My overly informative situation of MD vs PhD!

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Hey all!

So I have plenty of experience in the medical field with over 3 years from employment and around 150 hours volunteering. However, lately I have been really unsure of what path I should be taking!

I am extremely interested in both science and medicine (science including chemistry, biology, and physics). My wife says I should be a teacher all the time because I love teaching science so much to people and read nonfiction books for fun (I also think she is worried about me having any time for her over the next 8 years haha)

I have always loved medicine, and I think emergency trauma is particularly fascinating. However, after having worked in the ER for 2 years, I just question whether I could do it for a lifetime career. I have to immerse myself in a field that has variety because I can get bored veeery easily. I also don't think I could be in a suburban hospital setting for this reason either. However, city hospitals have what seems like half of their patients who shouldn't be there and abuse the system. I can't stand people who check in 3 times in a night, and it seems like everyone around me where I work develops a certain degree of cynicism the longer they work.

So the big question is how do MDs keep themselves intrigued with their profession and prevent themselves from developing a poor attitude? I don't want to hate going to work at any point in my future. Obviously you like it overall or you wouldn't be a doctor so what makes the good outweigh the bad?

I just love medicine AND science so I can't decide if I should still go to medical school or go to grad school for biochemistry, physics, biomedical engineering, or something similar. I mean, I do experiments dealing with physics & chemistry by myself in my free time just for the heck of it. Yes, nerd I know. But, I also love learning about how the body works and being able to solve its problems!

I think the 2 most important deciding factors of a career that makes me happy are probably:

1) Allows me to spend time with my family - aka 40 hr work week or less
2) Won't consist of monotonous regularity - I need to be entertained
3) Allows me to do something meaningful that helps the lives of others - I know I want to do some form of research at some point no matter what I decide

Sorry for being so long. Thanks for any advice!

You sound like an old guy so I don't know if this would be good for you but why not MD/PhD?

Nah I'm actually only 23 years old.

I've thought about it but worry about the time commitment of doing MD/PhD,and I've actually heard some say that MD is fine, and then just do research. But, I also heard an MD doing research compared to a PhD doing it is vastly different.

Basically I love learning and can't make a decision! Sometimes I kinda wish I could just get paid to learn for the rest of my life haha.

Originally Posted by matthewsrr

Nah I'm actually only 23 years old.

I've thought about it but worry about the time commitment of doing MD/PhD,and I've actually heard some say that MD is fine, and then just do research. But, I also heard an MD doing research compared to a PhD doing it is vastly different.

Basically I love learning and can't make a decision! Sometimes I kinda wish I could just get paid to learn for the rest of my life haha.

Lucky for you, being a physician means lifelong learning.

Consider:

(1) 4 years of MD schooling vs. anywhere from 5-8 years of PhD schooling

(2) Job security. It is INCREDIBLY difficult these days to get any sort of tenure-track professorship. Most jobs nowadays are either post-docs (get paid ~40K, no benefits, after all that schooling) or adjunct positions (which suck @$$ and pay very poorly). Perhaps certain sciences are immune to this PhD "mess", but that is the word on the street. Whereas, I have yet to hear about a MD who has failed to find a relatively well-paying job (granted, the MD does come out with substantial debt).

(3) As an MD, you can pursue research and great physicians pursue lifelong learning. I feel that everything you want, that you think a PhD provides, can be found in a career as a MD. And again, MD/PhD programs are typically 5 years, which still totally beats the PhD route which could, again, be up to 8 years. And not to mention the nightmare of becoming an ABD (all but dissertation)....what a waste.

http://100rsns.blogspot.com/

http://www.economist.com/node/177232...TOKEN=82403941

Originally Posted by huskydock

And again, MD/PhD programs are typically 5 years, which still totally beats the PhD route which could, again, be up to 8 years.

Come again?

MD >>>>>>>>>>>> PhD.

Originally Posted by huskydock

And again, MD/PhD programs are typically 5 years, which still totally beats the PhD route which could, again, be up to 8 years.

