After MD/PhD

[DarkChild]

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What do you guys plan on doing after you graduate from MudPhud school? I'm sure a bunch of folks are thinking about doing a residency and if so, which ones? How much does renumeration factor into your equation? Who hear is considering a post-doc? and after that, then what? And how about those considering doing something else in business or industry for example?
My party line was that I was going to do a residency in either neurology or psychiatry (following a PhD in neuroscience). But I have reservations about both: I think neurology is interesting because (relative to psychiatry) pathologies are well-defined and there are more interventional things which can be done for the pt. But the cool thing about psychiatry is that it aims at the big picture questions about who we are and why we are the way we are, so intellectually its arguably more interesting.
With that being said, I know full well I'm talking out of my a$$ since I really dont have any experience in either of these fields. 😀
I'd also really like to hear from any MD/Phds students out there now.
While its fun and all to be enthusiastic about research and academia, I cant help feeling that my welfare function will shift in the next few years in ways that I havent been able to anticipate: you know, kids, family, wives...

 

[canadagirl]

"wives"

LOL!!!!!

 

[mrpeters714]

Well, here' s my story if anyone cares:

I'm in my 8th year in my MD/PhD program. I'm currently applying to pathology programs. I never really considered doing a post-doc without a residency, because it seemed like a big waste of time to go through the pain and hassle of med school without doing a residency to "finish" the process of becoming a doctor. Also, I didn't find grad school to be the wonderful experience that I was hoping it would be. Grad school was mostly incredibly frustrating, just a dull slog with innumberable failed experiments. i just never quite caught fire and got really interested in the field i was studying, i guess. i had to force myself to read the literature, rather than wanting to read the literature, like many other grad students and post-docs. And if I thought grad school was a pain, a post-doc would be worse for certain. Most post-docs that i've met have been miserable at some level.

As I'm applying to pathology, I know alot about it, and alot less about psych and neurology. I did think neuro was interesting, but I hated the emergenices and overnight call, and of course--the thing that everyone critizes neuro for--the inability to do anything for most patient's conditions (although neurologists say this will be changing in the coming years). I didn't particularly like psych--WAY too much talking, and the conditions seemed very ill-defined and diffuse. Plus, you have to deal with very unhappy people alot of the time.

Pathology is a great field for md/phd's--it's the most scientifically based medical field (someone will probably argue with me over this), has great hours, is incredibly interesting (to me at least), and has a huge variety of career paths available within the field. also, md/phd'ers are in HUGE demand within path--the program directors at the best residencies are practically tripping over themselves to recruit me. i highly reccomend doing an elective in path during your 4th year of med school if you are even remotely considering it.

Career wise, I'm targetted towards academic pathology, although my wife is not exactly happy about the 50% pay cut that academics get relative to community pathologists. i'd like to get involved in translational research--letting the basic scientists do all the annoying bench work, then applying their work directly to patient care and diagnosis. There is going to be a huge amount of translational research to be performed in the coming decades, as the molecular basis of many diseases are being figured out at an alarming pace.

There are other ways to make money in an academic pathology setting however. Apparently, alot of academics consult for biotech companies on the side. Depending on how much you want to work and your connections, this can be a large amount of income on the side, and can boost your income to be comparable to community pathologists. Or, if you are really ambitious, or have that one great idea, you can start your own company and become rich.

And about wives--the md/phd program is REALLY long. Of the 6 of us who started in my class, 5 are now married, and 2 either have had a kid or have a pregnant wife. reproduction will happen. listen to the call of the gametes.

anyway, that was really long and rambling. i hope that at least partially answered a few of your questions.

-mrp

 

[AMHMN]

Thanks for sharing your story, mrpeters714. Despite finding your PhD years long and less thrilling than you hoped, would you do it all over again? Do you have any regrets about going the MD/PhD route?

 

[Bostonienses]

mrpeters714, you were just able to describe EXACTLY how a PhD is. I don't want to discourage anyone, but in a nutshell, this is what I do: I work about 10 hours every day INLCUDING SATURDAY AND SUNDAY. There is no end, and no guarantees whatsoever that you will be able to take ANY time off. I haven't stayed home on a weekend in three months! The worst part of it is that you can work your arse off and you will have NO guarantees that your experiments will work. It's pretty much the only field I know where the work you put in is DOES NOT correlate with how much you get out. It is also very hard to keep reminding yourself that you are doing this to help people when you have NO patient interaction, and you are seeing more of your cells and protein lysates than your friends at 10pm on a Sunday night. So, if your goal is to have patient contact and know that you are helping people everyday, it's very frustrating. IMHO, if you know that you really only want to do clinical work, get an MD, do your residency, and then a fellowship or post-doc in a lab to learn the research stuff. Plus, there are research electives that you can do...

