Covid19 EMPA word
No save-the-dates in this newsletter, as you might have expected. When the situation evolves, we will let you know the date of the next EMPA conference, which is likely to be moved to the beginning of 2021. Stay tuned.
In the meantime, we would like to assure you of our support. Whether you had a last set of experiments to wrap up, a key defense to attend before coming back to your MD next year or are already in a hospital treating COVID+ patients, we wish you good luck and courage.
For those of us not at a bedside but in confinement, let’s seize this opportunity to pause, take a step back and reflect on our busy double lives! Or alternatively, deal at last with the tasks pushed aside by nightshifts or experiments, such as this highly awaited newsletter…
Whichever shape it takes, we wish you a smooth transition to your new Covid life.
The European MD-PhD Association
In the Europolis section, learn about the past and upcoming events that the various European MD-PhD societies organize in their respective countries! Switzerland and France have their own MD-PhD societies (SMPA and AMPS, respectively), and EMPA plays this role in other European countries… Until they build their own national association! EMPA board members started embryos of national MD-PhD association projects in Germany and Italy, for instance. In the Netherlands, there are organized MD/PhD programs offered by local universities whose members also are in touch with EMPA. Find out below what MD-PhDs are up to in Europe and further!
International MD-PhD events
1) Re-election of the new EMPA executive board
At the European MD-PhD COnference last October, EMPA executive board got re-elected by the General assembly. We are glad to be part of the team for one more year!
From left to right, on the picture below:
– Clara Volpe (Milan, Italy): Social media and IT manager
– Maxime Beau (London, UK): Networking and Liaison officer
– Maleen Leimkühler (Groningen, Netherlands): National representatives coordinator and treasurer
– André Dos Santos Rocha, (Geneva, Switzerland): chair
– Laura Ostermann (Bonn, Germany): Vice-chair and Secretary
– Marc Scherlinger (Bordeaux, France): European representation
2) Asian Medical Students conference 2020, London
This year, the United Kingdom is hosting the annual AMSC for the first time in London.The main theme is “Trauma Care: Same Problems with Different Solutions”. You are invited to join in tackling such a multi-faceted problem, which will help you take on bigger roles as future health care professionals.
Obtain an academic guideline from your Regional Chairperson now to check out what we have in store for you. Alternatively, check it out at https://tinyurl.com/amsclondon2020
Date: 29 June – 05 July
Registration: 01 April – 30 April
3) USA: 2021 AAP/ASCI/APSA meeting (2020 meeting cancelled)
April 9-11 2021, Fairmont Chicago Millenium Park, IllinoisThe Association of American Physicians, the American Society for Clinical Investigation and the American Physician-Scientists Association sadly had to cancel the 2020 AAP/ASCI/APSA Joint Meeting which was to be held in April 2020 at the Fairmont Chicago Millennium Park.
The 2020 Joint Meeting will not be rescheduled. They hope to migrate certain features of the meeting to the 2021 Joint Meeting, to be held April 9-11 also at the Fairmont Chicago if the situation improves. The subscriptions are not open yet but stay tuned on AAP/ASCI/APSA website.
Italian MD-PhD events
Giornata del medico ricercatore: Physician scientist’s day
November 18th 2019, Università degli Studi di Milano Aula Magna, Milan
Congratulations to Clara Volpe for organizing this fantastic event which featured scientific as well as politic speakers, from the ministry of education!
Promoted by EMPA and University of Milan, “La Giornata del Medico Ricercatore” (“Physician Scientist day”) took place on November 18th in the Aula Magna of Università degli Studi di Milano. Many professors and MD-PhD students attended the event, which testified the necessity of such an event in the local MD-PhD ecosystem. Events where physicians are also presented as a professional in research are rare in a country, Italy, where being a physician is still mostly related to clinics and caring, while science is traditionally considered as a background discipline and mostly related to pedagogy. Since the separation between health care and medical research is rooted in the schemes of medical professional training, the presentations of “La Giornata del Medico Ricercatore” aimed to sensitize the audience about the importance of MD-PhD training tracks for excellent motivated MD students. The participants were more than 100 among students, graduated, researchers and professors of the audience.
