Agonizing about my chances - and whether I should even apply MD/PhD instead of just PhD

[acetylcholine]

This post is going to be an absurd combination of 'what are my chances' and 'should I'.

1) Would I get into these things in the first place?

If I decide to apply to some MD/PhD programs in addition to the several PhD programs I have picked out - I have already picked out which ones they would be (UT Southwestern, UVA, Case Western, Michigan) - would I, in fact, have a reasonable probability of getting in at least one? Never mind the fact that the number of applicants to these things is in the triple digits and the number of accepted is usually in the single digits, if not the double digits.

MY STATS:

3.69 GPA, haven't got the slightest idea what I'm going to get on my MCAT because I haven't taken it but I have a 167V/163Q/4.0A on my GRE, 2 summers of research in fairly prestigious places and 1 semester at my home university, 1 second-author publication in a pretty damn good but not Cell/Nature/Science/PNAS journal, good LORs blah blah blah you get the idea. I have no FORMAL clinical experience but I could spin a good yarn about having to do a bit of the caretaking, at different times, for Mom and Dad when they were ill, and having to use some of my own insights for when to cart them off to the doctor. Bear in mind that this is a fairly recent quandary so clinical stuff hasn't even been on the radar.

2) Should I try to get into these things in the first place?

If I could, I would do 100% research. All the time.

If I went the MD/PhD route, though, I'd probably choose to specialize my clinical work in clinical genetics and neurogenetic/neurodevelopmental disorders, because my research interests are in developmental neurobiology, primarily, particularly during early embryogenesis and in an evolutionary context (I am very interested in the use of invertebrate deuterostome models and also animals like cephalopods who have brains much like ours). The vast majority of my time would be spent doing research, which is how MD/PhDs do it anyway.

I am frankly not opposed to being a perpetual student or pulling stupid hours. I am also not planning to have children ever anyway for reasons wholly unrelated to the stupid hours that MDs often pull (I decided this YEARS ago), so no worries about that. To be honest, I have found that I feel the most alive when actually doing my work. (I just got my bachelor's degree and have been unemployed for a mnth. The unemployment has taken my moods to some truly abysmal places. I need to get back in the lab.)

I'm on the older side of things - I'd be 26 when I matriculate, so in theory I'd finish the second of both degrees at the ripe old age of 34 and probably start my career when I'm something like 40? Can someone comment on how much my professional career would be affected by this? Should I just go for the PhD where I'd finish it by 31 but have a significantly lower probability of actually getting an academic job?

Also, let's be honest, PhDs are very unlikely to be able to get jobs in academia, which is where I absolutely want to stay (I'd make a crappy industry cog or desk jockey). I honestly don't care as much about salary as I do just having a damn job that I enjoy, which appears more likely if I have an MD/PhD.

I intend to do solely basic science work in my research, if that's much of a question.

Help me figure this all out.

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[ValentinNarcisse]

Do not do it, it seems you have very little interest in being a physician. Medical school, like grad school, is not advisable to go through unless you are 100% committed. Futhermore, you will have to complete your residency/fellowship to have the neurogenetics specialization you envision. If anything, you would be an exceptional PhD candidate and can likely attend any institution you desire, allowing you to work with a big wig, and landing that Cell, Nature, or Science paper. MSTP admissions are much more competitive, but with your average GPA, no clinical experience, and no MCAT in hand, you would be unlikely to land a position in an equally high power medical school.

 

[gutonc]

If you have no interest in being a clinician, why would you go to med school?

Also, what makes you think that PhDs are less likely to get academic basic science jobs than MDs or MD/PhDs? I know the data is out there, and hope @Fencer will swoop in here with a link shortly, but anecdotally, basic science departments are full of basic scientists with PhDs doing basic science. Sure there's a smattering of MDs and MD/PhDs out there, but they're the minority.

