Advice about taking a year off from MD-PhD

[outlier]

---

Members do not see this ad.

Hi, first of all, I apologize for this long posting. Hopefully some of you will find it somewhat interesting...

I'm a first-year MD-PhD student, and ever since I started med school I've been feeling "lost" and undirected, like my life is taking a detour, and I've been questioning my reasons for doing a combined degree rather than just the PhD program, which had been my plan throughout college. I've realized that my primary incentive was that the MD-PhD program sounded so "impressive", and unfortunately I've always been a sucker for external validation. However, I also realize that there are many valid reasons for being in this program, even if my original motives were not so valid, so now I'm trying to figure out whether to stay or just transfer into the straight-up graduate school.

However, this decision is complicated by the fact that I'm also trying to figure out what kind of research I want to do. I've been fascinated by cognitive neuroscience for many years, and all my college and post-college (3 years) research experience has been in that area. However, for reasons that I won't go into here, I've become disillusioned with that type of research, and I now find it unsatisfying. So I'm trying to explore other types of research, preferably neuroscience-related, as that has always been my passion. I did a summer rotation (prior to my first year) in a molecular neuro lab, which I enjoyed and I've continued to do part-time research there during the semester. But I haven't found it to be as fascinating as cog neuro has always been for me. However, this could just be because I need to give it more time, and understand it on a deeper level. I'm trying a non-neuro biochemistry lab next summer (it sounded so interesting even though its not neuro!). I'm so caught up in looking into different types of research and trying out different labs, that my med school classes are the last thing on my mind. Luckily, I've been passing all my classes, but I resent the fact that they are taking time away from my discovering what type of scientist I want to become, which is far more important to me.

So... I've been thinking about trying to take next year off to work in some type of research lab away from my current school. In that time, I hope I could also explore what is going on at other labs, by attending lab meetings, shadowing students, meeting with PIs, etc., because I wouldn't have to worry about coursework. I believe that having this experience at another school would make it more about what type of scientist I want to be, ie. discovering "myself", rather than which lab I want to do my thesis in, a decision that I only want to tackle after this initial period of discovery. Hopefully I could also do some soul-searching about whether it is worthwhile for me to go to med school.

If possible, I would love to go abroad, because I've never lived abroad for any significant amount of time. So, besides more general advice about the above issues, I'm also welcoming advice on how to find year-long lab positions abroad.

Thanks for reading!

 

[wjstk]

Hi, first of all, I apologize for this long posting. Hopefully some of you will find it somewhat interesting...

I'm a first-year MD-PhD student, and ever since I started med school I've been feeling "lost" and undirected, like my life is taking a detour, and I've been questioning my reasons for doing a combined degree rather than just the PhD program, which had been my plan throughout college. I've realized that my primary incentive was that the MD-PhD program sounded so "impressive", and unfortunately I've always been a sucker for external validation. However, I also realize that there are many valid reasons for being in this program, even if my original motives were not so valid, so now I'm trying to figure out whether to stay or just transfer into the straight-up graduate school.

However, this decision is complicated by the fact that I'm also trying to figure out what kind of research I want to do. I've been fascinated by cognitive neuroscience for many years, and all my college and post-college (3 years) research experience has been in that area. However, for reasons that I won't go into here, I've become disillusioned with that type of research, and I now find it unsatisfying. So I'm trying to explore other types of research, preferably neuroscience-related, as that has always been my passion. I did a summer rotation (prior to my first year) in a molecular neuro lab, which I enjoyed and I've continued to do part-time research there during the semester. But I haven't found it to be as fascinating as cog neuro has always been for me. However, this could just be because I need to give it more time, and understand it on a deeper level. I'm trying a non-neuro biochemistry lab next summer (it sounded so interesting even though its not neuro!). I'm so caught up in looking into different types of research and trying out different labs, that my med school classes are the last thing on my mind. Luckily, I've been passing all my classes, but I resent the fact that they are taking time away from my discovering what type of scientist I want to become, which is far more important to me.

So... I've been thinking about trying to take next year off to work in some type of research lab away from my current school. In that time, I hope I could also explore what is going on at other labs, by attending lab meetings, shadowing students, meeting with PIs, etc., because I wouldn't have to worry about coursework. I believe that having this experience at another school would make it more about what type of scientist I want to be, ie. discovering "myself", rather than which lab I want to do my thesis in, a decision that I only want to tackle after this initial period of discovery. Hopefully I could also do some soul-searching about whether it is worthwhile for me to go to med school.

If possible, I would love to go abroad, because I've never lived abroad for any significant amount of time. So, besides more general advice about the above issues, I'm also welcoming advice on how to find year-long lab positions abroad.