France: the French MD/PharmD-PhD Association AMPS
1) French MD-PhD dinners
In November, December, January and February, the AMPS consistently organized their famous French MD-PhD dinners in Paris and Bordeaux. The concept of these dinners is to let senior MD-PhDs talk about key scientific and non-scientific experiences of their career to inspire younger trainees. they featured speakers from various fields:
Dr. Michael Spedding, general secretary of the Pharmacology International Union
Dr. Marie-Claude Potier, group leader of team Alzheimer at ICM (Institut du Cerveau et de la Moelle épinière)
Dr. Roman-Hossein Khonsari, maxillofacial surgeon at Necker Enfants Malades hospital.
Dr. Lina Benajiba, myeloid acute leukaemia specialist, INSERM assistant clinical chief (CCA) at Saint-Louis hospital
2) French MD-PhD journal clubs
AMPS started a new series of events this year, Journal clubs! They held their first one in November, and carried on every month since then, all in Paris. 3) Translational Medicine Federation Seminar
Held in Strasbourg 4-6th December 2019, this Seminar co-organized by Marc Scherlinger featured about 20 french and European MD-PhD students who came talk about their research and how it might be applied to patient care.
Switzerland: the Swiss MD-PhD Association SMPA
The Swiss-MD-PhD Association (SMPA) is fostering new bonds with the MD-PhD students from all Swiss Universities. Three local events were held in Zurich, Basel and Lausanne in February 2020 to spread SMPA mission and to gather opinions for the Annual General Assembly (see below).
June 26th, Friday, all swiss MD-PhD candidates and graduates are invited to join a full-day conference with keynote speakers along with talks from all five MD-PhD programme directors from Geneva, Lausanne, Bern, Basel and Zurich!
Finally, SMPA is supporting projects and initiatives that coincide with its aims with a grant up to CHF 1000. Deadline: March 31st.
United Kingdom: EMPA network of UCL/Cambridge
1) Third of the Euro-British MD-PhD dinners!
Last October, Maxime Beau and Julie Fabre organized the third edition of the Euro-British MD-PhD dinners! With a concept imported from France, the purpose of these dinners is to gather MD-PhD students and professors to debate about the structure of MD-PhD studies. An invited speaker details his personal MD-PhD career experience, and this is followed by an informal chat with drinks and pizzas. This time, we were delighted to feature two speakers: Dr. Beale, group leader at the Francis Crick Institute, and Pr. Marciniak, director of Cambridge MB-PhD programme. By the way, if you wish to have up-to-date trustworthy information on the coronavirus outbreak, we advise you to follow Dr. Beale on twitter, whose lab is working on covid-19 and who is very willingly sharing his interesting opinions: @bealelab.
2) UK MB-PhD Facebook group
Join our group if you want to be updated about the MD-PhD events happening in the UK! Get in touch with Maxime Beau to join (the group is secret hence cannot be searched for): email@example.com.
3) UCL MB-PhD Journal Clubs
Every Monday, UCL MB-PhD program members organize a weekly Journal Club at 8a.m., which is now held virtually on zoom. UCL MB-PhD secretary for more information: Carolyn Cohen.
Eurology is a section to help you decode the complexity of MD-PhD programs across European countries! In this newsletter, we will focus on the similarities and differences between the French and the British MD-PhD curriculum. This a written version of slides presented at the first Franco-British MD-PhD dinner, held at University College London on the 10th of January 2019, organized by Maxime Beau, Julie Fabre and Erwan Eriau and fully funded by the French MD-PhD Association AMPS.
Disclaimer: the author of this article is a French MD-PhD student who embraced the MD-PhD scheme Track 2 (sometimes referred to as ‘loaded’ scheme). Hence bear in mind there may be more details missing about the UK programs as well as subconscious bias in the description of the French programs.
Contact: Maxime Beau
A) Some definitions: ‘early’ versus ‘late’ MD-PhD training
Classical ‘late’ MD-PhD curricula are shared across all countries. In this curricula, students complete their research training after their medical training, typically during a break in their medical residency/specialization. This scheme allows trained MD-PhDs to have a good clinical training and to contextualize their research better. However, it can be difficult to strengthen as much their training in research because it can be hard to conciliate the clinical duties of a resident with a full-time 3-years-long PhD in a lab. Indeed, students might only be allowed to take a part of their time off by their residency boss, this might be obligatorily in the boss’ own research team, this might be on an imposed topic that interests the boss, and might also take place while having to simultaneously perform night shifts or work part-time with patients.