Even the MD/PhD programs that are shorter due to scheduling like Duke and Columbia average 7years, overall the average is closer to 8 (2years MD lectures + 3-4years PhD research + 2years rotations).

If you want to work less than 40 hours a week and spend a lot of time with your family, then I wouldn't recommend becoming a physician or scientist. There are very few medical specialties that work so few hours. Although emergency physicians do work about 35-40 hrs/wk as attendings, after 7-8 years of 60-80 hour weeks in med school and residency, that's still a misleading number. Since we work 24/7 in EM, there is a lot of time spent recovering from night shifts, and we work many nights, weekends and holidays. Our free time doesn't coincide with the free time of family members who have normal work or school schedules.

If you're concerned about lack of variety in emergency medicine, I don't know how to help you as we probably have a wider variety of almost everything than any other specialty. So far I find it a very stimulating and rewarding field (granted, only ten months into my intern year). Although there may be a small fraction of patients who shouldn't be in the ED, this isn't as much of an issue as you seem to think. I have yet to see anyone return three times in a day.

Others have touched on some issues with the PhD route. The average length of a PhD in biology is around 7 years these days, although it can be 5 or 6, followed by years of postdoc work. The funding environment is terrible and likely to get worse due to Republican antipathy toward science and the poor economy. Again, it's hard to be successful without working long hours.

I would really urge you to spend a lot more time exploring your options rather than rushing into something that's going to eat your soul for a decade.

Originally Posted by pseudoknot

Others have touched on some issues with the PhD route. The average length of a PhD in biology is around 7 years these days, although it can be 5 or 6, followed by years of postdoc work. The funding environment is terrible and likely to get worse due to Republican antipathy toward science and the poor economy. Again, it's hard to be successful without working long hours.

I would really urge you to spend a lot more time exploring your options rather than rushing into something that's going to eat your soul for a decade.

Is it really so bad to become a PhD? I've heard all of these stories about how it would be difficult to find a decent-paying teaching or research position as a post-PhD student, but I still see so many well-employed, tenured professors. Numerous PhD students graduate from the universities in my area and still get into fantastic programs afterward, but obviously these are all just useless and random statistics.

Originally Posted by notbobtrustme

MD >>>>>>>>>>>> PhD.

This. I'd probably go M.D. You would get to met new and various people and help them on a daily basis. You would get paid better than a Ph.D. And I honestly don't think your wife would mind being married to a medical doctor.

Have you considered engineering?

Regular hours.

Entertaining:
http://www.slashgear.com/university-...heme-02216575/

Help millions of people. If you are reading this, you can thank an engineer!


I think that medicine or academic-based research are bad ideas if you want a 40 hour/wk schedule.

Originally Posted by LizzyM

I think that medicine or academic-based research are bad ideas if you want a 40 hour/wk schedule.

Not nearly as bad as all the interesting kinds of engineering. Or law. Or business.

I think medicine is actually one of the best alternatives for a 40 hour week. It's 7 years of terrible hours while you're in training, but when you get to the end of it there actually is a very robust market for shift work, and a lot of people do work 40 hours worth of shifts a week. Engineers don't work shifts, and neither do researchers, lawyers, or businessmen: they stay until the project is done.

Originally Posted by pseudoknot

...
Others have touched on some issues with the PhD route. The average length of a PhD in biology is around 7 years these days, although it can be 5 or 6, followed by years of postdoc work. The funding environment is terrible and likely to get worse due to Republican antipathy toward science and the poor economy. Again, it's hard to be successful without working long hours.

I would really urge you to spend a lot more time exploring your options rather than rushing into something that's going to eat your soul for a decade.

+1000

Originally Posted by Algophiliac

Is it really so bad to become a PhD? I've heard all of these stories about how it would be difficult to find a decent-paying teaching or research position as a post-PhD student, but I still see so many well-employed, tenured professors. Numerous PhD students graduate from the universities in my area and still get into fantastic programs afterward, but obviously these are all just useless and random statistics.

The problem is that we educate more PhDs than the available number of tenure track positions. The bottleneck isn't immediately after graduation. Postdoc positions are a dime a dozen, especially if you have good communication skills. The problem comes in trying to find a position with upward mobility AFTER a postdoc. It's not easy.

