can an MD do basic science research?

[Sonya]

Hi,

Well, what's your take on that? Do you need an MD PhD to do basic science research? does basic science research need to be a full time thing?

I don't want to do a PhD (honestly, because i really dislike it in lab), but I want to do clinical research even less.

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[MacGyver]

Is it possible? Yes.

Is an MD/PhD a better pathway? Yes.

 

[Neuronix]

No Sonya, you do not need a MD/PhD to do basic science research. In fact, some of the most successful basic science researchers, even nobel prize winners, out there today are MDs. It just requires a post-doc, perhaps extended to get up to snuff in research.

Interviewers often like to ask: "Why MD/PhD, given that MDs can do basic science research."

There's two potentially good answers for these.
1. "It might increase my grant earning potential some day. MD/PhDs have alternate funding sources. Besides, MD/PhDs are better able to relate their findings to clinical medicine which is something the reviewers like."
2. Or, "Learning both medical science and basic science in a combined degree is the best way to start a career combining both. If I learn to think about both simultaneously, my education will be enhanced."

Personally, I think both of these answers are BS. The real answer is:

"Well I don't want to go be a MD researcher, make 1/2 to a 1/4 of my specialist MD counterparts, and owe $200,000+ in private loans when I'm done." You don't want to say that in an interview though 🙂

 

[elin]

Originally posted by Neuronix
No Sonya, you do not need a MD/PhD to do basic science research. In fact, some of the most successful basic science researchers, even nobel prize winners, out there today are MDs. It just requires a post-doc, perhaps extended to get up to snuff in research.

I have a question about this. It seems like it's possible and not uncommon to research as an M.D. if you take the correct steps, postdoc etc. However, it seems like MSTP in the past five or six years has become the standard track for people who want to basic science and have the possibility for clinical or translational work. In the future, when the students entering M.D./Ph.D programs now become investigators, won't it be uncommon/ disadvantageous to be doing research with the MD?

 

[vixey1230]

I don't think it'll be "uncommon" for MD's to be doing research. I know so many people who are in MD programs, but enjoy part-taking in research activities. And those people will most likely become like my old internship advisor... an academic physician working in a university hospital, and writing up case studies, and doing some research also.

But "disadvantageous"... that's a different question altogether. I do think that the MDs will be at a disadvantage compared to the MD/PhDs. In order to do research and get publications, the MDs will inevitably have to spend some of their time (which could otherwise have been spent in the clinic raking in the dough) on their projects. And others have already mentioned this, but I do think that it'll be more difficult for MDs to get funding for their research projects.

But regardless, I do not think that an MD/PhD is something that people should pursue unless they're pretty confident that they really do want both degrees. Even if the 'free MD' may sound appealing, from what I've heard to date, these joint programs will test your dedication (with the workload, time demand)... those who aren't in it for the right reasons usually end up leaving the program.

 

[Naphtali]

Originally posted by Sonya
Hi,

Well, what's your take on that? Do you need an MD PhD to do basic science research? does basic science research need to be a full time thing?

I don't want to do a PhD (honestly, because i really dislike it in lab), but I want to do clinical research even less.

A more basic (pardon the pun) question:

If you dislike it in the lab (enough to avoid the PhD), and "want to do clinical research even less," why would you want to do basic science research in the first place?

Naphtali

 

[Habari]

"Well I don't want to go be a MD researcher, make 1/2 to a 1/4 of my specialist MD counterparts, and owe $200,000+ in private loans when I'm done." You don't want to say that in an interview though

i'll assume you're being facetious neuronix.

while the financial component is certainly non-trivial, and has encouraged many people who would not have taken this route to do so [the point of the programs] it certainly isn't the only benefit. while it is possible to do a post-doc after an md or coupled with a residency - the 'start-up' time [time for post-doc to getting first tenure track faculty post] required for an md is, on average longer than for a phd or md/phd. the formal training and rationale acquired while pursuing a phd provides an academic framework, as well as a track record of solid work. an md would have to not only hone their research acumen - assuming they are terrific and this isn't an issue - they would still have to establish a track record of solid work to form the basis of job-search etc...

there have been and there continue to be many excelelnt basic science researchers who 'only' have an md. the md/phd program, however, provides a financially appealing, educationally cohesive [supposedly], and professionally acknowledged way to come to the same end. this route made sense to me - and i'm in a program - but it isn't to say this is the only, or even 'absolutely best' way.

