Is there a difference between phd--> med or md and phd same time?

I would say that there is no real difference in opportunities. When you graduate from med school with an MD and then decide to go for a PhD you still get to say that you're an MD/PhD...

However, the fact that you went through an MSTP program would have some benefit at the time of matching for residency. From what Ive heard, MD/PhD's have a slight advantage when they apply for residency programs. Its probably because they feel that you went through a slightly more competitive pool of applicants and succeeded at an earlier stage which means that you are a worthy candidate...

silverlion said:

I would say that there is no real difference in opportunities. When you graduate from med school with an MD and then decide to go for a PhD you still get to say that you're an MD/PhD...

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Considering both paths, your career opportunities will be similar. You'll probably have the same boost However, there are other differences.

advantages of MD/PhD vs PhD followed by MD
-financial advantage, equivalent to probably anywhere between $150-300k dollars (stipend of 25k/year while in med school, plus free MD tuition of 15-50k/year depending on the school)
-support advantage: you will be in a program with staff, administration specifically designed to help you with your combined career. You will also be in a class with 5-18 like-minded individuals
- it will be a major bummer to finish a PhD and then go back from being an independent, qualified researcher to an MS1. MD/PhD students experience this as well during the MS3 year but at least its closer to the end
-you're closer to your PhD research in time when you finish MD (2 yrs vs 4 yrs), which will make it an easier transition if you want to do research
-you won't have to explain to people why you did a whole PhD only to go back to medical school (which will be the majority of your med school interviews)

disadvantages of MD/PhD vs PhD followed by MD
-you commit yourself to at least 6 years before you will get any credential (PhD) followed by 2 more years to get MD. Although it would be same amount of time, with PhD you could potentially quit after 4 years and get a job/post-doc
-it is going to be more difficult to get into these programs, particularly if your application is weaker now. A PhD may boost you in terms of what med school you can get into
-these are grueling programs, and many of the posts on this forum reveal the frustrations.

MD/PhD is a useful career path, and I encourage if for people who think they can use both in their career goals. However, if you can choose one or the other now, then do it. If not, then I guess pursue one of the above

I heard that the MD/PhD programs would let students transfer MD classes for graduate school credits, and also allow you to skip some clinical rotations.

How much will this reduce graduation time (compared to PhD-->MD)?

newooub said:

I heard that the MD/PhD programs would let students transfer MD classes for graduate school credits, and also allow you to skip some clinical rotations.

How much will this reduce graduation time (compared to PhD-->MD)?

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http://more.studentdoctor.net/showthread.php?t=402917

I read over this link, and although its more than 2 years old the content is mostly accurate. PhD prior to MD is definitely a harder path, and it may be very difficult to get in to medical school as well as convince yourself that you can put up with 4 more years.

I don't think the link directly addressed any time savings which you might get from doing an MD/PhD. I think the savings are pretty significant, probably ranging from 1-3 years. The average time for a bioscience PhD alone is 7.7 years (according to this nature article: http://www.nature.com/nature/journal/v431/n7006/full/nj7006-382a.html). <Gasp!> I think that is probably very close to the average for complete MD/PhD programs which come in around 8.0 at most places.

There are multiple reasons for this:
1. Multiple class credit. Most MD/PhD programs have some scheme by which medical school classes get you out of anywhere from 25-75% of your PhD course requirements. This probably shaves off 1 year or so.

2. Increased programmatic support. Most MSTP programs also have a committee which is involved in your PhD committee selection and which exerts some pressure on you and your committee to get you out of your PhD in a timely fashion. So much PhD time is just bull**** hoops to jump through that you can often jump through just a bit faster.

3. Increased student urgency. (I think this is a big one). Imagine you're starting a PhD program with loosely formed goals, told that it will take you anywhere from 4-7 years. Then imagine you start an MD/PhD program looking at 8 years at the short end, but if you screw around it will be a whole decade. Which one would make you feel more urgent about it? Most PhD students do the majority of their useful research in the last 1-2 years, once they finally buckle down and get to work. MD/PhD programs give you a kick in the butt to get to that stage faster, because you'll never finish if you don't. Plus, you spend those first two unproductive years doing medical school anyway, so by the time you get to the 3rd (your first graduate school year) you are ready to get going. You are in fact facing 6 more years!

