MD/PhD (SSH) Psychiatry vs. Clinical Psychology PhD

[The Cinnabon]

I asked this a few days ago in the Clinical Psych form and one of y'all gave a super insightful answer and suggested I repost this question here to get Physician Scientist Input.


As I'm drafting my SOPs (for clin psych phd) and getting my application affairs in order it has hit me that I really need to keep ruling other pathways out. One pathway that's stuck with me is the idea of doing an MD/PhD and having the PhD be a soft science such as Social Psychology, Anthropology, or Sociology (I believe all of these fields could be comparable to develop a necessary skillset for my niche that MD training alone simply can't). For reference my research interest I plan on continuing in grad school is how culture influences psychopathology presentation and cultural adaptation to assessment and treatment.

I'm a pretty research heavy guy and obviously am inclined to clinical psych research, so the PhD in Clinical/Counseling seemed like an obvious avenue. It's also occurred to me that I did do the premed prereqs (decently well in them) and a solid chunk of hospital volunteering/shadowing and could do the MD/PhD and have a very similar lab at the end of the journey with the additional research training.

I guess what I'm really trying to ask is would an MD/PhD be worth the consideration, given that physician training could allow more versatility (there are serious perks to knowing the body/medicine) in what I'm able to research, and possibly be more competitive for grants (there are labs in Clin psych that do this, very few are ran by someone with medical training who may be able to bring unique questions someone without medical training may not even know to ask).

I truly don't know how pay would factor into this, as research heavy psychiatrists aren't exactly known for brining in a lot of money in the physician world and research heavy psychologists can bring in a similar amount of money at an academic medical center.

What I'm really asking for is any considerations I'm forgetting, any misconceptions I may have, and if you yourself would entertain this pathway if you could go back in time? I truly could see myself happy doing both in the end, albeit with medical training being far more hellish.


Oh, and for folks unfamiliar with the Clinical Psychology PhD lifestyle (that is research focused) at a teaching hospital, it's very similar to a physician scientist still active and heavy into research (albeit with much lower pay in most cases).

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[phonyreal98]

I'm going to answer your question under the assumption that you are considering MD/PhD->Psychiatry Residency vs. Clinical Psych PhD->Internship->Postdoc training pathways.

Just subjectively, your research interest in your post seems to be more in line with a Clinical Psych PhD dissertation than an MD/PhD dissertation. Physician training may be more versatile clinically, but are you ok with with 75-80%+ of an MD program being unrelated to psychiatry/mental health? I knew I wanted to do psychiatry from the beginning and getting through non-neuroscience/behavioral health/mental health stuff in med school was not my idea of a good time. I did a PhD in cognitive neuroscience and the majority of my dissertation committee were trained as cognitive or developmental psychologists, so I had quite a bit of statistics and psychometrics training relative to my other MD/PhD colleagues, but very little compared to my clinical psychology PhD colleagues.

I also imagine that you imagine yourself doing psychotherapy as part of your clinical training/work either way, but you should be aware that even in psychotherapy-heavy psychiatry residencies, your training will be much less than doing a clinical psych PhD. My spouse is a clinical psych PhD, and just doing some back of the envelope math based on numbers from her internship/postdoc, she got over 3200 hours of psychotherapy training, which isn't including her practica prior to doing internship. For comparison, in my particular residency we have about a half day per week of therapy training for PGY-2 and PGY-3 years which would add up to 416 hours; even if you did therapy your entire PGY-4 year, you'd only have about 2300 hours of supervised psychotherapy training.

 

[dl2dp2]

I think you focus too much on PhD and not enough on MD. I would never do a PhD in clinical psychology because I think being a doctor is cooler personally because you get to learn about how the REST of the body works. For some people that's a bore and worse. That's your main differential.

PhD is a secondary consideration. You may or may not even do academic research after the clinical training. Most likely statistically you will not.