Spend another year in PhD-land, or return to med school stat?

[Alvacea]

MSTP student here, at the end of year 4 of grad school. I'm torn between staying a fifth year in grad school, and wrapping up now to enter clinics. I'm feeling somewhat burned out but still interested enough in science to try continuing along the academic researcher track. My committee has given me the green light to defend and graduate, but my advisor wants me to stay to finish a side project that's gaining momentum

Main reasons to stay:
- improve upon a middling publication record (basically, from one second-tier first author paper to two such papers)
- have just gotten a cool research technique to work, with potential for collaborative projects
- given that I'm feeling nervous about choosing a clinical specialty in a year, could spend a bit of the next year to shadow / explore / prepare for M3

Main reasons to go:
- dislike the scientific subsubfield I'm in; will most likely switch fields in post-doc
- have plateaued in terms of honing technical skills
- am feeling kinda old and tired at age 30 now.. itching to move on

I'm sure lots of people have grappled with this dilemma. Would love to hear your advice, especially if there are things you realized belatedly that you wish you'd known at my stage. Thanks.

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[StIGMA]

Get out right now and head back into clinic. If you still want to do research in the future (during/after residency), use the extra year at that point. You have done your duty to your PI. This is not a difficult decision.

 

[uniqenam]

Get out right now and head back into clinic. If you still want to do research in the future (during/after residency), use the extra year at that point. You have done your duty to your PI. This is not a difficult decision.

Wasn't there a thread a couple weeks ago where someone talked about a friend (or maybe themselves?) who stayed a year and got a bunch of pubs/honorariums etc etc. that thought it was worth it?

 

[gutonc]

Get out now. While it's certainly possible that you could have an amazing experience, get a bunch more pubs and maybe a grant or three, it's more likely that you won't.... Then will you be having this discussion again next year?

Just get out.

 

[gbwillner]

Your publication record will be important down the line. However, if it were me, I'd do as others suggested and just finish up and move on. You will probably still have a chance to work on the project either in med school during free time, or possibly after graduation. Given that you want to switch fields later on, there is no reason to spend another year of your life on something that won't help you directly toward your career aims.

 

[Neuronix]

Get out now. While it's certainly possible that you could have an amazing experience, get a bunch more pubs and maybe a grant or three, it's more likely that you won't.... Then will you be having this discussion again next year?

Just get out.

If you need to spend more time in research, the time you spend later as a fellow or assistant prof will be more valuable.

Wasn't there a thread a couple weeks ago where someone talked about a friend (or maybe themselves?) who stayed a year and got a bunch of pubs/honorariums etc etc. that thought it was worth it?

http://forums.studentdoctor.net/showthread.php?t=1004621

 

[Watson104]

Leave now!! You've been in science full-time for 4 years. As you know, there will inevitability be a bump or three during your 5th year that could leave you with exactly the same amount of data as you have now. Things could go amazing, too. However, the year of postdoc research will be more valuable than another year of predoc research. In science, it's mostly what have you done lately that matters.

The extenuating circumstances that most of us advocate considering taking a few more months is if you end up returning really late compared to your classmates (Nov/Dec/Jan vs July start; just wait until next July) or you have some really compelling personal life reasons (significant other a year behind or you're pregnant/have a newborn and timing would be more ideal later).

 

[debateg]

I agree with the other posters. Return to clinics now. Is it possible that you will improve your publication record enough to affect your match or long term career? Yes. Is that likely? No. Get someone else to finish up your project and be co-first authors. Win-win.

A very wise mentor of mine said that every level of training you do should foster your professional, and not technical, development. How would staying a year add to your graduate school experience in terms of developing as a scientist? If your committee gives you the OK, that means they think you don't need any more development. Move on and learn how the hospital works.

 

[Alvacea]

An update for posterity's sake -- I returned to clinics without taking another year, and it was ABSOLUTELY positively the right decision. Especially since I unexpectedly ended up applying to a surgical subspecialty. What can I say, I'm taking the scenic route to life I guess. Clinics gave me a completely different perspective on my career, and I was luckily able to find my clinical field and tribe. The match is in ten days. Thank you to everyone who took the time to drop some sage advice!

If anyone out there is grappling with the same dilemma I was, get out now. You'll be glad you did.

 

[Doye]

An update for posterity's sake -- I returned to clinics without taking another year, and it was ABSOLUTELY positively the right decision. Especially since I unexpectedly ended up applying to a surgical subspecialty. What can I say, I'm taking the scenic route to life I guess. Clinics gave me a completely different perspective on my career, and I was luckily able to find my clinical field and tribe. The match is in ten days. Thank you to everyone who took the time to drop some sage advice!

