Ok so i'm currently 20. Assuming I get accepted, I will start my MD/PhD at the age of 22. Assuming an average of 8 years, I will be 30 when I start residency. If I decide to specialize in something like cardiology, I'm looking at 6-7 years of training. This means that I would be 37 before I could start practicing medicine and running my own lab. It seems to me that I would be so ready to start workin g and making money that a speciality like cardiology would be out of the question. Does this scenario occur often with graduate MD/PhDs?

Ok so i'm currently 20. Assuming I get accepted, I will start my MD/PhD at the age of 22. Assuming an average of 8 years, I will be 30 when I start residency. If I decide to specialize in something like cardiology, I'm looking at 6-7 years of training. This means that I would be 37 before I could start practicing medicine and running my own lab. It seems to me that I would be so ready to start workin g and making money that a speciality like cardiology would be out of the question. Does this scenario occur often with graduate MD/PhDs?

Four more years ain't much in the grand scheme of things. You'll be 37 rather than 33, but you'll have a PhD and the experience and contacts that go along with that. So you will run your lab better and be better in the long run. That's more important.

I am in the same boat as you revaldo (application wise)...I'm actually interested in learning more about this too.

Not to take your questions off the spotlight, but I figured it would be most appropriate in this thread: what do you guys think of programs like Stanford's Advanced Residence Training (ARTS) program? I'm not sure how old it is, I think it seems really new, so maybe there hasn't been many students through or admitted to the program...but from the jist of it, I think you do your PhD during residency. How would this aside from finances (and the idiocy of going through 4 yrs of med school riding the idea that you'd automatically be admitted) be compared to MSTP or MD/PhD programs? I keep thinking that programs like this would make your research stronger because you'll have the "clinical incite" an MD would, but then again the MSTP programs would have you do basic science before you've been, if its appropriate, domesticated? And prevent things like spoiling the experience, for example if in MSTP programs you did your research in radiology, and you wanted radiology programs but couldn't match, but still wanted to practice?

Ok so i'm currently 20. Assuming I get accepted, I will start my MD/PhD at the age of 22. Assuming an average of 8 years, I will be 30 when I start residency. If I decide to specialize in something like cardiology, I'm looking at 6-7 years of training. This means that I would be 37 before I could start practicing medicine and running my own lab. It seems to me that I would be so ready to start workin g and making money that a speciality like cardiology would be out of the question. Does this scenario occur often with graduate MD/PhDs?

I am 30 and will be starting residency this Summer. A 4-year difference in age is nothing if you are doing what you want to do. As a driven student, you have to think ahead to things like residency and career, but trust me, your perspective changes as you mature and acquire more education. Your life situation also changes. Anyway, assume the scenario that you mentioned - you finish formal training at the age of 37 - you still have AT LEAST 30 years that you can work. Many work beyond that age because they love what they do.

At this point in your career, you have to ask yourself why you want to do the MD/PhD program. You do not need a PhD to have a fruitful career as a physician-scientist. I am glad I chose this path because I love science and wanted to have protected/devoted time to learning how to be a scientist. There are many pathways.

Every few years, you come to a fork in your career and you have to re-evaluate and decide which way to go - this is both difficult and exciting.

You're "done" with school at 30 and start making decent money in residency (ie much better than $24,000 in MSTP, but not really close to private prac drs' $$). If you go into academia (like most MD/PhDs), you're not likely to ever be at the top of the physican money tree, so you'll be doing just fine money-wise post-grad.

As for shorter, no. It's rare for an MD/PhD to run a lab and have a practice and NOT be a specialist (caveat: super-long decade residencies like say neurosurgery aren't chosen so often; internal medicine specialities are more or less the norm for MD/PhDs with the other disciplines growning). There aren't many MD/PhDs in emergency medicine or general surgery or family practice. The joint lab-practice thing works best, most of the time, in specialties. Ideally both your lab and practice are closely related.

To paraphrase one of my interviewers, the MD/PhD track isn't really a 'journey' b/c that implies there's a destination or end point. Having a lab and practice isn't going to be an end, but likely just another part of your career. Ask any MD/PhD how "settled" they are. Most aren't. They start new projects, run new initiatives, take on administrative duties, focus more/less on lab or medicine and thus they're career is always in flux. Anyway, my interviewer said the MD/PhD is more like a dance and you just want to enjoy all the steps. It's fairly cool that you won't be doing the same thing day-in/day-out at any point for very long. So just enjoy it and don't be in such a hurry to 'finish' or 'get on with your career'. It's a very in flux life/career you're choosing.

