Accepted MD/PhD applicant no longer passionate about PhD

[applesauce14]

Hey everyone. I am very grateful to be accepted to some MSTPs. When I initially applied, my only research experience had been my work in my undergrad lab. I didn't really understand what it means to be a PI. Now that I have worked for almost a year in a lab at an academic medical center, I see what my PI does on a daily basis. I have come to realize that I do not want to be a PI myself. It is simply not for me. However, I still want to teach and pursue academic medicine. With that being said, should I accept an offer to one of the MSTPs I have been accepted to, or should I back out now and go down the MD only path? One of the programs I am accepted to offers PhD training in non-traditional fields. Should I go to that program and do a PhD in public health or epidemiology or something? I could see myself doing that type of research, I just don't really want bench research anymore. Finances are another consideration. I was kind of preparing for the stipend and tuition waiver (of course that is not why I chose MD/PhD). Now, I have nothing saved and no financial support from family. The thought of all the medical school debt stresses me more than anything. So what do you think I should do? Suck it up and do the MD/PhD in basic science like I originally planned? Go to the program that offers PhD in non-trad fields? Or back out now and go the MD-only route? Help!

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[Coffeeenthusiast99]

It is a complex situation for sure. At the end of the day, no one can tell you what to do. If I were you, I would email the schools asking if you can covert your MD/PhD acceptances to MD ones.

Based on what you are describing, you saw the research lifestyle and you don’t want it. If it were me, I would go the MD route if that’s the case. I know you are stressed about money, but think about the loss of attending or professors salary for the years you are doing the PhD. You can take out more loans to keep up your lifestyle and pay them back easily as a clinician. Also, you would be opening up a seat for someone who wants to attend such a program

However, consider if you are feeling burnt out by the research environment. You don’t want to drop out and realize you wanted the degree all along.

 

[mudfud26]

Is your PI a physician-scientist or PhD only? The life of a physician-scientist is very different from a basic science PhD. Many do all clinical research or highly translational work. Your time split depends on your funding, so you could get funding to just do clinical research and pay someone else to do the bench work.
If you’re able, talk to some MD-PhDs or physician scientists that are MD only to try to get a picture of their PI lifestyle.
If you absolutely hate all research and don’t want to apply for funding as an attending (less clinical time = less salary from the hospital), then covert to MD-only.

 

[wholeheartedly]

The above question is important. i do think it’s worth considering something like epidemiology though (even MPH in epi instead of PhD). I’m probably biased because that’s my area, but it’s very different from the basic science world. I would seek out some MD/Epi and public health physician researchers and have some conversations with them before you decide.

 

[Mr.Smile12]

I'll also say that academic medical professor is not the only career trajectory for an MD/PhD, but most training is designed for that outcome. Even as a professor without a Ph.D., medical education will have teaching faculty do a lot of juggling. I'm not sure if you have ever talked with teaching faculty and what they all have to go through, so I caution the dream of teaching is not one that comes without its issues.

The issue goes back to "do you want to do medicine"? This is a crossroads where going back to this point is almost impossible until you are settled in a career path. You can ask about turning down your MSTP slot for the MD spot only; I don't think it's that much trouble, and someone on the MSTP waitlist may be very happy. You can also still do research as a medical student without the long duration of the MSTP track.

Finances: talk to financial aid and the possibility of loan repayment (check out NIH LRP: Eligibility & Programs | National Institutes of Health | Division of Loan Repayment).

 

[Maebea]

Your situation is not unusual. Every year ~12% of the individuals who are admitted MD-PhD end up enrolling MD-only. It is not going to get any easier to make the decision later when you have 3 or 4 years invested in a program, so it is better to pull the trigger now. I would only recommend doing a non-bench PhD if you are truly interested in making that a significant part of your future career. You do not need a PhD to do Epi or public health. You can get a Masters in clinical investigation as part of 5-year medical school program, or learn how to do clinical research through a CTSA during your fellowship time. Not to downplay the money aspect, but trading 4 or 5 years doing something that does not excite you, at a salary that is 1/10th of what you could make sooner as a clinician, to avoid medical school debt is a false economy. Everyone's situation is different, but were I in your shoes I would follow my heart and take a pass on the PhD.

