Anyone want to share their perspective as a non-traditional MD/PhD (late 20s to early 30s)?

[Corgisforlife]

Hello,

I am thinking of applying MD/PhD (Bioengineering) at age of 28-29. So probably end up being around 36-37 when I start residency.

-Can any non-traditional MD/PhD give me some perspective on how life is like as a MD/PhD?
-Are you able to start a family?
-Are you able to occasionally go out?
-Are there any problem with money considering residency ends in your 40s?(Can you live off with just the stipend you're given? Or did you end up with taking up some loans? If so how much loan did you end up with at the end?)
-At what age is it really too old to start MD/PhD with the consideration of wanting a kids? (I'm guy if that matters)
-After residency, did you continue clinical work before jumping back into research? (if so for how many years?)

(Not really non-traditional related but...)
If you have a MD/PhD, with bioengineering as PhD, was it worth it?
What did you do after finishing?
Do you require undergrad degree in engineer to go into PhD for bioengineering? (saw in some thread you can, but what I really want to know is if taking PhD in bioeng. w/ out prior engineering education would be doable?)

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[Dullhead]

I'm just a non-trad pre-med, but curious about a few things, so a few questions for you:

- Why MD/PhD. Why not just MD? Why not just PhD?
- Have you been involved in research in the past? And currently?
- What's your life-goal that only an MD/PhD will make possible? (Invent something, cure cancer, etc)

 

[Corgisforlife]

Well, to answer the first and third question, I want to do research, and create new technology that will improve our medical field and everyday life. I have two reasons for wanting to do MD; I want to be able to help people(treating patient hands on either in sports med, surgery, psych), and I want to learn everything about the human body. This will give me the knowledge to create new/improve old technology; leading to possibly improving many people's lives. My reason for the PhD in bioengineering is it will help me create such technology.

For MD I have an interest in sport medicine (through PMR,FP or Ortho), PMR in general, neuro/ortho surg(probably not going to pick that if I consider MD/PhD) and psych. I want to do research(in creating/inventing/improving aspect) in human musculoskeletal system, nanotech, prosthetic organs/limbs, neurology finding ways to help people improve rehabilitation, ways to improve/heal paralysis and such.

To your second question, I just started going back to school, but I've applied to a bunch of research programs for the summer.

 

[StIGMA]

If you do not want to practice medicine then don't get the MD. It will be 4-10+ years of education for negligible benefit. You dont need an MD to develop technology that impacts the human body. You could consider some background in physical therapy if you really want some background/patient interaction (~3 years).

You won't be able to 1) have a medical practice and 2) create new technology that improves the medical field. You will be able to do one and do a little bit of the other (ie: practice medicine and consult/tinker with bioengineering stuff- but then you don't need to invest into a PhD for that).

The time/benefit ratio medical school/residency does not make sense for what you are proposing (~10 years for not much knowledge in your field when you will be working alongside the MD's anyways in developing your ideas).

You will hate living like a college student in your 30's/ early 40's and not have much free time. Older students (28+) are at the highest risk of dropping out of MD/PhD programs (generally drop the PhD).

 

[Transgenderinmedicine]

I notice there is always a lot of hate toward MD/PhD students on these boards and I don't understand why. Everyone is always questioning their motives. If the person wants to pursue an MD/PhD at 28 yrs old then more power to them. They are more mature than any incoming MD/PhD student who is 22 with minimal research exposure. I have a friend who was just accepted into an MD/PhD program and shes in her late 20s, single mom with a kid and couldn't be happier. I think if you have a fleshed out idea of your future career that best incorporates both degrees than that's amazing. Go do it and don't let anyone sway you away from it on here. I am rooting for you.

 

[URHere]

I notice there is always a lot of hate toward MD/PhD students on these boards and I don't understand why. Everyone is always questioning their motives.

It's not hate.

This forum is specifically filled with MD/PhDs who have experienced the doubt, uncertainty, and delayed gratification that comes with this program. We tend to grill people about their motives because it's not an easy path (even for people who want an MD/PhD for all the right reasons), and we don't want anyone to be miserable because they haven't thought things through fully. Please note that I say this as someone who is very happy to have gone through an MD/PhD program, and is a big advocate for the dual degree.

