Accepted MD and PhD. Having major second thoughts about medicine.

[bobdog20]

Hi everyone. Hope yall are doing well.

I have recently come to a fork in the road about what I want to do in the future and I am having a really hard time deciding.

I am currently accepted to a top 30 medical school and a #1 ranked engineering PhD program. I applied PhD spur of the moment because I was having seconds thoughts about medicine. I just really dont know what I want to do, and I dont think I want to treat patients for a living.

I have always liked medicine, but I am not sure if I wanted medical school just because of the prestige. I have always enjoyed engineering and computer science much more than biology and chemistry. Hence the reason my med app was research-focused with little clinical experience. Furthermore, I have always been very involved in leadership and management from being a former collegiate athlete, and head coaching.

I think my goal is to get into some sort of R and D engineering management position or healthcare consulting, but still, I am not quite sure. I am ready to grind these next 5 years at least because I am passionate about completing a doctorate degree. But I really dont know what I want to do. Also it sucks because my parents really want me to pursue medicine because it is prestigious and guaranteed money. While PhD can be an absolute crap shoot. This is why I am also weighing in job security and potential.

I was wondering, are there any job opportunities if I take the MD route outside of practicing? Some advice my MD-PhD advisor gave me was that the med school clinical experience is "second to none" and will give the skills to be competitive in any profession. In hind sight I really should have pursued an MD-PhD, but I am trying to get into the next step of my life NOW. Also, I spoke with a close friend of mine saying that I shouldn't do medicine because if I am not 100% committed to treating patients I am just wasting medical education, which ya know, makes total sense.

Sorry for the word vomit, but I really am trying to make the best decision for my future. I just dont want to be potentially miserable for the next decade of my life. Any advice from people that have gone through this or have friends that have gone through this would be great. Thanks!

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[Talldoctor96]

If you don’t want to practice medicine, don’t go to medical school.

 

[Putkernerinthehall]

Sounds like you should pursue the PhD in Engineering. I think that's what your gut is telling you. What engineering discipline ? Biomedical Engineering ?

 

[Hotshy]

It sounds like what you really want to do is get your PhD. You shouldn't go into medicine because of the perceived benefits and prestige if you're not really interested. Medical school and residency is hard enough, it will be painful for you if you're not fully invested in it.

 

[Matthew9Thirtyfive]

Sounds like the med school path will just lead to misery and regret. Head to phd land.

 

[LizzyM]

Are you paying for the PhD in engineering or do you have full-tuition and a stipend? Do you have a full-ride for medical school? How does the "guaranteed money" of a a physician balance with the possibility of student loan debt and no income from 2021-2025 and a very modest income for at least 3 years of residency after that?

It is possible to do something other than patient care after medical school -- a handful of students go into consulting and after residency, as a licensed physician, you could go into pharmaceutical or medical device industry and not take care of individual patients but have responsibility for groups of patients on clinical trials, (approving protocol deviations, reviewing adverse event reports, etc). Of course, some people eventually go into the insurance industry (lost souls). Bioinformatics and artificial intelligence are growing fields, too.

Aren't PhDs in engineering usually for people who want to teach or engage in engineering research rather than the practice of engineering? What do you intend to do with the PhD? What is the job market in that specific area of engineering?

 

[bobdog20]

Sounds like you should pursue the PhD in Engineering. I think that's what your gut is telling you. What engineering discipline ? Biomedical Engineering ?

Thank you for the response. I will be doing research in optical engineering and data science.

 

[bobdog20]

Are you paying for the PhD in engineering or do you have full-tuition and a stipend? Do you have a full-ride for medical school? How does the "guaranteed money" of a a physician balance with the possibility of student loan debt and no income from 2021-2025 and a very modest income for at least 3 years of residency after that?

It is possible to do something other than patient care after medical school -- a handful of students go into consulting and after residency, as a licensed physician, you could go into pharmaceutical or medical device industry and not take care of individual patients but have responsibility for groups of patients on clinical trials, (approving protocol deviations, reviewing adverse event reports, etc). Of course, some people eventually go into the insurance industry (lost souls). Bioinformatics and artificial intelligence are growing fields, too.

Aren't PhDs in engineering usually for people who want to teach or engage in engineering research rather than the practice of engineering? What do you intend to do with the PhD? What is the job market in that specific area of engineering?

Thanks for the reply.

