Applying both MD and MD/PhD

[eddie13231]

Ok guys,

Background info so you can evaluate: I have done 1.5 yrs of research with one pub and another probably out of the way. Biochemistry and Chemistry degrees. GPA: 3.96 and I am taking the MCAT in June. I have volunteer experiences, president of a club, TA'd orgo and a few other courses.

I have a significant delemma which I think speaks for itself. I have always wanted to apply MD since a little kid (I know it sounds so cliche) but took it seriously in college and actually stayed on track (AKA didn't get weeded out). I got into research through a friend and have been working in the lab seriously (10-20 hrs/week, more in summer/breaks). I was going to apply MD/PhD after working in the lab for 6 or so months but after going into my junior year I feel the burnout starting to kick in and I feel as if I couldn't complete such a long training process.

I spoke with the PhD's in my lab about my interest in a PhD and they said that I shouldn't get one: just go for the MD. I think they are burned out as they are 6th years as well. They say the pay sucks and the training is too long, plus good jobs are scarce. So I kicked the idea of the dual degree and wanted to focus solely on MD programs with a research focus.

Recently, I got some more enthusiasm for research again and began to look at MD/PhD programs again. The idea of being funded through schooling is extremely appealing but I also really enjoy doing bench work. I want to work in clinical medicine and research eventually but I'm not sure if I am cut out for a PhD + and MD too. Which do you guys think is better: research focused MD or an MD/PhD?

One other question:
In the application cycle, does it look bad to apply to both only MD and MD/PhD programs?
IE: Would they call me out saying that I am not interested enough in the MD or MD/PhD because I am applying to both, thus ending my possiblity of acceptance to either programs?
Thanks!

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[j-weezy]

The MD/PhD path is a long one - make sure it's for you before committing. You may want to apply MD-only to research heavy institutions. Some even require a certain amount of research to graduate! Or you can go for a fellowship later in life to give you some grounding in scientific research. You can also apply to other places that have the option of switching into an MD/PhD program after your first or second year. I think you can request to be evaluated for both MD and MD/PhD programs independently but it can raise some questions about your sincerity and commitment to a dual-degree program. Many programs will agree to consider you for MD-only if you fail to make the cut for the MD/PhD program. I'm relatively certain that you will not get shafted from either pathway for merely applying to both - assuming you are qualified (which you appear to be).

Anyways, these are just my thoughts. I'm sure other (more knowledgeable) people on this board will join in shortly with their own advice.

Cheers!

 

[TheCybermen]

The MD/PhD path is a long one - make sure it's for you before committing. You may want to apply MD-only to research heavy institutions. Some even require a certain amount of research to graduate! Or you can go for a fellowship later in life to give you some grounding in scientific research. You can also apply to other places that have the option of switching into an MD/PhD program after your first or second year. I think you can request to be evaluated for both MD and MD/PhD programs independently but it can raise some questions about your sincerity and commitment to a dual-degree program. Many programs will agree to consider you for MD-only if you fail to make the cut for the MD/PhD program. I'm relatively certain that you will not get shafted from either pathway for merely applying to both - assuming you are qualified (which you appear to be).

Anyways, these are just my thoughts. I'm sure other (more knowledgeable) people on this board will join in shortly with their own advice.

Cheers!

perhaps -- but be sure that you're able to justify why you did not apply the MD/PhD route across all institutions. they can really corner you with that question, and it's often difficult to answer (see below). ultimately, they want to see commitment to the goals and ideals that you have placed before you. if you apply to one school's MSTP program and interview there, i believe they have the ability to see which programs you applied to and where (last page of AMCAS). spending 8 years at their school versus spending 4 at another based on strength of research integration in either program is an argument among arguments.

i'll offer a related but not perfectly aligned story from my own experiences:

at a research-intense school at which I interviewed (among the top 10 per US News, if that means anything whatsoever to you) for the MD program (i was declined MSTP but invited for MD), they actually asked me why i didn't apply to the MSTP program at their school. i told them that i had in fact done so, been declined, and yet still opted for their specific MD program in light of my goals. they flat-out responded that the MD program at their institution would not give me the skills, knowledge, and qualifications that the MSTP program would with an eye toward a career as a physician-investigator.