Consider this in your decision. I encourage people to consider MD only before they consider PhD only, particularly if they are interested in clinically based research. I mentioned this in another thread, but with a little additional experience that can be obtained during fellowship most MDs can get involved in research pretty heavily, if that's what you want.

UofT9919 said:

Can you still have the same opportunities if you do a phd in medical genetics and then md or do a md/phd. What are other websites that I can read to educate myself about this.

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Yes. PhD-to-MD will get you to the same place as combined MD/PhD eventually, but it's a more circuitous path. You should see my post in the sticky thread at the top of this forum with advice for people looking to make the grad-to-med transition.

The disadvantages of doing PhD-to-MD are these (emphasis mine):

Shifty B said:

- it *is* a major bummer to finish a PhD and then go back from being an independent, qualified researcher to an MS1.
-you have to explain to people why you did a whole PhD only to go back to medical school (which will be the majority of your med school interviews)

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Plus these:

- you will probably have to pay/take out loans for your MD. (I was very fortunate to get a full scholarship, but you absolutely should *not* count on being able to get one.)
- it will likely take you longer to finish your degrees. I'm ultimately on the 14-year MD/PhD plan, although to be fair, I took some time off in between and I got a separate MS too.

However, in the whole scheme of things, this supposed "disadvantage," if it even exists, is so minimal that it shouldn't enter into your calculations:

silverlion said:

However, the fact that you went through an MSTP program would have some benefit at the time of matching for residency. From what Ive heard, MD/PhD's have a slight advantage when they apply for residency programs. Its probably because they feel that you went through a slightly more competitive pool of applicants and succeeded at an earlier stage which means that you are a worthy candidate...

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I'm preparing to apply for residency right now, and I've actually never heard of anyone caring that you got your PhD separately because they think getting separate degrees means you were less qualified as a premed. But I have seen many examples of people stigmatizing MD/PhD combined program grads for not having a "real" PhD. All I can say is that there are plenty of snobs out there in academia-land, and someone will probably look down on you no matter what you do.

newooub said:

I heard that the MD/PhD programs would let students transfer MD classes for graduate school credits, and also allow you to skip some clinical rotations.

How much will this reduce graduation time (compared to PhD-->MD)?

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It might be possible to get grad credit for some of your preclinical med school classes, but again, you shouldn't count on it before getting the info in writing. Med schools and grad schools have their own requirements, and they may or may not be willing to cut you some slack. You will *not* be able to skip any of the required third year rotations no matter what training path you take. Those rotations are required by the LCME, so every med school requires them. Maybe you meant substituting research for some of your clinical electives? That's totally doable. Even MD-only students at my school can do research for elective credit.

Shifty B said:

I read over this link, and although its more than 2 years old the content is mostly accurate. PhD prior to MD is definitely a harder path, and it may be very difficult to get in to medical school as well as convince yourself that you can put up with 4 more years.

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Dude. I hope it's "accurate;" this is my life that I'm posting about! Oh, and stop talking about me like I'm not here.

Consider this in your decision. I encourage people to consider MD only before they consider PhD only, particularly if they are interested in clinically based research. I mentioned this in another thread, but with a little additional experience that can be obtained during fellowship most MDs can get involved in research pretty heavily, if that's what you want.

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I agree completely.

OP, if you want both degrees, but you think you're not competitive enough to get into a combined program, then you should either take some time off to make your app more competitive or do MD-only. It's very, very easy for med students and residents to get involved in research, but the reverse is not true. Again, you should only do PhD-only if you never envision yourself getting an MD.

Well, how am I supposed to know that you are still on the forum? Maybe because you have more than 13000 posts!

Anyway, I did say your advice was both accurate and timeless. Doesn't get much better than that. Of course it's accurate for you, but what I meant is that the advice is generalizable and accurate for others as well.

Rock on with your 14 year plan. And don't feel too bad, because there are a fair amount of older residents who don't have PhDs. Maybe they went through a career as a nurse, paramedic, businessman, lawyer, whatever. Sometimes it just takes a little more time to figure things out, I guess.

Shifty B said:

Well, how am I supposed to know that you are still on the forum? Maybe because you have more than 13000 posts!

