Should I get a PharmD or continue with residency?

DazedMD said:

Sorry for a double post but I wanted the opinion of both PharmD's and MD's.

Here is the story:

I graduated from medical school in May, but did not apply for residency. I have mixed feelings about if I even want to practice medicine. I loved the first two years of medical school but hated the last two for the most part. I really don't enjoy H&P's. To tell you the truth I don't even get motivated by physical diagnosis for the most part unless the patient has a very interesting illness or any type of cancer.

Although I started studying for step 3 and enjoy studying medicine a lot. I'm fascinated by studying medicine but not by practicing it. So what am I supposed to do with my life??

Lately I have been talking to the pharmacy school and also to the pharmacology PhD people. Since I love biochemistry and pharmacology a PharmD seems like the best option. I am very detail oriented and love mechanisms.

I thought I wanted to do pathology but eliminated that after some elective rotations. I definitely don't want to do surgery, ob, peds or psych.

So that leaves me with IM, rads, or gas. But I didn't even do elective rotations in any of these my 4 th year so I don't know how to go about even trying to see if I would like these specialites. I'm shut out of clinical work because I'm not insured by any form of malpractice.

I am 26 now. Would start pharmacy school at 27. Complete the program by age 30 or 31 depending on if it takes me 3 or 4 years.

My question is what should I do? PharmD or continue with medicine. I really am not happy doing H&Ps, presenting patients, etc. So will it get better in residency or should I assume that it's time to walk away. I am also concerned with money and time. salary of $100K with PharmD plus paying for 4 more years of school vs potential for a lot more.

For those of you who love biochemistry, drug mechanisms, and the like would you do a residency even with all my dislikes of medical management, physical diagnosis, etc if you were in my position or go to pharmacy school?

I would appreciate your insight.

Click to expand...

Not PharmD yet, but I have almost 6 years of experience in retail pharmacy so I do have a few comments about that.

My first answer to your question is no, I would not do a residency unless you have some more compelling reason to think that you would love radiology or gas (is that anesthesiology??) than process of elimination. I was in a similar situation quite a few years ago - in a PhD chemistry program and decided that I loved studying chemistry but I did not love actually being a chemical researcher, and I couldn't teach (which I did like) on the college level without doing research. So, I got out with a MS, and it was one of the best (if not the best) career moves I've ever made. Life is too short to spend much of your waking hours doing something that you don't like to do.

Your first paragraph in a nutshell describes why I have never had any desire to go to med school. I would have loved the subject matter, but no interest in having to do a lot of hands-on or diagnose patients.

In terms of the PharmD, I doubt you would be happy doing retail. To be perfectly blunt, you have to deal with a lot of customers everyday (albeit not in a hands-on, diagnostic sense) and in a typical retail environment the pharmacist simply won't get the type of respect that you saw of doctors in your medical school career. The general public mostly has no idea how highly trained pharmacists are. Now, there are a lot of other practice settings for pharmacists - if you liked the hospital setting part of med school, then there would certainly be opportunities there. You can look at this link for info. about other practice settings - http://www.pfizercareerguides.com/default.asp?t=book&b=pharmacy. Also, in the PharmD programs now you would have to do a year's worth of rotations, but maybe only one or two would be retail.

Another possibility that occurs to me - have you considered employment with pharmaceutical companies? I would think that there would be clinical options for an MD with them - you might have to pick up some more pharmacology and med chem somehow (maybe an MS somewhere??)

I answered you on the same thread you posted in the Graduate Medical Forum

I'm in a similar position to you. I completed med school and about 15 months of residency before I more or less came to the same conclusion that I was interested in the science of medicine but realy disliked the hands on of dealing with patients and diagnosing vague complaints. I too enjoyed the first 2 yrs of med school and not much since then. I quit residency in Sept '05 and have been a stay at home dad with my infant daughter while figuring out what to do with my life (My wife and I couples matched into the same FP program and she, still a resident, loves her work). Long contemplation brought me to the same conclusion that other medical specialties are not for me but getting a PharmD would be totally up my alley (especially working on the inpatient side increasing pharmacists roles in med management, drug delivery systems issues, formulary selection etc.) So I'm applying to enroll in Fall '07. With nearly a year now since seeing patients, I have no regrets and I guess the future will tell me whether a PharmD is the right answer. But in your situation, I, too, am of the opinion that you need to find work you enjoy doing or else you'll be miserable, especially in a field as demanding as medicine. Good Luck!

