Any DISadvantage to MD/PhD???

[dan0909]

Ok,

When I am done with my MD/PhD program, I wouldn't be surprised if I decide to forego any academic/research medicine and simply do my residency and start my own practice...I really enjoy the idea of just being a pediatrician...is there ANY disadvantage (besides the extra time involved) to getting an MD/PhD and then deciding to go into a field that only really needs an MD...

For example, would a pediatric residency favor someone who only has an MD over someone who went through an MD/PhD program???


I'm really interested in hearing your thoughts...


Thanks for your Replies,
Dan

---

Members don't see this ad.

 

[dl2dp2]

uh, there are some advantages
(1) money. you get paid doing MD/PhD as you are probably aware. this is probably not really an advantage as with financial aid it's really quite a bargain to go to medical school even if you don't get paid a stipend, especially when you don't have to do any slave work/groundbreaking research for any basic science faculty

(2) it is generally believed that an MD/PhD would be a great credential for getting into the best residency programs. However, in your case I don't think it applies. In order to have your own practice in pediatrics, going to Penn or Johns Hopkins for pediatrics is a waste of time because they generally train specialists/fellows/future academic pediatricians. Rather, you ought to consider going to a residency program in the geological area in which you want to practice.

Again, unless you want to go into academia, MD/PhD is not preferred under most circumstances. IN your case, I'd say you should probably stick to the MD.

 

[surge]

Dan, make sure you say that during your interviews.

 

[Ceremony]

Dan,

I do recommend you tell the md/phd programs this. Really, why bother doing the MD/PhD? Trust me, it is not a trivial task getting the PhD.

 

[coldchemist]

I agree. The way I feel is, by entering into an MD/PhD program you are morally and ethically obligating yourself to an academic career. It is understood that the programs exist for that reason. If you are not capable of fulfilling this obligation, then what business do you have going into the medical profession in the first place? Ethics should be of primary concern to all aspiring physicians.

Another way to put it--

If you go into an MD/PhD program, you are taking a spot that probably would have been filled by someone else--someone who is very interested in biomedical research. Who knows? They could be the next Jonas Salk...but because you took their seat in the program they became dissillusioned and decided to get an MBA instead. Now an additional billion people will die of HIV because the person who would have cured them never got the training he needed to fulfill his destiny. Not probable, but possible.

 

[vixenell]

Originally posted by sluox
(1) money. you get paid doing MD/PhD as you are probably aware. this is probably not really an advantage as with financial aid it's really quite a bargain to go to medical school even if you don't get paid a stipend, especially when you don't have to do any slave work/groundbreaking research for any basic science faculty

Money might actually be a disadvantage. By doing MD/PhD, you're foregoing 3-5 years of a physician's salary, which is substantially more than tuition plus 20K.

 

[ImmunoANT]

I agree with everyone above me. One thing though, has anyone thought of going to industry (ie drug development + clinical trials), I wouldn't exclude such a possibility given that the pisitions in academia are being so heavily saturated. And speaking of which, does anyone know about the demand for PI (either in universities or government) in 15 years???


BTW, coldchemist are you in Montgomery? am in Rockville, well an off-campus facility of NIH.

 

[coldchemist]

Funny you ask. I'm in Rockville right now. I work at the main NIH campus, but I live in Rockville.

I think most of the programs sort of look down on graduates going into industry. It's probably the most lucrative pathway, though. But you bring up an interesting point...if academia is saturated I certainly wouldn't have any qualms about going into industry. On the other hand, academic positions in the basic sciences aren't really saturated. There are definitely plenty of PhD's to fill the spots, but I bet most departments would take an MD/PhD over a PhD, all else being equal.

The director of the MD/PhD program at Jefferson has an interesting career. He is director of the Division of Clinical Pharmacology at the hospital, doesn't really do any clinical stuff--all basic research, and he runs a private biotech company that was spawned from his post-doctoral research. So I guess he's sort of industry and academia. There's so many ways to do it....