 

[Neuronix]

I stand by what I said. Perhaps in the future there will be a more clearcut advantage to having a MD/PhD over just a MD for doing research, but I do not see one now. Certainly I also stand by what I said earlier, with those two reasons having some bearing, but they are still not that compelling to me. Yes, MDs sometimes need more time to get up to speed in research over a MD/PhD, but is it necessarily 3 - 4 years more? Both MDs and MD/PhDs have to do a post-doc, so if a MD gets a good post-doc and has prior research experience, whose to say they won't be done the same time or maybe a year after a MD/PhD? I suppose you could argue that having the PhD or having extended training will make you a better researcher. But, I'm not convinced that is the case.

 

[DarkChild]

yes. but not well.
hope that helps.
D'shank out.

 

[Gleevec]

While I think MDs still participate heavily in clinical and translational research, I dont think MDs do much in the way in basic science anymore

Grants are the limiting factor, and phds and md/phds are more preferable candidates for NIH basic science funding.

Also, a lot of the older basic researchers are MDs only because PhDs didnt rise to prominence until the 70s and 80s, and now there is a plethora of them. It used to be that an MD was also a research degree, until PhD and MSTP programs rose in prominence. Most of the younger MDs do clinical research or are on teams participating in translational research, but I dont know of too many young MDs with their own basic science lab who work alone.

If you are so interested in basic research, why not just get a PhD?

 

[MacGyver]

Originally posted by Neuronix
Perhaps in the future there will be a more clearcut advantage to having a MD/PhD over just a MD for doing research, but I do not see one now.

Sure there is. Look at the NIH data. MD/PhDs dominate MDs in every aspect of basic science research. More NIH grants, more publications, etc.

Both MDs and MD/PhDs have to do a post-doc

Its more complex than that. For MDs, doing a postdoc is MUCH more necessary than for MD/PHDs.

Neither group HAS to do a postdoc, but for MD/PhDs its not that big of a deal whereas most MDs do need to do one.

Med school doesnt train you to be a scientist.

so if a MD gets a good post-doc and has prior research experience, whose to say they won't be done the same time or maybe a year after a MD/PhD?

Yeah, but how likely is that to happen for an MD vs an MD/PhD? First off, an MD/PhD generally speaking is going to beat out an MD when competing for a postdoc in a highly coveted lab.

MDs have 1 year of research experience at most, unless they take an extra year or time off for research (which is very unusual).

MD/PhDs have at least 3 or 4 years of research experience in addition to whatever they did in college. That puts MD/PhD at a competitive advantage.

I suppose you could argue that having the PhD or having extended training will make you a better researcher. But, I'm not convinced that is the case.

Sure it is. Just because there are successful MD researchers doesnt mean the MD/PhD is superfluous or unnecessary. All the studies I've seen show that MD/PhDs do better in measures of research productivity than MDs only.

 

[pathdr2b]

All I have to say is that at the weekly pathology conferences, it's pretty obvious that the MD/PhD residents are just better clinical/research "thinkers" than the MD only folks. This is not to say that the MD only residents aren't good, but why be good when you can be great?

Sorry, but for a future career in research, MD/PhD is just the BEST way to go otherwise at 37 years old, I'd cetainily look for a quicker way out.

Dam, I'm going to be at least 43 by the time I finish😱 Oh well, I'll be doing my thing with that MD/PhD

 

[Sonya]

Originally posted by Naphtali
A more basic (pardon the pun) question:

If you dislike it in the lab (enough to avoid the PhD), and "want to do clinical research even less," why would you want to do basic science research in the first place?