Finally, the funding issue. It's true that there are some (very few) grants that only physician scientists are eligible for. But these aren't things you specifically shoot for. They're grants you submit your K proposal to if the cycle happens to coincide. The pay lines on those grants are ridiculous. One that I applied to (and later discussed with the chair of the review committee who was interviewing at my institution) had 8 grants and over 400 applications. That's a pay line of <2%, not the sort of thing you count on to build a career.

 

[foo]

Sure, you can do it. 26 is not old. Shadow a physician, get some exposure to the clinical stuff, see if you like it. That is what everybody does. No one is born knowing they want to be an MD, or an MD/PhD. So, why not consider it? Try it, you might like it. Leave all options open. Enjoy.

 

[el_duderino]

You seem to have zero interest in practicing medicine. The MD is useless to you except as an ego boost, I think.

 

[acetylcholine]

You seem to have zero interest in practicing medicine. The MD is useless to you except as an ego boost, I think.

More of a safety blanket. Not much de facto difference, though.

Thank you all for your comments (especially gutonc); it looks like I'm leaning back toward just a PhD. The paylines are still pretty frightening, but I have some extra perspective.

 

[gutonc]

More of a safety blanket. Not much de facto difference, though.

Thank you all for your comments (especially gutonc); it looks like I'm leaning back toward just a PhD. The paylines are still pretty frightening, but I have some extra perspective.

They paylines at NIH still suck but at least they're in the 10% range. Foundation grants are the disasters.

 

[tortuga87]

I would not rule out industry at this point. People in academia tend to talk down industry, like you just do mindless work. There are research scientist positions out there which involve creativity just like academia. In fact, if you truly want to be a scientist (as opposed to a grant writer/teacher/manager), then industry is probably a better bet for you


You have to be smart about the skills you acquire and get internships during your PhD. The scope may be more narrow, but you are generally working on a problem that can have more of an impact

 

[oxfordian]

You sound great for a PhD. Aim higher than your current prospect of schools.

 

[acetylcholine]

They paylines at NIH still suck but at least they're in the 10% range. Foundation grants are the disasters.

I have a relative at NIH. It's just getting worse. NIH people hate it too. Real baddies? Congress, who unfortunately rains down billions on defense industry because Jobs Jobs Jobs (for they but not for we?)

 

[acetylcholine]

I would not rule out industry at this point. People in academia tend to talk down industry, like you just do mindless work. There are research scientist positions out there which involve creativity just like academia. In fact, if you truly want to be a scientist (as opposed to a grant writer/teacher/manager), then industry is probably a better bet for you

I'm not saying industry is mindless. The goals of industry are very different from the ones I want to pursue. Industry is science done in service of someone else's aims, whereas in academia at least you have some freedom to pursue your own.

Honestly, my research interests aren't even slightly applicable to industry anyway.

 

[ratherbefishing]

If you finish your PhD and don't land a faculty position with funding, what are you going to do?

 

[acetylcholine]

If you finish your PhD and don't land a faculty position with funding, what are you going to do?

And that's what brought me here in the first place. 75% of MD/PhDs get one. 15% of PhDs do.

https://www.aamc.org/students/download/121086/data/mdphd_isitrightforme.pdf

Now I'm really confused.

 

[Neuronix]

And that's what brought me here in the first place. 75% of MD/PhDs get one. 15% of PhDs do.

https://www.aamc.org/students/download/121086/data/mdphd_isitrightforme.pdf

Now I'm really confused.

You are misinterpreting the data plus the summary slide is misleading. It's ok, most pre-meds don't understand that "medical school faculty" does not mean funded faculty position. Most academic center employments have no research involvement or give 20% protected time to do unfunded research that does not require a PhD.

The data in the slideshow comes from: http://www.researchgate.net/publica...4_MD-PhD_programs/file/32bfe50ca565cd324a.pdf

That data shows that 67% of MD/PhD graduates are employed in academic centers. Of that 67%, 64% devoted 50% or more percent of their time to research. That is a grand total of about 43% of MD/PhDs doing significant research in academic medical centers, not including graduates at the NIH (4%) or industry (8%). It is unclear from the data how much of that is basic science research, and we have no data as to how much is actually funded.