 

[Nuel]

This matter is very verrrrrrrry easy for the OP. The OP clearly has no interest in research/academic medicine, if I judge well, it appears landing a competitive residency is the main option. coldchemist has said it : by entering an MD/PhD program you are contracting yourself to an academic/research career. If you are thinking clinical medicine (private practice) and don't love the lab, then why bother with the MD/PhD? I mean . . . it is a gamble.

 

[superdevil]

not to start any back-and-forth crap on this thread but i really don't know about this:

coldchemist has said it : by entering an MD/PhD program you are contracting yourself to an academic/research career.

no, no, no. by entering an MSTP which is fully funded by the govt for a specific purpose, you are contracting yourself to such a life. you guys keep saying "MD/PhD" when it seems like you should be saying "MSTP."

if i spent 7-8 years paying for my MD/PhD at a non-NIH affiliated school, then i could be a g.ddamn librarian if i want when i'm done!

am i alone here? probably....

 

[tofurious]

In fact, no one is in any binding contract/agreement to do anything. It's a gamble by the government and your home institution. Some people who go into medical school/combined degree programs with full intention of staying in academic get fed up with the rampant BS in academic and instead go with 1) clinical medicine 2) private practice 3) industry. Many schools do have contracts that if you drop out before the PhD component, you will need to pay back-tuition from the first 2 years. Otherwise, the school/government really have no place dictating what one should do.

Coldchemist's view on "the spot": I am personally intrigued by the idea of "the spot" because I raised a question in another thread regarding the spot being offered to a non-traditional student. I know someone who is completing her PhD who went into a combined training purely because she couldn't afford medical school otherwise. In a way, I think if she beat out other applicants for that spot, the spot is hers to waste if she so chooses. Do you guys think every spot should be ONLY offered to people who will stay in academic?

 

[ImmunoANT]

To Tofurious,
just out of curiosity, how many md/phd classmates of yours do you think are "research-driven, academia-devotee"? (what am I asking??? Anyway, you know what I mean?)

 

[tofurious]

That's really a longitudinal question. My classmates and I will not be judged fairly as "academically driven" physicians until probably 10-15 years from now. As of now, I believe most are staying within academic one way or another. That means from doing no residency at all to doing one chart review during the entire residency. What does that say about what will happen 15 years from now? I don't know. However, a few years back 3 Harvard joint degree holders went into business together (or so I hear). Is that the failure of the program? Would you not apply to that program BECAUSE of that? Would you say that the students lacked ambition?

 

[doc05]

yes, there is a disadvantage. It will take 3-7 years to earn the PhD, so you will have wasted a ton of time, not to mention taxpayer money (assuming you do MSTP).

It's ok if you change your career plans mid-way through, but if you go in with no intention of pursuing academic medicine, you are being an idiot.

 

[superdevil]

Coldchemist's view on "the spot": I am personally intrigued by the idea of "the spot" because I raised a question in another thread regarding the spot being offered to a non-traditional student. I know someone who is completing her PhD who went into a combined training purely because she couldn't afford medical school otherwise. In a way, I think if she beat out other applicants for that spot, the spot is hers to waste if she so chooses.

yea, this is something that i hear a lot of, too. the idea of someone getting a CD to only use the MD is well documented (and criticized). its seems like there is a sentiment out there that people who don't want to do academic research are somehow maliciously depriving innocent people of their dreams by enrolling in MSTPs and other MD/PhD programs. this is kinda nutty if you try to apply this feeling in a more universal way.

the point of this idea is that someone who is enrolled in a combined degree program, with the intention of only really utilitizing ONE of the two degrees, is being, at the very least, inconsiderate- although i get a healthy chuckle at the word people on this forum use to gain moral highground: "unethical."

this can be turned on its ear, though. many people insist that the only proper way to use a CD (or, maybe just the "best" way) is to do basic science research or to serve in academia somewhere. this, though, contradicts the "Postulate of Spot-Stealing Bastards," however, as these people are, in actuality, only utilizing the PhD- and thus depriving someone of a "spot" in medical school, even though we all know that basic science (or biomedical, for that matter) research and academic service can be accomplished with a PhD alone. why then, would these people insist on having "M.D." follow their names?

clearly, i'm doing little more than playing devil's advocate here (given my audience's prevalent stance on the subject), but i feel its important to say that its more than just clinicians who are squandering the dual degree, because some researchers are, too.

go ahead and stone me. i just like looking at things differently.