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*And* I'm one of the Physician Scientist forum mods.

Anyway, I did say your advice was both accurate and timeless. Doesn't get much better than that. Of course it's accurate for you, but what I meant is that the advice is generalizable and accurate for others as well.

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You don't have to explain; I'm just messing with you, Shifty. I wasn't really upset, and to be fair, there are only these occasional PhD-to-MD threads where I get to jump in and passionately give my two cents (don't do it! don't do it!). Of course I can give some advice about picking mentors in grad school and that kind of thing, but I can't give much specific advice on MD/PhD admissions for obvious reasons.

Rock on with your 14 year plan. And don't feel too bad, because there are a fair amount of older residents who don't have PhDs. Maybe they went through a career as a nurse, paramedic, businessman, lawyer, whatever. Sometimes it just takes a little more time to figure things out, I guess.

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I know. I'm one of the Nontrad forum mods also. In that crowd, I'm almost a young'un.

All kidding aside, Shifty, I'm really glad you are hanging out here. We have such a pyramid-structured membership in the SDN special interest forums like Physician Scientists and Nontrad, with tons of premeds and a decent cohort of med students. But then things start to really fall off once people hit residency. There are several PS forum regulars who are applying this summer, including Neuro and me, so hopefully that will help even things out a little.

QofQuimica, your handle says postdoc, so are you doing a postdoc pre-residency (or are you applying direct out of med school)?

Freak said:

QofQuimica, your handle says postdoc, so are you doing a postdoc pre-residency (or are you applying direct out of med school)?

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All of the above. I am currently a fourth year med student, but I'm taking a research year and using some of my elective time to do research. So I will graduate in 2011, which means that I will be applying for residency directly out of med school (this summer).

i'm not feeling too wordy...

but here's how i felt for the phd -> md transition:

that's a priceless face, hahah

This question is directed to QofQuimica:
I think I might currently be in the same position you were a few years back. I have completed the first two years of PhD and will take the quals shortly. I have always wanted to work with the heart so I enrolled in this PhD program because it was easier to get into than med school. But if I had the opportunity, I would do the MD instead. I don't want to feel like a failure or dissappoint myself so I was thinking about just finishing the PhD, maybe four more years to finish my PhD thesis and then do med school instead of a postdoc. Any thoughts?

...

cvascfreak said:

This question is directed to QofQuimica:
I think I might currently be in the same position you were a few years back. I have completed the first two years of PhD and will take the quals shortly. I have always wanted to work with the heart so I enrolled in this PhD program because it was easier to get into than med school. But if I had the opportunity, I would do the MD instead. I don't want to feel like a failure or dissappoint myself so I was thinking about just finishing the PhD, maybe four more years to finish my PhD thesis and then do med school instead of a postdoc. Any thoughts?

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Have you really fleshed out your reasons for wanting to go to med school? You don't need an MD/DO if you want to work with hearts, but you do need one if you want to work with patients.

PfNO22 said:

This question is directed to cvascfreak:

private message.

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Dude, don't be like that. S/he's not hurting you by posting that question.

I think I wasn't clear enough. I have always wanted to be a doctor and work with patients. I figured that since I got the chance and got accepted to this PhD program, that I could give that up and go teach and have my lab instead. But as time has gone by and I have learned about how you have to constantly apply for grants, etc...I figured that is not the life I want for the rest of my life. For six or seven years it is ok, but not forever. I want to work at the clinic, affecting patients more hands on, not in the lab all my life. So, I came to realize that, now, midway through my PhD. So now the same question applies...Any thoughts?

Sorry I am new at SDN and didn't know you could private message someone else. Yet, maybe someone in my position might also benefit from this info as well.

cvascfreak said:

I think I wasn't clear enough. I have always wanted to be a doctor and work with patients. I figured that since I got the chance and got accepted to this PhD program, that I could give that up and go teach and have my lab instead. But as time has gone by and I have learned about how you have to constantly apply for grants, etc...I figured that is not the life I want for the rest of my life. For six or seven years it is ok, but not forever. I want to work at the clinic, affecting patients more hands on, not in the lab all my life. So, I came to realize that, now, midway through my PhD. So now the same question applies...Any thoughts?