 

[applesauce14]

The above question is important. i do think it’s worth considering something like epidemiology though (even MPH in epi instead of PhD). I’m probably biased because that’s my area, but it’s very different from the basic science world. I would seek out some MD/Epi and public health physician researchers and have some conversations with them before you decide.

Do you know what type of research public health physician scientists do? Do you have any examples?

 

[applesauce14]

Your situation is not unusual. Every year ~12% of the individuals who are admitted MD-PhD end up enrolling MD-only. It is not going to get any easier to make the decision later when you have 3 or 4 years invested in a program, so it is better to pull the trigger now. I would only recommend doing a non-bench PhD if you are truly interested in making that a significant part of your future career. You do not need a PhD to do Epi or public health. You can get a Masters in clinical investigation as part of 5-year medical school program, or learn how to do clinical research through a CTSA during your fellowship time. Not to downplay the money aspect, but trading 4 or 5 years doing something that does not excite you, at a salary that is 1/10th of what you could make sooner as a clinician, to avoid medical school debt is a false economy. Everyone's situation is different, but were I in your shoes I would follow my heart and take a pass on the PhD.

So if you do not need a PhD to do Epi or public health research, then why do people do MD/PhDs in Epi/public health? There must be some added benefit?

 

[wholeheartedly]

So if you do not need a PhD to do Epi or public health research, then why do people do MD/PhDs in Epi/public health? There must be some added benefit?

I would say that’s a function of interest into how deep you want to go into epi methods, how self reliant vs collaborative with other experts. Physicians can do good work with just an MPH in Epi or MS in clinical research etc. then again, covid has also shown you can still be a complete fool too with those.

I’ll try to send some examples this evening.

In the meantime, what areas of science or medicine interest you? any specialties you’re planning to look into.

 

[applesauce14]

I would say that’s a function of interest into how deep you want to go into epi methods, how self reliant vs collaborative with other experts. Physicians can do good work with just an MPH in Epi or MS in clinical research etc. then again, covid has also shown you can still be a complete fool too with those.

I’ll try to send some examples this evening.

In the meantime, what areas of science or medicine interest you? any specialties you’re planning to look into.

Thanks so much! I look forward to hearing some examples. I am interested in peds, food security, nutrition, and generally just improving access to healthy food for kids and adolescents. Also interested broadly in LGBTQ+ issues in health and medicine

 

[SurfingDoctor]

Thanks so much! I look forward to hearing some examples. I am interested in peds, food security, nutrition, and generally just improving access to healthy food for kids and adolescents. Also interested broadly in LGBTQ+ issues in health and medicine

Most of the people who address those issues... don't have nor need a PhD. That is public health policy. An MPH is better suited for that and even then... policy and research rarely achieve things in similar fashion.

 

[ChordaEpiphany]

So if you do not need a PhD to do Epi or public health research, then why do people do MD/PhDs in Epi/public health? There must be some added benefit?

People here will say, "adequate training" or "to go into greater depth." I think the reality for most is just not really knowing any better, and that's not just for epi/public health. Most MD/PhDs don't use the PhD to an extent that justifies the added expense. It's just the nature of a PhD, regardless of other training. Most of my PhD-only friends, who are now 2-5 years removed from graduation, basically say they are in or moving towards positions that never required a PhD, and that they are a few years behind on the pay scale compared to people in their company with an MS. It's actually disappointing, because the PhD students in my program are head and shoulders above the MS students in just about every academic sense, but it's the reality. Career-specific training will propel you further professionally than academic exploration in every environment (except academia).

Most of the time MD/MPH will prepare a person for these Epi/PH careers better. If you really had your heart set on a research career, I could see how an MD/PhD could be worthwhile under certain circumstances. If you could graduate in 7 years it would only be 2 more years than MD/MPH, and you'd be debt free. This could give you more freedom to take on positions with fewer clinical responsibilities and more research time.

The other side of it is that PhDs can be fun (if approached with the right attitude). I've had some of the best and worst times of my life in grad school. Had COVID not put my entire PhD into jeopardy and placed me under extreme amounts of stress, I probably would have looked back on these years as some of the best of my life.

 

[wholeheartedly]

Sorry for the delay.

