University of Southern California MD/PhD partial scholarship Program (+ Caltech) 

Review - 2007-2008

The Keck School of Medicine originated as a teaching department of LA County hospital which later established an affiliation with the University of Southern California. Historically it has produced private-practice clinicians, with about half of graduates entering primary care. In an attempt to create a setting imitating the many pre-existing California academic medical centers, a MD/PhD Program was started (at least in paper brochures) at USC in 1988 with a fraction of the needed support. Over the past 19 years, the five other California MD/PhD programs have had every MSTP grant application renewed, while USC has been annually denied by the NIH. Numerous habitual problems are an absence of support from the administration, few respected medical scientists, meager private funding, and a dearth of high-quality medical research. Further troubling to the NIH is that rarely have any active medical scientists been involved with "the program", which has remained no more than a colorful brochure in the curriculum office to go along with a partial scholarship.

Administration

In 2004 Brian Henderson was appointed dean of the medical school and 'director' of the MD/PhD program. Dr. Henderson had no previous MD/PhD program experience, no scientific degrees, and no formal research training in his background, but apparently was deemed appropriately qualified for the post anyway(?) His first act was to downsize the already tiny annual class size from 8 to 6 students, eliminating the unfunded positions. Dr. Robert Chow was named 'associate director'. Dr. Chow was a slightly more sensible choice as an active researcher, however he never completed a residency, and he is not a medical scientist, indicating clearly that he has no interest in the training of medical scientists.

Since Dr. Henderson's disastrous joint appointment as dean and MD/PhD program director two years ago, it has been embarrassingly obvious to everyone that he possesses neither the research experience nor the leadership ability to head even a second-tier medical school. After only about two years, in January 2007, USC provost CL Max Nikias abruptly announced Dr. Henderson's 'resignation', which he probably first learned of in the mail. The previous dean, Dr. Stephen Ryan, served 13 years and most deans will serve a decade or more, so it was a dramatically bad period under Dr. Henderson which caused his swift termination. Dr. Richard Bergman, the previous unenthusiastic director of the MD/PhD program was quietly returned to that position. In August 2007, Dr. Carmen A. Puliafito was announced to be Dr. Henderson's replacement. Hopefully, this time a wiser choice has been made of someone who possesses the courage to be the decisive leader desperately needed. Of course instability in the administration has done nothing to improve the school's dismal chances of ever receiving an NIH grant.

Funding

Every application for MSTP status from the USC program over the past 19 years has been denied. The program's webpage incorrectly states that students receive full funding during their MD years. Of course they never have and never will. In fact, six positions are available from private donations and school support which offer about 45% of full funding. Four positions are available for graduate training at USC and two are at Caltech. These positions offer free tuition during the MSI and MSII years with an $18,000 stipend. Students most commonly receive loans or family contributions to cover the difference between this stipend and the LA cost-of-living (the UCLA stipend is $23,000; the UCI stipend is $23,500). In contrast to all CA state schools and respectable universities in the country, stipends are distributed in an under-the-table arrangement in which earned income is not reported on federal or state income tax returns (a glaring red-flag indicator of a shady institution). During the MSIII and MSIV years MD/PhD students leave the program to return to the MD track. There is an end-of-the-year dinner to remind students they were once involved with a program, but otherwise the school does not supply stipends or tuition wavers on any part of the $44,000 (and rising) tuition. According to US News & World Report, the average graduation debt of USC medical students is astronomical at $146,300 in comparison to local competitors such as UC Davis and UC Irvine (average debt $70,000).

The stipends and tuition remissions given to funded USC MD/PhD students in the MSI, MSII years effectively make their overall financial situation roughly equivalent to unfunded positions at state schools. State schools (especially in CA) would offer many additional advantages such as high-quality academic research laboratories, an academic environment, advising and support from experienced medical scientists, motivated peers, better clinical training, and better reputations with residency directors. Realistically speaking, the USC program has no chance of receiving federal funding anytime in the next decade. Basic medical research is so ignored by the university administration that the NIH has not seriously considered supporting the program with grant money. The program's total student population of about 50 spread over 8 years is only a fraction of the size of a well-managed program. The WUSTL program, for instance, in 2005 alone had 31 fully-funded incoming students and a total student body over 200. At USC not even partial tuition waivers available for their 6 students during their clinical years.