 

[eddie13231]

they flat-out responded that the MD program at their institution would not give me the skills, knowledge, and qualifications that the MSTP program would with an eye toward a career as a physician-investigator.

This is what tends to make me think twice about applying to both programs. If they see, for example, that I applied for MD/PhD at another school then they may send a barrage of questions at my as to question my career goals: "just getting school paid for with MD/PhD", "you need to decide what to do in life", "we produce doctors not medical scientists".

To be honest, I think I would be happy with MD/PhD from a high ranked institution with a massive research base with unlimited resources, but not so much from some small MD/PhD programs. I wouldn't apply to my state school's MD/PhD program because I don't think they would have the resources or focus on research I would like. I know what my state school's research environment is like (I'll have been exposed to it for almost three solid years when I graduate) and want to move up to something bigger and better.

Overall, I think that I just don't want to be rejected from some of my top choice programs just because they will see I applied to MD/PhD programs. I'd almost rather not apply as MD/PhD in that case which is why I asked my original question: Should I simply apply to research focused MD schools? IE: Mayo and Duke

I guess I should share with you guys what I overall want to do. I want to practice, research, and teach, in that order. I want to focus my research on medicinal chemistry/pharmaceuticals and basically clinical research as well. I am tired of bench work (getting bored) but can stick it out if I need to so that I can have a stronger research background. I really like teaching b/c of my experience as a tutor and TA for many courses. I want to a variety of things with my degree(s).

I don't know any MD/PhD's to discuss this with and my advisor is worthless in the department which is why I posted up in these forums. I really appreciate everyone's comments about my dilemma!

 

[Circumflex]

This is what tends to make me think twice about applying to both programs. If they see, for example, that I applied for MD/PhD at another school then they may send a barrage of questions at my as to question my career goals: "just getting school paid for with MD/PhD", "you need to decide what to do in life", "we produce doctors not medical scientists".

To be honest, I think I would be happy with MD/PhD from a high ranked institution with a massive research base with unlimited resources, but not so much from some small MD/PhD programs. I wouldn't apply to my state school's MD/PhD program because I don't think they would have the resources or focus on research I would like. I know what my state school's research environment is like (I'll have been exposed to it for almost three solid years when I graduate) and want to move up to something bigger and better.

Overall, I think that I just don't want to be rejected from some of my top choice programs just because they will see I applied to MD/PhD programs. I'd almost rather not apply as MD/PhD in that case which is why I asked my original question: Should I simply apply to research focused MD schools? IE: Mayo and Duke

I guess I should share with you guys what I overall want to do. I want to practice, research, and teach, in that order. I want to focus my research on medicinal chemistry/pharmaceuticals and basically clinical research as well. I am tired of bench work (getting bored) but can stick it out if I need to so that I can have a stronger research background. I really like teaching b/c of my experience as a tutor and TA for many courses. I want to a variety of things with my degree(s).

I don't know any MD/PhD's to discuss this with and my advisor is worthless in the department which is why I posted up in these forums. I really appreciate everyone's comments about my dilemma!

If you are tired of benchwork, I would not do a PhD. It sounds like you want to do clinical trials with pharmaceuticals. You can easily do this with a MD. Also, you can take a year off after your 3rd year of med school and go to the NIH to do clinical research (they offer a similar program for basic research after your 2nd year). That kind of training would be more relevant and interesting to you if you want to do clinical trials.

Also, use the internet or PubMed to find physicians who are doing the kind of work that you want to do and email them. Ask them for advice. I have had good luck doing this. Who knows, letting some of these people know that you are interested in what they do may open doors down the road. I just think that you would be miserable doing a PhD if your heart is not in it.

