In search of advice: PhD, MD/PhD, or something else?

[evolving_door]

Hey all, a long-time lurker and a first-time poster here hoping to glean some advice from the SDN community. Also, warning: long, rambling post

I am a recent grad looking to apply to either PhD, MD/PhD, or both sometime in the future. My stats are as follows:
3.3 cGPA from one of the top-3 liberals arts colleges
5 summers of research - three in GU pathology, two in flight biomechanics
2 publications - one middle-author in Histopathology; one first-author in the Journal of Experimental Biology
2 posters at national conferences; 1 oral presentation at a national conf.
About 100 hours of volunteer work at a medical mission abroad
2 week-long shadowing experiences
Two research-related awards from my undergraduate institution
Sigma XI nominee
Fulbright finalist (this is probably inconsequential)
Previously a contributing writer for my college's newspaper

I still need to take the MCAT, orgo II, and biochem. For the purposes of this post, assume these turn out well.
Right now I'm working as a research assistant in a top (not my words) neuroscience lab and plan to continue doing so for at least two years, maybe more. I'm simultaneously taking classes that are pertinent to graduate school and medical school (think along the lines of statistics, computer science, and chemistry).

I'd ideally like to apply to a combined (MD/PhD) program. I'm committed to a career in both medicine and science, and feel like this is the best, albeit the most competitive, route for me. However, after looking and identifying labs of interest at schools that offer combined programs, I've found very few that align with my current research interests. This may be due to my studying a relatively small and new field (motion-detecting and distance-estimation circuits in Drosophila). I encountered some labs that conduct similar research in mice, but I much, much (ad infinitum) prefer using Drosophila as a model system. Furthermore, the majority of the labs that do this type of research as located in very selective (think UWash, Columbia, Yale) or PhD-offering only (Janelia Farm - the joint program with JHU) institutions.

I doubt that I have a reasonable shot at these kinds of places with my current stats, even with additional publications (pretty much guaranteed as I am only doing independent research) and stellar grades in the undergrad and grad classes I'm taking. This leaves me with four conceivable options: a) apply to MD/PhD programs; b) just PhD; c) both at the same time; d) apply broadly to MD/PhD programs and settle with doing research in a field I am not particularly interested in.

To me, working and completing my dissertation in a field and lab that I am 100% committed to is far more attractive than biting the bullet and matriculating into a program that I am lukewarm about just because I'll get both degrees at the end of the (long) road. Where (the type of lab) I might do research is far more important than where I receive my medical training (all medical schools have a similar curriculum).

To this end I am most strongly considering applying to PhD programs first, and then any MD (including specialized PhD-to-MD) programs after I receive my degree. I have also entertained the idea of applying to both PhD and combined programs at the same time to hedge my bets. I do not want to apply to MD-only programs first because I want to continue my research pretty much immediately after I conclude my assistantship. I also do not feel that my resume is currently geared towards MD-only programs. Again, I am committed to a career as a physician scientist, but research is definitely my priority.

Of course I also realize that getting into PhD only programs at selectives places is no easy feat, especially with my stats, but I've been reassured by multiple PI's in my field that my application is competitive, and that graduate school places greater emphasis on actual research credentials because grades are only a proxy for this metric. Perhaps this is misguided, but from these experiences I tend to feel I have a better chance at PhD-only than MD/PhD programs, hence my consideration of a non-traditional route.

TL;DR: I need advice. Should I continue with my current line of thinking? Should I stop being so picky and just apply broadly to MD/PhD programs? Should I reconsider the "MD first, leave of absence for PhD, then finish MD" route? Should I drink some water and calm TF down??

All advice welcome!

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[Gorilla-san]

Although your GPA is on the lower end of the spectrum it definitely does not disqualify you from a competitive MD/PhD program(in my humble opinion). Assuming you do well in your classes and get a really high MCAT >90th percentile (you use this to make up for your GPA) you should be in a competitive spot given the rest of your credentials. For a PhD program your pretty competitive already given your research experiences as other PIs have noted.

 

[eteshoe]

What is your long-term career goal? I'm asking since your research interests are so niche

 

[evolving_door]

Although your GPA is on the lower end of the spectrum it definitely does not disqualify you from a competitive MD/PhD program(in my humble opinion). Assuming you do well in your classes and get a really high MCAT >90th percentile (you use this to make up for your GPA) you should be in a competitive spot given the rest of your credentials. For a PhD program your pretty competitive already given your research experiences as other PIs have noted.

Thanks for the vote of confidence, Gorilla.