 

[gbwillner]

And that's what brought me here in the first place. 75% of MD/PhDs get one. 15% of PhDs do.

https://www.aamc.org/students/download/121086/data/mdphd_isitrightforme.pdf

Now I'm really confused.

The data there are pretty biased, IMHO. First, the caliber of MSTP and PhD-Only folks are just different. Many PhD students go into it because they just don't know what they want to do with their lives. MSTPers are top notch and more likely to succeed, as a whole, than anyone in most fields.

Secondly, "landing an academic job" is different things to different people. For a vast majority of MSTPers, right now, it means having little to no protected research time and doing a vast majority clinical work. Why would you compare that to what a PhD does?

I don't believe that 65% of MSTPers have "significant" research components to their job, from personal experience. Probably that many have less than 50% clinical work. But it's not the same thing as protected research time. And that may be true for the older generation- it certainly is not true today.

 

[gutonc]

@Neuronix and @gbwillner beat me to the punch. The data in that slide are both biased and easily misinterpreted. I technically count as an MD/PhD who is med school faculty. I am an assistant professor at a med school (not adjunct, not Clinical Ass Prof) on a tenure track. I have a 100% clinical appointment with no protected research time and work at an off-site location associated with a community hospital (that is not associated with the med school at all). So I count in that "75%".

The other thing is that the number of those MD/PhDs doing exclusively bench research with no clinical work is vanishingly small. An MD/PhD without a residency or fellowship is worth no more to the average academic medical center than a straight PhD and will be recruited, hired and paid as such. If you have no desire to

The moral of the story is that, if you have absolutely no interest in clinical medicine, you shouldn't do MD/PhD. You're looking at an additional few years (2-4) in school over the PhD alone as well as 3-7 years of residency/fellowship PLUS the "research fellowship" (AKA post-doc) you'll need to do in order to have a shot at the position you want...plus they're going to want you to move some meat in the clinic, push some glass, read some studies, whatever your specialty requires.

 

[acetylcholine]

Thank you, gutonc, gbwillner, and Neuronix - it's good to hear clarification from people who've already been through it.

 

[Neuronix]

I'm amazed that you managed to get three MD/PhD graduates to respond to one post within ~30 minutes in the middle of a Wednesday. You pushed our collective buttons on that one. The physician-scientist dream is fading, and the varnish put on it by MD/PhD programs seems very thin to recent graduates who are trying or have tried to live that dream.

 

[ValentinNarcisse]

I'm amazed that you managed to get three MD/PhD graduates to respond to one post within ~30 minutes in the middle of a Wednesday. You pushed our collective buttons on that one. The physician-scientist dream is fading, and the varnish put on it by MD/PhD programs seems very thin to recent graduates who are trying or have tried to live that dream.

Given that we will all likely end up in majority clinical careers, is it better to match into the speciality which interests you the most clinically, rather than a less competitive one at a top institution with infrastructure to support the physician-scientist tracks?

 

[Neuronix]

Given that we will all likely end up in majority clinical careers, is it better to match into the speciality which interests you the most clinically, rather than a less competitive one at a top institution with infrastructure to support the physician-scientist tracks?

Great question.

First, it's hard to predict what percentage of us will end up in majority clinical careers. I don't know that every MD/PhD student or pre-MD/PhD around here will end up in a majority clinical career. Even if the funding remains bad, at least someone posting on this forum will become a serious scientist within the physician-scientist framework. Further, I've been hearing "the funding will get better soon" for over 10 years now, and maybe at some point it will. When funding gets better, the research job market will get better, and more of us will end up in research positions.