To the OP, research is great for people who love learning. I honestly think that a strong sense of curiosity is necessary in order to do well in research. Otherwise, I can't see how anyone would be able to justify the workload. But, the thing is, you can absolutely perform research (basic, translational, or clinical) with "just" a MD. Grab a postdoc position post-residency or a research year before getting your MD if you want formal training. It's just a thought.

Originally Posted by pseudoknot

Others have touched on some issues with the PhD route. The average length of a PhD in biology is around 7 years these days, although it can be 5 or 6, followed by years of postdoc work. The funding environment is terrible and likely to get worse due to Republican antipathy toward science and the poor economy. Again, it's hard to be successful without working long hours.

And let us not forget the incredibly unhealthy system of tying your entire career to a single professor who has the ability to completely f- over your career and who also has every professional motivation to keep you around as indentured labor rather than letting you actually graduate. Say what you will about medical school, but it does try its best to be objective and you do know how long its going to last.

Originally Posted by Ebola4Breakfast

The problem is that we educate more PhDs than the available number of tenure track positions. The bottleneck isn't immediately after graduation. Postdoc positions are a dime a dozen, especially if you have good communication skills. The problem comes in trying to find a position with upward mobility AFTER a postdoc. It's not easy.

This. A friend who's a professor at University of Michigan says that about 200 candidates apply for every faculty opening in his department [natural sciences], and with the decrease in Staff Scientist positions across the country, many postdocs who are unable to enter academia or industry are stuck indefinitely unless they take up teaching. For that matter, even teaching positions are highly competitive these days, going by the experience of postdocs I know applying to lecturer positions in the UC/ Cal State systems.

Originally Posted by huskydock

http://100rsns.blogspot.com/

http://www.economist.com/node/177232...TOKEN=82403941

These are good links.

I'm a chemistry postdoc with ~15 papers, a good teaching history, and total antipathy to academia by now. The interesting research in industry is moving overseas and I can't imagine begging for grant money and teaching the same course twice a year for the rest of my life. My successful colleagues in pure science aren't the inquisitive set I would call peers, they're the worker bees that know how to ask for grants. The savvy people from my generation (science phds included) went into finance or medicine.

IMO, pure science is great if you want to be far removed from the people you help, forgo the good pay, work the long hours, and have constant job insecurity. I hope I didn't sugar coat it too much.

Originally Posted by Perrotfish

And let us not forget the incredibly unhealthy system of tying your entire career to a single professor who has the ability to completely f- over your career and who also has every professional motivation to keep you around as indentured labor rather than letting you actually graduate. Say what you will about medical school, but it does try its best to be objective and you do know how long its going to last.

This. Most people don't understand the uncertainty of completing a PhD. The nature of a PhD is so project dependent that it's really difficult to gauge how you're doing in comparison to your peers. You spend a lot of time wondering if you're progressing at a reasonable pace or are doing enough. Should you read more papers? Should you be writing a grant? Should you be networking more? How much is enough? You'll never know unless you don't do enough... which is a crappy way to do things.

And then there's graduation. The departmental average may be X number of years, but that's in no way a guarantee that you'll be able to graduate in that many years. There are so many factors involved, both controllable and uncontrollable. The biggest uncontrollable factor is your committee. If they don't feel you are "ready to graduate"... then it won't happen. After all, your committee has to sign off on your defense. How many years you've been in the program doesn't mean a whole lot. People are asked to leave. Sometimes with a terminal Masters... sometimes not. I honestly didn't "know" I was going to attempt my defense until about six months prior.

I promise I'm not a bitter ex-academic. I love research. I graduated in 5.5 years, the departmental average. I had an awesome mentor who wanted me to succeed, and a very functional committee who also supported me. It was the path that was right for me at the time I entered. I'll still be leaving my postdoc position in July to start medical school. Like the other postdoc mentioned, you spend a lot of time very far away from the people you idealistically set out to help. It can be isolating. I have a hard time ever recommending someone to attempt a straight PhD because of the current funding situation. As mentioned by others, it's very unstable. There's a reason why the average age for the first R01 grant has pushed upwards of 40. It is a tough market.