So public health and epidemiology research are incredibly broad. It’s pretty much the study of disease and the determinants of health at the population level. That can range from things like trials of new diagnostics, pharm and non-pharmacologic therapeutics, or medical devices to things like studying the impact of pollution on asthma attacks or food deserts on diabetes. The possibilities are endless. A PhD isn’t necessarily required but I would recommend some advanced training to get a solid foundation to do rigorous work with sound methodology (and if you do something like an MPH or MS in clinical research during a fellowship, you can often get it funded)

My focus is ID, so that’s most of what I’m familiar with. Here’s some MDs doing public health research. just go to epi phD program websites and see what MD faculty are doing. don’t be afraid to reach out to a few and ask questions

David Boulware, MD MPH

David Boulware

med.umn.edu

He does very translational work ranging from bench research to large trials in a global health setting. One his areas of focus is improving diagnosis and treatment of cryptococcal meningitis and TB meningitis in resource limited settings. He’s recently been involved with trials looking into possible covid19 therapeutics.
Practices clinically.

Chandy John, MD MS
Chandy C. John, MD, MS
He also does a mix of laboratory and population level work research on pediatric cerebral malaria. Everything from immunologic factors to treatment.
Also practices clinically.

Alan Lifson, MD MPH

Alan Lifson, MD, MPH | School of Public Health Directory

directory.sph.umn.edu

HIV treatment protocols and community interventions

Good read

An Interview With A Physician-Epidemiologist – Early Career Voice

Melissa Laska, PhD, RD (not an MD but since you mentioned nutrition)

Melissa Laska, PhD, RD | School of Public Health Directory

directory.sph.umn.edu

Simon Rosser, PhD MPH (not an MD but because you mentioned LGBTQ)

B.R. Simon Rosser, PhD, MPH | School of Public Health Directory

directory.sph.umn.edu

Behavioral HIV prevention and interventions

Kamakshi Lakshminarayan, MBBS PhD MS

Kamakshi Lakshminarayan, MBBS, PhD, MS | School of Public Health Directory

directory.sph.umn.edu

Colin West, MD PhD

Colin P. West, M.D., Ph.D.

Colin P. West, M.D., Ph.D., is a quantitative health sciences researcher at Mayo Clinic whose work focuses on physician well-being, evidence-based medicine and biostatistics, and medical education.

www.mayo.edu

west cp[Author] - Search Results - PubMed

west cp[Author] - Search Results - PubMed

pubmed.ncbi.nlm.nih.gov

Biostats PhD, has done large health sciences work, evidence based medicine, more recently been focused on physician well-being and medical education, and some covid stuff.
I think he still practices clinically.

example clinical translational topics

Alumni - Center for Clinical and Translational Science - Center for Clinical and Translational Science (CCaTS)

www.mayo.edu

Steven Goodman, MD MHS PhD

Steven Goodman | Stanford Medicine

med.stanford.edu

Ana Baylin, MD DrPH

Ana Baylin - Faculty Profiles - U-M School of Public Health

sph.umich.edu

nutritional epi

Eduardo Villamor, MD DrPH

Eduardo Villamor - Faculty Profiles - U-M School of Public Health

sph.umich.edu

nutritional epi

Zhenhua Yang, MD PhD

Zhenhua Yang - Faculty Profiles - U-M School of Public Health

sph.umich.edu

TB epi

Haitao Chu, MD PhD

Haitao Chu, PhD, MD | School of Public Health Directory

directory.sph.umn.edu

biostats, trials, diagnostics, methodolgy

Pascal Geldsetzer, MD PhD

Pascal Geldsetzer's Profile | Stanford Profiles

Pascal Geldsetzer is part of Stanford Profiles, official site for faculty, postdocs, students and staff information (Expertise, Bio, Research, Publications, and more). The site facilitates research and collaboration in academic endeavors.

profiles.stanford.edu

primary care and population health

Horacio Duarte, MD MS
health services research, pharmacology, cost effectiveness of therapeutics

Horacio Duarte, MD, MS | School of Public Health Directory

directory.sph.umn.edu

Aaron Folsom, MD MPH

Aaron Folsom, MD, MPH | School of Public Health Directory

directory.sph.umn.edu

cardiovascular epi and preventive med

Madhukar Pai, MD PhD

Madhukar Pai

Prof Madhukar Pai, MD, PhD, FCAHS Canada Research Chair in Translational Epidemiology & Global Health Associate Director, McGill International TB Centre Dept. of Epidemiology, Biostatistics & Occupational Health McGill University 1020 Pine Avenue West Montreal, Canada H3A 1A2 (514)...