But of course the answer to your question comes down to opinion. I chose the former option--I chose the specialty which interested me the most clinically knowing that it limited my choices in residency program and research opportunities compared to a less competitive specialty. I still think that's the right answer for me. But MD/PhD programs will typically push you towards picking a specialty and program that is heavily research focused. On this forum you will find opinions to support either option. My take is that research is always available no matter what specialty you choose. It's just a question of how hard you're going to have to push for it within your specialty (i.e. does your desired track already exist with a clear pathway to your niche), and how much (money, job security, location flexibility, free time, etc) you'll have to give up by leaving the mostly or all clinical side of the specialty.

 

[ValentinNarcisse]

Great question.

First, it's hard to predict what percentage of us will end up in majority clinical careers. I don't know that every MD/PhD student or pre-MD/PhD around here will end up in a majority clinical career. Even if the funding remains bad, at least someone posting on this forum will become a serious scientist within the physician-scientist framework. Further, I've been hearing "the funding will get better soon" for over 10 years now, and maybe at some point it will. When funding gets better, the research job market will get better, and more of us will end up in research positions.

But of course the answer to your question comes down to opinion. I chose the former option--I chose the specialty which interested me the most clinically knowing that it limited my choices in residency program and research opportunities compared to a less competitive specialty. I still think that's the right answer for me. But MD/PhD programs will typically push you towards picking a specialty and program that is heavily research focused. On this forum you will find opinions to support either option. My take is that research is always available no matter what specialty you choose. It's just a question of how hard you're going to have to push for it within your specialty (i.e. does your desired track already exist with a clear pathway to your niche), and how much (money, job security, location flexibility, free time, etc) you'll have to give up by leaving the mostly or all clinical side of the specialty.

Agreed, its just hard to reconcile MD/PhD program expectations to be at a "top" program when people going into field like PRS, Derm, and ENT are just happy to match anywhere period.

 

[Neuronix]

Agreed, its just hard to reconcile MD/PhD program expectations to be at a "top" program when people going into field like PRS, Derm, and ENT are just happy to match anywhere period.

It's so much more complicated than that. What makes a "top" program anyway? Because at least in my field, top programs often are not the best to actually launch a research career from. They're prestigious and might help you get a faculty position at a big name place, surely. But big name places often have big name faculty who are concerned about their own research--not the residents' research. Thus they don't let you out of clinic enough of the time to do a research track residency or perform significant basic science research.

 

[gutonc]

Agreed, its just hard to reconcile MD/PhD program expectations to be at a "top" program when people going into field like PRS, Derm, and ENT are just happy to match anywhere period.

One thing you need to keep in mind about this is that the MD/PhD programs don't actually give a s*** about where you land for residency/fellowship as it pertains to your personal and career goals. They only care about the name of the program they get to put on their website attached to your name under the "Where do our graduates go?" tab.

This is of course of gross oversimplification but I think it's a useful way to remember what matters to you.

 

[dl2dp2]

I think it's very hard for an undergrad to make a decision like this. My general recommendation is actually apply to both MD/PhD and PhD programs, and see which ones you get in. If you can get into both, you might want to consider just going to PhD programs. The usual scenario is people with MD/PhD offers from lower tier programs also get PhD offers from top programs. Then they are sort of equivalent offers.

There are specific niches in translational research within which MD/PhDs do have a leg up. However, I would say straight basic biology bench research is not one of them. The kind of research OP wants to do is not part of that niche.

If all of the below applies, and it sounds like they do, you should just go for the PhD
(1) you have a lot of geographical flexibility, and likely will for the greater duration of your career
(2) you really like a very specific narrow research focus, and to the extent of what you know as of right now, this narrow focus will not change.
(3) you don't mind filing for grants and worrying about job insecurity
(4) you don't mind a constant stream of rejections
(5) you don't mind getting paid somewhere between 50k and 100k for the majority of your career, to the best of your knowledge, and making 200k+ is not something that you care about.
(6) you do not have a lot of outside hobbies that are time consuming, and you are willing to spend more than 40 hours a week in a lab. (expect to work a total of 60+ hours a week)
(7) there is no other compelling personal reason to be a physician (i.e. you are not one of those people who "really wanted to be a doctor" since the age of 2 for some other reason)

If this sounds like you and resonates with you, forget about the MD. If any of those above doesn't apply, though, MD may provide a better pathway.