Thanks for reading!

Hi outlier, I’m just an undergrad so just please take my input with a grain of salt 🙂 There are many others who can better provide you answers, but I just wanted to help 😛
I think that the ultimate goal of MD/PhD programs is to train scientist in clinical or basic science with the medical background. There are also some schools that offer the HHMI cross-disciplinary graduate training program to train PhDs with emphasis in clinical medicine. The difference here would be the access to patients which is totally up to your real goal. Some other differences I think in terms of getting grants there’s not much difference having a PhD or MD/PhD (different programs to apply perhaps but similar funding amount, I guess) but in terms of getting a position…I think an MD/PhD has more advantage (not very sure, please someone correct me if wrong 😳).
Also, instead of taking a year off, I believe that during your MD/PhD program you can start your PhD training after the first year of med school (again not sure).
Hope that somehow my post helps, definitely talk to your training program advisors.
Good luck!

 

[Neuronix]

I can't stress how bad of a move throwing away a MD is. The research world is very unstable. There are far too many PhDs out there. Obtaining funding is very difficult. The MD world means job security and much higher salary for roughly the same amount of work. Keep that in mind. Unless you absolutely cannot tolerate the idea of doing clinical work, you are already in medical school, and I think you should keep working towards your MD.

What are you saying and proposing is somewhat unusual, but I'd like to understand your motivations. Why do you dislike your first year of medical school so much? Or if that's not it, why do you feel so unfocused by medical school? I think you'll get what you seek in your first year graduate school within the MD/PhD program. There's no need to force that now, though you could in theory go off to PhD after one year of medical school in some MD/PhD programs. It depends on how flexible the program is. Still, why not hang in there?

I don't think you should take a year out for these reasons at this time, unless you absolutely abhor medical school. How possible what you're suggesting is depends on the program. Honestly, med school isn't that bad, and if you hate the first year, it's going to change a lot by third year. Careers within medicine vary wildly. Everything from Peds to Path. From 100% clinical to 10% clinical. Keep your flexibility and keep your options open. It's ok to feel somewhat unsettled at this point.

 

[dl2dp2]

first of all, congrats to getting into a MD/PhD program.

secondly, there are a lot of people in your boat who's sort of all over the place w/in the MD/PhD program. you are not alone.

thirdly, i would strongly recommend against taking a year off. you need to use your second year med school to prepare for step I.

if you want to at all become a doctor, i would continue with the flow and at least finish step i. you can work for the lab you want to work for during your graduate school years. remember there is no perfect job. cognitive neuroscience has its shortcomings, but it also has its advantages. during your training you should think more globally, learn the process, learn the people skills, learn the critical skills and worry less about the exact field you go into. i find that people who go into cognitive neuroscience tend to be very driven by philosophical issues, but then realize that the day to day research is too trivial for them to focus.

at the end of the day though, any day-to-day job is hard. don't worry, go with the road of least resistance, and you'll be fine. i feel like when i was your stage nobody ever told me this, and i just bumbled around...and i turned out ok.

 

[outlier]

you all have given me very good advice, thanks so much. but it made me realize that another reason i feel so strongly about taking a year off is that i've been living in the same city my whole life and have committed to doing this program there (which i think was the right choice, because i really do like the program more than the others that accepted me), without ever living anywhere else for more than a few months. i guess for personal reasons i'm regretting starting the program without going off somewhere first for the kind of "discovering yourself" experience that i have always wanted but postponed because of more pressing responsibilities. i keep imagining now that if i did this, it would put me in a better mental state to handle this program.

in other words, you all are probably right about the benefits of sticking with the MD training, but i feel like my head isn't in the right place for it right now. i entered the program already feeling burnt-out from having to meet goals set by others rather than creating my own goals and understanding what it was i wanted. i wish i had taken an extra year off (besides my 3 years of postbac premed training and research!) to go somewhere else. but since i didn't, i'm wondering about taking that year off now, before things get too intense at school. so i think the reasons i originally presented aren't valid reasons for taking a year off, but they are the issues that have been bothering me alot and that i was hoping to address during a possible year off. i guess you could just call this avoidant behavior...

 

[dl2dp2]

in other words, you all are probably right about the benefits of sticking with the MD training, but i feel like my head isn't in the right place for it right now. i entered the program already feeling burnt-out from having to meet goals set by others rather than creating my own goals and understanding what it was i wanted. i wish i had taken an extra year off (besides my 3 years of postbac premed training and research!) to go somewhere else. but since i didn't, i'm wondering about taking that year off now, before things get too intense at school. so i think the reasons i originally presented aren't valid reasons for taking a year off, but they are the issues that have been bothering me alot and that i was hoping to address during a possible year off. i guess you could just call this avoidant behavior...