It will be very tough to have a 40 hour workweek in either career path.

Originally Posted by LizzyM

Have you considered engineering?

Regular hours.

Entertaining:
http://www.slashgear.com/university-...heme-02216575/

Help millions of people. If you are reading this, you can thank an engineer!


I think that medicine or academic-based research are bad ideas if you want a 40 hour/wk schedule.

She's got a point here. I'm an engineer, it's pretty cool and the hours are great. In my relatively short 7year career, I've:
Worked on the space shuttle
designed jet engines for the new 787
Accumulated 5 patents
never worked more than 40 hr per week for an extended period
Done some groundbreaking research for advanced military afterburners
done a whole lot of other work I cant talk about (for national security reasons)

It's really not a bad way to go. And that's just one area. Plenty of stuff being done all over

Originally Posted by Perrotfish

Not nearly as bad as all the interesting kinds of engineering. Or law. Or business.

I think medicine is actually one of the best alternatives for a 40 hour week. It's 7 years of terrible hours while you're in training, but when you get to the end of it there actually is a very robust market for shift work, and a lot of people do work 40 hours worth of shifts a week. Engineers don't work shifts, and neither do researchers, lawyers, or businessmen: they stay until the project is done.

Engineers don't work shifts which means they are at the table for every holiday meal, every celebratory event in their extended familiy.

Engineers work until the project gets done but projects get done over weeks, months or years. I shared a house with an employed mechanical engineer for 2 academic years and I don't think he missed being home in time for dinner more than twice. Electrical/electronics engineers do their work and have every weekend free to go to their kids' games. Civil engineers, out in the field Monday through Friday and home all weekend.

Originally Posted by LizzyM

Engineers don't work shifts which means they are at the table for every holiday meal, every celebratory event in their extended familiy.

Engineers work until the project gets done but projects get done over weeks, months or years. I shared a house with an employed mechanical engineer for 2 academic years and I don't think he missed being home in time for dinner more than twice. Electrical/electronics engineers do their work and have every weekend free to go to their kids' games. Civil engineers, out in the field Monday through Friday and home all weekend.

I went to an engineering school, have an engineering degree, and almost all of my college classmates are engineers. The hours for engineering do vary, but it seems like the ones who got interesting jobs with upward mobility often live in the office and miss a lot of meals and work a lot of weekend. The ones who do fairly repetitive, boring work that doesn't lead anywhere (lots of computer modeling) normally get home for dinner regularly. Most of all it doesn't necessarily get better later in your career, like medicine. Actually if you don't get onto the management track it gets worse, as your technical skillset ages and you start killing yourself to try to hold on to the job that you have.

Easy hours aren't impossible, even with a good engineering job, but I don't think its any more likely than in medicine.

Originally Posted by Ebola4Breakfast

And then there's graduation. The departmental average may be X number of years, but that's in no way a guarantee that you'll be able to graduate in that many years. There are so many factors involved, both controllable and uncontrollable. The biggest uncontrollable factor is your committee. If they don't feel you are "ready to graduate"... then it won't happen. After all, your committee has to sign off on your defense. How many years you've been in the program doesn't mean a whole lot. People are asked to leave. Sometimes with a terminal Masters... sometimes not. I honestly didn't "know" I was going to attempt my defense until about six months prior.

I remember at my undergrad we had one materials science professor who gave his PhDs 5 years to graduate, which is lightning fast even by the already fast standards of engineering doctorates. No one worked for him longer than that, almost everyone finished in 5 years and the rest got sh!tcanned. One day in class, someone asked him why and he did that.

He said that when he was in his doctoral program he had a classmate that had been stuck in a PhD for 10 years. He wasn't incompetent, he published regularly, taught well, and was well liked. However he was the only one in his lab who knew how to do a number of fairly involved technical procedures, and his 'mentor' refused to sign off on his thesis defense because he wanted to keep him around for the labor. Everyone knew about the situation and thought it was appalling but the way doctoral programs there is basically no appeal for this kind of thing. On his 10th anniversary of the program the student went to his professor, one last time, and asked him if he could finally graduate. The professor said at least one more year. That's when the student shot him in the head.