FIGURE 1: Definition of ‘late’ and ‘early’ MD-PhD programs
Specific MD-PhD programs were developed to address these issues, allowing physicians to get early training in research–when students do not yet depend on a clinical department and thus have less time and political constraints. Students are thus free to pick the PhD topic they want, free to work full time to achieve it, and free to change country if they wish so. In this article, we will focus on ‘early MD-PhD trainings’ i.e.’MD-PhD programs’, which involvedoing a master and/or a PhD before the end of your initial medical training (typically 6 years long).
B) Where can you join early MD-PhD programs in France and the UK?
There are two national programs in France. The first program was developed by the École Normale Supérieure (ENS) in Paris, a general academic ‘grande école’, which based their program on American around 1975. Each year, a few students from Medicine and Pharmacy are selected via a highly competitive written and oral ranking exam. This program has now been extended to the ENS in Lyon, and about 20 MD-PhD students are accepted in the two schools’ programs every year. Link here (in French): https://www.ens.fr/une-formation-d-exception/admission-concours/concours-normalien-etudiant/programme-medecine-0.
FIGURE 2: National MD-PhD programs in France
The second French national program was founded in 2003: the École de l’INSERM (National institute of health and medical research), funded by the Bettencourt-Scheller trust. Each year, about 25 students from Medicine, Pharmacy or Dentistry are selected, an oral ranking exam based on science material covered during an intensive 2-weeks. More info on the INSERM website (in French): https://www.inserm.fr/connaitre-inserm/double-cursus-medecine-science.
In addition to these 2 national programs, local universities have elaborated their own MD-PhD programs, often by collaborations between the medical and biomedical departments. They have progressively emerged since 2006. There are now about 70 students joining these programs in total, in 10 different universities.
FIGURE 3: Local MD-PhD programs in France
In the UK, 2 universities offer local MD-PhD programs. These programs are referred to as’MB-PhD’ programs, with ‘MB’ standing for Medical Bachelor. ‘MD’ has a different meaning in the UK, where it designates a specific 2-year long research degree, that is only rarely completed today.
Cambridge University and University College London offer MB-PhD programs which are run independently from each other. Here are the links of their respective programs: https://www.ucl.ac.uk/prospective-students/graduate/research-degrees/medicine-mb-phdand https://www.medschl.cam.ac.uk/education/courses/mbphd/. There is also a cluster of students in Imperial University, where there is no explicit ‘MB-PhD program’ but MB students do have the opportunity to intercalate a PhD during their studies: https://www.imperial.ac.uk/study/ug/courses/school-of-medicine/medicine-phd/. On average, Cambridge and UCL host 6 students each, and the number of students at Imperial is unknown.
FIGURE 4: Local MD-PhD programs in the UK.
C) Comparison of French and British clinical training structures
In both countries, students first complete ‘medical school’: about 6 years of general training before their specializating in a medical discipline. In France, this general training is the ‘Diplôme de Formation Générale/Avancée en Sciences Médicales’ (DFG/ASM) and, in Britain, it is the ‘Medicine Bachelor and Bachelor of Surgery’ (MBBS). The two programs can be broken down into two sections: first, pure theory education and, second, combined theory and practice education, where students also learn clinical skills through internships in their affiliated hospitals.
After medical school, students complete the residency or specialization, which lasts a variable amount of years depending on the chosen specialty (from 3 years for General Practitioner to up to 5-6 years for some surgery specializations). The UK has a specificity: before the actual residency, students attend 2 ‘Foundation’ years (F1 and F2), to transition from the predominantly theoretical MBBS and the fully clinical residency. In comparison, French students attend more clinical internships during their DFG/ASM, and hence dive into their residency directly.
Interestingly, because of a confusion with the American system where students are called ‘MDs’ at the end of medical school, British students informally refer to themselves as MDs at the end of their 6 years of general medical school, even though in the UK ‘MD’ is a title given at the end of a specific degree, as explained above. In France, practitioners usually only refer to themselves as MD once they have finished their residency, and written a specialization thesis. In conclusion, appointing the title ‘MD’, after finishing general medical training, on a research paper is recognized in the American system and can be tolerated in other countries like the UK.
FIGURE 5: Comparison of French and British clinical training.