 

[Nuel]

sluox, I see my statement was rather general. Thanks for the correction.
But I still maintain that if one goes into some MD/PhD program, and that one is funded either by the school or the government, the funding body is hoping that such a one will someday be doing some kind of research and that one is "ethically" saying he/she will do so. Someone mentioned the BS in academia /research arena. However, I strongly believe that if one truly loves biomedical research for what it is, then the BS initially alluded to become little mountains to climb.
A disclaimer: I am a mere undergrad who will probably be going MD if not accepted MSTP, but I think everything discussed so far purely lies in reason. Bottomline: going MD/PhD means I want to do a "different" kind of medicine-- meaningful research. I think this is just my opinion.

 

[dan0909]

Well,

Here's my personal situation. My brother and I are in the first year of a non-MSTP MD/PhD program, a program that they claim will take 6 years, although I heard, unofficially, may take longer. Nonetheless, we've started the PhD part this year, and the plan is for us to then do two years of medical school, while PhDing during the summers, come back for a year of PhD, and then rotations, I believe. The fact of the matter is, we are the FIRST students to go through the program, and had we not applied, they would still be waiting for their first takers, so I know I didn't take a spot from anyone. Furthermore, the exact curriculum isn't exactly laid out in stone, as no one has ever gone through it before.

During my interview, I was asked something along the lines of where I thought I would be in 10 years. I admitted that I didn't know, but could see myself doing research, in academia, practicing on my own, or even serving our country. Despite my admitted non-100% commitment to academic medicine, they still admitted me. Perhaps they are just eager for someone to do the program, which has been sitting on teh burner for a few years, as they haven't had any qualified applicants willing to take the 6-7 year plunge.

I don't dislike the lab, but I'm not committed to it. And I'm not sure that I don't want to just start my own practice whenever I'm able, but I am 100% confident in finishing this program and getting my MD/PhD. However, I'm not sure that I want to be in a lab day in and day out.

As this is my situation, my question is whether I will ever be at a disadvantage in going through the necessary steps to become something other than an academic physician, such as a pediatrician.

Thanks for your helpful replies,
Daniel

 

[ManchotPi]

--

 

[pbp4]

dan-
to answer the question- the PhD will NEVER hurt you- If some place did not want you because of your PhD- you do not want to be there. the point about the wards are some what true but when i did my rotations i was much more into it than most students having spent three years in lab- i guess i was ready to get on with it.

i must say- if you get a "PhD" in a couple summers and one year in lab your PhD will not help you much if you want a career in research. but it sounds like this is not really a concern for you. i would caution you to find out how the PhD is awarded- at most schools the paperwork alone would take a year. in addition, if there are other PhD students i would not tell them you are finishing after one year.

good luck-
-p

 

[dan0909]

oh nono...itll be 2 years total in addition to several summers...and on top of that, they indicated that it would likely take longer...medical school is supposed to cover only a small portion of required PhD classes, i htink one fourth...other htan that, the PhD will be as long as a regualr PhD...i might have typed something wrong up there

 

[ewing]

Originally posted by sluox
Rather, you ought to consider going to a residency program in the geological area in which you want to practice.

Geological area? Like the earth's crust? Where else would he find a residency?

