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What does an MD/PhD do?

Discussion in 'Physician Scientists' started by BigEast55, 11.21.07.

  1. BigEast55

    BigEast55

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    I'm a little confused as to what an MD/PhD does, the idea interests me, but I don't want to do solely research for the rest of my life, I also want to have patient contact, does that degree allow both. Also is there any sort of substantial salary decrease if someone goes with an MD/PhD, I don't exactly wanna spend 7-8 years in school for no real reason.
  2. foster033

    foster033

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    MD/PhDs usually end up doing an extensive amount of research, most likely having their own lab and spending 80% of their time dealing with research/lab issues/grants/etc. They will also see patients in a clinical setting, generally about 20% of their time. Of course, these are just estimates and if you wanted to tip them either way I'm sure that is possible depending on where you work and the amount of support staff you have.

    You can do research with just an MD, but it usually makes funding harder and if you have you're own lab the time requirements above apply.

    If you are interested in research at all I think MD/PhD is the way to go. Most programs will pay for all of your schooling and give you a stipend so you won't owe a ridiculous amount afterwards.
  3. cbsmd

    cbsmd C.S.M.D.

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    the Ph.D. is first and foremost a research degree in any field of science. People who pursue the phd/md degree are interested in curing diseases like cancer just to name one of thousands. They are also the docs that run clinical trials and things of that nature. If you pursue this degree it will be entirely up to you with the clinical exposure aspect. You may spend your life in a lab or you can spend all your time practicing medicine. It is entirely up to you. I would not get a Ph.D. if you are not interested in research at all. Just like I would not get an md if I was not interested in seeing patients. This degree is primarily for people who love both aspects of medicine.
  4. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting.... Administrator SDN Senior Moderator Lifetime Donor

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    Allow me to introduce you to the Physician Scientist forum, where plenty of current and graduated MD/PhD students can tell you all about their career plans and how their programs work. :)
  5. Neuronix

    Neuronix Super Corgi Away! Administrator SDN Senior Moderator SDN Advisor

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    I will answer your questions concisely. I would recommend you check out the official viewpoint at:

    http://www.aamc.org/research/dbr/mdphd/applicantfaq.pdf

    Also the student run website at:

    http://www.mdphds.org/

    The goal of the program is about 80% research 20% clinical. There is no obligation. You can take the degrees and do whatever you want with them. A very significant percentage of MD/PhDs do mostly clinical work, but this is not the goal of the MD/PhD program.

    Your salary is roughly tied to how much clinical work you do as long as you're in a specialy that brings in reasonable clinical revenue. If you do mostly research you will roughly be paid like a PhD. If you do mostly clinical you will roughly be paid like a MD. Yes, this is an oversimplification, but it is roughly true.

    The goal is to become a basic science researcher. If you don't see yourself doing mostly basic science, don't do the MD/PhD.
  6. BigEast55

    BigEast55

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    In applying to an MSTP program, would they place more focus on research background (I am a freshman right now and already in research and applying to several programs over the summer), than clinical background (I've yet to start any shadowing, etc.,) or is it the same as regular MD admissions?
  7. Neuronix

    Neuronix Super Corgi Away! Administrator SDN Senior Moderator SDN Advisor

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    Yes, do as much research as possible as an undergrad. The more you do and the more productive you are in research the better off you'll be. Of course the GPA (~3.8 average) and MCAT (~34 average) requirements are higher than for regular MD so don't do too much research at the expensive of those.

    Some programs will evaluate your clinical experience to some extent, but it's not as scrutinized as the research. Maybe 100 hours of volunteering in a hospital and some shadowing sometime during your undergrad would suffice. Some programs don't care about clinical experience at all.
  8. richardlo

    richardlo MD/PhD applicant

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    My experience is that the focus is more on research, but that also highly depends on which school you apply to. Some schools interview you directly for MSTP, and some schools require that you be admitted by MD first before considering you for MSTP. In that case, you need to do well on the clinical stuff as well.