D) Comparison of FR and UK research training structures in the context of MD-PhDs.
In order to design a quality MD-PhD program, how can we insert some research in an already arduous medical curriculum, while ensuring that enough time is dedicated to lab work and without letting the students forget their clinical knowledge?
French programs have two schemes for ‘early’ MD-PhDs. The first scheme involves evening science lectures and 2 summer lab internships during years 2 and 3 of medical school, followed by a 1-year break to obtain a master degree. Students then go back in year 4 of medical school. Students embracing this scheme are expected to enter a PhD program later, during their residency. This scheme, although similar to classical ‘late’ MD-PhD training, still significantly differs from them. Indeed, students discover academia earlier, not only through lectures but also by creating bonds with up to 3 different labs, where they spend between 3 to 6 months. This gives them a small taste of the world of research and prepares them to return to research during their residency.
The second scheme is a more ‘loaded’ version of the first scheme. Students also take evening lectures, attend 2 summer internships and obtain a master degree the students. On top of this, students then complete their PhD before resuming medical school.
These ‘light’ and ‘loaded’ early MD-PhD trainings are called ‘Track 1’ and ‘Track 2’ on figures 6 and 7, respectively.
Of note, funding (denoted in purple of Figures 6 and 7) exists to encourage students to embrace Track 2. MD-PhD programs do not fund the PhDs themselves, but offer an income (~1200 euros/month) when students resume general medical school. This enables students to remain financially independent from their family once their PhDs are over. These are called ‘contrats de jonction’ (junction contracts).
FIGURE 6: Comparison of where French and British programs insert research in their respective clinical training.
In the UK, MB-PhD programs can be compared to the French Track 2 because a full PhD is completed between years 4 and 5 of medical school. However, they do not involve a master degree or mandatory lab summer internships–although students often take extra classes and internships voluntarily. On Figures 6 and 7, they are called ‘Track 2’ to underline the similarity with the French Track 2. Importantly, year 3 of medical school in the UK is effectively a Bachelor of Science (BSci on Figure 6), which provides British students with enough scientific training to go for a PhD directly without having to obtain a separate science master degree first. Unlike France, there is no funding available in years 5 and 6 of medical school (to the best of the author’s knowledge). Another interesting feature of British MB-PhD programs is the existence of continuous light clinical training during PhD training, allowing students to maintain basic clinical knowledge.
On Figures 6 and 7, the ‘Track 1’ scheme does not correspond to the MB-PhD programs but rather illustrates the opportunities of classical ‘late’ MD-PhDs in the UK. It can be compared to the French Track 1 since it can involve early light scientific training (BSc, internships) and a PhD during the residency. Contrarily to France, very attractive schemes exist to allow residents to dedicate a very strong amount of time to research: the Academic Clinical Fellowship (ACF) and the Academic Clinical Lectureship (ACL), that can be completed before and after a full-time PhD. During ACF and ACL, residents can pursue a research project part-time (30% and 50% of their time, respectively), while they continue their residency. For more information on ACFs and ACLs, see
-> Conclusion 1: Comparison of French and British MD-PhD structures.
A major advantage of the French system is the existence of a lighter scheme, the Track 1. This allows medical students to still give research a shot during a full-time master degree without having to commit too much, before eventually going for a British MB-PhD style early PhD if they wish so. This system also increases the amount of ‘MD-PhD students’, leading to more networking opportunities within the MD-PhD community. See conclusion 3 for further comments.
For the same reason, the French Track 2 scheme is longer than the British equivalent MB-PhDs. Students embracing this track take a 4-year break rather than 3, which is often prolonged to 5 since some PhDs can require extensions. This is an advantage of the British MB-PhDs: they can be significantly shorter than French Track 2 schemes or can allow for a longer PhD.
Another advantage of the MB-PhDs is the continuous clinical training during the early PhDs, which might be a welcome addition to the French Track 2.
In terms of funding, French Track 2 students can be better off than British MB-PhD students, thanks to junction contracts. This is however only true when comparing between MB-PhD and French Track 2 students: classical ‘late’ British MD-PhD students (that the author refers to as ‘Track 1’ British students) have the tremendous opportunity to conduct paid research with the ACF and ACL programs during their residency, while French students do not have this funding and dedicated time for research.