With respect to the original question, I can't answer fully because I wasn't a non-trad when I started this program. I can say that most of my MD/PhD classmates were in their late 20s when they started. They were all men and they almost all had children by the time they reached the end of the program. They find time to attend beer socials with the rest of the group at least once a month, and they don't seem to regret their decisions. Without being in their shoes, I can't really tell you anything else.

Regardless, it sounds like the original poster still needs a few years of research experience before MD/PhD is even a remote possibility. Enjoy those years and use them to figure out if this is the right path for you.

 

[StIGMA]

I notice there is always a lot of hate toward MD/PhD students on these boards and I don't understand why. Everyone is always questioning their motives. If the person wants to pursue an MD/PhD at 28 yrs old then more power to them. They are more mature than any incoming MD/PhD student who is 22 with minimal research exposure. I have a friend who was just accepted into an MD/PhD program and shes in her late 20s, single mom with a kid and couldn't be happier. I think if you have a fleshed out idea of your future career that best incorporates both degrees than that's amazing. Go do it and don't let anyone sway you away from it on here. I am rooting for you.

I am an MD/PhD student. I think most people are happy when they get their acceptance. Advice is advice. I don't know why you took what I wrote as negative unless you have an axe to grind. I gave my perspective as an older MD/PhD student. It sucks being a student at 30 when most people you know are starting families, etc., and you still have around a decade to go to be employed. I answered with my perspective as to whether it would be worth it to the OP or not; based on what he wrote (not your friend who I know nothing about) I think one degree or the other would be a better choice. Do you have an informed opinion to advise the OP? Someone who hasn't started or is just starting MD/PhD training cannot "have a fleshed out idea of your future career that best incorporates both degrees." (Unless you can predict science/biomedicine research, funding climate, etc. 15 years in the future including your future desire to still do that). That's the point.

 

[Corgisforlife]

Thanks for the replies!

I have no problem with the idea of finishing when I'm in my 40s if it's something I really want to do. The idea of living poorly during my 30s is fine; been doing it my whole life.

Yes, I know I still have a lot of thinking to do before making a decision; mainly why I posted here. Your replies will definitely help me make my decision easier later on (at least some aspects of it). I still have 2-3 years; I will probably know after doing a few researches, and when I am closer being done with my undergrad.

Thanks again

More input on this matter would be awesome!

 

[Ariodant]

As others have said, you don't need an MD if your main career focus is creating new technology. If you don't see yourself treating patients, don't bother with an MD. Teaming up with physicians to test your technology is perfectly fine.

Your perspective will change dramatically once you have a family. Unless your spouse has significant earning power, you will likely run into problems you may not even be aware of at your current age. Perhaps your spouse is OK living with your paltry stipend, but what about your kids? Are you OK with not being able to afford nannies, daycare, better living conditions, living in a safer neighborhood, a larger car for transportation, etc.? Little kids run into trouble constantly, do you have funds in case of a medical emergency? Those are only a few things off the top of my head, I'm sure someone who actually have children can list more.

 

[Corgisforlife]

I definitely want to treat patients too, 100% want to.

Hmmm... Yea, I'll probably need the money if I start a family. How do medical students who starts a family during medical school handle their financial problems? Do they take out more loans? Would I be able to take out loans if that were to happen?

 

[Neuronix]

I notice there is always a lot of hate toward MD/PhD students on these boards

Nobody hates MD/PhD students on this forum. We are MD/PhDs and we don't hate ourselves.

Everyone is always questioning their motives. If the person wants to pursue an MD/PhD at 28 yrs old then more power to them. They are more mature than any incoming MD/PhD student who is 22 with minimal research exposure.

Maturity has nothing to do with it. I've seen a lot of misconceptions about MD/PhD over the years. It is proper advising to make sure potential applicants have good reasons for wanting to do MD/PhD before investing time and money to apply. This is over a decade of training including residency, and should not be entered into without thorough introspection.