I have a good friend who's like you. he dropped out of md/phd to pursue journalism. he's now infinitely happier.

it's very possible that MD/PhD may not be a very good fit for you.

i would STRONGLY suggest against doing the PhD in your case. I think an MD + psychiatry would be an excellent combination if you want to stay in medicine. otherwise the earlier you drop out completely the better. indecision is only going to prolong the eventual shock of transition and unhappiness.

 

[gstrub]

I can't stress how bad of a move throwing away a MD is.

Thread closed.

 

[SaltySqueegee]

Grasshopper. The purpose of Medical School is to feel lost. The purpose of graduate school is to feel even more lost. It is not until you are lost that you can find your true calling. A butterfly flaps its wings.

*Ding*

 

[outlier]

Thanks for all the advice. I agree about giving med school a real try, but I don't think I'm in the right mental state to do that right now. The last year was very difficult for me with major family issues (so there are many factors playing into this decision), and I think staying in the same place and starting this long program is taking a toll on me. But I really think that taking a "breather" for a year and going someplace else would refresh me and help me figure out if this is really the right path for me. So, I guess I'm going to temporarily ignore all this good advice, and try to leave for a year. I'm starting a new thread to specifically ask about year-long post-college research opportunities.

 

[tiedyeddog]

Thanks for all the advice. I agree about giving med school a real try, but I don't think I'm in the right mental state to do that right now. The last year was very difficult for me with major family issues (so there are many factors playing into this decision), and I think staying in the same place and starting this long program is taking a toll on me. But I really think that taking a "breather" for a year and going someplace else would refresh me and help me figure out if this is really the right path for me. So, I guess I'm going to temporarily ignore all this good advice, and try to leave for a year. I'm starting a new thread to specifically ask about year-long post-college research opportunities.

So, you are dropping out or will your program give you this leave?

 

[mercaptovizadeh]

Thanks for all the advice. I agree about giving med school a real try, but I don't think I'm in the right mental state to do that right now. The last year was very difficult for me with major family issues (so there are many factors playing into this decision), and I think staying in the same place and starting this long program is taking a toll on me. But I really think that taking a "breather" for a year and going someplace else would refresh me and help me figure out if this is really the right path for me. So, I guess I'm going to temporarily ignore all this good advice, and try to leave for a year. I'm starting a new thread to specifically ask about year-long post-college research opportunities.

I would request a year of deferral and say you want to explore other interests. Unfortunately, at my school (and probably a lot of others), getting a LOA requires "productivity" (i.e. research, international medicine, service), a family tragedy or illness, or personal illness. I think Neuronix was able to take a year off without any of these. I would strongly advise against getting a label of depressed. If you do not go on to complete the PhD, residencies will want to know what was going on in the year off. Perhaps you could make up something "productive" like international research where you have a light load, travel, see places, do something medically-related, etc. I wouldn't take a year off to work in lab, unless that's what you really want to do.

Speaking personally, I think it's a big mistake to drop the MD, especially in this economic crisis. Sometimes we have to sacrifice our desires out of practical considerations. The MD is a lot easier than the PhD in terms of how it's structured and how someone is pushing you and holding your hand throughout the whole experience. All you have to do is the work, which is admittedly a lot, but it is a lot less taxing on self-motivation, being proactive, etc. (which is what the PhD requires).

 

[Neuronix]

I think Neuronix was able to take a year off without any of these.

Yes, it was a "personal leave of absence" in my case. At my school anyone can request one for any reason.

 

[outlier]

no, i'm not dropping out-- i will request a year off. i actually had a major family issue last year that is still affecting me psychologically, so i think i will use that as my reason (even though there are actually many different reasons). also, i will be doing research, so i will be "productive", and i will make the case that it might shorten my PhD time by giving me more skills and helping me focus on a particular area of research. i don't know what my school's policy is on this, but i will try my best to convince them...

thanks for the advice!

 

[Neuronix]

outlier in full disclosure, I took a year out myself, but it was after my PhD. My PhD (and related experiences) gave me some very strong and very rare skills that are invaluable to the types of labs that do what I do. So I was able to find a "post-doc" in an area where there is excellent skiing--one of my hobbies. I put post-doc in quotes because it's part-time and more of a consultant type position than me working on my own project.