A personal graphical summary of the advantages and disadvantages of the French and British MD-PhD schemes has been drawn of Figure 7. Hypothetical ‘Fr-english’ students would have the best of both worlds.
FIGURE 7: The Frenglish program, the best of both worlds.
-> Conclusion 2: Comparison of French and British MD-PhD programs critical mass.
MD-PhD training seems less developed in the UK than it is in France. This difference is due to French MD-PhD programs offering two options, the light Track 1 and more loaded Track 2, whereas the British MB-PhD programs only encompass the equivalent of the French ‘loaded’ training: both UCL and Cambridge programs require their students to achieve a full PhD before starting over their MB degree. This stems from the fact that British medical students all do a BSc in year 3, which involves research. Hence a one-year-long break to do slightly more research is less needed in the UK than in France–where the purely clinical training does not involve any lab work at all. For a fair comparison, we should compare the number of Track 2 in France with the number of MD-PhD trainees in the UK: about 20 students per year go for early PhDs in France, not 100.
In conclusion, MD-PhD programs are more developed in France than in the UK in terms of number of involved universities and overall students, but the difference between French Track 2 students and British MB-PhDs is not as striking as the difference in overall student populations, ~100 in France against ~10 in the UK.
-> Conclusion 3: Comparison of French and British MD-PhD social structures.
Students selected by ENS and INSERM come from all over France, and the national scale of these programs is a major factor of the country-wide MD-PhD community present in the country. In particular, ENS and INSERM initially funded the French MD-PhD national association AMPS (http://www.amps-asso.fr/). Now self-funded, AMPS is a major unifying force fostering a unified national MD-PhD community. AMPS organized punctual events all over the year in different cities, as well as a national annual MD-PhD conference, where students can meet other MD-PhDs from all over the country and network.
In the UK, there is no national MD-PhD program nor a national MD-PhD association, with the latter unlikely given the smaller scale of British programs. Hence students identify themselves more strongly to their home universities and do not interact as much with students from other cities. Cambridge and UCL organize yearly symposiums to help promote cross-university exchange, but it remains hard to attract students from the other city to come to the hosting city and vice versa. One of the goals of the European MD-PhD Association EMPA (https://www.eumdphd.com/) is to provide a networking shell in countries where there is no national MD-PhD Association, with the hope that such associations would be able to fill this shell and develop a major networking structure. Two Euro-British MD-PhD dinners have been organized so far by EMPA (funded by AMPS, both in UCL). Building on these dinners, more work can be accomplished in order to foster more interactions across British universities, both by EMPA and the British MB-PhD students.
Europeers informs you about recent papers that your MD-PhD peers have published in the last few months – if you have a paper to share with your friends and colleagues, get in touch with us and we’ll add you to the next newsletter!
First of all, a bit off-topic but useful read:Free lists of grants and fellowships around the world available online!
Svetolik Spasic, Institute for Pathological Physiology “Ljubodrag Buba Mihailovic“, University of Belgrade:
> Spasic, Svetolik, et al. “Two distinct electrophysiological mechanisms underlie extensive depolarization elicited by 2, 4 diaminobutyric acid in leech Retzius neurons.” Aquatic Toxicology 220 (2020): 105398.
Paul Ryan, University College Cork MD-PhD programme:
> Ryan, Paul MacDaragh, and Tapas Mondal. “Does domperidone prolong QTc in a clinically relevant manner in infants with GORD?.” Archives of Disease in Childhood 105.2 (2020): 202-205.
Maleen leimkühler, University Medical Center Groningen:
> Leimkühler, Maleen, et al. “Adding diagnostic laparoscopy to computed tomography for the evaluation of peritoneal metastases in patients with colorectal cancer: A retrospective cohort study.” Surgical Oncology 33 (2020): 135-140.
Swiss MD-PhD community
Sophia Wiedemann, University of Basel MD-PhD program:
> Hepprich, Matthias, et al. “Postprandial Hypoglycemia in Patients after Gastric Bypass Surgery Is Mediated by Glucose-Induced IL-1β.” Cell Metabolism (2020).
French MD-PhD community
Nathan Peiffer-Smadja, MD-PhD École de l’INSERM, CCA Bichat hospital:
> Peiffer-Smadja, Nathan, et al. “Machine learning for clinical decision support in infectious diseases: a narrative review of current applications.” Clinical Microbiology and Infection (2019).