So just enjoy it and don't be in such a hurry to 'finish' or 'get on with your career'. It's a very in flux life/career you're choosing.

Exactly...

It's a very in flux life/career you're choosing.

Yes, but you can dampen the flux with an adequate flux capacitor.

I personally think you "young guns" tend to look at this MD/PhD thing all wrong when it comes to money.

If you start at 22, that means you make ~24K for the next seven years (of course, if you happen to be in one of the many programs the NIH has, you can get ~5% pay raise EVERY year). You're 29 and now it's off to residency where given the current rate of inflation, let's say you'll make ~47K as a first year (Again, if you go the NIH route for residency, you could get paid a more for having a PhD. In fact, a close friend with an MD/PhD, left NIH making 66K as a resident and that doesn't include the 35K they gave her in loan forgiveness). On to fellowship, then your "career" where by now your salary is probably ~ 8X what it was when you were 22. Really, how many realistic careers are out there where your salary can be 8-10X greater in a 10 year period?

I don't care what ANYONE says, going MD/PhD is ALWAYS a "half-full" proposition. So the question I'm ALWAYS left asking is, how much money is enough?:confused:

If you start at 22, that means you make ~24K for the next seven years (of course, if you happen to be in one of the many programs the NIH has, you can get ~5% pay raise EVERY year).

???? What do you mean by this???? MSTP????? I nver got one of these fancy raises- I'm still getting $23K!

The raise thing seems to be program dependant. I started at 23k and I'm up to 25.5k after 4 years.

Ok doing some more math. Everyone always says, don't do the md/phd for the money. While I agree with this statement, one has to fully consider his/her options especially when it comes to taking out major loans.

Ok so here we go; Assuming it takes you 8 years to complete the program, you would have received a total of $192,000 in total stipend (24 thousand a year). Also, assuming an average medical school tuition and fees of 35 thousand a year, you would be spared the $140,000 in med school loans (ignoring the interest you would have to pay on that loan). Now, the only thing you lose are those 4 years of a doctor's salary. Assuming you make an average of $200,000 a year, you would be left with about $120,000 after taxes. So, where do you stand after completing the MD/PhD? 192+140-4*120=-$148,000

I think that looking at the program from this perspective, I think that its not really as financially burdensome as it may have seemed at first. Its true that you will be a student well into your 30's, but you would be doing something you loved doing and you would providing a service that society is in desperate need of (clinical investigators).

This discussion would be hysterically funny if it wasn't so sad. I'm finishing my MD/PhD this year, living on ramen noodles and powdered milk, and I have several close friends (who graduated from college with me) making upper 6-lower 7 figure salaries after dropping out of med school and going into venture capital/hedge funds. Don't do it for the money. I repeat--DON'T DO IT FOR THE MONEY. You'll just drive yourself crazy if you think about how much money your friends are making at the same age.

Just remember all the government's money that we get to waste doing science.

This discussion would be hysterically funny if it wasn't so sad. I'm finishing my MD/PhD this year, living on ramen noodles and powdered milk, and I have several close friends (who graduated from college with me) making upper 6-lower 7 figure salaries after dropping out of med school and going into venture capital/hedge funds. Don't do it for the money. I repeat--DON'T DO IT FOR THE MONEY. You'll just drive yourself crazy if you think about how much money your friends are making at the same age.

Personally, I would take out a small person loan if Ramen noodles didn't suit my culinary tastes and it shouldn't change my bottom line by much when repayment time comes.;)

I of course have absolutely no idea of your position. But just for the sake of people reading seeking another opinion:

I'm living on a single income, with no kids. I go to a generous MSTP and live in charming (but thrifty) studio apt in the middle of a nice neighborhood in the city, buy fresh fruit and vegetables at the supermarket (blueberries! i know...decadent), manage to go out a few nights a week, and still save a couple hundred $/mo.