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Fair enough. In that case, what experiences have you had that have led you to decide that you'd like to work with patients? Clinical jobs? Clinical volunteering? Shadowing? All of the above? If you don't have any of these things on your CV, how do you know you want to be a physician?

Sorry I am new at SDN and didn't know you could private message someone else. Yet, maybe someone in my position might also benefit from this info as well.

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It's not a problem. If it were, I'd let you know.

Yes I shadowed on two different places while I was an undergraduate. The first and best experience shaped my whole interest in cardiovascular sciences. I had the priviledge of knowing someone in the VA hospital near my house and he was good friends with one of the Cardiovascular Surgeons so I got the wonderful opportunity to go into the OR with him, and I stood next to the anesthesiologist and saw a whole bypass surgery for around 6 hours and loved it!! I knew I didn't want to be a cardiovascular surgeon because it is physically very draining but I was amazed at how the human body could do such a thing!! Brilliant, amazing!! I then also went to the CHOP in Philly and shadowed a neonatologist that worked specifically on the neonatal intensive care unit, this one was shorter, but still a great experience. So I got interested in what they both did, to be able to save babies' lives like that, impressive, but since I didn't think i had the grades (GPA around 3.45) then I didn't bother for med school and found instead good letters of rec that got me into this phd program.

cvascfreak said:

Yes I shadowed on two different places while I was an undergraduate. The first and best experience shaped my whole interest in cardiovascular sciences. I had the priviledge of knowing someone in the VA hospital near my house and he was good friends with one of the Cardiovascular Surgeons so I got the wonderful opportunity to go into the OR with him, and I stood next to the anesthesiologist and saw a whole bypass surgery for around 6 hours and loved it!! I knew I didn't want to be a cardiovascular surgeon because it is physically very draining but I was amazed at how the human body could do such a thing!! Brilliant, amazing!! I then also went to the CHOP in Philly and shadowed a neonatologist that worked specifically on the neonatal intensive care unit, this one was shorter, but still a great experience. So I got interested in what they both did, to be able to save babies' lives like that, impressive, but since I didn't think i had the grades (GPA around 3.45) then I didn't bother for med school and found instead good letters of rec that got me into this phd program.

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Ok, that's a good beginning. Here's what you need to do next.

First, most of a physician's typical day isn't amazing. Even cardiac surgery, as amazing as it is the first time you see it, becomes mundane if you do it on a daily basis for a few decades. Plus, cardiothoracic surgeons still have to do paperwork and spend a significant amount of time seeing patients outside of the OR. So, it's essential that you get enough clinical experience to where you can get some idea as to whether you would still love this job even though it isn't going to be new and amazing every time you do it. If you want to do more shadowing, I suggest finding a PCP who will let you spend some time with them. That is basic, bread-and-butter medicine. Or, if you think surgery might be your future, then find a general surgeon. Spend time in clinic, go on rounds before you go to the OR. See what their life is really like. Or, spend some more time in the ICU. Saving babies' lives is all well and good, but how will you feel the first time when one of those babies dies despite the docs having done everything they possibly could to save it?

As helpful as shadowing is, it's still not the same as the real deal, because you don't get much patient contact yourself. So it would be even more helpful if you could spend some time either working part-time in a health care setting or doing clinical volunteering where you are directly interacting with patients. The human body is messy and even disgusting sometimes, especially when it's sick. Really sick people will vomit on you, pee on you, poop on you, bleed on you, cough up sputum on you, squirt you with pus or ascitic fluid or amniotic fluid. Many patients also have problems that are impossible to solve for social, economic, or logistical reasons. Want to try anyway? Work or volunteer at a free clinic, or a suicide hotline, or a nursing home, or an emergency department.

If you do these things, and you still think medicine is cool and exciting, then it will be time to talk about the practical steps you need to take to get into medical school.

I cannot thank you enough for your insight! I am truly grateful. I will put the advice into practice and keep you posted. One thing I found out about doing rounds with doctors at that VA hospital is that often times you don't understand what is going on, so you are just standing there while they talk and talk jargon about the patient and don't really get much out of it but volunteering in a free clinic sounds like a great suggestion. Our medical school has one and I can talk to some people to see if they'll let me do something more than just paperwork.

Thanks