What is your long-term career goal? I'm asking since your research interests are so niche

My end goal (not 100% sure on this) is to specialize in something cognitive, maybe neurology or neuro-ophthalmology, and run a lab where I can teach and study systems neuroscience, most likely on visual processing/sensorimotor integration. I'm not really planning on doing any clinical or strictly translational work, though my stance may change with time. Basically I'm interested in similar things (how the nervous system controls, and ailments of, sensory/motor circuits) in both clinical and basic science contexts.

 

[floured]

I am convinced that you want the PhD, but what are your reasons for pursuing the MD? You say:

I'm not really planning on doing any clinical or strictly translational work

So what is the point of getting the MD?

 

[eteshoe]

Thanks for the vote of confidence, Gorilla.



My end goal (not 100% sure on this) is to specialize in something cognitive, maybe neurology or neuro-ophthalmology, and run a lab where I can teach and study systems neuroscience, most likely on visual processing/sensorimotor integration. I'm not really planning on doing any clinical or strictly translational work, though my stance may change with time. Basically I'm interested in similar things (how the nervous system controls, and ailments of, sensory/motor circuits) in both clinical and basic science contexts.

What you've described doesn't really sound as if you need the MD. I know plenty of basic scientists in clinical departments. I say this because if you do the dual degree pathway, it'll be expected that you want some clinical portion in your future career (though understandably not everyone goes further w/ their clinical training). The med school part can be tough (not impossible) if you don't intend on using it in the future.

The only gripe I'd have in suggesting someone such as yourself pursues the non-trad MD/PhD is that if you manage to get through med school (after the PhD), you're pretty much going to have to go on into residency (even if you don't like medicine that much) since you'd have incurred the heavy debt burden associated w/ med school. The dual degree at least affords you the option but it would be 8-10 yrs long and it may be tough to get into some of the more selective MSTPs that have the research you're after. You could of course relax your criteria parameters and focus on the place that would provide the best training close to what you want to do and later do a Postdoc or research yrs during residency and/or fellowship in the area you'd most likely want your lab to focus on (which will most likely change after 15 yrs).

 

[evolving_door]

I am convinced that you want the PhD, but what are your reasons for pursuing the MD? You say:

So what is the point of getting the MD?

What you've described doesn't really sound as if you need the MD. I know plenty of basic scientists in clinical departments. I say this because if you do the dual degree pathway, it'll be expected that you want some clinical portion in your future career (though understandably not everyone goes further w/ their clinical training). The med school part can be tough (not impossible) if you don't intend on using it in the future.

The only gripe I'd have in suggesting someone such as yourself pursues the non-trad MD/PhD is that if you manage to get through med school (after the PhD), you're pretty much going to have to go on into residency (even if you don't like medicine that much) since you'd have incurred the heavy debt burden associated w/ med school. The dual degree at least affords you the option but it would be 8-10 yrs long and it may be tough to get into some of the more selective MSTPs that have the research you're after. You could of course relax your criteria parameters and focus on the place that would provide the best training close to what you want to do and later do a Postdoc or research yrs during residency and/or fellowship in the area you'd most likely want your lab to focus on (which will most likely change after 15 yrs).

Oh, sorry, I realized I made a gigantic typo in my first response. I meant to say "I am not interested in clinical research" rather than "work." I am definitely interested in clinical work, otherwise I wouldn't bother pursuing medical training!

On the clinical side, I am primarily interested in working with patients who have experienced problems with their visual system. I'm thinking along the lines of retinotopic and motion perception defects, as well as diseases that affect eye and pupil control - basically all types of problems that affect vision and are neurologically based. I also have noticed that there is an overlap in thinking and approach in the field of basic science I'm interested in and neuro-ophthalmology (for example, designing and interpreting psychophysical tests). Essentially, I feel like I'd be able to directly apply my experience in the lab to the clinic, and vice versa, to directly and indirectly affect patient health and our knowledge of how the visual system works.

I think that dual-degree option makes the most sense to me, but as it's been mentioned, it'll be difficult to gain admission to places that house the labs I'm most interested in. The non-trad route, in this sense, is definitely more of my plan B, but I think one caveat is that I would like to be able to pursue research during the summers of medical school because a 4 year drought without research would probably make it a hurdle to re-enter my field. If this is impossible then I might just derestrict my selection criteria for MD/PhD programs.

 

[floured]

If you are determined to get the MD, I would go ahead and take the MCAT and then reassess your options. Scoring very well will remove any doubts about being competitive for top programs as you already have very strong research. I was in the same boat a couple months ago when I started applying. My research is also in a small (and extremely expensive) field that only occurs at a select few schools (UCSF, Harvard... ), but I went in with an open mind and applied broadly. I think you should keep your options open in terms of research fields, especially if you are just graduating university. I am confident that any reputable MSTP program will have a lab that you will be interested in.