 

[DarkChild]

Bostonieses and MrPeters.
Thanks for talking about your experiences. Especially MrPeters path discussion - I've been leaning there a lot lately because the lifestyle seems much more manageable than either neurology or psych...
As for the torture of doing a PhD, I've already seen that up close and personal. The grad student I worked really closely with as an undergrad has taken maybe 8 years to do her PhD and its still not complete. The two years I worked in that lab, I watched her suffer emotionally and socially... it wouldnt be a missrepresentation to say that she dislikes neuroscience intensely now. Its funny, but thats why I've actually had a relatively difficult time on my interviews - what my interviewers sometimes perceive as a lack of enthusiasm is really a grim familiarity of the frustrations of doing a PhD. In fact one guy at a recent interview said I havent been immersed in a lab where the folks eat and breathe the science... 🙄
With that being said, I've started composing a list of survival strategies for the PhD student - please free to comment, append or ridicule 😉 :
1) find a thesis supervisor who will take an active interest in your progress, who is flexible to new ideas and who you work well with - i.e. not necessarily the guy doing the coolest research or who has the biggest name
2) find a lab that is well funded and isnt cheap - there was one lab in particular I saw where the PI didnt believe in any kits and insisted people do everything from scratch. which in my opinion is stupid, if you've got something that can shave a week or two of an experiment you better use it, because when you're doing stuff five or six times over, that can amount to a month or two in time savings... btw in that lab, one guy took 11 years to graduate.
3) choose a project that is manageable with definitive milestones which generate some data... I would rather work on a project for 3-4 years and every 8 months come up with a small paper, than work for 4 years and release my work on to the world in an orgasmal rush that results in a nature and science paper...

 

[pathdr2b]

Hi Everyone!

You all have posted some excellent advice for PhD students! Alot of the gripes mentioned in previous posts exactly echo some of how I felt while in a Master's program contemplating a PhD program. I made the mistake of considering a PhD in Chemistry (I got the terminal Master's) which is FULL of people that don't think anyone that spends less than 100 hours a week in the lab is doing serious research. I also found them extremely nonpersonable. While I have never been a med student, I tell people all the time that I think getting a PhD is 100X harder than an MD because of all the "stuff" you have to deal with.

At any rate, after getting the MD/PhD with a cancer genetics focus, I plan to do a residency in experimental pathology followed by a fellowship in breast pathology. I hope to continue to do research in BRCA 1 related breast and ovarian cancer with a focus on early onset (before 50) cancer patients at the National Cancer Institute or in academe.

 

[mrpeters714]

Would I do the MD/PhD over again--well, now that it's over with, it's not nearly as painful as it was while it was happening, so yes, i'd do it over again. It's like some author said--she hated writing but loved having written.

However, I would do a few things differently, mostly along the lines of what DarkChild mentioned. Dittos on the kits comment! I don't understand how PI's in this day and age can refuse to allow their people to use kits, but it happens alot. Also, I agree with the small project comment. I think you succeed in science biting off the tiny-teeniest bit of a project that you can, make it work in a short amount of time, then pick another tiny-teeny project, make that work, then before you know it, you have a great story on your hands. People that try for home runs very occasionally win and get nobels, but most fail. this is even more important for md/phd'ers who are under more time constraints than regular phd's.

Mainly, I might have looked for a smaller lab with a young PI who would have been more of a mentor to me. As it was, I worked in a big basic science lab for a big name PI with HHMI funding ($$$$) that was a paper factory. He had never had a MD/PhD in the lab, and didn't quite know what to make of me. Also, he was gone alot on conferences, so in reality, it was a couple of post-docs in the lab that ended up teaching me for the most part. I also would have rotated through more labs--I did the minimum three, and had really picked the lab I ended up in before I even started rotating.

However, maybe I'm overstating how awful grad school was. At certain times, it was awesome--that moment after you pull an autorad out of the developer and find out that your experiment worked is quite a rush. Unfortunately for me, this seemed like a pretty rare event. And attending scientific meetings can be really fun. But overall, grad school was a success for me: I learned alot about science, learned how to write papers, give talks, and to think critically and talk about science. It just wasn't a joy-joy happy-happy experience for most of it, but then alot of formative life experiences are not.

anyway, enough typing for now

-mrpeters

 

[gonflable]

It seems to me that a critical issue is oversight. Some advisor(s) need(s) to help steer MDPhDs toward healthy lab environments. My suggestion is to always select a lab where multiple MDPhDs have succesfully trained. Of course this may not always be possible in your field at your school. I'm only applying now, so I have no experience of all this, but mentoring is a major factor that will influence my choice of school in the end.

 

[pathdr2b]

Originally posted by mrpeters714

Mainly, I might have looked for a smaller lab with a young PI who would have been more of a mentor to me-mrpeters

I tend to think it's better to work for an inverstigator with tenure not a young, assistant professor. While a younger professor may be "hungrier" than a tenured professor, they're also more likely to want you to be in the lab 80 hours/week in their effort to get published and get tenure.

I also agree that the most well funded and largest lab is not always best although here at NCI, getting funding is NOT an issue.

 

[DarkChild]

the discussion of tenure reminds me of this one md/phd dude I met on the interview track who's PI didnt get tenure and because of that, after working for a year and a half, he had to get a new project. 😱