Undergrad thinking of MD/PhD

[JuniperTree]

Hi,
Due to my interest in research, I've been aiming towards a PhD in psychology. I thrive on the entire research process - conceptualizing, coordinating details, collecting data, and writing.
Would an MD/PhD program be right for me?

Pros:
- Love science (in psychology, would go into biopsychology or neuroscience)
- Guarantees a job at the end with a life of research
- Guarantees to earn enough money to put food on the table
- No worries about what to do if I don't get into grad school, and if I do get into grad school, being funded

Cons:
- Background in the sciences unrelated to psychology in some way is nonexistent although I'm planning to take 'Biology for [biology] majors' next semester.
- Adds a year to my undergraduate and I'm a junior aged 21
- Have very little research experience, all in psychology so far, and no contacts in the MD/PhD field
- Takes 4-5 years more than a PhD in psych

I appreciate any and all advice.
JuniperTree

---

Members don't see this ad.

 

[tortuga87]

Hi JuniperTree,

I also studied psychology in my undergrad (preferred the bio side of things) and thought of those reasons. I wanted to become a clinical psychologist before college, but I ended up picking the MD/PhD because of your reasons and also because better research funding and better interactions with patients (through therapy & medication)

If you decide to do an MD/PhD, you should think about going into cognitive neuroscience rather than biopsychology even though they are pretty much the same thing. I have to say though... molecular and computational neuroscience are also fascinating fields (you should check them out). Also, be prepared to focus more on translational research instead of basic.

Be sure to work hard in your premed courses. They are much harder than psychology courses! Also, pwn the MCAT!

 

[JuniperTree]

Hi JuniperTree,

I also studied psychology in my undergrad (preferred the bio side of things) and thought of those reasons. I wanted to become a clinical psychologist before college, but I ended up picking the MD/PhD because of your reasons and also because better research funding and better interactions with patients (through therapy & medication)

If you decide to do an MD/PhD, you should think about going into cognitive neuroscience rather than biopsychology even though they are pretty much the same thing. I have to say though... molecular and computational neuroscience are also fascinating fields (you should check them out). Also, be prepared to focus more on translational research instead of basic.

Be sure to work hard in your premed courses. They are much harder than psychology courses! Also, pwn the MCAT!

Hi Tortuga87,
Thank you so much for sharing your experience. I really admire you for accomplishing this!

I hadn't even considered the "pro" of enhanced interactions with patients, is that because you can prescribe medications? However I am still worried about pre-med classes - as I am 2 semesters away of graduation, would it make more sense to take a pre-med program after undergrad instead of starting now?

Both molecular and cognitive neuroscience are fascinating to me as well, since my curiousity about the biological foundations of mental illness and treatment are the core of what interests me in psychology, so I am going to focus on finding labs that do such research to volunteer in!

This would be applicable later on, but I'm still curious as why you would suggest cognitive neuroscience over biopsychology. Is it because dealing with humans is more directly translational research?
Thanks again,
JuniperTree

 

[URHere]

Just some thoughts on your list of pros and cons:

Pros:
- Love science (in psychology, would go into biopsychology or neuroscience)

In general, neuroscience research is very, very different from psychology research. Neuroscience focuses on the biology of the brain and could involve studying ion channels, anatomical pathways, small molecule interactions, etc. In short, it's not even close to psychology.

You need to experience biology research before you decide if something like that interests you. Otherwise, consider programs with the option of pursuing a PhD in psychology or find schools with programs that are closer to the behavioral neuroscience end of the spectrum (still biology, but generally deals with things like direct observational studies rather than microdissections and microscopes).

Guarantees a job at the end with a life of research

If you are talking about clinical research, then yes, the MD will be a great help to you. If you are talking about bench research, there are never any guarantees. You will need to apply for grants and fight for funding just like everybody else.

- No worries about what to do if I don't get into grad school, and if I do get into grad school, being funded

MD/PhD programs are far more difficult to get into than general PhD programs, so I'm not sure that this pro is entirely valid.

- Background in the sciences unrelated to psychology in some way is nonexistent although I'm planning to take 'Biology for [biology] majors' next semester.

You will need to complete all MD program requirements in order to gain acceptance to MD/PhD programs. This includes biology, general chemistry, organic chemistry, physics, math, and may include biochemistry or genetics depending on where you decide to apply. That could add more than a year to your undergraduate career.