I have a friend who was just accepted into an MD/PhD program and shes in her late 20s, single mom with a kid and couldn't be happier.

I'm very curious who will be raising that child. It's impossible to afford daycare and living expenses on an MD/PhD stipend. Even if you did have family money to support you, the hours at times are so irregular that daycare isn't an option.

I think if you have a fleshed out idea of your future career that best incorporates both degrees than that's amazing. Go do it and don't let anyone sway you away from it on here. I am rooting for you.

The problem with life is that people in charge have to agree with your plans. You can figure things out all you want, but if nobody agrees with you, then you won't acheieve your professional goals. Think of us as a kinder and gentler version of an interview.

 

[Transgenderinmedicine]

I apologize I don't mean to cause any drama. I am an MD/PhD applicant and whenever I personally talk about it I usually get a lot of aggressive questions from people. I just noticed that what Stigma was saying was all negative things and didn't mention any good prospects of actually aplying to MD/PhD programs. That is all. Again I aplogize. My friend is who is currently doing her MD/PhD is doing very well and does have day care at the moment. She is a first generation college student like me and so I am very very proud of her and her achievements. I only post on SDN sparingly, but mainly read posts for advice

 

[tr]

I notice there is always a lot of hate toward MD/PhD students on these boards and I don't understand why....
I just noticed that what Stigma was saying was all negative things and didn't mention any good prospects of actually aplying to MD/PhD programs.

Don't mind us over here. We're all just old and bitter because spending 7/12/15 years in postcollege training will do that to you. Oldies are extra bitter because now we can't get jobs doing what we trained for. But, yanno, don't let us bring you down.

 

[StIGMA]

I usually get a lot of aggressive questions from people. I just noticed that what Stigma was saying was all negative things and didn't mention any good prospects of actually aplying to MD/PhD programs.

Again, I am an MD/PhD student (post-PhD, and I would re-choose this path again if given the option at this point). Second, I thoroughly encourage and actively promote MD/PhD program consideration among people considering MD/PhD programs (generally in person, not on the forum). Third, I always mention as many downsides to MD/PhD program as I can, because you cannot make an informed decision unless you know the downsides. People figure out the upsides on their own just fine.

 

[Transgenderinmedicine]

I'm curious why is it so difficult to find jobs? Is it due to funding or something else? That's unfortunate to hear that I'll be spending so long in school and walk out on the other end without the job I intended. I currently have a masters and have spent around 3.5 years working on the same project so I am aware of the trials and tribulations the go along with basic research, but I would hate to come out of all of this with a lackluster career. i know a few older physician scientists who have made it work, but maybe they just got lucky?

 

[tr]

I'm curious why is it so difficult to find jobs? Is it due to funding or something else? That's unfortunate to hear that I'll be spending so long in school and walk out on the other end without the job I intended. I currently have a masters and have spent around 3.5 years working on the same project so I am aware of the trials and tribulations the go along with basic research, but I would hate to come out of all of this with a lackluster career. i know a few older physician scientists who have made it work, but maybe they just got lucky?

I think it was always very competitive but funding has gotten much tighter in the past few years. People who landed their first faculty jobs prior to 2009 or so may have had it slightly easier than it is now (though it was never easy per se). Several senior people have said to me that this is about the tightest funding situation they have seen.

That said, it's pretty much impossible to guess what the funding situation might look like 14-15 years from now when you would be looking for your first faculty job. It could well be much better than it is now. When I was applying to MSTPs in 1999 the NIH was flush and pouring cash into science.

 

[gutonc]

I'm curious why is it so difficult to find jobs? Is it due to funding or something else? That's unfortunate to hear that I'll be spending so long in school and walk out on the other end without the job I intended. I currently have a masters and have spent around 3.5 years working on the same project so I am aware of the trials and tribulations the go along with basic research, but I would hate to come out of all of this with a lackluster career. i know a few older physician scientists who have made it work, but maybe they just got lucky?