Quality of Training

USC is completely unknown in the world of biomedical research- probably because the scope and quality of research has always been closer to the community college level than the prestigious California university system. In California all the major, top-tier universities- UCSF, UCLA, UCSD, Scripps, Stanford, Berkeley, Caltech, UCD, and UCI- have a greater array and sophistication of research in well-known labs which regularly publish in respectable journals. The 2008 USNews survey of general reputation of Biology departments lists all CA universities with USC ranked as dead last- far behind such programs as UC Riverside and UC Santa Cruz which no one outside of California has ever heard of-

The nobel prize, another indicator of research quality, has been awarded to 5 active faculty at UCLA, 5 at Caltech, and 3 at Scripps. Down a tier at the associate's degree/ community college level is USC's research community, which needless to say will never receive a call from Stockholm. When interviewing applicants, most universities will present a list of recent student publications (for example see the UC Davis student publications, or UC Irvine student publications ). USC does not distribute a list of recent student publications because the infrequent publications with students as third or fourth author are always in embarrassingly obscure journals.

By all measures, clinical training is equally subpar at County Hospital. USNews does not list County among 176 ranked hospitals (in contrast, UCLA Hospital is ranked fifth nationally). Student board scores on the USMLE are consistently below the national mean (a good question for interview day). Keck may be the only school in the nation where fluency in spanish is a must to interview patients- basically if you don't know spanish, don't apply. There won't be time to learn in your first two years before the wards. LA County Hospital technically is a condemned building since the 90's earthquake which is chronically underequipped and reaches sweltering temperatures in the summer without AC. The new building is more appropriate for the financially-challenged and shrinking medical school with 20% fewer beds. However it is behind schedule and over-budget and will not be finished for at least 3 years.

USC Medical Campus

The single worst aspect of the Keck School of Medicine is the campus. The only positive is the California weather, which is terrific. However no applicant on the national interview cycle will encounter a medical school with a more depressing campus. Seven miles from the main campus, in a deserted concrete corner of east LA, its easy to see why the Keck School of Medicine is still thought of as a department of LA County Hospital rather than a part of USC. The 'medical campus' consists of 4-5 buildings grouped together that could be mistaken for a corporate office complex except for County Hospital across the street. There are no restaurants, no coffee shops, no supermarkets, no safe student houses, no gyms, no bars, and no shopping centers anywhere within five miles. The few lone students encountered do not remain on campus after dark or on weekends. Students reside in housing scattered about LA and Pasadena and survive the daily commute through LA traffic. A car is an absolute must, though somehow it is overlooked in the student budget where the yearly transportation allowance used for loan calculations is a meager $1500- enough for a nice bike, but not a car loan plus CA insurance which are closer to $6,000 per year. All-in-all the campus would be a miserable place to spend the next 8-9 years of your life.

Diversity

Its fair to say that USC has the least diverse MD/PhD program in the country. According to the administration, the program has 0 under-represented minority (URM) students currently enrolled in a student body of about 45. And despite its location in one of the largest and most diverse urban centers in the world,

the USC MD/PhD program has never enrolled a URM student in the 19 years of its existence.

Outright discrimination by the administration is difficult to prove- potential URM students are likely turned-off by the program and decide they have much better options elsewhere. In reality most USC students found nothing positive about the school but had no other option for getting letters after their name. Any respectable 21st century medical school, such as Johns Hopkins, has a large, thriving minority student body.

Alternatives

In summary, enrolling in the USC MD/PhD partial scholarship program really doesn't make sense from any perspective. If you are seriously interested in research it would be wise to seek advise from a professional medical scientist at an academic center before applying to USC. Also consider the following alternatives:

Please do not be lured into being an "official MD/PhD program member" on paper- at USC you will discover once your scholarship runs out second year that being "in a program" means an annual dinner with students you would otherwise never encounter. Students at a school at this level do not particularly like their situation but had no other realistic options prior to enrolling. The Keck School of Medicine is not an academic medical center but rather a department of a public hospital which has always prepared physicians for careers in private practice, not research and academia. Acquiring a residency position is easy since there are more positions than medical students. Faculty positions in basic research at respectable institutions however, are much more competitive and entering a good lab early in your career is key. Attempting to launch a career in biomedical research and academic medicine from the USC MD/PhD program doesn't make sense in light of the above alternatives. The career prospects in basic research or in leadership in the biotech industry for a USC graduate are dismal; however if you still decide to gamble with your future career instead of following tried and proven paths to solid medical research, hopefully this review has given you a better idea of the reckless leap you are making with the next 8-9 years of your life.