- Have very little research experience, all in psychology so far, and no contacts in the MD/PhD field

The MD/PhD contacts aren't important (although you will need letters of recommendation from your research mentors), but the research is. If you apply to MD/PhD programs, you will be competing against applicants with extensive research experience. If you apply to programs with psych research options, then psychology research is fine. If you intend to switch into something more biology-heavy (like neuroscience), then you should spend some time working in a more relevant lab before you apply.

 

[tortuga87]

I hadn't even considered the "pro" of enhanced interactions with patients, is that because you can prescribe medications?

Yes. Nature and nurture. Also, from my experiences, many neuropsychologists focus on assessments using pre-established batteries. MDs are much more fluid in their patient interview. Sometimes neuropsychologists will administer the battery and then report to the physician

However I am still worried about pre-med classes - as I am 2 semesters away of graduation, would it make more sense to take a pre-med program after undergrad instead of starting now?

My advice: Go slow but steady. I would spread everything out - one or two premed courses per semester with only the easiest professors from ratemyprofessors.com from your college. You can take the rest after you graduate in a post-bacc - again, only one or two serious classes per semester. Focus on getting the highest GPA you can. Then dedicated time to study for the MCAT with ExamKrackers or Berkeley Review (don't be afraid to cancel an MCAT score and retake the test. Just don't have two scores). MD/PhD programs are much more numbers-based than psych PhD programs. You can use this to your advantage by taking only one or two serious classes per semester rather than cramming in 20 units of rocket science hoping it will impress someone.

Remember to also get good research letters. Just do some research while in college and after graduation. You should try going above and beyond the other RA's in your research lab. Then, when the time comes, explicitly ask if the PI can write a "strong letter." Some will say yes, some wont. It's unfortunate, but one bad letter can keep you out of an MD/PhD program

This would be applicable later on, but I'm still curious as why you would suggest cognitive neuroscience over biopsychology. Is it because dealing with humans is more directly translational research?

I am not aware of any difference between biopsych and cognitive neuroscience (so both biopsych and cog neuro can be equally translational). People in medicine just prefer a traditionally bio field over psych. From my experience in psychiatry and behavioral neurology, these departments hire a team of psychologists (PhDs) but the MDs say they do neuroscience research and the MD/PhDs have PhDs in neuroscience. It's more of a prestige thing.


And yes, as you can probably have guessed from reading in between the lines, MD/PhD people are more gunner-ish than psych PhD people. Go forth and conquer (but be nice)

 

[JuniperTree]

Just some thoughts on your list of pros and cons:

In general, neuroscience research is very, very different from psychology research. Neuroscience focuses on the biology of the brain and could involve studying ion channels, anatomical pathways, small molecule interactions, etc. In short, it's not even close to psychology.

You need to experience biology research before you decide if something like that interests you. Otherwise, consider programs with the option of pursuing a PhD in psychology or find schools with programs that are closer to the behavioral neuroscience end of the spectrum (still biology, but generally deals with things like direct observational studies rather than microdissections and microscopes).

Thank you for your thoughts. I hear what you are staying and am thinking about how to find out if I like basic research.
What programs are there with the option of pursuing a PhD in psychology? Do they offer the opportunity of stopping without an MD?
Behavioral neuroscience is definitely a PhD that would interest me, as Tortuga mentioned.

If you are talking about clinical research, then yes, the MD will be a great help to you. If you are talking about bench research, there are never any guarantees. You will need to apply for grants and fight for funding just like everybody else.

I definitely want to do clinical research, no question.

MD/PhD programs are far more difficult to get into than general PhD programs, so I'm not sure that this pro is entirely valid.

Hoping I don't sound overconfident, but most things require work and determination, and once the work is done one gets into the program. This just requires a little more work, but is it reasonable for me, and is it work I will enjoy doing.

You will need to complete all MD program requirements in order to gain acceptance to MD/PhD programs. This includes biology, general chemistry, organic chemistry, physics, math, and may include biochemistry or genetics depending on where you decide to apply. That could add more than a year to your undergraduate career.

This is the main thing discouraging me but if everything else works out, one of those pre-MD programs where you get the cores over and done with might be fine.