If anyone out there is grappling with the same dilemma I was, get out now. You'll be glad you did.

Just out of curiosity, do you plan on continuing bench or translational research throughout your career or have you decided to go full clinical now? Thanks for updating this for the youngins

 

[solitude]

An update for posterity's sake -- I returned to clinics without taking another year, and it was ABSOLUTELY positively the right decision. Especially since I unexpectedly ended up applying to a surgical subspecialty. What can I say, I'm taking the scenic route to life I guess. Clinics gave me a completely different perspective on my career, and I was luckily able to find my clinical field and tribe. The match is in ten days. Thank you to everyone who took the time to drop some sage advice!

If anyone out there is grappling with the same dilemma I was, get out now. You'll be glad you did.

Thanks for the update. This is a great example of how all the pre-MS3 shadowing/exploration/etc in hopes of identifying a specialty pales in comparison to actually going through MS3.

 

[RustBeltOnc]

Your update is very appreciated. I agree with everyone's advice. You were faced with diminishing returns, and still have the greatest challenges ahead of you. Staying in grad school longer is like Hermann Buhl spending even more time in the Alps: He could have gotten burned out there, and never conquered Nanga Parbat.

 

[Alvacea]

Just out of curiosity, do you plan on continuing bench or translational research throughout your career or have you decided to go full clinical now? Thanks for updating this for the youngins

I intend to continue basic science research for as long as I can do good science. The ideal eventual scenario would be running a lab in partnership with a full-time researcher. There are some inspiring examples out there of conjoint labs in which the surgeon is a true intellectual contributor and not merely a provider of tissue samples. Not very many, but they exist.

But if at any point I feel I have to give up science in order to become/remain a technically excellent surgeon, I'll do it in a heartbeat.

Clinical research has become a lot more interesting after going through MS3/4 years, and I hope to do technology/device development stuff too. On the other hand, I was stunned by the amount of CV padding that goes on in surgery. The day I start publishing stuff about the association between post-operative complications and surgeon scrub cap color is the day I will quietly take down my PhD diploma from my office wall.

 

[hopefuldoc97239]

Delaying your entry into the workforce as a physician for a year will cost you a full year of salary. You either have to give up that year of salary, or work an extra year before retiring.

If you assume you'll be making about $200,000 a year, that's about what you give up to do another year of graduate school (not quite because you are getting a stipend in graduate school, but that's not much).

Do you think it's worth giving up $200,000 to stay in graduate school for another year?

 

[Neuronix]

Shrug. Going into academics after residency for me means taking half my expected salary to start (at best) and losing millions over the first 10 years with no expectation that I would ever earn that back.

 

[Lucca]

Shrug. Going into academics after residency for me means taking half my expected salary to start (at best) and losing millions over the first 10 years with no expectation that I would ever earn that back.

Isn't the reduced salary one of the reasons the debt burden is lifted? Or are you hoping to return to academia later in your career or are you just done with it in general? Just curious.

 

[Neuronix]

My point is that you probably should never look at finances if you plan on doing serious research. Many of my classmates are looking at taking on another year of residency/fellowship vs. a mostly clinical faculty position (reminder: most "academic" or "faculty" positions are 80-100% clinical with NO lab opportunities). The finances work out to another year at ~$60k/year vs. bailing into mostly clinical practice at ~$300k/year. I'm hoping that is not my near-term fate. In my specialty, the MD/PhD debt burden relief is a drop in the bucket compared to the millions you will lose during a physician-scientist career as opposed to a clinician. That of course assumes you are even successful as a physician-scientist, despite the currently bleak prospects.

The idea that you are going to "leave academia" and come back to a serious research position is practically a myth. You can always come back to a mostly clinical gig in academics. But you never needed a PhD for that kind of position.

I still recommend that MD/PhD students spend extra time on research when it counts--i.e. when they are residents, fellows, instructors, etc and they know their clinical niche and people start caring about the research you did for major grants, faculty appointments, etc. What you did in your MD/PhD program, unless directly relevant to your clinical area, is as important to faculty hiring as what you did in high school is to medical school admissions. In most cases it just doesn't matter. Invest the time when it counts.

Now if you can spend a year skiing or scuba diving or something, yeah that's not a bad idea. Spending another year toiling away in someone's lab is going to benefit the lab's PI, but not really you.