Clinician-scientist training refers to the concomitant undertaking of medical and PhD degrees by a medical student. While such training is well-established in the US, Canada and many European countries, uptake in Australasia has been less successful.

The reasons underpinning the low uptake are unclear. Some insights are gleaned from the relevant literature. For example, Funston et al surveyed medical students from several countries about their perceptions of research-oriented careers.1 New Zealand medical students were among the least likely to believe that they had been provided sufficient information about career options involving research.1

Historical notes

One of the longest running such programmes in Australasia is the intercalated MBChB/PhD programme at the University of Otago. Introduction of the combined programme was suggested by the then-Dean of the Faculty of Medicine, Prof John Campbell, in 1996. He had “borrowed” the idea of the combined degree from that at the University of Cambridge. A working party, headed by Prof Linda Holloway, was convened, and after discussions with several medical schools in the UK, a decision was made to implement a similar programme at Otago. The group formulated an acceptable pathway—this involved an “upgrade” system in which already-intercalating BMedSc(Hons) students would be offered to upgrade their degree to a PhD (personal communication, Ms Jacqui Bradshaw, University of Otago). The first student to upgrade to PhD at Otago was in 2001.

The University of Auckland (New Zealand’s only other medical school) does not formally offer such a programme.2 Medical students have previously separately arranged a PhD project, but the pathway appears cumbersome; only three students managed to complete both degrees in the past decade or so (personal communication, Prof Warwick Bagg, University of Auckland).

Current trends

Otago’s MBChB/PhD programme

Since its inception, a total of 25 students matriculated in the combined MBChB/PhD programme (as of 2018; see Table 1). The career outcomes of this group have been described elsewhere.4 Of note, students who preferred psychiatry and medical specialties were found to be more likely to have undertaken the combined degree.3

Table 1: A summary of career outcomes of Otago’s MBChB/PhD current and past students.

Māori student enrolment in intercalated degrees

Over a 20-year period, a total of 180 students intercalated a BMedSc(Hons) or PhD at the University of Otago, of whom six (3.3%) identified as Māori. All Māori students successfully completed an intercalated BMedSc(Hons), but none had enrolled in an intercalated MBChB/PhD as of 2018. While we are dealing with small numbers, it may warrant further exploration as to whether the universities are providing sufficient research support and opportunities for Māori students.

Conclusions

On average, just over one student per year make use of the opportunity to complete an intercalated MBChB/PhD programme at the University of Otago, and even less so at the University of Auckland. The reasons for this are unclear, and may reflect lack of awareness, underappreciation of academic degrees among medical students, and/or scarcity of appealing research opportunities. Further investigations into the low uptake of the intercalated MBChB/PhD programme among all New Zealand medical students, and especially Māori students, should be considered.