 

[Maebea]

To clarify: Each school you apply to only has acces to the information which is germane to that school. If you apply to MD-PHD at Yale UCSF, and Duke, but MD only at Harvard, Yale, UCSF and Duke will see the MD-PhD essays, Harvard will not. Furthermore, Yale, UCSF, and Duke will not know what other schools you have applied to, much less whether you applied MD-only to Harvard. Ditto for Harvard. The only time a school becomes aware of information regarding your application to other schools is in March, when the Acceptance Report becomes available to admissions officers. If you have accepted an offer from Duke MSTP, from Harvard MD, have turned down UCSF's MSTP, and have been waitlisted at Yale, Duke and Harvard can see that you have accepted offers from both schools, but they do not know whether your acceptance has been of an MD or an MD-PhD offer. They cannot see that you have been waitlisted at Yale and have declined an offer from UCSF. Yale and UCSF cannot see any informtion on you at all. On May 10, you decline the Harvard MD, but keep the Yale waitlist. On May 15, Yale can see that you have an acceptance at Duke. They decide that they want to make you an offer because someone turned them down to do the HST at Harvard. They call Duke and tell them that they are going to offer you a position. They then call you and give you the good news. You then withdraw from Duke and enroll Yale's program. Harvard & UCSF will not know that you decided to take a spot at Yale until the AAMC matriculation list comes out in the Autumn.

The important point here is that programs do not know what your status is at other programs unless you tell them, or unless you hold an acceptance at their school. At that point they know what other programs you have acceptances from. In June, when programs start to backfill their classes, schools that have waitlisted you can see where you are holding acceptances.

 

[TheCybermen]

If you are tired of benchwork, I would not do a PhD. It sounds like you want to do clinical trials with pharmaceuticals. You can easily do this with a MD. Also, you can take a year off after your 3rd year of med school and go to the NIH to do clinical research (they offer a similar program for basic research after your 2nd year). That kind of training would be more relevant and interesting to you if you want to do clinical trials.

this is very-well put. an MD is sufficient training to implement clinical trials.

but (putting this out there for the sake of putting this out there), say you don't just want to "implement" the clinical trial. it's important to note that in the past, an MD was also sufficient training to:

1) lead or otherwise partake in the preclinical investigations of a drug in develpment
2) design and coordinate a clinical trial across a number of institutions, either through a cooperative group or an industry sponsor
3) receive due credit for your contributions in the lab and in the ward.

many of your mentors/role models went to medical school 15-30 years ago, when there was a) less to know and b) a vastly different curricular model for medical education.

at the present time, insofar as drug development is concerned, there is a growing demand for basic science training to correlate to clinical training. this is because drug design and outcomes assessments need both physicians AND scientists. scientific lore and labor, technique, experience, methodology, quantitative/statistical background and analysis - much of this has been replaced in MD program curricula by other foci. that's not necessarily bad -- medical school trains medical students to be doctors, and whatever makes them better doctors (rather than scientists) is a good thing. that's what medical school is for, after all.

having said that, an MD/PhD is not the only way to get yourself into a leadership position from a clinical trials vantage point, as I delineated above. one way of doing so is to do a research fellowship as part of your postgraduate training. many successful MDs who have taken this route boast blossoming clinical practices alongside their efforts to spearhead drug design as an integral part of their profession. while there are differences in the training to be sure (perhaps someone else can elaborate?), one perhaps minor one is that rather than an added degree, the research fellowship is tacked on as a noteworthy bullet-point on your C.V.

 

[TheCybermen]

To clarify: Each school you apply to only has acces to the information which is germane to that school. If you apply to MD-PHD at Yale UCSF, and Duke, but MD only at Harvard, Yale, UCSF and Duke will see the MD-PhD essays, Harvard will not. Furthermore, Yale, UCSF, and Duke will not know what other schools you have applied to, much less whether you applied MD-only to Harvard. Ditto for Harvard. The only time a school becomes aware of information regarding your application to other schools is in March, when the Acceptance Report becomes available to admissions officers. If you have accepted an offer from Duke MSTP, from Harvard MD, have turned down UCSF's MSTP, and have been waitlisted at Yale, Duke and Harvard can see that you have accepted offers from both schools, but they do not know whether your acceptance has been of an MD or an MD-PhD offer. They cannot see that you have been waitlisted at Yale and have declined an offer from UCSF. Yale and UCSF cannot see any informtion on you at all. On May 10, you decline the Harvard MD, but keep the Yale waitlist. On May 15, Yale can see that you have an acceptance at Duke. They decide that they want to make you an offer because someone turned them down to do the HST at Harvard. They call Duke and tell them that they are going to offer you a position. They then call you and give you the good news. You then withdraw from Duke and enroll Yale's program. Harvard & UCSF will not know that you decided to take a spot at Yale until the AAMC matriculation list comes out in the Autumn.