Geoffroy Delplancq, resident in Franche Comté university:
> Margot, Henri, et al. “Immunopathological manifestations in Kabuki syndrome: a registry study of 177 individuals.” Genetics in Medicine 22.1 (2020): 181-188.
> Delplancq, Geoffroy, et al. “Cardiomyopathy due to PRDM16 mutation: First description of a fetal presentation, with possible modifier genes.” American Journal of Medical Genetics Part C: Seminars in Medical Genetics. Vol. 184. No. 1. Hoboken, USA: John Wiley & Sons, Inc., 2020.
> Garret, Philippine, et al. “Report of the first patient with a homozygous OTUD7A variant responsible for epileptic encephalopathy and related proteasome dysfunction.” Clinical Genetics 97.4 (2020): 567-575.
United-Kingdom MB-PhDs community
Thomas Parr, UCL MB-PhD program, University College London:
> Too many papers to list them here. If you are interested in free energy, working memory, oculomotor synergies and computational neuroscience in general, check them out on his personal website: https://tejparr.github.io/
Viren Pandya, UCL MB-PhD program, University College London:
> Pandya, Virenkumar A., and Rickie Patani. “Decoding the relationship between ageing and amyotrophic lateral sclerosis: a cellular perspective.” Brain (2019).
Daniyal Jafree, UCL MB-PhD program, University College London:
> Jafree, Daniyal J., et al. “Tissue clearing and deep imaging of the kidney using confocal and Two-Photon microscopy.” Diabetic Nephropathy. Humana, New York, NY, 2020. 103-126.
> Jafree, Daniyal J., et al. “Spatiotemporal dynamics and heterogeneity of renal lymphatics in mammalian development and cystic kidney disease.” Elife 8 (2019): e48183.
> Jafree, Daniyal J., and Joanna M. Zakrzewska. “Long-term pain relief at five years after medical, repeat surgical procedures or no management for recurrence of trigeminal neuralgia after microvascular decompression: analysis of a historical cohort.” British journal of neurosurgery 33.1 (2019): 31-36.
Ryan Wee, UCL MB-PhD program, University College London:
> Wee, Ryan WS, and Andrew F. MacAskill. “Biased connectivity of brain-wide inputs to ventral subiculum output neurons.” Cell Reports 30.11 (2020): 3644-3654.
Vishal Rawji, UCL MB-PhD program, University College London:
> Rawji, Vishal, et al. “Impaired automatic but intact volitional inhibition in primary tic disorders.” Brain (2020).
Thomas B K Watkins, UCL MB-PhD program, University College London:
> López, Saioa, et al. “Interplay between whole-genome doubling and the accumulation of deleterious alterations in cancer evolution.” Nature Genetics 52.3 (2020): 283-293.
> Biswas, Dhruva, et al. “A clonal expression biomarker associates with lung cancer mortality.” Nature medicine 25.10 (2019): 1540-1548.
Dhruva Biswas, UCL MB-PhD program, University College London:
> Biswas, Dhruva, et al. “A clonal expression biomarker associates with lung cancer mortality.” Nature medicine 25.10 (2019): 1540-1548.
> Wu, Yin, et al. “An innate-like Vδ1+ γδ T cell compartment in the human breast is associated with remission in triple-negative breast cancer.” Science translational medicine 11.513 (2019).
> Chemi, Francesca, et al. “Pulmonary venous circulating tumor cell dissemination before tumor resection and disease relapse.” Nature medicine 25.10 (2019): 1534-1539.
Lawrence Best, UCL MB-PhD program, University College London:
> Best, Lawrence MJ, et al. “Induction immunosuppression in adults undergoing liver transplantation: a network meta‐analysis.” Cochrane Database of Systematic Reviews 1 (2020).
> Best, Lawrence MJ, et al. “Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta‐analysis.” Cochrane Database of Systematic Reviews 9 (2019).
> Gurusamy, Kurinchi S., et al. “Validity of criticism of Cochrane Review on closed-system drug-transfer devices.” American Journal of Health-System Pharmacy 76.17 (2019): 1267-1269.
Thank you for reading our newsletter! We more or less settled to a seasonal format, with 4 newsletters a year. We’re looking forward to sending our Summer 2020 newsletter!
the European MD-PhD Association executive board