This discussion would be hysterically funny if it wasn't so sad. I'm finishing my MD/PhD this year, living on ramen noodles and powdered milk, and I have several close friends (who graduated from college with me) making upper 6-lower 7 figure salaries after dropping out of med school and going into venture capital/hedge funds. Don't do it for the money. I repeat--DON'T DO IT FOR THE MONEY. You'll just drive yourself crazy if you think about how much money your friends are making at the same age.

Yeah, don't do it for the money, but the money's not THAT BAD. I eat out for the majority of my meals (typically <$10 for dinner, <$5 for lunch). I drink a reasonable amount of beer and wine, something I could never afford to do before medical school. I travel on the order of once a month (typically a small weekend trip or two) with my girlfriend. Sure, I don't own a car, but it's not hard to rent one when I need one now that I'm over 25. If I wasn't in the MSTP I don't know how I would have ever taken some of the big vacations I've taken since joining the program. This summer I'll be taking 3 weeks and going to eastern Europe. Two summers ago I spent 6 weeks in Guatemala.

All this and I also end up saving a couple hundred dollars a month. I did have to take loans to get me started, but I'm in a pretty atypical situation with NO parent help and coming in with a decent amount of debt.

Yes, if I didn't do the MSTP I would make more money over the long run. I'm looking at Radiology, which in private practice these days means big big money. In one or two years of private practice I could annihilate med school loans. That being said, I think of the situation this way. When I was a little kid, I remember I always wanted $20 for this or $20 for that and could never have it. I was so broke sometimes as a teenager I couldn't even afford a slice of pizza when I was hungry. Now, $20 doesn't really mean anything to me. But that's because the MSTP gives me a decent standard of living. If I had to pay for med school, I would have been just scraping by like I've been doing most of my life, and I was sick of just scraping by. I guess I'm atypical in this regard, because I've met very few other MD/PhDs who are from poor backgrounds.

Someday, the amount of money I make now may mean nothing to me. The MD/PhDs who left my lab to go into private practice Rads make what I make in a year in a month. That being said, at least I'm having a good time getting to wherever it is I'm going. So yeah, I did MD/PhD partially for the money. If I had to get buried in med school debt AND take four more years out of my life, I would have never gone MD/PhD.

As for the op's question. Just about any residency + fellowship path you take is going to be ~5 years. So what if it's really more like 3-7 on the extremes? An extra 1 or 2 years I don't think means alot since you're spending so much time to train anyways. You might as well train in what you really want.

I have never ever met a "poor" MD or MD/PhD student, INCLUDING URM's. I have met PLENTY of poor doctoral students. Interesting observation that I'd never thought of until now.

Depends on how you define poor I guess... When half the world lives on less than $2/day, it's hard to call any American truly poor :laugh: It's relative poverty not absolute poverty of course, but different people draw the lines at different places. Let's just say I applied disadvantaged, and nobody ever once questioned it, even on skeptical SDN. Some of my interviewers didn't believe my story, and questioned me as such. Some even admitted to my face they didn't believe me at first :laugh:

Hijacking the thread a bit, I think the vast majority of med students and MD/PhDs (probably even more so MD/PhDs) come from middle class backgrounds or better because there's just certain advantages that come from having money. I'm not talking just about better schools and tutoring, but also just having enough money to not have to worry about taking an unpaid research or volunteering spot or going abroad during the summer. Some of you can say "oh, don't do it for the money" because you don't know what it's like to not have a safety net. When I needed to get my wisdom teeth removed, I couldn't just go to my parents and ask them for help. If I run into a financial hardship, there's not a mommy and daddy fund I can tap into. This is not true for anyone else in my MD/PhD class I can think of. Most of them have parents who have bought them or contributed a large chunk of money towards their house, condo, or apartment. The process really biases against people who have to support themselves. Grad school is so much easier to get into but the average earning level after graduation is much less, so the system propogates itself.

That being said, the whole URM thing irks me because race is in no way a proxy for class anymore in America and the lines of what makes a URM are so completely arbitrary. For example if you're a descendant of north Africans and are white (like most north Africans) you're not URM. There's more "poor" white people than black people in this country no matter how you define poor (though of course by percentage it's more blacks). By segregating based on race, not class, schools hurt the people who need (and deserve?) the help the most...