Not having funding is not an issue you will need to worry about, as long as you are willing to accept a low salary and have geographical flexibility. There are always postdoc positions, though the exact research you do might be dictated by your boss. The salary of a postdoc will always be enough to support a modest lifestyle in most parts of the country.

What's interesting is that a lot of 20 year olds think that they fulfill these criteria, but your mindset in your late 20s early 30s changes completely. Given that you are already in your late 20s you probably know yourself better.

 

[acetylcholine]

I don't mind the first part of 3, but the latter part is terrifying and so are some aspects of 5 (because that 50-100k is incumbent on you drawing it from a grant much of the time)

Augh.

Also, here is a horrifying survival graph of those people that DO get to become PIs: http://grantome.com/blog/odds-success

 

[gutonc]

I don't mind the first part of 3, but the latter part is terrifying and so are some aspects of 5 (because that 50-100k is incumbent on you drawing it from a grant much of the time)

Augh.

Also, here is a horrifying survival graph of those people that DO get to become PIs: http://grantome.com/blog/odds-success

#3 will be true whether you have an MD or not if all you're doing is basic science research. Schools don't pay MDs to do research. They pay them to do clinical work...if you can't pay your salary out of your grant, you have to make it up in "service". For straight PhDs that's going to be administrative, leadership, teaching, etc. For anyone with an MD, that's going to be moving the meat.

5 is kind of the same issue. But to help palliate your concern, I offer the recent experience of a close PhD only friend of mine. She got several job offers after a single 3 year post-doc in a cancer biology/stem cell lab (something about 2 first author Cell papers as a post-doc really makes people want to hire you I guess). One was at "Prestigious Southern Medical College" where her lab space was 4 benches in a shared lab, expected teaching load was 2 undergrad and 2 PhD courses per year and 80% of her salary was from grants. Offer #2 was from well known "West Coast State University" no med school, big grad and undergrad. Lab space is 6 benches, equipment budget given that was not included in start up costs, expected teaching load of 1 course per semester, 100% of salary covered years 1-3, no more than 50% from grants thereafter. There were several others but these were the ones she seriously considered.

Moral of the story...if you're a desirable candidate, you're going to do fine with a PhD, whether there's an MD attached or not.

 

[dl2dp2]

One was at "Prestigious Southern Medical College" where her lab space was 4 benches in a shared lab, expected teaching load was 2 undergrad and 2 PhD courses per year and 80% of her salary was from grants. Offer #2 was from well known "West Coast State University" no med school, big grad and undergrad. Lab space is 6 benches, equipment budget given that was not included in start up costs, expected teaching load of 1 course per semester, 100% of salary covered years 1-3, no more than 50% from grants thereafter. There were several others but these were the ones she seriously considered.

These offers are awful, unless we are talking about Emory or Duke, which doesn't sound like it--I would expect more start-up from Emory or Duke. The West Coast University has no medical school, which means that the offer is really awful.

Given the fact that this is a female candidate with 2 first author Cell papers, I think we are getting a sense of the ridiculousness of the job market. WTF? It's really really wasteful, in my opinion. Someone like her should be a junior faculty at a TOP school with millions in start-ups.

A semi-decent clinical job EASILY EASILY in my book beats these offers. This may be a bit harsh, but there is no real scientific future in my opinion if you work as a professor at a "West Coast State University" with no med school. You can easily lose your R01, even if you were able to get one, and are living constantly in fear. And you are not in a condition to collaborate with good teams to create anything meaningful, and all the students and post-docs you can get are not good enough to really do anything creative. And you get paid at most 110k as a full professor. This is the end game people.

Be smart, do the MD.

 

[Neuronix]

These offers are awful, unless we are talking about Emory or Duke, which doesn't sound like it--I would expect more start-up from Emory or Duke. The West Coast University has no medical school, which means that the offer is really awful.

