience?

Some people might tell you that it’s better to do the PhD later on in your career when you are more certain of your clinical speciality. There may be some truth in that – but I’m sceptical.

To put it bluntly I think this sort of thinking misses the point of a PhD. The doctorate is an apprenticeship in the scientific method. The most important skills you learn are transferable. They involve broader changes in your attitudes to research, clinical practice and work-life balance. The doctorate will change how you approach problems, critically appraise evidence and come to balanced conclusions.

In fact, this statement applies to me: my PhD was most relevant to psychiatry and neurology, but I don’t know for sure if I will end up being a psychiatrist, neurologist, or something else entirely. Nevertheless, I am so, so glad I did the PhD when I did. Firstly, it gave me three years totally immersed in a research project – something that is basically impossible to get otherwise. It maximised my output and meant I could publish a big, first author paper (amongst others) well in time for my Foundation Year applications.

Secondly, the PhD taught me to think about long-term goals. In medical school, thinking ‘long-term’ is thinking about the exams at the end of three terms of an academic year – in a PhD, ‘long-term’ is three years. A marathon like this is never going to be smooth the whole way, and it can be hard to think of the ultimate goal of submitting a thesis when you have setbacks along the way. You learn to be resilient: when experiments fail, you don’t always treat it as a negative. You use failure as an opportunity to learn. You reflect on your practice. All key skills to develop as a both a scientist and a doctor, regardless of your speciality.

Aren’t things really time pressured having to finish your PhD before you come back to medical school?

They are. But you learn to be organised with your time. I had several busy experiments to manage but was also required to keep up with clinical supervisions and teaching requirements – as well as extra-curricular activities. You have to be disciplined, organised and make the most of every minute. It’s pretty tiring but at the same time empowering. You’ll surprise yourself with just how much you can get done in the space of one day!

Time-management, together with an excellent, understanding supervisor and my confidence to set boundaries meant I completed my thesis in time. You will learn how to say ‘no’ – you won’t have the time to help with every experiment, train every new student or give a talk at every conference. It’s best to focus on a smaller number of jobs and do them well, rather than spread yourself too thinly.

As I mentioned above, the reality is that there will be some overhang of the PhD into your first few weeks of clinical work. Fortunately, my viva happened early on in my first year back and it was useful to have it close to completing my thesis. I remembered all the experimental details, statistical methods and caveats. I also had a review article and experimental paper to write in the first few months, but I prioritised: my main concern was clinical work, so I allocated my time appropriately.

Is there an opportunity cost?

There is a financial opportunity cost: the stipend you get as an MB/PhD student is less than the pay you’d get if you did the PhD later. However, you’re probably going to be more competitive for job applications in the future.

The other cost to think about is time – you’ll be taking three years out of conventional training. It can be hard to see your colleagues progress on through their training whilst you remain a student. On the other hand, getting a funded research degree (especially a PhD) at a later stage in your career is a lot more competitive. For many consultant posts at top hospitals you’ll need a PhD or MD anyway.

I haven’t ever really thought of my research as a cost, though. The PhD has given me so many opportunities that many other clinical students simply couldn’t do. I have spoken at multiple national and international conferences; travelled to Washington DC, San Diego, Paris and Shenzhen; and met world-leading scientists. You become an expert in your field – granted, it will be a very specific area of science, but you will have the privilege of being consulted by other researchers for your advice.

To top it all off, you’re going to have both a medical degree and PhD before the age of 30. If I say much more it’s going to sound like an ego-trip, but I’m trying to emphasise just how amazing an opportunity the MB/PhD is. I’ve never had second thoughts

Just ask yourself three questions. Am I passionate about research? Do I want to learn more about how research works? Do I want to develop as a clinician? If your answer is yes to these questions, go for it.

If you want more information about the Cambridge MB/PhD programme, check out the course website here. MB/PhD directors are more than happy to meet undergraduates to discuss, and you can contact the MB/PhD director Professor Stefan Marciniak at sjm20@nullcam.ac.uk