The topic of MSTP demographics (in general, as well as perhaps in contrast to doctoral and straight MD programs) is interesting - in itself, as well as perhaps insofar as it might illuminate something about the philosophy of the programs and the motives of its students.

This discussion reminds me of an thread from last year which, interestingly, seemed to suggest the opposite observation that people are making here about the backgrounds of students in MST Programs (e.g. that a disproportionate number of MSTPs come from less professional/upper class backgrounds).

http://forums.studentdoctor.net/showthread.php?t=266032&highlight=parents+professions

Granted, this is all just anecdote vs. anecdote (and maybe some SDN poster selection bias - ha). Does anyone have any keener sense of this issue (or, perhaps, at least more experience/anecdotes for the pool)?

Thank you all for your replies,

The point I was getting to with my previous post is that if you take into account all the money your gaining and losing, you're not really losing 4 years. As one member pointed out, if MD/PhD students were forced to take out loans and spend 4 extra years in grad school, very few people would do it. So in a way, it is about the money. I would love to go into research, run my own lab, and see patients pat-time, but I also have other goals and desires. I would like to get married and start a family, maybe buy a house. If I had to do this with 300 thousand of loans and a full salary at the age of 37, I wouldn't do it. I don't think i'm being selfish, just being realistic.

Using Excel:
MSTP: 671446.0189
MD: 902140.7905

Deficit -230694.7715

at the end of 12 years at 5% interest rate. This is assuming you don't borrow at a higher rate, only that you break a deposit that is earning 5% to pay fees. Also assuming a 4 year residency and a 7 year MSTP.

Amortizing this deficit using equal payments over 12 years - ~$14000 per year
Not that much to get the PhD

I would like to get married and start a family, maybe buy a house. If I had to do this with 300 thousand of loans and a full salary at the age of 37, I wouldn't do it. I don't think i'm being selfish, just being realistic. If this is a sincere statement, then I think the question of what your true motivations are needs to be addressed. Law or business may be a better way to go if you're scared off by 300K in educational debt, IMHO.

Who isn't afraid of a $300,000 student loan? Are you telling me that I should reconsider my motivations for becoming a doctor becuase i'm afraid of starting my life off with such a huge financial burden?

There is some circular logic going on here. If you do the MSTP, you should not have $300,000 in debt and be starting your clinical practice at the age of 37 (if you enter medical school at 22). Just one or the other.

Your future is personal - you have to be honest with yourself about what you want. If buying a house, having kids, and a good income at an early age is important (nothing wrong with that), then maybe the extra time invested in a MSTP program is not worth it. The bottom line is that you are paid more for clinical duties than research/lab duties. Therefore, GENERALLY, strict clinicians will make more money than physician-scientists in the same specialty.

Everyone has different goals and priorities, so no one can tell you what to do. Follow your heart and gut (and any other organ that may speak to you).

Now if only I could properly plan the next 10-15 years of my life when I was 22... ;)

Who isn't afraid of a $300,000 student loan? Are you telling me that I should reconsider my motivations for becoming a doctor becuase i'm afraid of starting my life off with such a huge financial burden?
No what I'm saying indirectly is that 300k is relative to the cost of other important things in life. Here are some examples:

1) By an MD styly house ~700-1mil
2) Have ONE kid ~1 mil, including Ivy League education
3) Marry the wrong woman and pay her alimony since she worked while you were in med school, PRICELESS!!!:laugh:

Of course the idea of getting paid anything is great when you are graduating from college. You do not realize how little you make really until you look around at your old college buddies who now work for Texas Instruments after getting their MBA.

I was bitter about this fact and my stagnant situation for a brief period as a jaded graduate student. This is pretty evident from my past posts. But then things turned around, the data started to come together, and I started enjoying science again. We get to play with mice, zap neurons, grind tissue, and come up crazy experiments. It's way more fun than shuffling papers or writing code for a company from 9 to 5.

Don't get me wrong though. We don't make much money to goof around or even raise kids. If I would stick to my budget, I could eat really well and take vacations fairly often. However, I choose to purchase expensive toys, so am always in the red. I try to make up for it by working at our school gym, selling fish (seriously), DJing, TAing, and tutoring, but these small jobs wont make up for the fact that I just bought a $2600 keyboard (doh! ;) )

Seriously folks. We're fine.