Yes it's the funding...check out the paylines on R01s these days. As an example, for 2013, NCI paylines were at 9% with 12% of new investigator grants funded...12%, that's 1 out of every 8.5 applications that got funded. Imagine having to write 9 different grants just to get one funded. I quit after 6...perhaps the next 2 or 3 would have broken through...but F*** it.

But it's not just the funding. Or rather, it's not just the outside funding issues.

The academic medicine world has changed dramatically, even in just the last 10 years that I've been paying attention (which encompasses my M3/4, residency, fellowship including post-doc and faculty position). The days of soft money and institutional slush funds to support non-clinical work are essentially over. In many cases these days, in addition to the formal training timeline for your specialty, you're looking at 2-5 years as an adjunct/instructor before you get a tenure track position. And you're only going to get protected research time if you come with your own money for that time. I have friends with first author papers in Blood, Cancer Cell, Nature Medicine and Cancer Research and K-level grants, who are struggling to find TT spots 2 and 3 years after finishing training.

So...is it possible to have the kind of career you envision for yourself? Absolutely, and if that's what you really want to do then go for it...you definitely won't have it if you don't try. But the numbers are not on your side so you should absolutely set yourself up with an escape plan if things go sideways.

 

[Neuronix]

This forum is specifically filled with MD/PhDs who have experienced the doubt, uncertainty, and delayed gratification that comes with this program.

Plenty of doubt and uncertainty here. I'm still waiting for the gratification.

i know a few older physician scientists who have made it work, but maybe they just got lucky?

Mid-2000s is when funding abruptly stopped growing. It has been flat (arguably losing against inflation) ever since. In the 1990s and early 00s we were training a new, expanding generation of scientists. Then the wall hit. Now there's a huge glut of jobless or minimally employed PhDs competing for grants. Gutonc accurately describes the current environment. The "older" physician scientists likely started their careers when funding was growing. It's easier to sustain a career as a physician scientist than to start one. For new investigators starting in an area without funding growth, the environment is bleak.

I think it was always very competitive but funding has gotten much tighter in the past few years. People who landed their first faculty jobs prior to 2009 or so may have had it slightly easier than it is now (though it was never easy per se). Several senior people have said to me that this is about the tightest funding situation they have seen.

2009? Meh, try 2001. http://nexus.od.nih.gov/all/2013/09/24/one-nation-in-support-of-biomedical-research/

I remember faculty complaining about funding rates in the 40% range in the 90s. Also many training pathways have gotten longer since the 90s. E.g. MD/PhD programs have gotten longer, residencies have been adding years, fellowships have become more common, and now the limbo time of "instructor" or extending fellowship/post-doc level positions are common for MD/PhDs whereas they barely even existed existed before.

The academic medicine world has changed dramatically, even in just the last 10 years that I've been paying attention (which encompasses my M3/4, residency, fellowship including post-doc and faculty position). The days of soft money and institutional slush funds to support non-clinical work are essentially over. In many cases these days, in addition to the formal training timeline for your specialty, you're looking at 2-5 years as an adjunct/instructor before you get a tenure track position. And you're only going to get protected research time if you come with your own money for that time. I have friends with first author papers in Blood, Cancer Cell, Nature Medicine and Cancer Research and K-level grants, who are struggling to find TT spots 2 and 3 years after finishing training.

I know you already know this, but for the young and impressionable out there, there are a few factors.

First, all these "soft money" sources and slush funds were previously used to support promising new investigators or investigators who lost funding to bridge over to new funding sources. Now the expectations for success are so low that few are willing to invest in you. By investments I mean your salary, protected time to do research, startup packages for your own lab... These are now all very difficult to actually obtain.

Second, departments have less money for a variety of reasons. Declining reimbursement pressures for clinics have been a problem, lowering the overall revenue for the department that researchers could get a piece of. Further, academic medicine is becoming more of a competitive, revenue-generating business to support an army of mid-level administrators and hospital managers, and so the mission of academics gets further diluted.

 

[gbwillner]

I think it was always very competitive but funding has gotten much tighter in the past few years. People who landed their first faculty jobs prior to 2009 or so may have had it slightly easier than it is now (though it was never easy per se). Several senior people have said to me that this is about the tightest funding situation they have seen.

