I really like your post. I don't mean to write it off and it's an important perspective to keep in mind. But I'll ask you to go look up the MD/PhD forum about... I dunno... 5-6 years ago when I was a new mod. You'll find posts I made that sound almost exactly like yours. There were a bunch of now long gone senior students griping and a few pre-meds/1st years (we have a few now) saying, "stop being so bitter! It's not really like this!" That was me. I was Mr. Optimism. I annoyed the senior students right off this board with my constant little nitpicky posts about how you should hang in there and things are great and why are you people so bitter? The real world isn't like this, it's just you gripers love to flock to SDN. I was Mr. MD/PhD is the best way to train for a research career and if you just plan things out the right way and pay attention and work hard all things will work out for you in life.
Unfortunately, I'm Dr. MD/PhD now. I've watched a whole class of students go from definitely/probably doing research to never/unlikely doing research. When I get together with my classmates, I'm probably the most upbeat and optimistic about a research career. The last time we got together, before I took my year out, my classmates were really surprised to hear I was having issues with my PI and my committee because I seemed very successful, very happy, and always so upbeat about doing research forever and ever.
What I'm NOT saying is don't do this. What I am saying is, this is reality. If you want to ignore reality or live in your own world, that's your choice. Maybe things will line up well for you and you won't have any significant roadblocks on the road to tenure (yeah right). You'll probably get very screwed over more than once. The stuff that's out of your control could potentially stifle or kill your career. I've seen it happen to good people over and over again. I've seen other optimistic first years end up in private practice. You can't ignore reality forever. You can't ignore that well less than half of MD/PhD graduates actually end up in a majority research career. And I'm of the belief that MD/PhD students don't start MD/PhD programs to be clinicians. We're all reasonably sure we want to be researchers. We're the most qualified and talented and have the most experience coming in. What happens on the way through that makes us like this? I have a lot of good ideas, but nobody wants to talk about it. Instead the 6th years talk to the 6th years, the 1st years talk to the first years, and we all look at our MSTP grants and make them sound as great as possible to get the best workers... errr students and keep those grants funded.
What's happening? You'll see. Maybe you'll be lucky. Maybe you'll take it all in stride. Maybe you'll end up like me. It's hard to say. My fuel is fired by the incoming students to med school and grad school who once told me I as cynical/pessimistic/bitter who become more bitter than myself. But you won't see them posting on SDN. They don't want to be labelled as bitter. They don't want to see themselves as cynical. I mean, why would they try to tell the incoming students what's up? You won't listen anyways. So you have only a handful of senior students (myself, sluox, gstrub, gbwillner, others) and you can see what we sound like. We don't disagree that much.
It's reality. It's academic medicine. It's a recommendation-based hierarchy that lends itself to abuse of those under them. The politics that come out from that is a nightmare. Output (money) is the most rewarded no matter what the means of that output. In today's funding environment, to get ANY output only the strong survive. And when you pick a lab, you don't know who's taking the steroids. You only find out too late and either drop the PhD or fight like hell on out of there.
Don't get me wrong... MD isn't much better. Output is rewarded. Is residency at all about education? No. Could you be fired from your residency program for any reason? Yep. Is the 80 hour work week largely ignored? Pretty much. Is this cynical? It's reality, regardless of the personal judgements.
Come back in another 6 years or so. Keep in touch and stick around. I hope you have a happy and productive life. If the funding situation improves we probably won't need the steroids anymore. We might all start sounding like optimistic MD/PhDs who never had to battle through single digit funding rates to start a career. We might not feel the acute pressure of a PI whose grants and/or job might run out and thus beats you and everyone else in the lab to get MORE DATA MORE DATA NOW NOW NOW. And that's the optimistic part of the post.
But don't be surprised if some of us will continue to be scarred from the trauma. I know one MD/PhD who's very successful at research who came through in the last bad funding cycle of the 80s. He's very insistant everyone should do residency, preferably in something that's got a good gig clinically. Everyone knows this whole career is unstable. That you might work hard and things may not work out regardless. That no matter what you do if you try to start your career on a bad cycle you won't get those R01s in the three years your department requires and be screwed. These scars and experiences stay with you. The scars of the assistant profs you look up to getting fired, while the ones who are most abusive and least knowledgeable stay on. Or the grad students who got so depressed they sit in their room in their underwear for months because they put in months of all night work only to get yelled at by their PI for not working hard enough. Of the other grad student who wants to kill his PI or kill himself because he just constantly gets beaten and can't deal with the constant political struggle just to survive. The worst scars are the recently hired professors who were so fed up with it all for the same reasons as me that they ran as far from here as they could. But still they spent all those years and years trying oh so hard to bang their square peg into that round hole. All those years training in research... It has to be good for something right?? Right???? I can't just throw it all away? Are all those people really smarter than me? But my grants aren't getting funded? My papers take forever to get published? It's a constant battle just to do my job. I'm so unhappy and it never seems to be getting better??? And then one of the unhappy ones, the one I looked up to most, dies one night in his sleep, having fought all that time for their career and never getting there.
It's all there in my head and I can't get rid of it. It's kind of like when I was growing up and I was hungry and had to bum money from my friends to eat. It's all in there. You can't expect it not to color our perspectives. You
can try to isolate me as being one dissatisifed MD/PhD student who's alone in this. But I'm not alone. I'm just vocal. Scratch some more senior students, and not the few cheerleaders an MD/PhD program will recommend. You'll see what I mean.
Good luck.