  9. Neuronix

    Neuronix Super Corgi Away! Administrator SDN Senior Moderator SDN Advisor

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    That's only a handful of MSTPs and even at most of those schools exceptions are made for MD/PhDs because it's not expected they will have as much clinical experience as your usual MD applicant. The only real exception to this I'm aware of is UCSF.
  10. richardlo

    richardlo MD/PhD applicant

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    True, I wrote that with UCSF in mind. I'm not sure about the other schools.

  11. Dodo23

    Dodo23 MS0

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    I thought Yale and Harvard were also like this (i.e., in requiring applicants to get into the MD program before the MSTP).
  12. chrisisinnocent

    chrisisinnocent Elbow deep

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    I was under the impression that you get paid out of your grants and also by your department so the pay is roughly equivalent to the levels of your clinical colleagues. The idea being that the department will reward you for your scholarly contributions to the department even if you do not bring in the same amount of revenue clinically.
  13. Neuronix

    Neuronix Super Corgi Away! Administrator SDN Senior Moderator SDN Advisor

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    What you're saying totally depends on the department. I don't want to go into details on this because it totally depends on the specialty, the institution, etc etc etc... If the clinical department brings in no revenue anyway and is losing money for every patient it sees (this happens in several at my institution), then they don't mind you doing research as long as you're successful. In this case you'll probably make roughly the same if you're an 100% clinical MD as you would as a PhD in the department anyway. If you're in a wildly profitable specialty, you're going to get dinged. This is why I said it's a total generalization. I know in the field I'm going into you take a tremendous pay cut by doing mostly research at most institutions, and so it's almost impossible to find new young MD 80% or greater researchers.

    Edit: I'm going to stick this in before anyone else responds as I've been thinking about it. In the intermediate pay specialties, everyone knows there's a huge pay grade going from PP (highest) to smaller/less prestigious academic institutions to big name academic instituitions (lowest). Why is this? Well there's a reputation factor, but the reality is the biggest name places have the most resources and most other big name faculty and will likely be the most flexible about giving you protected time for research. So while everyone in at the big name academic place is getting paid the same, the pay is lousy compared to the rest of the field regardless. All this and you'll probably work harder and get less vacation with your less pay to boot. So the more you want to just be a clinician, the more sense it makes to get away from the big name academic place where we will likely go to get a 80/20 (if it's even possible).

    That being said I'm aware of at least one department with a very obvious pay difference between MDs. In the department with which I'm most familiar, the pay differential comes in the form of bonuses and I think this is an institution wide thing. The yearly bonuses are a very substantial contribution to one's salary, and they're entirely based on RVUs. But this is kind of a moot point because I'm not even sure it's possible to get a position here as an 80/20. I've been laughed at for mentioning 80-90% research as a MD/PhD so many times I don't even bother anymore. Also, your pay is determined by the "track" you're on. Some tracks pay better than others--and of course the ones that pay more have more clinical duty. There's all kinds of games played at this at other institutions. Sure, one other big name place might give you as much protected research time as you want and you're making the same lousy pay as everyone else, but all the routine clinical stuff gets outsourced to a different department. BTW, make no mistake. When I say lousy, in my specialty we're talking about 2-fold pay cuts between comparative institutions where you'd do 100% clinical and even 3-fold compared to private practice. Make no mistake, as far as I can see you have to make tremendous sacrifices to be a MD (or MD/PhD) who does significant research, especially in the current funding environment. Every recent graduate from my lab has gone into private practice or is very discouraged by the academic environment they've seen (except one guy who didn't even do residency), and you'd have be really dense to not figure out why.

    Regardless, you're still going to improve your pay quite a bit in most specialties by going into private practice and being 100% MD. The short answer to the op's question is still, yes, expect to take a salary cut by doing the MD/PhD. There are cases where this isn't true of course, but you should expect it. If this doesn't appeal to you, don't go MD/PhD.

    Must stop editing this post, most start making Thanksgiving dinner...
  14. Neuronix

    Neuronix Super Corgi Away! Administrator SDN Senior Moderator SDN Advisor

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