The MD/PhD contacts aren't important (although you will need letters of recommendation from your research mentors), but the research is. If you apply to MD/PhD programs, you will be competing against applicants with extensive research experience. If you apply to programs with psych research options, then psychology research is fine. If you intend to switch into something more biology-heavy (like neuroscience), then you should spend some time working in a more relevant lab before you apply.

Thank you very much for clarifying many points. In this way it is very much like psychology.

Yes. Nature and nurture. Also, from my experiences, many neuropsychologists focus on assessments using pre-established batteries. MDs are much more fluid in their patient interview. Sometimes neuropsychologists will administer the battery and then report to the physician

That is really interesting!

My advice: Go slow but steady. I would spread everything out - one or two premed courses per semester with only the easiest professors from ratemyprofessors.com from your college. You can take the rest after you graduate in a post-bacc - again, only one or two serious classes per semester. Focus on getting the highest GPA you can. Then dedicated time to study for the MCAT with ExamKrackers or Berkeley Review (don't be afraid to cancel an MCAT score and retake the test. Just don't have two scores). MD/PhD programs are much more numbers-based than psych PhD programs. You can use this to your advantage by taking only one or two serious classes per semester rather than cramming in 20 units of rocket science hoping it will impress someone.

That's a good idea and a safe way to try it out. I have a 4.0 and definitely don't want to ruin that with impossible courses!

Remember to also get good research letters. Just do some research while in college and after graduation. You should try going above and beyond the other RA's in your research lab. Then, when the time comes, explicitly ask if the PI can write a "strong letter." Some will say yes, some wont. It's unfortunate, but one bad letter can keep you out of an MD/PhD program

So it's better to get research from several different places, rather then one from an amazing PI?

I am not aware of any difference between biopsych and cognitive neuroscience (so both biopsych and cog neuro can be equally translational). People in medicine just prefer a traditionally bio field over psych. From my experience in psychiatry and behavioral neurology, these departments hire a team of psychologists (PhDs) but the MDs say they do neuroscience research and the MD/PhDs have PhDs in neuroscience. It's more of a prestige thing.

Interesting. The prestige doesn't really matter to me but being able to study what I want does.

And yes, as you can probably have guessed from reading in between the lines, MD/PhD people are more gunner-ish than psych PhD people. Go forth and conquer (but be nice)

No prob with that, I like people with strong personalities and am pretty gunner-ish myself.

 

[Neuronix]

I definitely want to do clinical research, no question.

That's the key statement. You only need an MD or clin psyc PhD to do clinical research and the vast majority of MD/PhD programs are not going to take you with that stated goal. MD/PhD programs are geared to do basic biomedical research, and occasionally basic research in other social science/economic/etc areas.

Now if you do want to get more experience in bench research so you know what you're getting yourself into it, I think that's a great idea. If you want to do something very psych oriented, look into animal experimental models or highly technical in vivo research (MEG/EEG/fMRI/etc...).

I think a major question is do you want to have and see patients? That's another thing you should start getting exposure to. The MD is not just a tool to get you a more stable job. The MD gets you patient training and a residency (almost always). The "pros" you list of the MD/PhD program (guaranteed job and money) come from patient care.

So you have a couple pathways here:
Don't want patients --> PhD in non-clinical psychology or neuroscience.
Do want patients and research --> PhD in clinical psychology OR MD to psychiatry residency. That's a whole separate discussion.

I'd consider adding on the PhD to the MD only if you enjoy basic research and want to have patient care on top of that.

 

[JuniperTree]

That's the key statement. You only need an MD or clin psyc PhD to do clinical research and the vast majority of MD/PhD programs are not going to take you with that stated goal. MD/PhD programs are geared to do basic biomedical research, and occasionally basic research in other social science/economic/etc areas.

Now if you do want to get more experience in bench research so you know what you're getting yourself into it, I think that's a great idea. If you want to do something very psych oriented, look into animal experimental models or highly technical in vivo research (MEG/EEG/fMRI/etc...).

I think a major question is do you want to have and see patients? That's another thing you should start getting exposure to. The MD is not just a tool to get you a more stable job. The MD gets you patient training and a residency (almost always). The "pros" you list of the MD/PhD program (guaranteed job and money) come from patient care.

So you have a couple pathways here:
Don't want patients --> PhD in non-clinical psychology or neuroscience.
Do want patients and research --> PhD in clinical psychology OR MD to psychiatry residency. That's a whole separate discussion.

