Applying to both MD-PhD and PhD

[Rubipy3]

I'm currently in the process of applying for MD-PhD programs for Fall 2014, but I've also been considering applying for the PhD alone at some institutions. This realization came from a conversation with a professor who applied to both some forty years ago and had to decide between two offers, one MD-PhD, one PhD in April of his Senior year. Its not that I am having second thoughts about pursuing an MD, but after looking comparing the research opportunities available at lower MD-PhD programs to top grad programs, I realized that my chances for a productive fulfilling research career are better at some places than others.

I've signed up for the GRE and I've chosen a few places to apply, but the question is will MD-PhD programs care if I'm also applying for a PhD alone [to the same institution]? It seems like applying MD/MD-PhD is almost expected, but would applying PhD/MD-PhD be seen the same way?

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[cpi89]

My opinion on the matter would be that the MD PhD pathway is a hefty commitment. Thus, if you aren't 100% committed (that is, you would be just as happy doing a PhD), you should consider whether applying to MD PhD is worth it for you. How do you envision your future career? It seems like you are very interested in the PhD, how will you use the MD? That's probably what a program is going to ask you if they catch wind of the fact that you applied for the PhD only.

 

[dl2dp2]

My general opinion is that if you are considering MD/PhD vs. PhD only, drop the PhD only. It's not a matter of commitment but a matter of practicality. The consideration is usually a top 50 MD/PhD vs. a top 5-10 PhD. In my experience, the former has consistently outperformed the latter in terms of the latitude of careers available, salary potential, and if desired, scientific future. My impression is that it is yet easier to get into a top residency in a cognitive specialty from a top 50 MSTP than a regular MD from a top 10 medical school. This may change. I don't have a crystal ball.

This (i.e. the fact that an MD/PhD from a top 50 school is often substantially more marketable than a PhD from a top 5 school), by the way, is also reflected in the labor market. In the past 10 years, the competitiveness of all of the NIH MSTPs have grown significantly, even though they expanded in size. The PhD programs, however, are probably now LESS competitive than they have been in the past. Students are not idiots. They see and hear and make choices.

The party line is that all of the NIH funded MSTPs in the country are quality programs, and can likely train you into a successful physician scientist if all other variables are equal. PhD programs, however, the same cannot be said at all. Your ability to hustle and stay afloat in a competitive, hostile environment and yet still develop a community of mentors and peers who like you and support you will be extremely important in that case. I would say if you can't get into a top 5 program or a world famous laboratory in your field, a PhD in biological sciences in the US is a very risky proposition right now. And even if you could, you need to realize that you are jumping into a potentially dangerous career. Given that R01s have a funding rate of 10%, you are applying to get into Harvard every 4 years. For the rest of your life. Without a cushion of practicing medicine on your back. Think about that.

The only reason to choose PhD only over MD/PhD is if you absolutely positively cannot stand the thought of becoming a practicing physician. I have very rarely met people graduating from MD/PhD who regretted doing the MD, even if they decided to not practice medicine at all. I've met a handful of PhDs who are trying desperately to get back into medical school. In their 30s. With kids. DESPERATELY. Be very very careful.

 

[Neuronix]

after looking comparing the research opportunities available at lower MD-PhD programs to top grad programs, I realized that my chances for a productive fulfilling research career are better at some places than others.

You are looking at this wrong. After the MD/PhD program, you will spend 5+ years in residency and fellowship. Exactly what you did for your PhD stops mattering. What matters when you come back to research is where you are at for fellowship, and your ability to get things done as a fellow and junior faculty. Those are more related to the institution for fellowship/faculty, your training, and your own drive. Your ability to get the top residencies and fellowships are also more based on your medical school performance than your graduate school performance.

I've signed up for the GRE and I've chosen a few places to apply, but the question is will MD-PhD programs care if I'm also applying for a PhD alone [to the same institution]? It seems like applying MD/MD-PhD is almost expected, but would applying PhD/MD-PhD be seen the same way?

PhD and MD/PhD are completely different. As an MD/PhD you will spend many years, probably 10+, committed mostly or entirely to clinical work. If your backup to MD/PhD is a PhD, your commitment to medical school and residency will be seriously questioned. If your concern is that you're not a strong enough applicant for MD/PhD, that's one thing to have a backup. The backup is typically MD only, but you could make an argument for PhD only. If you have a strong application and you're saying that you'd only attend a top 10 MD/PhD program, or I think that's what you're saying, then I would reject you without a second thought.

Otherwise sluox is exactly right. An MD from a bottom tier medical school has far better job prospects than a PhD from a top tier PhD program in biomedical sciences. Unless you are certain you don't want to be a doctor or you just can't get in to medical school, you shouldn't be applying PhD only. If you're certain you don't want to be a doctor, you shouldn't be applying MD/PhD. But of course you're probably about 21 years old, which means you aren't certain about anything 10 years from now, so apply MD/PhD to a range of programs and move on with life.