For the PhD I would have full tuition, stipend, and potentially a fellowship. In graduate school, I would be researching AI and imaging.
For medical school, I do not have a full-ride, I have a minor scholarship and I would be taking out loans for in-state tuition.

The possibilities you mentioned of the handful of students going into other fields, is what I currently feel like I would be interested in after med school/residency.

Yes, for the most part, from my experience, a majority of PhDs in engineering will pursue academic positions. But from my interviews with potential PIs, recruitment fairs, and forums, there are a lot of opportunities outside of academia. Personally, with the PhD, I would like to master an area of data science or optical instrumentation in biomedical imaging. With the PhD, I would like to pursue an R and D position as a researcher and/or manager. Right now, I am unsure about the job market and the competitiveness of these positions. From my research, I have seen that there is a market for electrical engineering/optics/data science research/management positions in companies like Medtronic and GE. But I am really not sure how competitive or if these positions are unrealistic to obtain.

 

[Banco]

It seems like your heart is set on the PhD option and mostly external pressures are pushing you to MD.

That being said, don’t decide too rashly. You can always you an extra research year in medical school and make it an MD + MS/MBA type situation which can set you you up pretty well for non-clinical career paths.

 

[LizzyM]

Ask the school that has accepted you to the PhD where the recent grads have ended up. Ask if there are recruiting fairs on campus with orgs such as Medtronic and GE. This is an up-and-coming field and people will technical skills will be in demand,

If you become a physician within the world of optics/imaging, it will be for your expertise (and license) as a physician. You will be expected to have had a residency in medicine or radiology or even surgery and perhaps even fellowship training (2 years or more) in a specialty area. Do you want to train for 10 years to take care of patients, so that you can take a job where your responsibility will be the well-being of other people's patients in clinical trials of devices you didn't have the engineering expertise to design but that were designed by others. I think I know where your heart is. Your job now is to help your parents understand that you need to follow your heart and success will come to you.

 

[Goro]

Thanks for the reply.

For the PhD I would have full tuition, stipend, and potentially a fellowship. In graduate school, I would be researching AI and imaging.
For medical school, I do not have a full-ride, I have a minor scholarship and I would be taking out loans for in-state tuition.

The possibilities you mentioned of the handful of students going into other fields, is what I currently feel like I would be interested in after med school/residency.

Yes, for the most part, from my experience, a majority of PhDs in engineering will pursue academic positions. But from my interviews with potential PIs, recruitment fairs, and forums, there are a lot of opportunities outside of academia. Personally, with the PhD, I would like to master an area of data science or optical instrumentation in biomedical imaging. With the PhD, I would like to pursue an R and D position as a researcher and/or manager. Right now, I am unsure about the job market and the competitiveness of these positions. From my research, I have seen that there is a market for electrical engineering/optics/data science research/management positions in companies like Medtronic and GE. But I am really not sure how competitive or if these positions are unrealistic to obtain.

Given your goals, the MD portion of your education would be a waste of time.

Go for the phD

 

[bobdog20]

Ask the school that has accepted you to the PhD where the recent grads have ended up. Ask if there are recruiting fairs on campus with orgs such as Medtronic and GE. This is an up-and-coming field and people will technical skills will be in demand,

If you become a physician within the world of optics/imaging, it will be for your expertise (and license) as a physician. You will be expected to have had a residency in medicine or radiology or even surgery and perhaps even fellowship training (2 years or more) in a specialty area. Do you want to train for 10 years to take care of patients, so that you can take a job where your responsibility will be the well-being of other people's patients in clinical trials of devices you didn't have the engineering expertise to design but that were designed by others. I think I know where your heart is. Your job now is to help your parents understand that you need to follow your heart and success will come to you.

I think so as well. Thank you so much.

 

[Nugester]

Hi everyone. Hope yall are doing well.

I have recently come to a fork in the road about what I want to do in the future and I am having a really hard time deciding.

I am currently accepted to a top 30 medical school and a #1 ranked engineering PhD program. I applied PhD spur of the moment because I was having seconds thoughts about medicine. I just really dont know what I want to do, and I dont think I want to treat patients for a living.

I have always liked medicine, but I am not sure if I wanted medical school just because of the prestige. I have always enjoyed engineering and computer science much more than biology and chemistry. Hence the reason my med app was research-focused with little clinical experience. Furthermore, I have always been very involved in leadership and management from being a former collegiate athlete, and head coaching.