I couldn't imagine going through 4 years of the lowest circle-of-hell only to elect to go through 4 years in the 8th circle-of-hell in exchange for lesser pay and an ungodly amount of student loans. I'd suggest exhausting every other avenue as an MD. Sounds like you haven't explored everything yet.. definitely do whatever it takes to explore those other specialties. Is it completely impossible for you to get insured?

In my last year of medical school, I took a bioethics elective with this guy named Brody, an FP with a PhD in philosophy. He was a great teacher. He shared with the class that he realized he wasn't cut out to be a physician several years after residency. He went back to school and got his PhD and found his niche in bioethics. I remember thinking to myself, that very day, how I never really wanted to be a doctor, how it was important for my father that I be a doctor, and how my whole life, I always wanted to be a lawyer.

Well, I finished medical school and matched into an IM/Psych residency, which BTW, is where I really learned how to be a doctor, and I really was unhappy doing that. I really found myself hating a great deal of my patient interaction -- especially in GYN, NEURO, IM, EM. I finished my residency and then took the LSAT and ended up going to law school part-time. I graduated with my JD and then passed the bar exam and am still in the process of leaving medicine for law. Having practiced law for ONLY three months now, I can tell you one thing, I LOVE IT! This is what I was meant to do.

However, having said all that, going back to my senior year of medical school, in Dr. Brody's bioethics class, where I realized I really didn't want to be a doctor...I still went through my residency and took the USMLE I and II. Why? I worked that hard up to that point, why not finish?

In my case, I asked myself one important question: Zack, what do you really want to do with your life? Law was the answer. If you ask yourself what you really want to do, but don't know, then you have some soul-searching to do. If you know the answer as quickly as I did, do some research, and go for it.

HOWEVER, here's my advice. You already have your MD. Finish a residency, any residency, and get fully licensed in your state. Once you're done, like with a 3 year FP residency, then think about a few options:

1) Medical Admin (get an MHA/MBA/MPA) and work for an insurance company, gov't agency, hospital, etc., as a medical director, medical claims consultant, hospital admin, etc. No patients, just bureacrats.

2) Research - you might need an MS or PhD, but with your MD, and an area of interest, you could pursue research at a Uni, pharm company, NIH, etc.

3) Teaching - you could go teach at a medical school, pharmacy school, vet school, chiro school, NP program, PA program, PT program, etc. An MD = PhD in most cases, for biomed programs, and you could teach and do some research.

Or, you could move into another career. Go to law school, get your JD, pass the bar, and with your MD, you could use your background, like me, to specialize in biotech, patent law/IP, med-mal, health care law, etc.

Don't give up NOW. Finish and then give it thought. But search your soul and ask yourself what you really want to be doing.

My A & P teacher in undergrad went to med school. After school, she became a college professor. She would rather teach the subjects that she enjoyed.

I'm not sure that you would be happy as a pharmacist. There's no patient interaction, but it is not real challenging. You might want to look into a PhD in pharmacology. With an MD and a PhD, you could work in clinical drug research.

Or, since you like cancer, why not try to specialize in that area? Did you look at infectious disease? That's my favorite part of pharmacy. If I would have chosen to go to medical school, being an ID doc would have been right up my alley.

At any rate, I agree with the poster that said to just finish your residency and get your license first. You've spent lots of money on med school and it would be a waste not to finish.

If you're really interested in the science rather than the clinical aspect of medicine I think you should go into research. There are alot of people in my department and throughout campus who are MD's who do research. Some do clinical rotations, while others have no patient interaction whatsoever and stick with the benchtop work. Rather thatn doing a residency why don't you seek out a fellowship in an area of study that interest you. The fellowship, in my opinion, would be a better alternative than going to school again for phd or pharmd.

This may not work as well for you, but I worked with a couple at my previous pharmacy company. These guys were smart as hell and nothing spun their boat more than sitting in a chair, laid back and thinking about how they would drug a specific pathway. They would then find a chemical from our library of over 400000 compounds and see if it would work invitro. If it did they started working in single human or hamster cells to see if the drug could get into the cells and not be so toxic that it killed the cells. If it worked there the project moved to trials in mouse or rats.

This sounds right up your alley.
DR
As a side note, I was watching a movie about the first black surgeon, and how he developed by pass surgeries and things like that. Maybe somekind of medical research like that would suite you.