Research training for MDs. Recruitment of MDs to the PhD-degree in health sciences at the University of Aarhus
Professor Michael J. Mulvany, PhD
Director of PhD-studies, Faculty of Health Sciences
University of Aarhus, Aarhus, Denmark
Research training at the Faculty of Health Sciences at the University of Aarhus is organized in the University of Aarhus Graduate School of Health Sciences. It is major aim of the Graduate School to recruit MDs to the PhD program. Of almost 450 enrolled PhD students, 54% are MDs or MD-students. This report lists the steps which are taken to ensure a continuing uptake of MDs into the PhD program.
The Danish PhD-degree
The PhD degree in health sciences in awarded in the context of the Danish PhD-degree program for which the basic regulations are similar for all subjects. These state that: ìThe program leading to the PhD degree is set up with the purpose of training researchers at an international level in interplay with the international research world. The PhD program provides mainly active research training under supervision.î The PhD program is planned to be of 3 years duration, including a half-year of course-work as well as up to a half-year of teaching duties. Extension can be granted under certain circumstances. The program is performed under the guidance of at least two supervisors and is concluded by the submission of a thesis. The thesis may be a monograph, but more usually is based on a number of articles, submitted manuscripts or manuscripts ready for submission, together with a review. The thesis is evaluated by a three-man assessment committee, of which two of the members are from outside the Faculty concerned. If the thesis is satisfactory it has to be defended publicly, where the candidate gives a 45-min lecture and is then is examined for at least 1 hour by the assessment committee. If the committee finds the defence to be satisfactory, the Faculty then will award the PhD-degree.
During the PhD-study, Danish PhD-students are generally salaried at a level corresponding roughly to what they would earn as employed academics.
University of Aarhus Graduate School of Health Sciences
The University of Aarhus Graduate School of Health Sciences was established in 1996, and was based on a tradition of providing quality postgraduate courses started in the 1970s. The Graduate School has currently about 450 PhD-students (128 enrolled in 2006). The Graduate School is part of the Faculty of Health Sciences, which is formally related to the Aarhus University Hospital. The clinical faculty members have joint appointments in the Aarhus University Hospital. The Faculty has a total of about 540 professors and associate professors; the current intake of medical students is about 360 per year.
The University of Aarhus Graduate School of Health Sciences provides PhD-training in all aspects of health sciences within the national PhD-regulations as described above. Broadly similar programs are provided by the other Danish health science faculties in Copenhagen and Odense.
The School is led by a Director of PhD-studies who is responsible to the Faculty Research Training Committee chaired by the Dean of the Faculty. The Director works with the PhD-administrator and the staff of the PhD-office.
Scope of the PhD program
The PhD program has five parts:
1. completion of an independent research project under supervision (PhD project),
2. preparation of a thesis on the basis of the PhD project,
3. satisfactory completion of PhD courses. The number of courses should correspond to 6 months work. The Graduate School holds about 80 courses per year.
4. participation in an active scientific environment, including a stay if possible at other, primarily foreign scientific institutions or in other ways,
5. attainment of teaching experience in one form or another.
For further details see report in the program for the 2005 ORPHEUS meeting: http://www.orpheus-med.org/files/Proceedings_2005.pdf.
Steps for ensuring participation of MDs in the PhD program.
Involvement of MDs in the PhD program is encouraged as follows. The timing of these programs is shown in Fig. 1.
Fig. 1. Timetables for the various research programs for MDs and medical students. Reserach periods shown in black. Part-time research periods performed currently with medical studies shown chequered. Full-time medical study shown in white, where each block is one year.
Research assignment for all medical students
All medical students have to follow a 6 wk assignment in research methodology. This takes place at the start of the 5th year of the 6-year medical study program. It consists normally of a literature review to answer a specific question (e.g. What is the mechanism by which thiazides lower blood pressure?), but can also involve a short experimental study. All Faculty have the opportunity to provide assignments, the whole program being net-based. The student writes a report, and then presents it at a tentamen to the Faculty member concerned and a censor.
This is an optional research year for medical students. Those wishing to enter the program must find a supervisor (often on the basis of announcements by Faculty members who are looking for research year students). The research year may be taken at any point of the medical study program, but normally after completion of the fourth year. Information meetings about the research year are held as part of the third-year course. The research year program consists of a full time research project and participation in a number of courses. Entry to the research year is on the basis of application to the Faculty; the application includes a full description of the research project, which must include a timetable showing that it can be completed within the year, together with a recommendation from the supervisor. During the research year, students receive a scholarship (DKK 10.000 per month) often awarded by the Danish Medical Research Council or private foundations. On completion of the year, the student writes a report which may be in the form of a short review and a manuscript ready for submission. The report is assessed by the supervisor and a censor; if it is satsifactory a tentamen is held where the student presents the work and answers questions.
It has been found that about one third to one half of the research year students go on to do a PhD.
This is a new program that has been introduced to allow medical students to do a PhD concurrently with their MD studies. The program is based on the research year. If during the research year the student decides to apply to for enrolment in the MD/PhD program, application can be made based on recommendation from the supervisor, acceptance of the PhD project by the Faculty Research and Research Training Committee, and a satisfactory timetable for completion of the medical studies. Those enrolled in the MD/PhD program are expected to follow their research project at least 20 hours a week during the pregraduate period. On completion of the medical studies, students must pass a midterm examination concerning progress of their project. Assuming this is passed, it is expected that the PhD program can be completed within 1? years. During the pre-graduate part of the program, MD/PhD students receive a scholarship and study stipend (ca. DKK 10-15.000 per month); during the postgraduate part, they receive a normal PhD stipend (ca. DKK 25.000 per month). Sickness and maternity benefits are available throughout the program as for a regular PhD.
A flexible approach is used in allowing MDs to enter the PhD program at any time after they have received their MD degree. In particular, the PhD may be taken before or after the students' internship training. Recruitment is encouraged by the holding of a Preparation Course that is advertised widely among recently graduated MDs.
A new "internship PhD" program has been introduced which aims specifically to attract MDs to basic departments, with a view to increasing later recruitment of these MDs to the scientific staff of these departments. Here PhD students are paid at a rate corresponding to junior doctors and their internship is located close to Aarhus. The PhD has to be performed at one of the basic departments, and has to be carried out before the internship.
Our Faculty places great emphasis on recruitment of MDs to the PhD program for a variety of reasons.
- Medical research requires the involvement of MDs if the aim of creating better treatments is to be obtained.
- It is important that the pregraduate medical study program is taught by a staff in which MDs are strongly represented, if the program is to remain relevant.
- MDs with a research training are thought to be more capable of providing rational therapy in their future treatment of patients, and to be more critical regarding the development and possible introduction of new therapies.
As indicated, the various programs have been reasonably successful, in that over half the PhD students have a medical background. There are, however, tendencies towards a reduction in this proportion, and continual improvement in the programs is therefore needed.
Further information is available on http://www.health.au.dk/forskeruddannelsen
31 August 2007
Michael J. Mulvany
Director of PhD-studies
Faculty of Health Sciences
University of Aarhus