I'd consider adding on the PhD to the MD only if you enjoy basic research and want to have patient care on top of that.

Thank you! Interestingly, since I last posted, I contacted a senior person in the NIH (Biostatistics) and they told me nearly the same thing. (They also said to do what you love, and can make it worthwhile for someone to pay for - as I was worried about the neuroscience PhD job market.)

The plan now is a PhD in neuroscience (which was the only option I knew of until hearing about the MD/PhD option from SDN.) I will also take a lot more hard science classes next semester so that every option can remain open. And like you said, I will have to find a research position doing basic research related to neuroscience in order to observe what goes on in the lab, to decide whether I also love that kind of research.

You are a very clear thinker. The way you presented the options helped me understand what I'd be getting into with each option.

• Patient care: No interest, but I'd be good at it. Would run to research at the first opportunity.
• Basic research: Plan to do as you suggested. If I do end up enjoying it, it may be worthwhile. It can't hurt and will help me avoid future regrets.

This SDN forum is outstanding in the quality of responses from its posters. Thank you all so much for helping me understand and narrow my career options, and I will make sure to update sometime with the outcome for the benefit of future posters. Any advice is still welcome!

 

[Neuronix]

You're welcome.

My only qualm with your post is when you say you'd have no interest in patient care but be very good at it. To me, the biggest factor to being an excellent clinician at any level (student, resident, attending) is interest. It's caring for the patient (on more than just a clinical/medical level), going the extra mile for them (explaining your reasoning, tailoring your treatment to the patient and their beliefs, listening to their symptoms and concerns rather than just putting them quickly into a box), and being thorough in your data collection and analysis. This takes time. It is easy when under pressure to get the minimum amount of information necessary to make a diagnosis (correct? Who knows) and take the minimum amount of time to treat the patient (minimal explanation and minimal/no patient input into the treatment plan). If all you can think about is research and getting back to the lab, your patients won't get optimum care.

 

[JuniperTree]

You're welcome.

My only qualm with your post is when you say you'd have no interest in patient care but be very good at it. To me, the biggest factor to being an excellent clinician at any level (student, resident, attending) is interest. It's caring for the patient (on more than just a clinical/medical level), going the extra mile for them (explaining your reasoning, tailoring your treatment to the patient and their beliefs, listening to their symptoms and concerns rather than just putting them quickly into a box), and being thorough in your data collection and analysis. This takes time. It is easy when under pressure to get the minimum amount of information necessary to make a diagnosis (correct? Who knows) and take the minimum amount of time to treat the patient (minimal explanation and minimal/no patient input into the treatment plan). If all you can think about is research and getting back to the lab, your patients won't get optimum care.

You're right. They wouldn't get optimal care from me, and that is a good reason not to spend the money on medical school. I'm a direct person and am not going to pass myself off as something I'm not to get into a school.
Even in psychology, I dislike the therapy process, although I have mentored several people until they could accept professional help, and always try to help when I see people who need it. It's emotionally draining and gets boring after a while. (This sounds harsh - I'm very sweet in real life, really! But this is my natural preference and relevant to a long-term career.)

 

[Neuronix]

There's no judgments here on your personality--different strokes for different folks. Good on you for figuring this out and not just chasing money/prestige/family pressure/whatever other bad reasons people have for going into medicine.

Good luck!

 

[JuniperTree]

There's no judgments here on your personality--different strokes for different folks. Good on you for figuring this out and not just chasing money/prestige/family pressure/whatever other bad reasons people have for going into medicine.

Good luck!

Thank you for helping me figure it out, and good luck to you too!

 

[wuhanese]

"That's a good idea and a safe way to try it out. I have a 4.0 and definitely don't want to ruin that with impossible courses!"

im not sure if this is true for other people, but this philosophy (and most of this thread) goes against pretty much everything i believe should constitute what a physician-scientist should be

 

[JuniperTree]

"That's a good idea and a safe way to try it out. I have a 4.0 and definitely don't want to ruin that with impossible courses!"

im not sure if this is true for other people, but this philosophy (and most of this thread) goes against pretty much everything i believe should constitute what a physician-scientist should be

I think I'm being realistic here. If you want to get into the grad program of your choice, everyone knows a 3.7+ GPA is very helpful. Since I still have a long way to go, it makes sense for me to be especially careful.