 

[Mike2]

I think you can do an MD/PhD program if you want to. You don't owe anyone ANYTHING after you are out. Maybe you end up going one way or the other, but that ultimate decision is YOURS after you are out, and no one should be spouting morals, ethics, and such to you about it. They are just taking themselves too seriously and life is too short for that kind of stuff. I agree with whoever said the PhD will not hurt you. You will also not be depriving innocent genius souls of the ability to cure HIV or some other such nonsense. If you can experience an MD/PhD program and get enjoyment and enrichment out of it (like I did), so be it. Good luck!

(The majority of great scientific breakthroughs doesn't come from MD-PhD's anyway. How's that for taking the pressure off?)

 

[ClassSwitch]

As an MD-PhD student who finished his PhD and is now applying to residency programs, I have to agree with the folks who put a positive spin on doing the program, and to seriously disagree with those who tout its negative qualities or who argue that you're morally obligated to do research afterwards.

(1) PhD means "doctor of philosophy," nothing more, nothing less. The reason students (whether in a combined degree or straight-PhD program) pursue the degree in the first place is because they have a zeal for investigating the scientific or philosophic systematology of things at an exceptionally detailed level of understanding. Yes, most PhD-ers start off their studies being open to or positive about a future career in academia. But things change, and life just sort of happens. You're not robbing anyone by doing a PhD or an MSTP if you're genuinely interested in exploring the detailed mechanism of some aspect of the world we've been given or the world we've created.

(2) As mentioned above, life does whatever it wants to do, and sometimes all we can do is just keep up with the tides. A position in academia is really tough to secure nowadays, so it's impractical for anyone who's a mere college student to be 100% convinced that they're going to go become some researcher somewhere down the road. Yes, if you're applying for MD-PhD programs, you still have to say that you envision doing an academic job. But know that your goals will probably change, and some incredible physicians I've known or worked with in my own education have been MD-PhDs who decided to devote their lives to clinical work in the end.

(3) What you should know before doing an MD-PhD program, and what's been said already on this thread, is that it takes a LOT of time and committment, not to mention the fact that you'll be going through clerkships and residency applications a few to several years older than your classmates, which can be mentally challenging at times. But I can say with certainty that, unless you take way too long to finish your PhD, having the combined degree will only help your residency application. Programs will want to interview you like crazy -- the two "big crazes" in clinical medicine nowadays are molecular medicine and EBM, both of which demand a thorough understanding of the scientific method, the ability to critical analyze scientific work, and the capabitility to design experiments to push the boundaries of medicine further. Residency directors at top programs all know that anyone who spends 3-5 years delving into some project has the potential to do all these things.

I have no intention of coming across as a prick here, but it's a bit irritating to hear people poo-poo the MD-PhD program when in fact the benefits are quite real. I know other MD-PhDers may disagree with me -- and believe me, I really struggled during grad school, to the point where I constantly questioned whether or not I had indeed made a mistake by doing the program. Ever since starting on the wards, however, I've been immersed in a sea of positivity regarding my having done the combined degree program. I'm keeping myself open to the possibility of an academic career, but I also am totally dedicated to doing patient care and wouldn't be disappointed if that's what I end up doing with my life. And I've seen enough on the wards to know that, regardless of what path my career takes, doing the PhD has only helped my own abilities as a clinician.

 

[surge]

Okay ClassSwitch,

I have to admit I was very impressed with your post. Even though I maintain that someone without any interest in research as a career should not pursue the combined degree, your arguments are valid and articulate (unlike OP's, who, my guess is, doesn't have this level of understanding of the issue).

But be that as it may, even though I don't subscribe to the moral/ethical and robbing-the-world-of-genius arguments, I have to say that I still have a problem with someone trying to get into a CD program by lying (saying they are interested in academia when they're not).
It's not even an ethical question of lying - it's simply that I really feel that it should be about merit and potential.
If an argument and motivations are valid, they should stand for themselves, and we should let the powers to be (read: adcoms) decide.

Which is, after all, why I still think the OP should be honest.