I agree with sluox on this. I saw my share of very talented post-docs with lousy offers when I was in grad school. Your fallback as a PhD is teaching with uncommon exceptions. Your fallback as an MD/PhD is to be a clinician with uncommon exceptions. If you don't want to be a clinician, MD/PhD is not a good place to be. I guess it's a question of which fallback you prefer, but keep in mind that to get that clinical fallback you'll need to do 4 years of med school and 3+ years of residency, which is a big investment for something you don't really want to do.

 

[gutonc]

These offers are awful, unless we are talking about Emory or Duke, which doesn't sound like it--I would expect more start-up from Emory or Duke. The West Coast University has no medical school, which means that the offer is really awful.

Not Emory or Duke but same tier.

Given the fact that this is a female candidate with 2 first author Cell papers, I think we are getting a sense of the ridiculousness of the job market. WTF? It's really really wasteful, in my opinion. Someone like her should be a junior faculty at a TOP school with millions in start-ups.

It is a top (research) school but not one with a med school and it is about 2 R01s worth of startup costs so it's pretty good deal.

A semi-decent clinical job EASILY EASILY in my book beats these offers. This may be a bit harsh, but there is no real scientific future in my opinion if you work as a professor at a "West Coast State University" with no med school. You can easily lose your R01, even if you were able to get one, and are living constantly in fear. And you are not in a condition to collaborate with good teams to create anything meaningful, and all the students and post-docs you can get are not good enough to really do anything creative. And you get paid at most 110k as a full professor. This is the end game people.

No argument here...other than the fact that the OP said he doesn't want to do clinical work. I think this is about as good an offer as one can expect in academia these days. I got out of the game for this very reason. In fact, another friend of mine who just got his first R01 funded (yesterday) is already talking about shutting down his lab when it runs out. He's younger than me, does great science, is part of a SPORE and is tired of the bulls***.

 

[dl2dp2]

Not Emory or Duke but same tier.


It is a top (research) school but not one with a med school and it is about 2 R01s worth of startup costs so it's pretty good deal.


No argument here...other than the fact that the OP said he doesn't want to do clinical work. I think this is about as good an offer as one can expect in academia these days. I got out of the game for this very reason. In fact, another friend of mine who just got his first R01 funded (yesterday) is already talking about shutting down his lab when it runs out. He's younger than me, does great science, is part of a SPORE and is tired of the bulls***.

Huh, now that you qualified your statements, the offers actually sound somewhat decent, other than the extreme soft money coverage, which appears to be the norm now no matter where you go, which is why everyone needs a K.

Well, a lot of people say they don't want to do clinical work, but given how poor the job market is for PhDs it's almost like saying I want to be an artist and not do any other kind of work. There's so much you can give to your labor of love.

Neuronix is right though, there are pitfalls to the MD route, we can compile a similar list:
(1) 7-8 years minimum of committed training
(2) high barrier of entrance, lots of red tape, applications, pre-reqs, exams, licensure
(3) decreasing salary, though still 200k+ generally
(4) usually much more expensive, but with MDPhD this is moot
(5) long hours, relative little flexibility, though this is specialty dependent
(6) relatively little creativity is involved
(7) the actual practice of medicine has a strong business component
(8) at least during training, there are many parts that can be quite unpleasant (blood and gore if you are not a surgeon, memorization, kissing up the ladder, competition with peers, evaluations, exams, etc)

The advantages:
(1) you can almost always get a job somewhere
(2) you can almost always get a job somewhere close to where you want to be
(3) you will almost always get paid more than almost everyone else around you
(4) it's very hard to lose your job
(5) after training, your hours are usually very controllable (depending on specialty)
(6) you can often make a very direct, visceral and immediate difference in someone's life (this one is big for me)
(7) there is still a lot of social prestige, somewhat more so than being a scientist
(8) the knowledge you have is much more practical and people are interested in what you have to say

We are contrasting now the pros and cons of being a physician against the pros and cons of being a scientist. Might as well list the pros of being a scientist/researcher.

