Why do you want both degrees?

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philosonista

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I have heard so many varied perspectives this summer on the MD/PhD route.

You shouldn't do it because:

-- If you want to be the best at something, it's a lot harder when your time is split when everyone else is focusing.
-- You likely won't need one of your degreed unless you do a percent split of your time
-- It's a LONG time to be done. You finish and THEN you go into post-doc or residency when you're already 30-something.
-- There is likely not going to be a synergy in your work. That buzzword is mostly a lie.

You should do it because:

-- If you want to get an MD, now is the time to get it for free.
-- You can jump ship on one career path to pursue another quite easily.
-- As an MD, you have job stability.
-- Because you can't imagine not doing both.

So WHY should one pursue an MD/PhD?!?!

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Are you asking because you're conflicted on going down this path? Or just curious?
 
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Conflicted, four years running.

Understandable. I can give you some of my thoughts as someone still in the training path (yr 2 of the PhD). Hopefully some posters further down the line can chime in.

I'll start off by saying that I was a non-trad applicant that was 4 yrs out of UG when I started. I originally didn't think I could handle med school (until I pretty much finished UG). I thought I'd work in oil as an engineer and really didn't think of other career paths. Worked in it for a bit -> didn't like it -> tried process engineering and industrial R&D -> liked it decently but eventually got bored -> met an MD/PhD working in the pharma industry -> path piqued my interest. Did tons of research, talked to many MD/PhDs + MD-only physician scientists, decided to go back and do a biochem MSc and apply to med school. Ultimately I'd like to have a research heavy career in cancer research while treating patients most likely in an academic setting (maybe even industry). The dual degree pathway suits my personality and since I already tried out another career I know myself enough to know I don't mind the journey (but I'll know for sure in a few yrs when I'm done) because ultimately I'd like to go to work everyday enjoying what I do, even if that job is mentally exhausting. Age is but a number and since I'm not doing physical, back-breaking work I can't complain if I start my next career a bit later than others.

The PhD portion does tend to be the 'scarier' part due to it's open-ended nature, but I've found that it's really helped me learn how to think about certain things. The synergy of the degree with the rest of your medical training will be variable depending on how your interests evolve between the time you finish the PhD and choose your medical specialty. In my case med onc lines up pretty well with my goals and I don't expect it to change that much over the next few yrs. With these thoughts I can't really see the PhD training as a waste, even if it's not absolutely necessary -> I do tend to be an optimist though and try to see the positives in each of the decisions I've made regarding my career.

A few questions you can ask yourself:
- Do you want to see patients? Would you be fine not doing the PhD? Do you want to be a PI some day? Basic science (bench) research or clinical research? How do you handle failures/shortcomings (since you'll run into quite a few during grad school)? Do you mind delaying settling down for a while?

If you don't want to do the PhD, there are other paths to get the scientific training needed to establish a lab (such as research yrs during residency/fellowship or in a postdoc after your medical training). If you don't see yourself running a more basic research lab in the future, you can also look at getting a masters in something like clinical research or MPH if those suit your interests.

It's quite common and normal to question this path (hell I still do some days). Try to talk to as many physician scientists as you can to get a sense of what their lives are like. I feel like I skipped some points but hopefully you find my words somewhat helpful. Good luck!
 
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So WHY should one pursue an MD/PhD?!?!

Masochism.

I always give the three main reasons why to do a combined program (particularly viewed as adding a PhD to an MD):

1. Building bridges between MD and PhD.

2. Integrated training has benefits in realizing the bench-bedside and bedside-bench translations compared to separate training (e.g. MD/post-doc or PhD->MD).

3. Free med school helps. The freedom from debt allows you to pursue lower paying career choices (research instead of clinical medicine).

Adding an MD to a PhD is largely a function of interest and job stability.

The main reasons people say that you shouldn't do MD/PhD are:

1. You can't be good at both medicine and research. One ends up suffering.

2. If you want to do research, you compete with the PhDs who are 100% research focused. The MD/clinic is of questionable and often marginal (or perhaps no) benefit.

3. The training is too long and grueling. Additionally, for society the training is too expensive, especially given #4.

4. Your odds of using the PhD for basic science research are low in the current, ultra-competitive research job market.

5. You are committing in your early 20s to at least an 8 year program, very likely followed by 5+ years of residency/fellowship. MD->PhD/post-doc allows you to choose the research pathway at around age 30, when you likely have a better idea of what's going in your life and whether you really want to practice primarily clinically.
 
Yeah, I kinda agree with Neuro that MD to PhD is probably the smartest move for those who aren't sure what they want to do but know they want to have a clinical career. PhD to MD is also possible for the more research-oriented who decide later that they want a clinical component as well, but it's significantly harder than doing it the other way around.

OP, it would help us advise you if you could tell us what kind of career you're envisioning for yourself. Do you like patient care? Bench research? Clinical research? Teaching?
 
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