www.mcgill.ca

Michael Mina MD PhD

Michael Mina

(Former Bio) Dr. Michael Mina, MD, PhD was an Assistant Professor of Epidemiology at Harvard T. H. Chan School of Public Health and a core member of the Center for Communicable Disease Dynamics (CC…

ccdd.hsph.harvard.edu

Christopher Golden, PhD

https://www.hsph.harvard.edu/-golden/

nurtitional epi, climate change

Dominique Earland, MD PhD student in Epidemiology

Dominique E. Earland

med.umn.edu

You can skim this list of MSTP alumni to see who did Epi, thesis topic, and what they are currently doing. (4 epi., 1 health informatics, 1 environmental health)

Alumni Directory

Since program inception, 183 trainees have completed MD-PhD training. A total of 140 (76%) hold research positions in academic medicine or industry, or are still in academic medicine training. In a recent alumni survey, 82% of respondents indicated that they would choose to training again in an...

med.umn.edu

Profiles on this page

Courses, Schedules & Enrollment | School of Public Health

publichealth.pitt.edu

sample thesis topics near bottom of page for Mayo Clinical and Translational Sci PhD

Clinical and Translational Science - Tracks - Ph.D. Program in Biomedical Science - Mayo Clinic College of Medicine & Science

Learn more about the Clinical and Translational Science (CTS) track within the Ph.D. Program at Mayo Clinic Graduate School of Biomedical Science.

college.mayo.edu

see the following areas for Case MSTP, if you scroll through you’ll see mentors in clinical and translational science and epidemiology

MSTP Mentors | Medical Scientist Training Program | Case Western Reserve University

The CWRU MSTP has a group of amazing mentors. Our faculty are often recognize for their outstanding mentorship, locally and nationally. Congratula...

case.edu

University of Michigan School of Public Health Faculty

At the University of Michigan School of Public Health, more than 200 professors and research scientists teach tomorrow’s public health leaders and perform cutting-edge research that helps advance the field of public health. Many faculty members are leading experts in their fields who consult...

sph.umich.edu

quite a few MD PhD under courtesy faculty

Faculty

med.stanford.edu

 

[applesauce14]

People here will say, "adequate training" or "to go into greater depth." I think the reality for most is just not really knowing any better, and that's not just for epi/public health. Most MD/PhDs don't use the PhD to an extent that justifies the added expense. It's just the nature of a PhD, regardless of other training. Most of my PhD-only friends, who are now 2-5 years removed from graduation, basically say they are in or moving towards positions that never required a PhD, and that they are a few years behind on the pay scale compared to people in their company with an MS. It's actually disappointing, because the PhD students in my program are head and shoulders above the MS students in just about every academic sense, but it's the reality. Career-specific training will propel you further professionally than academic exploration in every environment (except academia).

Most of the time MD/MPH will prepare a person for these Epi/PH careers better. If you really had your heart set on a research career, I could see how an MD/PhD could be worthwhile under certain circumstances. If you could graduate in 7 years it would only be 2 more years than MD/MPH, and you'd be debt free. This could give you more freedom to take on positions with fewer clinical responsibilities and more research time.

The other side of it is that PhDs can be fun (if approached with the right attitude). I've had some of the best and worst times of my life in grad school. Had COVID not put my entire PhD into jeopardy and placed me under extreme amounts of stress, I probably would have looked back on these years as some of the best of my life.

That’s the thing, I genuinely love learning and love being student. The idea of doing a PhD honestly just sounds fun to me! (And I want to do something good for the world of course). Do you think that is a silly reason to do the MD/PhD? I have acceptances so I feel like I should just roll with it at this point

 

[applesauce14]

Sorry for the delay.