Pros of being a scientist
(1) In academic medicine, if you want to move up, you almost always have to be a researcher (or administrator, but that's a discussion for another time)
(2) you might get to address a very specific, interesting question
(3) much more creative freedom in pursuing your intellectual interest
(4) flexible hours
(5) a lot of writing and presentations
(6) more travel and collaborative opportunities
(7) respect from peers, not just society at large
(8) publication and dissemination of the knowledge you gather
(9) work is driven by specific projects, rather than by a daily list of tasks (this one is big for me)
(10) utilization of cutting edge technology, being an expert, leading a team

As you can see, all the pros of being a scientist are soft, amorphous, and depend on many things. All the pros of being a physician are hard, concrete.

I think a lot of us would commit and do science if being an average scientist has the same job security and pay as an average physician, but the reality is that the average scientist in the US is constantly fighting for survival and job security. This unfortunately changes things up quite a bit...

 

[gbwillner]

I disagree with Sloux on two of the major points he brings up as big advantages for an MD over a PhD.

First, if we are talking about academic medicine, salaries are generally NOT over $200k, especially for the common specialties like medicine, pathology, and pediatrics. Even sub specialties of medicine at academic med centers are well below that at many parts of the country. In places like NYC the pay may seem pretty good in terms of numbers, but compared to most other fields you are paid like a chump and you will actually be middle class.

Secondly, if you do want more than $200 k, the specialties that generate that kind of income are typically not the kind of job where you can work anywhere you choose. Rads, rad onc, pathology, and other specialties are very restrictive with only a few opportunities available in any particular town. You have to be much more willing to move, IMHO.

 

[Petypet]

I agree with sluox on this. I saw my share of very talented post-docs with lousy offers when I was in grad school. Your fallback as a PhD is teaching with uncommon exceptions. Your fallback as an MD/PhD is to be a clinician with uncommon exceptions. If you don't want to be a clinician, MD/PhD is not a good place to be. I guess it's a question of which fallback you prefer, but keep in mind that to get that clinical fallback you'll need to do 4 years of med school and 3+ years of residency, which is a big investment for something you don't really want to do.

Very good advice, keep in mind your fall-backs. 7 years is a long time if you don't love what you do, but if theres a chance you will enjoy it then I would recommend, as a few have, to apply to both and see where the chips fall. I didn't read all the thread, but it seemed like there was some very good advice all around, very intelligent people in this discussion.

My experience was a little more negative, coming from the PhD side of things, wishing I did MD/PhD. I entered my PhD thinking maybe I should've done medicine because I have an interest in both, but it wasn't until I realized this was a JOB, and I needed a job to support my family. As a newly minted PhD 2 years ago, I applied (with around 8 pubs, several impact factor >14) to 30 post docs (in and out of my field) and about 30 industrial jobs. Industry SUCKS right now, and while post docs are the mainstay, it is very common for you to switch fields and end up taking positions you don't love just for the sake of getting the job. Many of my peers at my PhD institution ended up taking teaching gigs at liberal arts colleges or small branch campuses, making 38-50k (range of their salaries). Some of them applied to upwards of 200 jobs, and some ended up taking technical positions at say sigma aldrich or something, answering phones. Industry is a great place for great minds, but its a risk. We had a seminar before we graduated, that entry level PhDs have like a 65-75% chance of holding 3 or more jobs within the first 5 years post graduation (I am not 100% sure of the number, its been a few years). Mind you, it is NOT easy to get a job in the same city, with exception of a few major research hubs. Similarly, I know several (n=3) 65+ year old PhDs that love research, but quit academia b/c of the BS and are basically traveling salesman for selling instruments/parts.