I think my goal is to get into some sort of R and D engineering management position or healthcare consulting, but still, I am not quite sure. I am ready to grind these next 5 years at least because I am passionate about completing a doctorate degree. But I really dont know what I want to do. Also it sucks because my parents really want me to pursue medicine because it is prestigious and guaranteed money. While PhD can be an absolute crap shoot. This is why I am also weighing in job security and potential.

I was wondering, are there any job opportunities if I take the MD route outside of practicing? Some advice my MD-PhD advisor gave me was that the med school clinical experience is "second to none" and will give the skills to be competitive in any profession. In hind sight I really should have pursued an MD-PhD, but I am trying to get into the next step of my life NOW. Also, I spoke with a close friend of mine saying that I shouldn't do medicine because if I am not 100% committed to treating patients I am just wasting medical education, which ya know, makes total sense.

Sorry for the word vomit, but I really am trying to make the best decision for my future. I just dont want to be potentially miserable for the next decade of my life. Any advice from people that have gone through this or have friends that have gone through this would be great. Thanks!

Looks like you should go for the PhD. But to answer this question, yes, there are job opportunities outside of practicing.

 

[LatentStudying]

I can't speak on an engineering PhD, but the Math/CS PhD industry market is crazy good at the moment. Bio/ML based companies are popping up too, so having that focus during your dissertation would help get your foot in the door. Essentially, the only reason to go the MD route is if you directly want to interact with patients rather than have an MD be the liaison. Going MD/PhD also puts you at a severe disadvantage as you need to have a consistent ramp up of publications/cites during your grad stage in order to be competitive for top tier AI positions.

Lastly, the current trend is for AI focused PhDs to go into industry due to the |tenure positions|/|PhDs| imbalance and high salary.

 

[moralis]

If your goal is R&D management or consulting, a PhD from a #1 engineering program should be sufficient.
A common path to industry management positions I've seen is top-tier PhD -> Big 4 consulting -> client side exit.

You could also get to consulting or pharma management from the medical side as well, but it would cost more.

MD/PhD for either would be overkill, imo.
(actually I'm convinced now that it's basically overkill for every position, let alone industry admin/consulting)

 

[YCAGA]

Also it sucks because my parents really want me to pursue medicine because it is prestigious and guaranteed money. While PhD can be an absolute crap shoot. This is why I am also weighing in job security and potential.

You parents don't know what they are talking about, and I would not hesitate to tell them that if I were you. Try to be nice about it of course haha.

A PhD in machine learning from the #1 program is about as close to guaranteed money as you can get in 2021. The "worst case" in terms of compensation and prestige is if you go into academics. That will get you 6-figures very quickly and amazing job security once you can secure tenure. Getting fired as a tenured engineering professor takes a special kind of person. Anyways, the far more lucrative path would be to go work for a FAANG, unicorn company, or quant firm...plenty of ML needs in all of those places. You will be make more money than the vast majority of doctors within 5-10 years at one of these companies. I can link salary stats if there are doubters

Congrats, you have picked and have been accepted into the one field that can go toe-to-toe with medicine in terms of job security, income, and future shortages/needs. You got into the top program for the highest degree possible, so a lot of the issues with computer science jobs have been eliminated by the connections and prestige your program will afford you. The main reason why comp sci doesn't beat out medicine in terms of compensation is that almost every MD/DO makes >$200k/yr, but a ton of comp sci grads are...well average and go to average schools and work at average companies, and max out in the mid $100k range as managers. When getting a PhD, academia can be very competitive so job security is not great...but you stack the deck in your favor so much by going to Stanford or MIT or Cal Tech or whatever school you got into, that you will be fine.

But seriously, nice job on your accomplishments thus far and I am sure that you will have a very successful career in engineering.

 

[SCallergydoc]

I think the PhD sounds more promising however you should ask what the source of your funding will be for the tuition and stipend. Many training program grants come with Pay-back stipulations if you forgo a career in teaching or research. If you are not excited about medicine it will be a long 4 plus years.

 

[bobdog20]

You parents don't know what they are talking about, and I would not hesitate to tell them that if I were you. Try to be nice about it of course haha.