 

[noplacelikehome]

I'm not going to pretend like I know exactly what you're thinking or what you're going through, but I remember writing something very similar my first year of the program. I was in medical school and completely unsure if I'd done the right thing, very disillusioned and sick of it and generally not feeling well at all. I'd also stayed in the same place I grew up and went to undergrad, and felt like I'd made a huge mistake and needed to go somewhere else and see something else to get some perspective. I was still headed the same direction I was as an undergrad, but it didn't seem to make as much sense as it did earlier. I thought about the year off, too, but in the end never ended up asking. I took a fellowship for the summer after my first year of medical school (took a shorter leave of absence from the MSTP), went somewhere else and dove as much as I could into another very inclusive department. I tried all kinds of things, talked to people about all kinds of research I never would have otherwise, met lots of people, went to dozens of talks, and spent a ton of time thinking and wandering around town. I didn't get as much lab work done as I intended, and it wasn't quite as much time as I would have liked, and I'd pick up and go back any minute now if I could, but it helped. A lot. Gave me some time to think, and people willing to talk to me about it that aren't a part of my program. So, I guess what I'm saying is just that if you think you need a break and some perspective, you might well be right. I compromised and only went with a few months off and even though I didn't think it would be it was enough for me. Did it compromise how I did in medical school? Probably. It's not the ideal time at all to take any kind of time off. I'm not sure how I would have made it though the first two years of medical school otherwise, though, so it was worth it. Anyway, PM me if you want any suggestions (things I was thinking about when I did it) or more details or just want to talk about it. I don't really want to post anything more - I never told anyone from the MSTP program why I did what I did. It was a short enough time that I never had to. In any case, I know others that have done similar things - just realize this is all a part of the program. I know the program directors where I am wouldn't have had any problem with what you're saying - that question of what it is we're doing and why seems to come up pretty often, whether or not most people actually do anything about it.

Anyway, hope that helps, and let me know if I can help with anything!
Best of luck!

 

[gbwillner]

you all have given me very good advice, thanks so much. but it made me realize that another reason i feel so strongly about taking a year off is that i've been living in the same city my whole life and have committed to doing this program there (which i think was the right choice, because i really do like the program more than the others that accepted me), without ever living anywhere else for more than a few months. ..

I've been really busy lately but I wanted to contribute here and perhaps give somewhat different advice.

If I read your original post correctly, it sounds like you are saying "I never really wanted the MD, and only did it because other people expected it of me." If this is true, and you are forcing yourself to do something for others, you will not be happy, especially given the difficulty of this particular task, as you are finding out. Unlike what some other here have said, you CAN make it with just PhD if that's what you want to do. It's silly to think otherwise. If you are a good scientist you will be fine. I still haven't seen a long line at the PhD unemployment office. While there is a perception that there are "too many" PhDs- if this is so, why are there so many foreign PhDs and MD/PhDs as faculty at most academic institutions? I would wager it's because there just isn't that much competition for those spots. Who would your random college/university want to hire? You or some guy from some place they probably never heard of? Sure, you have to be successful at some point to keep going, but there is a difference between wanting security versus a free hand out.

Secondly I wanted to comment on the desire you have to go elsewhere. There is this fundamental truth- in Murphy's law- that states that the grass is always greener on the other side of the fence. Had you gone elsewhere you may have felt irresponsible for leaving your family in a time of need, or lonely and unable to make new friends, or homesick, or realizing that your new city sucks more than the one you used to live in. It's like dating the same nice girl for three years and then dumping her because it's getting "too serious" and you want to sow your "wild oats"- then you break up with her and you are alone and can't find a date. Besides, You can always leave for residence/post-doc. In fact, you probably should.

Finally, a word of caution. Be absolutely sure you want to do this or quit the MD before telling anyone at your program about this. Even if you are sure you want to return. Most people who go on sabbatical this early never come back. You will be adding more time to an already ridiculously long program, and will watch friends leave for grad school before you, graduate before you, etc. Things will get harder in that regard. On the other hand, realize that the basic science years were just a useless exercise for most of us- it gets a lot better in the clinics. And this is coming from a pathologist 😀. You may yet find you niche in medicine and have an epiphany moment where you realize exactly how you would like to combine medicine and science in your career.

Good luck!

 

[Jorje286]

If I read your original post correctly, it sounds like you are saying "I never really wanted the MD, and only did it because other people expected it of me." If this is true, and you are forcing yourself to do something for others, you will not be happy, especially given the difficulty of this particular task, as you are finding out.

👍

I wanted to get in to say something like this. Don't do the MD if you know you have little to do with medicine. Doing it just for the "job security" seems a bad reason for me. You'll be working your ass off in the clinics in the residency years (on top of med school) for like 80 hours/week, and if you won't be remotely enjoying what you're doing, then you're wasting your life and energy, which I think are more important than money. If your heart is in research, then follow that path.