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      Canadian M.D.-Ph.D. Programs Produce Impactful Physician-Scientists: The McGill Experience

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      Journal of Biomedical Education
      Hindawi Limited

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          Abstract

          On June 18, 2015, the Canadian Institutes of Health Research (CIHR) announced that it would terminate funding to M.D.-Ph.D. programs due to budget constraints, against the recommendations from two advisory panels. CIHR’s M.D.-Ph.D. program grants, which amounted to an annual average of $1.8 million in the form of 14 six-year studentships, represent only 0.15% of CIHR’s $1.2 billion operating budget. As over half of M.D.-Ph.D. trainees are dependent on these studentships, this poses a threat to physician-scientist training in Canada. In response to the current volatile funding climate, we surveyed McGill University’s M.D.-Ph.D. program alumni to assess its success in producing physician-scientists. In this program, 60.0% of graduates who have completed training have become physician-scientists, the majority being retained in Canada. These individuals have attained positions with sufficiently protected time for research and had grant success and significant publications for early- to mid-career investigators. This suggests that the current M.D.-Ph.D. system is an effective way of producing competent physician-scientists. As physician-scientists have remarkably contributed to Canadian healthcare innovation despite making up a fraction of physicians and researchers, vulnerability in the M.D.-Ph.D. pipeline would invariably affect the health of Canadians.

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          Most cited references10

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          Intraoperative brain cancer detection with Raman spectroscopy in humans.

          Cancers are often impossible to visually distinguish from normal tissue. This is critical for brain cancer where residual invasive cancer cells frequently remain after surgery, leading to disease recurrence and a negative impact on overall survival. No preoperative or intraoperative technology exists to identify all cancer cells that have invaded normal brain. To address this problem, we developed a handheld contact Raman spectroscopy probe technique for live, local detection of cancer cells in the human brain. Using this probe intraoperatively, we were able to accurately differentiate normal brain from dense cancer and normal brain invaded by cancer cells, with a sensitivity of 93% and a specificity of 91%. This Raman-based probe enabled detection of the previously undetectable diffusely invasive brain cancer cells at cellular resolution in patients with grade 2 to 4 gliomas. This intraoperative technology may therefore be able to classify cell populations in real time, making it an ideal guide for surgical resection and decision-making.
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            Analytical validation of the PAM50-based Prosigna Breast Cancer Prognostic Gene Signature Assay and nCounter Analysis System using formalin-fixed paraffin-embedded breast tumor specimens

            Background NanoString’s Prosigna™ Breast Cancer Prognostic Gene Signature Assay is based on the PAM50 gene expression signature. The test outputs a risk of recurrence (ROR) score, risk category, and intrinsic subtype (Luminal A/B, HER2-enriched, Basal-like). The studies described here were designed to validate the analytical performance of the test on the nCounter Analysis System across multiple laboratories. Methods Analytical precision was measured by testing five breast tumor RNA samples across 3 sites. Reproducibility was measured by testing replicate tissue sections from 43 FFPE breast tumor blocks across 3 sites following independent pathology review at each site. The RNA input range was validated by comparing assay results at the extremes of the specified range to the nominal RNA input level. Interference was evaluated by including non-tumor tissue into the test. Results The measured standard deviation (SD) was less than 1 ROR unit within the analytical precision study and the measured total SD was 2.9 ROR units within the reproducibility study. The ROR scores for RNA inputs at the extremes of the range were the same as those at the nominal input level. Assay results were stable in the presence of moderate amounts of surrounding non-tumor tissue (<70% by area). Conclusions The analytical performance of NanoString’s Prosigna assay has been validated using FFPE breast tumor specimens across multiple clinical testing laboratories.
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              Are MD-PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD-PhD programs.

              MD-PhD training programs provide an integrated approach for training physician-scientists. The goal of this study was to characterize the career path taken by MD-PhD program alumni during the past 40 years and identify trends that affect their success. In 2007-early 2008, 24 programs enrolling 43% of current trainees and representing half of the National Institutes of Health-funded MD-PhD training programs submitted anonymous data on 5,969 current and former trainees. The average program enrolled 90 trainees, required 8.0 years to complete, and had an attrition rate of 10%. Nearly all (95%) of those who graduated entered residencies. Most (81%) were employed in academia, research institutes, or industry; 16% were in private practice. Of those in academia, 82% were doing research and at least 61% had identifiable research funding. Whereas two-thirds devoted more than 50% effort to research, only 39% devoted more than 75% effort. Many with laboratory-based PhDs reported doing clinical, as well as basic and translational, research. Emerging trends include decreasing numbers of graduates who forego residencies or hold primary appointments in nonclinical departments, increasing time to graduation, and expanding residency choices that include disciplines historically associated with clinical practice rather than research. Most MD-PhD program graduates follow career paths generally consistent with their training as physician-scientists. However, the range of their professional options is broad. Further thought should be given to designing their training to anticipate their career choices and maximize their likelihood of success as investigators.
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                Author and article information

                Journal
                Journal of Biomedical Education
                Journal of Biomedical Education
                Hindawi Limited
                2314-5021
                2314-503X
                2016
                2016
                : 2016
                :
                : 1-4
                Article
                10.1155/2016/3836467
                1a588513-07a9-4522-8da6-7cea7bc74ad8
                © 2016

                http://creativecommons.org/licenses/by/4.0/

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