The important point here is that programs do not know what your status is at other programs unless you tell them, or unless you hold an acceptance at their school. At that point they know what other programs you have acceptances from. In June, when programs start to backfill their classes, schools that have waitlisted you can see where you are holding acceptances.

thanks for this clarification. i was under the impression that the last page of your AMCAS, on which is summarized the schools and programs to which your application has been submitted, is a universal part of the application.

 

[Maebea]

thanks for this clarification. i was under the impression that the last page of your AMCAS, on which is summarized the schools and programs to which your application has been submitted, is a universal part of the application.

The AAMC does a pretty good job of balancing the needs of the applicant with those of med schools. They probably figure that there is little legitimate reason for a school to know what other programs an applicant has applied to, so this data is not released. Of course, that does not stop a school for asking for this information on their secondary application.

 

[eddie13231]

this is very-well put. an MD is sufficient training to implement clinical trials.

but (putting this out there for the sake of putting this out there), say you don't just want to "implement" the clinical trial. it's important to note that in the past, an MD was also sufficient training to:

1) lead or otherwise partake in the preclinical investigations of a drug in develpment
2) design and coordinate a clinical trial across a number of institutions, either through a cooperative group or an industry sponsor
3) receive due credit for your contributions in the lab and in the ward.

many of your mentors/role models went to medical school 15-30 years ago, when there was a) less to know and b) a vastly different curricular model for medical education.

at the present time, insofar as drug development is concerned, there is a growing demand for basic science training to correlate to clinical training. this is because drug design and outcomes assessments need both physicians AND scientists. scientific lore and labor, technique, experience, methodology, quantitative/statistical background and analysis - much of this has been replaced in MD program curricula by other foci. that's not necessarily bad -- medical school trains medical students to be doctors, and whatever makes them better doctors (rather than scientists) is a good thing. that's what medical school is for, after all.

having said that, an MD/PhD is not the only way to get yourself into a leadership position from a clinical trials vantage point, as I delineated above. one way of doing so is to do a research fellowship as part of your postgraduate training. many successful MDs who have taken this route boast blossoming clinical practices alongside their efforts to spearhead drug design as an integral part of their profession. while there are differences in the training to be sure (perhaps someone else can elaborate?), one perhaps minor one is that rather than an added degree, the research fellowship is tacked on as a noteworthy bullet-point on your C.V.

Thanks for all the input guys.

I do think that it is very important to have clinical training along with a strong basic science understanding (along with investigative training) with the work I wish to someday do. This is why I thought that MD/PhD was my best option. As I said before, I really want practice clinical medicine, research, and teach. I think I may contact some MD clinical researchers and ask their information. I feel like I am late in putting in my final thoughts into which program to apply to, but I really need to be confident in my final decision.

One specific question for Cyber, do you know how long most of these fellowships are? You seem well versed in this topic. I am guessing they are similar to post-docs and can last from 1-2 years. I did a quick google and found specific about fellowship dealing with neurology:

http://www.epilepsyfoundation.org/research/upload/clinicalrfpfy07.pdf

Is this typical of most fellowships following an MD as far as time and training go? It seems as though they accept a variety of degrees which makes this path even more appealing. It makes me question why I would even need to do a PhD if this will train me appropriately.

 

[TheCybermen]

Thanks for all the input guys.

I do think that it is very important to have clinical training along with a strong basic science understanding (along with investigative training) with the work I wish to someday do. This is why I thought that MD/PhD was my best option. As I said before, I really want practice clinical medicine, research, and teach. I think I may contact some MD clinical researchers and ask their information. I feel like I am late in putting in my final thoughts into which program to apply to, but I really need to be confident in my final decision.