I am in biochemistry and was applying into pharma type research, and "entry level" jobs wanted 2-4 years post doc experience or 5-10 years industrial experience. There were a few industrial post-doc type positions that hire you once you prove that you are not an idiot, but its very competitive. The post doc I landed before starting my PhD had about 50 applicants and it was a small lab at a local children's hospital. Some of the industrial jobs easily have several hundred applicants due to the plethora of PhDs being graduated.

Certainly the PhD hadn't panned out like I had hoped, and its important that you look at the end game with what you hope to obtain with the PhD. Its not the late 1980s-1990's where PhDs were rockstars making booming salaries.

 

[acetylcholine]

I never said that I would NEVER do clinical work; I actually think I would find being a clinical geneticist rewarding, but only in conjunction with being a researcher.

 

[acetylcholine]

Let's be honest, you're all 'OH SALARIES ARE DECLINING I'M MAKING $150K AND NOT $200K' and I'm thinking 'from my perspective as someone who was originally just considering a PhD, that's comparing a McMansion to a sprawling estate'.

I'd be absolutely happy if I made just $100K as an MD/PhD. Because let's be honest, in the scheme of things, if you make above $75K you can live comfortably somewhere.

 

[acetylcholine]

TBH right now I'm just applying to LAB TECH jobs. Round 1 of applying to grad school was not successful through maybe 50% fault of my own, because half of my six programs were top 5s, one didn't get a training grant (I was told I would have gotten in if they did), one preferred its undergrad alums, and one was the bog-standard Everyone Gets Rejected From One School institution. My year off right now is essentially enforced...

Mostly I'm just scrambling, and I guess all of my thoughts on this come from the fact that the economy is so bad right now I can't even get a position as a Reagent-Pushing Lackey with my Should Probably Be In A PhD Program By Now CV. I feel humiliated, scared, and almost hopeless.

 

[uniqenam]

Let's be honest, you're all 'OH SALARIES ARE DECLINING I'M MAKING $150K AND NOT $200K' and I'm thinking 'from my perspective as someone who was originally just considering a PhD, that's comparing a McMansion to a sprawling estate'.

I'd be absolutely happy if I made just $100K as an MD/PhD. Because let's be honest, in the scheme of things, if you make above $75K you can live comfortably somewhere.

It's easy to think this when you're in your 20s, single, no kids etc. Much harder when you've got a mortgage, a marriage, undergrad debt, and a couple kids. The extra 50-100k is huge. I don't think it's very realistic to pretend that anyone is immune to the pull of money. It's pretty easy to assess your situation, and realize "dang, I worked pretty hard for the past 30+ years of my life at school, I think I deserve better than what I'm at now". 100k seems great at the age of 22, but you're not going to have a dearth of financial obligations for much longer in life.

 

[acetylcholine]

I suppose, but that would by logic make the MD/PhD more attractive than just a PhD. My own lifestyle desires (I have no undergrad student debt and am setting the process in motion to obtain permanent sterilization as I do not want children) mean it's only the mortgage and marriage I would have to deal with...

 

[dl2dp2]

Might not be quite the right place for this but maybe time to visit a mental health professional.

 

[acetylcholine]

Might not be quite the right place for this but maybe time to visit a mental health professional.

What makes you say this?

 

[dl2dp2]

"I just got my bachelor's degree and have been unemployed for a mnth. The unemployment has taken my moods to some truly abysmal places. "

"I have no undergrad student debt and am setting the process in motion to obtain permanent sterilization as I do not want children."

"I feel humiliated, scared, and almost hopeless."

While it is possible that you can make a rational and thoughtful major life decision under these circumstances, and the symptoms you are describing are transient and not impairing your functioning, what you are describing can very well be manifestations of a significant, but treatable mental illness such as depression or bipolar disorder. While it is against SDN policy to make any kind of medical advice/evaluation on this forum, my suggestion is to find a professional to talk through these issues and rule out potential complicating psychiatric diagnoses rather than (or in addition to) finding advice on the Internet.

 

[acetylcholine]

In that case, I've already beaten you to it, since I am, in fact, consulting a therapist about some very difficult life circumstances I'm navigating at the moment.