A PhD in machine learning from the #1 program is about as close to guaranteed money as you can get in 2021. The "worst case" in terms of compensation and prestige is if you go into academics. That will get you 6-figures very quickly and amazing job security once you can secure tenure. Getting fired as a tenured engineering professor takes a special kind of person. Anyways, the far more lucrative path would be to go work for a FAANG, unicorn company, or quant firm...plenty of ML needs in all of those places. You will be make more money than the vast majority of doctors within 5-10 years at one of these companies. I can link salary stats if there are doubters

Congrats, you have picked and have been accepted into the one field that can go toe-to-toe with medicine in terms of job security, income, and future shortages/needs. You got into the top program for the highest degree possible, so a lot of the issues with computer science jobs have been eliminated by the connections and prestige your program will afford you. The main reason why comp sci doesn't beat out medicine in terms of compensation is that almost every MD/DO makes >$200k/yr, but a ton of comp sci grads are...well average and go to average schools and work at average companies, and max out in the mid $100k range as managers. When getting a PhD, academia can be very competitive so job security is not great...but you stack the deck in your favor so much by going to Stanford or MIT or Cal Tech or whatever school you got into, that you will be fine.

But seriously, nice job on your accomplishments thus far and I am sure that you will have a very successful career in engineering.

Thanks for the kind words. Appreciate it. The information you mentioned is what I was finding as well, but you make a very good point about the abundance of comp sci grads and their compensation due to the lack of prestige involved with their training institution.

Im Just gonna have to grind and see where it takes me. Best of luck in your studies as well

 

[bobdog20]

I think the PhD sounds more promising however you should ask what the source of your funding will be for the tuition and stipend. Many training program grants come with Pay-back stipulations if you forgo a career in teaching or research. If you are not excited about medicine it will be a long 4 plus years.

Thank you for this information. I will definitely have to look into this.

 

[LindaAccepted]

Thanks for the reply.

For the PhD I would have full tuition, stipend, and potentially a fellowship. In graduate school, I would be researching AI and imaging.
For medical school, I do not have a full-ride, I have a minor scholarship and I would be taking out loans for in-state tuition.

The possibilities you mentioned of the handful of students going into other fields, is what I currently feel like I would be interested in after med school/residency.

Yes, for the most part, from my experience, a majority of PhDs in engineering will pursue academic positions. But from my interviews with potential PIs, recruitment fairs, and forums, there are a lot of opportunities outside of academia. Personally, with the PhD, I would like to master an area of data science or optical instrumentation in biomedical imaging. With the PhD, I would like to pursue an R and D position as a researcher and/or manager. Right now, I am unsure about the job market and the competitiveness of these positions. From my research, I have seen that there is a market for electrical engineering/optics/data science research/management positions in companies like Medtronic and GE. But I am really not sure how competitive or if these positions are unrealistic to obtain.

YOu're right that PhD's in engineering work in industry as well as academia. Given that it's fully funded, it's also a much less expensive route to go. Finally it seems to be training you for what you want to do, not for something that you don't really deep down want to do.

I vote for the PhD.

 

[chs]

I was a mechanical engineering undergrad, worked for a while then did med school. I love what I do (surgery) but once there was a job at this company that just seemed fascinating.

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brconline.com

It was consulting on accidents like the space shuttle disaster as a physician. I would do it part time if I could or it’s a good idea for when you are past prime operating years.
This is mostly to show you that there are all sorts of neat jobs that mix up academic specialties - if you are smart, motivated person, nothing closes doors. Think about the end goal (what do you want to be doing every day) then tailor your academic credentials to that goal.

PS Michael Crichton parlayed med school into a pretty good non clinical career. But that was before med school became so expensive

 

[proudofmykids]

Thanks for the reply.

For the PhD I would have full tuition, stipend, and potentially a fellowship. In graduate school, I would be researching AI and imaging.
For medical school, I do not have a full-ride, I have a minor scholarship and I would be taking out loans for in-state tuition.

The possibilities you mentioned of the handful of students going into other fields, is what I currently feel like I would be interested in after med school/residency.

Yes, for the most part, from my experience, a majority of PhDs in engineering will pursue academic positions. But from my interviews with potential PIs, recruitment fairs, and forums, there are a lot of opportunities outside of academia. Personally, with the PhD, I would like to master an area of data science or optical instrumentation in biomedical imaging. With the PhD, I would like to pursue an R and D position as a researcher and/or manager. Right now, I am unsure about the job market and the competitiveness of these positions. From my research, I have seen that there is a market for electrical engineering/optics/data science research/management positions in companies like Medtronic and GE. But I am really not sure how competitive or if these positions are unrealistic to obtain.