So public health and epidemiology research are incredibly broad. It’s pretty much the study of disease and the determinants of health at the population level. That can range from things like trials of new diagnostics, pharm and non-pharmacologic therapeutics, or medical devices to things like studying the impact of pollution on asthma attacks or food deserts on diabetes. The possibilities are endless. A PhD isn’t necessarily required but I would recommend some advanced training to get a solid foundation to do rigorous work with sound methodology (and if you do something like an MPH or MS in clinical research during a fellowship, you can often get it funded)

My focus is ID, so that’s most of what I’m familiar with. Here’s some MDs doing public health research. just go to epi phD program websites and see what MD faculty are doing. don’t be afraid to reach out to a few and ask questions

David Boulware, MD MPH

David Boulware

med.umn.edu

He does very translational work ranging from bench research to large trials in a global health setting. One his areas of focus is improving diagnosis and treatment of cryptococcal meningitis and TB meningitis in resource limited settings. He’s recently been involved with trials looking into possible covid19 therapeutics.
Practices clinically.

Chandy John, MD MS
Chandy C. John, MD, MS
He also does a mix of laboratory and population level work research on pediatric cerebral malaria. Everything from immunologic factors to treatment.
Also practices clinically.

Alan Lifson, MD MPH

Alan Lifson, MD, MPH | School of Public Health Directory

directory.sph.umn.edu

HIV treatment protocols and community interventions

Good read

An Interview With A Physician-Epidemiologist – Early Career Voice

Melissa Laska, PhD, RD (not an MD but since you mentioned nutrition)

Melissa Laska, PhD, RD | School of Public Health Directory

directory.sph.umn.edu

Simon Rosser, PhD MPH (not an MD but because you mentioned LGBTQ)

B.R. Simon Rosser, PhD, MPH | School of Public Health Directory

directory.sph.umn.edu

Behavioral HIV prevention and interventions

Kamakshi Lakshminarayan, MBBS PhD MS

Kamakshi Lakshminarayan, MBBS, PhD, MS | School of Public Health Directory

directory.sph.umn.edu

Colin West, MD PhD

Colin P. West, M.D., Ph.D.

Colin P. West, M.D., Ph.D., is a quantitative health sciences researcher at Mayo Clinic whose work focuses on physician well-being, evidence-based medicine and biostatistics, and medical education.

www.mayo.edu

west cp[Author] - Search Results - PubMed

west cp[Author] - Search Results - PubMed

pubmed.ncbi.nlm.nih.gov

Biostats PhD, has done large health sciences work, evidence based medicine, more recently been focused on physician well-being and medical education, and some covid stuff.
I think he still practices clinically.

example clinical translational topics

Alumni - Center for Clinical and Translational Science - Center for Clinical and Translational Science (CCaTS)

www.mayo.edu

Steven Goodman, MD MHS PhD

Steven Goodman | Stanford Medicine

med.stanford.edu

Ana Baylin, MD DrPH

Ana Baylin - Faculty Profiles - U-M School of Public Health

sph.umich.edu

nutritional epi

Eduardo Villamor, MD DrPH

Eduardo Villamor - Faculty Profiles - U-M School of Public Health

sph.umich.edu

nutritional epi

Zhenhua Yang, MD PhD

Zhenhua Yang - Faculty Profiles - U-M School of Public Health

sph.umich.edu

TB epi

Haitao Chu, MD PhD

Haitao Chu, PhD, MD | School of Public Health Directory

directory.sph.umn.edu

biostats, trials, diagnostics, methodolgy

Pascal Geldsetzer, MD PhD

Pascal Geldsetzer's Profile | Stanford Profiles

Pascal Geldsetzer is part of Stanford Profiles, official site for faculty, postdocs, students and staff information (Expertise, Bio, Research, Publications, and more). The site facilitates research and collaboration in academic endeavors.

profiles.stanford.edu

primary care and population health

Horacio Duarte, MD MS
health services research, pharmacology, cost effectiveness of therapeutics

Horacio Duarte, MD, MS | School of Public Health Directory

directory.sph.umn.edu

Aaron Folsom, MD MPH

Aaron Folsom, MD, MPH | School of Public Health Directory

directory.sph.umn.edu

cardiovascular epi and preventive med

Madhukar Pai, MD PhD

Madhukar Pai

Prof Madhukar Pai, MD, PhD, FCAHS Canada Research Chair in Translational Epidemiology & Global Health Associate Director, McGill International TB Centre Dept. of Epidemiology, Biostatistics & Occupational Health McGill University 1020 Pine Avenue West Montreal, Canada H3A 1A2 (514)...

