I am interested in academic medicine and will matriculate in MD/PhD. Here's a thought. There are residency-PhD, and usually the PhD is only two years. For MD-PhD, the PhD is usually four. Please do not get too idealist about how, long PhD = full PhD. I love science, but I want to start my academic medicine career without detours. And preferably, I want to connect research with medicine. Looks like Res-PhD is more efficient that MD-PhD. Now I know that the topic of the PhD does not matter, and that the important skills gained from PhD is thinking like a scientist. But wouldn't it be more efficient to gain "scientist's skill" WHILE advancing your medical specialty via Res-PhD? The length is determined by the feasibility of the model system as well as the pressure from PI. If you are starting a new experimental system and your PI wants you to take risks, chances are you won't be publishing and you're not leaving with a PhD any time soon. Now let's hear your opinions: does that mean once you are an MD and full certified, you can throw your weight around and demand "high-yield" projects leading to quick PhD? If so, does that imply MD-PhD are been abused more? Now I know some of us want to do basic research, for that, I can see the benefit of doing full PhD, filled with high-risk/high-reward projects as well as pioneering new model systems and techniques. But for translational research with clinical relevance (the goal of NIH MSTP), would it be more efficient to do research once you have decided on the specialty?