You indicated research in imaging, then AI and optics. In the field of electrical engineering, optical != imaging. Optical typically deals with transmission, encoding, decoding, lenses, materials and devices. Imaging is very heavily algorithmic based (transforms etc for image processing ) for compression and manipulation (think photoshop modification of contrast, edges, highlights, motion, sharpness, blurr, saturation etc.). Imaging is also currently very heavily linked to AI for facial And Image recognition, and related technologies stemming from the developed imaging/AI capabilities (automation for many things relate to visual inspection or review).

many PhD in electrical engineering go into industry to work on R&D for large corporations, and will typically get a 40% salary premium over a starting BSEE position which $100-120k on the west coast.

it sound like this is what you want! Assuming you complete your PhD program in 4 years (those that do it in five or six are just enjoying the student life style), and then will start earning $150k/year. If you compare that with the MD residency path of 4+4years, you’ll have spend about $380K (plus any compounded interest from loans) versus having earned $600k and doing what you want to do.

 

[LatentStudying]

I also think it's important to highlight that in terms of making money, it doesn't make sense to do any PhD (or MD). I did a PhD in CS, so I've done this calculation for myself already. You'll make ~30k a year during your PhD for 4-5 years which will mostly be eaten up by cost of living expenses (rent/food/small luxuries); however, you would make ~120-140k as a new undergrad assuming you're competitive. This nets you a solid 400-700k behind after you finish your PhD (accounting for their promotions). Yes, industry internships pay better, but not even FAIR/DeepMind/MSR makes a dent in this gap.

Now, after you finish and were successful (somewhat dependent on your self marketing as well as your advisor's network), you can get a 200-300k + stock options and probably some nice bonuses. I've had some friends get starting packages around 500k, a single friend got a million...this is unlikely and becoming increasingly rare as ML PhDs are starting to become common. You will still be behind someone who just did an MS due to limits on IRA/retirement investments, and they'll have gotten close to 180-200k with promotions during your time finishing your PhD. This means that due to untaxed capital growth, you will still be very far behind a successful undergrad/MS in the field.

To summarize, the only reason you should do a PhD is that you enjoy research and are willing to take a substantial midlife equity hit to do it. The above scenario is even more extreme when you include the MD portion.

 

[futureapppsy2]

Aren't PhDs in engineering usually for people who want to teach or engage in engineering research rather than the practice of engineering? What do you intend to do with the PhD? What is the job market in that specific area of engineering?

My dad recently retired from a career in engineering (industry R&D)--he only had a bachelors, but the vast majority of his coworkers/supervisees/supervisors had engineering PhDs. Engineering is one of those fields where most PhDs go into industry, and there's plenty of opportunities in industry for them where a PhD is highly valued.

 

[TheFutureDoctor9]

Hi everyone. Hope yall are doing well.

I have recently come to a fork in the road about what I want to do in the future and I am having a really hard time deciding.

I am currently accepted to a top 30 medical school and a #1 ranked engineering PhD program. I applied PhD spur of the moment because I was having seconds thoughts about medicine. I just really dont know what I want to do, and I dont think I want to treat patients for a living.

I have always liked medicine, but I am not sure if I wanted medical school just because of the prestige. I have always enjoyed engineering and computer science much more than biology and chemistry. Hence the reason my med app was research-focused with little clinical experience. Furthermore, I have always been very involved in leadership and management from being a former collegiate athlete, and head coaching.

I think my goal is to get into some sort of R and D engineering management position or healthcare consulting, but still, I am not quite sure. I am ready to grind these next 5 years at least because I am passionate about completing a doctorate degree. But I really dont know what I want to do. Also it sucks because my parents really want me to pursue medicine because it is prestigious and guaranteed money. While PhD can be an absolute crap shoot. This is why I am also weighing in job security and potential.

I was wondering, are there any job opportunities if I take the MD route outside of practicing? Some advice my MD-PhD advisor gave me was that the med school clinical experience is "second to none" and will give the skills to be competitive in any profession. In hind sight I really should have pursued an MD-PhD, but I am trying to get into the next step of my life NOW. Also, I spoke with a close friend of mine saying that I shouldn't do medicine because if I am not 100% committed to treating patients I am just wasting medical education, which ya know, makes total sense.