That said, it's pretty much impossible to guess what the funding situation might look like 14-15 years from now when you would be looking for your first faculty job. It could well be much better than it is now. When I was applying to MSTPs in 1999 the NIH was flush and pouring cash into science.

Funding + lower clinical reimbursements across the board leave little wiggle room or patience in budgets to let you tinker with science in their shrinking budgets.

 

[ratherbefishing]

To OP. If I had started at 30 and had the same issues come up during my MD/PhD, I would have quit the PhD.

 

[Corgisforlife]

To OP. If I had started at 30 and had the same issues come up during my MD/PhD, I would have quit the PhD.

If you don't mind me asking; what age did you start on your MD/PhD?

 

[RustBeltOnc]

Corgisforlife:

When I encounter the occasional youth who asks about MSTP programs, I don't discuss career possibilities per se or paylines with them.

What motivates you? Would you derive satisfaction from asking /answering basic science questions? Would you find existential reward in pushing yourself to investigate, write, even if in regards to "negative results"? Are you also excited about clinical medicine and its attendant problem solving? Are you excited about biting off all this to chew even if it compromises your career prospects? In a phrase, is it that you cannot help yourself?

If the answer is yes, then the answer is yes, and this person will find a way to complete and benefit from the program.

The problem with starting in your late 20s is, life has a way of blunting this very helpful, blind enthusiasm.

 

[dl2dp2]

Starting MDPhD in your 30s is a really bad idea. I would do an MD only and go from there.

 

[Fencer]

Every year, we have 610 - 640 students beginning their MD/PhD in all programs in the country. Typically, only 5 (or less) are students matriculating in the program with of age 30 or older. I don't know how many applicants are age 30 or older, but there are very few of them.

 

[beekle]

Corgisforlife: Have you given any thought to an MD/MBA? I started an MD/MBA at 29 and it occurs to me that alot of the goals you mention - improving people's lives, developing new technologies, etc. - can be achieved through this route as well, only a few years faster. Even if you decide the MD/PhD is right for you - stick with it. You're gonna be old someday soon no matter what - better to get where you want to be late than not at all. Take all the stuff you hear on here with a couple of grains of salt - including this.

 

[Corgisforlife]

Wow, thank you for all your inputs. I really appreciate it. I don't think I would go for MD/PhD if I was in my 30s, but I may consider it if I'm younger than 30.

I will definitely remember to ask all those questions right before I apply; right now I would answer yes to all of them.

I actually never thought about MD/MBA; I going to look into that. Is it possible to switch from MD/PhD to MD/MBA?

 

[beekle]

Not sure you can switch from an MD/PhD to an MD/MBA or if you'd want to - best to do your homework and know what you want going in. Make the big decisions in your life slowly and in advance.

Added selling point: some MD/MBA programs are done in 4 years - i.e. Tufts. Look into it.

 

[gbwillner]

Corgisforlife:

When I encounter the occasional youth who asks about MSTP programs, I don't discuss career possibilities per se or paylines with them.

What motivates you? Would you derive satisfaction from asking /answering basic science questions? Would you find existential reward in pushing yourself to investigate, write, even if in regards to "negative results"? Are you also excited about clinical medicine and its attendant problem solving? Are you excited about biting off all this to chew even if it compromises your career prospects? In a phrase, is it that you cannot help yourself?

If the answer is yes, then the answer is yes, and this person will find a way to complete and benefit from the program.

The problem with starting in your late 20s is, life has a way of blunting this very helpful, blind enthusiasm.

This is sage advice.

 

[L72521]

I started a family during my MD/PhD. The finances are going to differ from person to person though. My wife has a job and draws a middle-class salary, so we are able to afford child care. Without reliable child care, I think it would be extraordinarily difficult if not impossible. My short answer would be -- if your spouse has a regular job, it's doable. If your spouse is an MD student or MD/PhD student, it would be almost impossible to start a family during school.