That apparently made an impression on my prof. He decided that everyone was getting out of his lab within 5 years, one way or another.

YMMV as they say. My family's experiences are with Raytheon, Texas Instruments, Sikorsky Aircraft, local government (civil engineering), and self-employment (civil engineering and mechanical engineering/computer engineering of factory systems).

Originally Posted by K31

Come again?

Woops! I must have been misinformed...

Originally Posted by matthewsrr

So the big question is how do MDs keep themselves intrigued with their profession and prevent themselves from developing a poor attitude?

I cannot speak for anyone else, but I remain "intrigued" by my field because 1) every case is different, and somewhat like opening a box on Christmas morning, and 2) it takes a lot of work to stay current, and it's interesting to see the field evolve as old problems are solved and new ones appear. I keep a good attitude because I put bad thoughts in my mind vice and crush them.

Originally Posted by matthewsrr

I just love medicine AND science so I can't decide if I should still go to medical school or go to grad school for biochemistry, physics, biomedical engineering, or something similar.

A big part of why I went MD instead of postdoc was that I had time to make an honest assessment of the career prospects in biomedical sciences. I can't speak for physics or BME, but here is what you can expect these days going the PhD route in one of the biomedical disciplines:

1. PhD: 5-7+ years living on dirt wages.
2. PostDoc: 3-9+ years living on double dirt wages.
3. Assistant professorship. After 1-2 years your salary is dependent on getting grants funded, which are each 100+ pages and have about a 5-15% chance of success.
4. Oops, your money ran out and nothing got funded. Time to move to a new institution and get fresh startup funds.
5. Go back to 3.

The halcyon days of stable, predictable funding for medical sciences is over. The image of a career in science that we grew up with is now a caricature from a bygone era.

Originally Posted by Gut Shot

1. PhD: 5-7+ years living on dirt wages.
2. PostDoc: 3-9+ years living on double dirt wages.
3. Assistant professorship. After 1-2 years your salary is dependent on getting grants funded, which are each 100+ pages and have about a 5-15% chance of success.
4. Oops, your money ran out and nothing got funded. Time to move to a new institution and get fresh startup funds.
5. Go back to 3.

The halcyon days of stable, predictable funding for medical sciences is over. The image of a career in science that we grew up with is now a caricature from a bygone era.

Wow, is this really typical? It sounds as though being able to actually conduct research is fairly dependent upon grants with a 5-15% success rate?! Does this mean numerous post-docs never actually have an opportunity to conduct research experiments--or at least, never their own experiments?

Yes, very few postdocs go on to become independent investigators. Science is a pyramid scheme.

Originally Posted by Perrotfish

I remember at my undergrad we had one materials science professor who gave his PhDs 5 years to graduate, which is lightning fast even by the already fast standards of engineering doctorates. No one worked for him longer than that, almost everyone finished in 5 years and the rest got sh!tcanned. One day in class, someone asked him why and he did that.

He said that when he was in his doctoral program he had a classmate that had been stuck in a PhD for 10 years. He wasn't incompetent, he published regularly, taught well, and was well liked. However he was the only one in his lab who knew how to do a number of fairly involved technical procedures, and his 'mentor' refused to sign off on his thesis defense because he wanted to keep him around for the labor. Everyone knew about the situation and thought it was appalling but the way doctoral programs there is basically no appeal for this kind of thing. On his 10th anniversary of the program the student went to his professor, one last time, and asked him if he could finally graduate. The professor said at least one more year. That's when the student shot him in the head.

That apparently made an impression on my prof. He decided that everyone was getting out of his lab within 5 years, one way or another.

I'm surprised this doesn't happen more often.

That is the nice thing about getting a medical degree. Once you get into school, it's hard not to finish without some sort of catastrophe. PhD programs have a vested interest in keeping you around forever and there's no recourse for the excellent researcher who is just getting screwed over.