Sorry for the word vomit, but I really am trying to make the best decision for my future. I just dont want to be potentially miserable for the next decade of my life. Any advice from people that have gone through this or have friends that have gone through this would be great. Thanks!

I am a first-year medical student and was sort of in the same situation. I studied biomedical engineering in undergrad and really enjoyed engineering, technology, and R&D.

If you decide to do MD, you will have plenty of job options outside of medicine (and you don't have to do residency if you don't want to). Every company from medical technology companies, pharma companies, to consulting companies need MDs for their medical knowledge and pay top dollar. And during medical school, you will be able to determine if you want to treat patients for a living or do something else. If you decide you like dealing with patients and caring for them, you will be able to pursue a residency. If you don't enjoy it or don't see yourself doing it, you will have plenty of options and you will not have difficulty finding a job. The MD is one of the most respected if not most respected degree and you can do practically anything with the degree.

 

[Angus Avagadro]

I always tell students if you are thinking about applying to med school, then don't. Its basically a calling to service to other human beings. It's much too hard a road, physically and mentally, to travel unless you feel called to it. Good luck in engineering. Sounds very cool!

 

[bobdog20]

I also think it's important to highlight that in terms of making money, it doesn't make sense to do any PhD (or MD). I did a PhD in CS, so I've done this calculation for myself already. You'll make ~30k a year during your PhD for 4-5 years which will mostly be eaten up by cost of living expenses (rent/food/small luxuries); however, you would make ~120-140k as a new undergrad assuming you're competitive. This nets you a solid 400-700k behind after you finish your PhD (accounting for their promotions). Yes, industry internships pay better, but not even FAIR/DeepMind/MSR makes a dent in this gap.

Now, after you finish and were successful (somewhat dependent on your self marketing as well as your advisor's network), you can get a 200-300k + stock options and probably some nice bonuses. I've had some friends get starting packages around 500k, a single friend got a million...this is unlikely and becoming increasingly rare as ML PhDs are starting to become common. You will still be behind someone who just did an MS due to limits on IRA/retirement investments, and they'll have gotten close to 180-200k with promotions during your time finishing your PhD. This means that due to untaxed capital growth, you will still be very far behind a successful undergrad/MS in the field.

To summarize, the only reason you should do a PhD is that you enjoy research and are willing to take a substantial midlife equity hit to do it. The above scenario is even more extreme when you include the MD portion.

Thanks for the response.

I like research, furthermore, I want the training to think like a researcher and to experience that academic environment.

Do you have any advice on choosing advisors and how to market myself for industry?

 

[LatentStudying]

Thanks for the response.

I like research, furthermore, I want the training to think like a researcher and to experience that academic environment.

Do you have any advice on choosing advisors and how to market myself for industry?

Probably the best option is to meet with them and chat about research as the most important thing is the empathy of the advisor. I know of great PhDs whose careers were killed because their advisor did not really care about them beyond increasing cites/pubs from the lab for more grants/securing tenure.

Also, a heads up, if you do an ML focused thesis, industry positions are mostly software engineering where one applies established methods (hot architectures/training regimes) with very little true research (referred to as 'applied scientist' positions) unless you go to FAIR/MSR/DeepMind/Google Brain. Even Amazon is mostly geared towards product. Getting good industry positions is tied to your advisor/lab as they can help you setup visiting talks and network at conferences.

 

[mr_unlimited]

I was in a similar situation some years ago (I was deciding between a really great PhD opportunity and MD-PhD at not my top school) so figured I would give my two-cents. Follow the path you're most excited about in the moment, and be confident that choosing a highly productive path opens more doors than it closes. Coming out of undergrad, I was extremely excited about research, and less enthusiastic about memorizing a bunch of facts in medical school, so I chose to do the PhD. I don't regret getting my PhD at all, but while doing it, I realized that research wouldn't be enough to satisfy me and that I needed clinical engagement to reach my career goals. So now I've applied to medical school, gotten into my top choices, and I'm extremely excited to begin learning how to care for patients. An important caveat is that since I did my PhD abroad, I could finish it in three years, and it would have changed my calculus if I knew it would take much longer. But even if it takes longer, I don't think you need to consider the MD as a closed door if you go get your PhD.