One specific question for Cyber, do you know how long most of these fellowships are? You seem well versed in this topic. I am guessing they are similar to post-docs and can last from 1-2 years. I did a quick google and found specific about fellowship dealing with neurology:

http://www.epilepsyfoundation.org/research/upload/clinicalrfpfy07.pdf

Is this typical of most fellowships following an MD as far as time and training go? It seems as though they accept a variety of degrees which makes this path even more appealing. It makes me question why I would even need to do a PhD if this will train me appropriately.

sorry to get back to you so late i know you posted this some time ago (or that's what i'm assuming). i've worked in experimental oncology for two years now and i see, speak to, interact/work with medical oncology attendings and fellows on a daily basis. 80% (without any sort of exaggeration whatsoever) of the fellows have both degrees -- and that probably speaks to the caliber AND overall goals of the institution's training program (it's among the top 3 ranked oncology fellowship programs in the nation) than the oncology fellowship as a general program of post-graduate study at just any institution. in other words, rather than being focused on producing clinical oncologists, this institution is dead set on training academicians -- i.e. experimental oncologists. all their fellows thus need to have demonstrated that they are well-versed in bench and clinical research and that they intend to continue along this course throughout their career. having an MD/PhD certainly puts you a cut above the rest in this regard. the fellowship program here is 3 years, and it is more or less evenly divided between the lab and the clinic.

you can always PM me if you'd like to speak about this more.

 

[CampusHippo]

perhaps -- but be sure that you're able to justify why you did not apply the MD/PhD route across all institutions. they can really corner you with that question, and it's often difficult to answer (see below). ultimately, they want to see commitment to the goals and ideals that you have placed before you. if you apply to one school's MSTP program and interview there, i believe they have the ability to see which programs you applied to and where (last page of AMCAS). spending 8 years at their school versus spending 4 at another based on strength of research integration in either program is an argument among arguments.

i'll offer a related but not perfectly aligned story from my own experiences:

at a research-intense school at which I interviewed (among the top 10 per US News, if that means anything whatsoever to you) for the MD program (i was declined MSTP but invited for MD), they actually asked me why i didn't apply to the MSTP program at their school. i told them that i had in fact done so, been declined, and yet still opted for their specific MD program in light of my goals. they flat-out responded that the MD program at their institution would not give me the skills, knowledge, and qualifications that the MSTP program would with an eye toward a career as a physician-investigator.

I applied this cycle for MD/PhD programs and asked for MD-only consideration in addition to MD/PhD at all of the schools I applied to that permitted it. My reasons were two-fold. First, I wanted to make sure that I got into something, somewhere. I've been out of school for a while doing some unusual stuff, and wasn't sure if schools would dig it. (Turns out it worked out ok.) Second, there are lots of paths to becoming a physician-scientist. I think the MD/PhD is a particularly good one, but it's certainly not the only one. Sure an MD doesn't train you to be a scientist, but a post-grad research fellowship will ... Rhetorically, there's also the old, "I love your school so much I'll apply for 2nd cycle MSTP admission" line.

Schools did ask me about applying to both, but the purpose seemed to be to sniff out any uncertainty about wanting to do science. Needing to get an acceptance is understandable to MD/PhD programs - the spots are few. And I'd venture to guess that if you claim that an MD/PhD is the only way to get trained to do good medical research it would demonstrate a lack of understanding of what you're getting into. (And perhaps insult some interviewers!)

I know a lot of people might hate this idea, but I don't think there's anything wrong with applying MD/PhD even if you have some lingering doubts. The year-long application process can really teach you a lot, and help you make your decision. I wouldn't start a program, though, unless I was positive I wanted to do a PhD. You might take a hit in MD-only admissions at some schools. I got the feeling that schools where I didn't get admitted outright to the MSTP tended to waitlist me for med school. Perhaps the med school didn't like me for the same reason their MSTP didn't, or that I overemphasized the research stuff in my med interviews, but it also could be that they knew I would go to an MSTP elsewhere if I got in.

Wow. That turned out to be long. One last anecdote. I once found myself drinking in a bar with a person whose parent is the director of a top-20 MSTP. The kid said the parent really liked it when applicants didn't check the "Also consider me for MD-only" box. They thought it demonstrated commitment to research.

