December 30, 2019

Shai Madjar, PhD: Staying curious

Non-traditional MSTP encompasses academic exploration of humanities and social sciences

The Michigan Medical Scientist Training Program (MSTP) offers students the opportunity to combine an MD and PhD in any field that connects to medicine. About 10-12 students are admitted each year to this competitive program. Shai is one of a handful of MSTP students who chose to pursue a non-traditional PhD field outside of the Medical School.

Shai completed two years of medical school before applying to the MSTP with the Department of Philosophy. He successfully defended his dissertation about emotion regulation and now has transitioned back into the Medical School to complete his MD training. Here, he answers 10 questions about the role of philosophy in his training and how he plans to apply the knowledge and skills he has mastered to his career in medicine.

Why did you choose to do your MD/PhD in philosophy?

While I was working on my undergrad philosophy thesis project, I wondered if there could be a way for me to continue thinking about philosophical questions in the future. I didn't really think very seriously about the possibility of doing a PhD in philosophy, or that it was even a possibility, until I came to do my medical school interview at Michigan and one of my tour guides turned out to be doing an MD/PhD in history. 

I didn't really fully appreciate until then that you could do a combined MD/PhD in the humanities. And so after being admitted to Michigan as a regular MD student, I got in touch with our very wise director, Ron Koenig, MD, PhD, and I asked him about the possibility of applying as an internal applicant, and he was open to that. Luckily I was ultimately accepted.

How does the field of philosophy tie into your future career goals?

I really want to go into psychiatry, and I'd love to keep using my philosophical training to think about questions at the intersection between psychiatry and philosophy. I can see myself doing this through further philosophical research, philosophy education, or both.

How does philosophy give you room to explore the questions that interest you?

I think a lot of people have the impression that philosophy is up in the clouds and not very practical, but I think a lot of the philosophical questions that I'm most interested in are really practical, even by the standards of very practical fields like medicine: questions about what a good life looks like, how to figure out if an action is right or wrong, and, with respect to my specific area of interest, questions about when and how people should regulate their emotions and the implications this has for psychiatry and psychotherapy.

My dissertation is divided into three chapters, each addressing a different question about either emotion assessment or emotion regulation. As a whole, my dissertation addresses philosophical concerns about emotion regulation and, in particular, whether emotion regulation might interfere with the development of evaluative understanding.

What was your transition back to med school like after wrapping up your dissertation?

I was lucky that I was able to return to medical school for my clinical year at the same time that the M2 students were starting their clinical year, so everybody was sort of in the same boat. I was mostly worried that I would be really rusty after a few years away, and that I would have forgotten everything, but this didn't actually turn out to be as big a deal as I thought, since what I learned came back pretty quickly as I was thinking about things on the wards.

I think the hardest part wasn't really transitioning back as much as just starting the clinical year at all, which I think is hard for everybody at that point. We learn a lot in our classroom studies, but we still have so little knowledge and experience at that point that the first rotation is always a little bit overwhelming - at least I felt that way.

You will be entering the Branches next with opportunities to explore different areas. Which electives are you looking forward to most?

Since I'm interested in psychiatry, I'm definitely going to load up on psychiatry electives. On my schedule right now, I have a month with the addiction treatment services, a month of the psychiatry consult service, and a month in the eating disorders program. I'm also going to want to pursue some other electives that are in related areas that might help, so I think I'm going to do a month in the pain management rotation, and I'd like to do a month in neurology, if I can, along with the sub-I’s everyone does to have general medical knowledge.

As an MSTP student in a non-traditional field, what would you say are your biggest challenges and benefits so far?

The PhD years for me were challenging in a very different way than medical school is challenging. It's actually kind of interesting. I think that the PhD years were mostly challenging because you have this huge project that you're working on, and it's always there hanging over your head, and even if you're at home, and at the end of the day, you are still thinking about it.

Medical school has been very different, challenging in a completely different way because the hours are really long. I have worked a lot more hours in medical school than I did in my PhD. But at the same time, it has been almost less anxiety-producing and less stressful, because I go to school, go to the wards, go see patients. It's all very engaging and it’s a lot of hours at work, but it's fun to talk to people. Medicine is really fascinating, and then at the end of the day you come home and you're tired, but you're done.

How do you find community as a non-traditional MSTP?

As an internal applicant, I joined the MSTP community one year in, but I felt immediately welcomed and invited by everybody. It was pretty easy to make friends with my MSTP classmates. I've been involved in the activities committee for the MSTP, I helped with the ethics refresher, and we have the MSTP retreat every year where I always enjoy seeing everybody.

What is your advice for someone thinking about a non-traditional MSTP?

It's funny, I actually get a few emails about this per year for the last couple of years, asking about the MD/PhD in philosophy, specifically. Often these are students interested in medical ethics. Medical ethics is a well-recognized area of intersection between philosophy and medicine, but one of the things that I've said to these students is to think carefully about whether going down this path is really advantageous or necessary for them, when compared to alternative paths that could also potentially get them the result that they want.

For myself, I felt that the PhD would give me a much deeper set of tools for answering questions that lie at the foundation of more applied issues. Medical ethics, for example, is a very applied field in the sense that you're asking first order questions, the answers to which can directly inform whether someone should pursue a certain course of action. But there are questions that call for a deeper set of tools and that require you to be a little bit more well-versed in the analytical skills needed to read and engage with the philosophical literature.

Additionally, I ended up wanting to answer questions about emotions and emotion regulation, and that quickly gets into some really foundational areas of philosophy.. How do emotions function as mental states? Do they represent the world? Do they represent values? I needed the PhD to answer the deeper questions that I wanted to answer.

What makes the Michigan MSTP unique?

One of the most unique parts of our MSTP is the fact that it has been so open to non-traditional fields, and that's all due to our director, Dr. Ron Koenig. The community that he has created here is tight-knit, organized, and supportive of students.