www.mcgill.ca

Michael Mina MD PhD

Michael Mina

(Former Bio) Dr. Michael Mina, MD, PhD was an Assistant Professor of Epidemiology at Harvard T. H. Chan School of Public Health and a core member of the Center for Communicable Disease Dynamics (CC…

ccdd.hsph.harvard.edu

Christopher Golden, PhD

https://www.hsph.harvard.edu/-golden/

nurtitional epi, climate change

Dominique Earland, MD PhD student in Epidemiology

Dominique E. Earland

med.umn.edu

You can skim this list of MSTP alumni to see who did Epi, thesis topic, and what they are currently doing. (4 epi., 1 health informatics, 1 environmental health)

Alumni Directory

Since program inception, 183 trainees have completed MD-PhD training. A total of 140 (76%) hold research positions in academic medicine or industry, or are still in academic medicine training. In a recent alumni survey, 82% of respondents indicated that they would choose to training again in an...

med.umn.edu

Profiles on this page

Courses, Schedules & Enrollment | School of Public Health

publichealth.pitt.edu

sample thesis topics near bottom of page for Mayo Clinical and Translational Sci PhD

Clinical and Translational Science - Tracks - Ph.D. Program in Biomedical Science - Mayo Clinic College of Medicine & Science

Learn more about the Clinical and Translational Science (CTS) track within the Ph.D. Program at Mayo Clinic Graduate School of Biomedical Science.

college.mayo.edu

see the following areas for Case MSTP, if you scroll through you’ll see mentors in clinical and translational science and epidemiology

MSTP Mentors | Medical Scientist Training Program | Case Western Reserve University

The CWRU MSTP has a group of amazing mentors. Our faculty are often recognize for their outstanding mentorship, locally and nationally. Congratula...

case.edu

University of Michigan School of Public Health Faculty

At the University of Michigan School of Public Health, more than 200 professors and research scientists teach tomorrow’s public health leaders and perform cutting-edge research that helps advance the field of public health. Many faculty members are leading experts in their fields who consult...

sph.umich.edu

quite a few MD PhD under courtesy faculty

Faculty

med.stanford.edu

Wow! Thank you so much for this! This is very helpful and I find a lot of this really interesting. My plan is to stick with the MD/PhD at least for now, because there seems to be a pretty strong epi program at the school I’m planning to enroll!

 

[ChordaEpiphany]

That’s the thing, I genuinely love learning and love being student. The idea of doing a PhD honestly just sounds fun to me! (And I want to do something good for the world of course). Do you think that is a silly reason to do the MD/PhD? I have acceptances so I feel like I should just roll with it at this point

No. This kind of attitude will carry you through an MD/PhD, and it's one of the only true valid reason. Personally, I couldn't see myself not doing a PhD. There are days (and long nights) where I really have to remember that, and it will be the same for you.

What you should realize though is that probably you will fail to reach your highest aspirations, and MD/PhDs usually have very, very lofty goals. You will eat a lot of s*it from egotistical PIs and collaborators. You will be broke longer than you are comfortable. At the end of it, you may have very little to show for 4-5 (sometimes 6-7) years of effort. I got scooped tonight. Not entirely, I can still publish well, but a big paper in my field showed something I thought I'd be the first to show. If I were here solely because of ambition, I'd be in a sorry state right now. Instead, I'm reminded that it's kind of crazy that I was racing with one of the top 5 leaders in the field to show something, and at the end of the day, my lab doesn't have even half the capacity necessary to compete so whatever. A lot of stuff will be completely out of your control. Only your passion for science will make this worth it. If you want anything else, skip the PhD. It's not worth it.

 

[mudfud26]

I got scooped tonight. Not entirely, I can still publish well, but a big paper in my field showed something I thought I'd be the first to show. If I were here solely because of ambition, I'd be in a sorry state right now. Instead, I'm reminded that it's kind of crazy that I was racing with one of the top 5 leaders in the field to show something

To be fair, this means what you’re doing is REAL and replicable. Yeah, someone else showed it, but if you submit within the next few months, it’s for sure that you’ve been working on your project for just as long. Isn’t there a journal that has a policy where they’ll still publish you even if someone published right before you?
Also, bioRx your stuff, like right now for the credit.