Good luck deciding!
-CHO

 

[QofQuimica]

The AAMC does a pretty good job of balancing the needs of the applicant with those of med schools. They probably figure that there is little legitimate reason for a school to know what other programs an applicant has applied to, so this data is not released. Of course, that does not stop a school for asking for this information on their secondary application.

Just FYI to everyone on this topic: you can choose to leave those questions blank. I did that last year, and it never even came up at the interview at most schools. One interviewer did grill me a little, and I named a few names that he would have expected. No biggie.

Edit: I should say that I was an MD-only applicant, so I am not sure how MD/PhD programs would respond to this. But in my somewhat limited experience, MD-only programs didn't care.

 

[eddie13231]

Can you guys point me in the direction of some more research focused MD programs? I only know of Duke and Mayo.

 

[Auscultate]

Can you guys point me in the direction of some more research focused MD programs? I only know of Duke and Mayo.

Yale has a thesis requirement and so about half of their class usually take an extra year to do research for their thesis.

 

[Mr. Tee]

Can you guys point me in the direction of some more research focused MD programs? I only know of Duke and Mayo.

Stanford

 

[CCLCMer]

Can you guys point me in the direction of some more research focused MD programs? I only know of Duke and Mayo.

You might look into some MD/MS programs or consider taking a fifth year wherever you end up if you're in an MD program. I think that just about every med school offers an optional fifth year for people who want to get an MS or do research, even state schools. You can also take some time off from med school after your M2 or M3 year to do a PhD at some schools. So even if you're not in a formal MD/PhD program, there are still options to get a PhD while you're in med school if you decide you really want to. The downside of doing that is that you'll have to take out loans for med school, which you wouldn't have to do if you joined an MD/PhD program.

One other option is that you can do a formal MD/MS or MD research program. Mine (CCLCM) is a five year program with an optional MS through Case Western. There is a required thesis year plus two summers of lab rotations (one basic science, one clinical). You can choose to do your thesis in basic or clinical science research. If you're going to be applying to Case's MSTP, you might as well apply here too, because it's free to apply to CCLCM once you've paid the secondary fee for the Case MSTP. I didn't apply to MSTPs last year, but several of my classmates did, so there is definitely a lot of overlap in the kind of people the programs attract. A few of my classmates got into MD/PhDs and decided to come here instead. I think some people realize that they don't want to commit to a PhD, but they do want to do significant research while they're in med school. So this program is kind of a compromise. Another formal program to consider is Harvard's HST program, which you probably already know about. You have to have a really strong physical science and math background to do that program because you take classes jointly at MIT. Also, U Pitt has these two five year basic science and clinical science training programs. You can opt to finish them in four years too if you want, and then you just get a certificate instead of an MS. I'm sorry that I can't tell you as much about those programs, but if you go to the Harvard and Pitt websites, you can find more info. Or maybe there are some posters who are in them and can tell you more about them.

One good thing about picking a formal program is that you have a better chance of getting some research funding from the schools. I don't know what the HST does, but CCLCM and Pitt both definitely give scholarships and sometimes stipends to some of the students in these programs. CCLCM is eventually going to be completely tuition-free for everyone, though not in time to help my class, unfortunately. 😛

 

[TheCybermen]

Yale has a thesis requirement and so about half of their class usually take an extra year to do research for their thesis.

sure, but my interviewer from yale was quite frank in stating that the research thesis that the medical students undertake at the school "is a joke compared to the work that the MSTPs do." for me, that was quite an eye-opener, especially coming from someone who'd spent his entire career overseeing the curricular development of both programs at the institution. it may be something to consider.

 

[ThatOne]

sure, but my interviewer from yale was quite frank in stating that the research thesis that the medical students undertake at the school "is a joke compared to the work that the MSTPs do." for me, that was quite an eye-opener, especially coming from someone who'd spent his entire career overseeing the curricular development of both programs at the institution. it may be something to consider.

Well, yeah... a 3 - 4 years of hard work versus one will yield a lot more results. Especially considering the steep learning curve. In fact, a lot of PhD students have told me 90% of their results came in the last year... so a one year research committment would seem like a joke in comparison. But if one isn't certain about doing the whole PhD and just wants to wet their feet a bit in the lab or something... it's an option, I suppose.