 

[Newquagmire]

Originally posted by ClassSwitch
Yes, most PhD-ers start off their studies being open to or positive about a future career in academia. But things change, and life just sort of happens. You're not robbing anyone by doing a PhD or an MSTP if you're genuinely interested in exploring the detailed mechanism of some aspect of the world we've been given or the world we've created.

You're right, in this situation the hypothetical student is not doing the things in question. But I have to agree with Surge and claim that somebody who (at this point in time) has no actual interest in a career in academia should at least mention that in an interview if the question is asked.

Which brings up my question. There aren't that many residencies/fellowships with protected bench-time, even for MD-PhD graduates. Any idea of how this could change in the next 10 years?

 

[superdevil]

If an argument and motivations are valid, they should stand for themselves, and we should let the powers to be (read: adcoms) decide.

um, i'm not sure that i understand (or agree with) you, surge. so what you're saying is that adcoms always act in a way that is logically valid and that their decisions are always accurate reflections of valid arguments and motivation? i know that you're in a postion of greater experience than i, but i just can't swallow that. i'm sure plently of applicants with compelling (or "valid") arguments for matriculation have been turned away by adcoms who themselves may have acted in illogical ways to serve some type of personal agenda or preference. i don't think that we can just put all of our faith in them to recognize and reward our "valid" reasons for applying...maybe i'm just too cynical.

or did i just totally miss your point?

 

[ClassSwitch]

Surge, newquagmire --

Points well taken.

We actually had a guy in my glass who seemed indeed to use the MSTP strictly for financial gain without any intention of doing scholarly work -- he did as much med school time prior to grad school as he could without raising eyebrows, and then after less than a year in the lab, he dropped out of the program. The administrators ended up hating him, as did others in our class (for obvious reasons).

 

[nuclearrabbit77]

I FOUND YOU LEO

Originally posted by Ceremony
Dan,

I do recommend you tell the md/phd programs this. Really, why bother doing the MD/PhD? Trust me, it is not a trivial task getting the PhD.

 

[hockebob]

Going back to Dan's original question for a moment, no, I don't think you are disadvantaged for a pediatrics residency by completing the MD/PhD program. It's an often-quoted statistic that about 90% of MD/PhD grads end up in academic medicine. The other 10% or so is then split between private practice and industry. Granted, many of those entering private practice probably do so as specialists, but I would be very surprised if there haven't been a least a couple Md/PhD-ers that went into general pediatrics.

In my opinion, an extra degree can never hurt, however, with your background, some residency programs may expect you to take on a research fellowship during your time there... so be careful about that.

Also, I've been thinking a lot about the more philosophical question that your post raised (and the one that most people so far have chosen to analyze when responding)... that being the long-term goal of the MD/PhD program itself. I don't think anyone would disagree with the idea that, for the most part, the program is designed to train medical scientists -- people who have extensive knowledge of both medicine and the science underlying general biological processes. I would guess that most people who go through the program end up in some field of basic biological science research. However, during my interviews this fall, I've been impressed by the number of people with interests outside of the basic biological sciences, including chemical biology, medical imaging, biomedical engineering and epidemiology, to name a few. What I think this shows is the enormous diversity of opportunities for MD/PhD students and, perhaps more importantly, the expanding goals of the MD/PhD program.

Now, I understand that you want to go into primary care, but I would suggest that you really take advantage of the opportunity that you have been given and explore the possibilities available to you with an MD/PhD. Just as it is important for the more research inclined of us to invest ourselves fully in the clinical aspects of the MD/PhD training, it might be benefical for you to really give research a try. Play with it a little. Throw some stuff against the wall and see what sticks. That, I think, is really at the heart of the MD/PhD program... a desire for creativity and exploration of all possibilities. If you go into the program with a predetermined path, you're likely to miss out on what really makes it special and, then, you're not wasting other people's money but your own potential.

Then again, what the hell do I know?
Also, did anyone note the number of times I said "really"? Ha!

Best wishes,
Aaron