Go back to lab, you buffoon! :D

Well, honestly I think it depends on yourself more than anything else. Some people really want to make big money and some people would be satisfied by getting the minimum + a bit more.

The fact is, I don't think PhD or MD/PhD (students on stipends) will be dying of hunger or cold anytime soon. I personally would be satisfied with money enough to get me a studio (small but comfortable) + average food (and if you cook you'll save a ton of money. Neuronix, you spend too much money on food :laugh: ) + public transport if you don't have a car + going out on a few nights + and ofcourse bying some accessories across the year (clothes..etc). The stipend is good enough to cover those expanses almost everywhere. I would be satisfied and happy with that sort of a life style. I don't think one needs the biggest plasma TV or whatever to be happy. So I think that's one thing to take in consideration.

Plus, anyway, consider residency as a starting job. A lot of starting jobs open at 40k something a year. So starting to work 28-30 isn't that bad.

No what I'm saying indirectly is that 300k is relative to the cost of other important things in life. Here are some examples:

1) By an MD styly house ~700-1mil
2) Have ONE kid ~1 mil, including Ivy League education
3) Marry the wrong woman and pay her alimony since she worked while you were in med school, PRICELESS!!!:laugh:

ROFL!! well stated ;) thanks for the laff

Plus, anyway, consider residency as a starting job. A lot of starting jobs open at 40k something a year. So starting to work 28-30 isn't that bad.

I agree. However, for the number of hours worked ~40k is pennies.

if money is the only thing that you worry about, mstp is NOT for you. here is another way looking at this issue:

md - 4 years of student loan + living expenses + interest = -$400,000
- extra 4 years for not doing a phd + subspecialty = +$800,000
- net = +$400,000

md/phd - no student loan + stipend ($25,000/yr for 8 yrs) = + $200,000
- 4 extra years of joy doing minipreps = $0
- net = +$200,000

there, md comes out ahead assuming everybody retires at 65. this is your opportunity cost if you want to do an md/phd. anyway, back to my constructs!

- 4 extra years of joy doing minipreps = $0

:laugh: :laugh: :laugh: :laugh:

CLASSIC! PURE COMEDY!

and oh SO TRUE!!!

and oddly enough, I'm still:

MSTPbound:cool:

I agree. However, for the number of hours worked ~40k is pennies.

I know of a couple of professions, one in particular that I'm leaving to pursue medicine, in which you can work 60-70 hrs a week 6-7 days a week year around and get paid maybe $30-$32k starting out. So, for the number of hours worked, $40k or so isn't all that bad comparitively speaking.

I know of a couple of professions, one in particular that I'm leaving to pursue medicine, in which you can work 60-70 hrs a week 6-7 days a week year around and get paid maybe $30-$32k starting out. So, for the number of hours worked, $40k or so isn't all that bad comparitively speaking.

Ditto that. I spent most of my 20s driving trucks, worked 70 hours per week, every week, and in my best year made 40k (and that was hauling gasoline tanks!).

wow, this thread is great, thanks. :)

I think some of those numbers are a little deceiving. True, over the course of your career, an md/phd who stays in academia could have 3-4 fewer years making a decent wage and that wage could be considerably less than that of a traditional MD. Ofcourse you could also beat out the MD for the seat in a lucrative specialty, sell out entirely, and put off retiring cause you actually enjoy your work thereby rendering that 4-year "head start" irrelevant.

Simply I don't know anyone (that didn't enter a very, very lucrative surgical program) ten years out of residency that is free of loans. Even at state schools they project that it will take approximately 25 years to pay off your debt, so this isn't a simple 4-year differential. My basic point is it will be a long time before that +150K turns up, if it ever does, so if you want to pursue an md/phd that is the least of your worries.

In either case expect to be relatively poor for a good long time before suddenly you're making decent money free of debt or in ignorance of it.

Also, there is no way I would an md/phd if massive debt came with it. Ofcourse then we'd be relegated to having to choose between a phd or an md, perish the thought.

Looks like this thread is pretty much dead but I'll add two cents
MD/PhD is a long road, and four years isn't much of an addition. Its some what less common, but you can also do research in residency. Both basic science and clinical. This may add two years to your residencey. You don't get three extra letters for doing it, but typically its in a field more interesting to you, and is more likely to enhance your fellowship possiblities.