You can certainly go out occasionally during an MD/PhD. Especially during the PhD time. Academic research is time-intense but often very time-flexible at the same time. In other words, you need to spend a lot of time on it, but it doesn't matter when you spend much of that time--you can do it during a 9-5 work day, or you can come in on weekends or in the middle of the night if you want to. If you want to go out for a drink with a friend at happy hour, you can often come in an hour earlier that day and start your experiments so that you can finish early and go out. This will depend on whom you choose to be your thesis adviser--some are less flexible than others--but if you're productive in the lab, most advisers are not going to care when you're producing.

That said, you will probably only be going out very occasionally if you start a family. Hard to take a baby with you, hard to pay for a babysitter to go out. But this is true regardless of whether you are an MD/PhD or not.

 

[phonyreal98]

Nobody hates MD/PhD students on this forum. We are MD/PhDs and we don't hate ourselves.

You sure about that?

 

[Neuronix]

You sure about that?

Yes. I know you're kidding. But my serious opinion is that you have to have a strong neutral to positive sense of self as a physician scientist trainee. Positive feedback or tangible rewards are incredibly difficult to come by during the twenty or more years of training and establishing your career.

 

[chuck84]

I'm an MD/PhD that started at 27. I'm about halfway done with a house, wife and 1 year old kid. It's definitely doable, I really enjoy the program, and I'm fine finishing up around age 35. Probably my biggest complaint is money. I have to take out loans for daycare and we're living paycheck to paycheck. I'd image it would be easier if you lived near family to help with kid stuff or if your significant other had a decent salary.

 

[Fencer]

I started a family during my MD/PhD. The finances are going to differ from person to person though. My wife has a job and draws a middle-class salary, so we are able to afford child care. Without reliable child care, I think it would be extraordinarily difficult if not impossible. My short answer would be -- if your spouse has a regular job, it's doable. If your spouse is an MD student or MD/PhD student, it would be almost impossible to start a family during school.

You can certainly go out occasionally during an MD/PhD. Especially during the PhD time. Academic research is time-intense but often very time-flexible at the same time. In other words, you need to spend a lot of time on it, but it doesn't matter when you spend much of that time--you can do it during a 9-5 work day, or you can come in on weekends or in the middle of the night if you want to. If you want to go out for a drink with a friend at happy hour, you can often come in an hour earlier that day and start your experiments so that you can finish early and go out. This will depend on whom you choose to be your thesis adviser--some are less flexible than others--but if you're productive in the lab, most advisers are not going to care when you're producing.

That said, you will probably only be going out very occasionally if you start a family. Hard to take a baby with you, hard to pay for a babysitter to go out. But this is true regardless of whether you are an MD/PhD or not.

It also depends a lot on the program and the cost of living of the city where you live. We had our 2 kids during my PhD phase, and it worked out with only my stipend. My program has similar set of circumstances, partly created by my own experiences. We have 24% of our students with kids (from MS1 to MS4). Time & money management skills are key (living within your means) but having the support of your partner is the most critical step for a clinician scientist.

 

[Neuronix]

The federal poverty level for a family of 4 is $23,550. MD/PhD stipends are at this level or minimally above. The benefits typically suck, which continues into residency but at least the salary is higher. Is it possible to have a family of 4 on this income? Sure, but it's difficult even in cheaper parts of the country. It's going to be very difficult without extended family assistance or some supplemental income (either from family or prior savings) to raise a family anywhere in the USA on that income. You could potentially put your spouse to work, but it's going to be hard for them to make enough to justify the cost of full-time child care, particularly for more than 1.

To put it in perspective, even rookie truck drivers make at least $40,000/year. My cousins who started working construction around the age of 20 and managed to keep their drug habits under control have been making on the order of $100,000/year for years now. Where I currently live, I'd have a lot of concern for my family's safety raising them on an MD/PhD salary, and this is in a cheap part of the country.

 

[L72521]

In light of @Neuronix comments, I reiterate that it would be difficult in most markets without wage support from your spouse or other family member to raise a family as an MD/PhD. You don't really get to choose the city that you do your MD/PhD in unless you are so extraordinarily gifted a candidate that any program would take you. That said, you could certainly place as many applications as possible in less expensive cities.