Naphtali

Because,
I really liked research in undergrad, well in some parts of undergrad (I work now full time in a lab and graduated last year). And some select parts of it working after, but really not much. I like what i've been told by COUNTLESS professors is supposed to be the point/Essence of research.

So, I think i'll like research once I find my place in it (ie, what area to study) or progress to a certain level. I can tell, that place probably wont be in clinical research projects. And, it may be harder for me to find my place then others, but I don't want to close myself to opportunities to finding it. But, i don' t want to commit to a PhD when I'm not sure I will find place in a lab. I don't want to be IN a PhD program and not wanting to be there.


I disagree with Neuronix about the funding. It depends on your situation and loans you take out, of course. But, in the long term, the four years of lost MD salary due to doing a PhD more then makes up for the tuition perks.

I thought it came down to:
Do you want to pursue research during or after medical school? There are advantages to both. I am tempted to believe (at the moment) my interest is in bioengineering and designing medical devices. But, i really don't know to much about it (except that I enjoyed research when it was in the pure engineering design /physics level). And, given that, to define my resarch area, I would need to know my specialty. Thus, why I am tempted to wait to do research after MD. Plus, it'll give me four more years to explore what's out there.


Yes, a lot of people have told me you can do a PhD or do a post doc after MD/Residency. Still, a lot of PhDs say MDs can NOT do basic science research (but then, they are PhDs, so they like to think good of their degree...maybe???). I guess there is a point, that you need to commit full time to basic science research (do you think t his is true, can't you colloborate with someone?. and practicing MDs can't do that.

The MD Phd is a new invention (70s? i think). So, I share elin's and gleevec's concern that MD PhD are going to take over as the MDs that do research.

BTW, i somewhere f oudn a piece of paper summarizing residency placement of WashU MSTPs over the last 20 years. Only 10% went on to a post doc. MD PhDs don't really need post docs, I think (Well, certainly not as long a post doc as MDs).

 

[Neuronix]

MacGyver, could you please give me references for some or all of the data you cited in your last post.

Thanks.

In response to Sonya, the stats you are citing are the stats for those who went straight from a MD/PhD program into a post-doc, skipping residency. If you look at the total number of graduates who do a post-doc instead of or after a residency, the number will certainly be higher. Then if you look at the graduates who go into basic science (maybe 50%?), I bet 100% or close to it will have done a post-doc. Also, you will talk to alot of PhDs who say that MD/PhDs don't get real PhDs and therefore are not qualified for basic science jobs. I've heard that sentiment many times. I can only imagine how these kinds of people would respond to a MD-only researcher...

About post-docs, I can't say I've ever seen a basic science faculty member in the biological sciences with any degree who hasn't done a couple years of post-doc (well, under 70 years old). I am certain that people who don't have PhDs have to spend longer times in post-docs before they can get a job as an assistant professor. However, is that amount of extra time on average 3 - 4 years? I've seen it both ways. I've seen MDs do two post-docs that end up being 3 - 4 years more. Then again, I've seen MDs do one successful post-doc and move on.

BTW, for anyone interviewing, be careful to whom you voice the opinions listed in this thread. I was intereviewed by on average one or two MD-only researchers at every school I visited. In general, these were some of the most successful researchers I got to meet. For example, if you look at the list of hhmi researchers, one of the indicators of who is a big shot in science, you'll see a similar number of MD/PhDs and MDs. No, I didn't count, I just browsed through it. http://www.hhmi.org/research/investigators/index.html

 

[pathdr2b]

Originally posted by Neuronix
MacGyver, could you please give me references for some or all of the data you cited in your last post.

I don't know where the dat is on this, but I've personally seen it myself and can tell you thata this is a fact. Also, as a current NIH fellow the folks around here like to brag about it while they convince studnets to do the MD/PhD.

 

[Primate]

So Neuronix,

I suppose you disagree with the speaker at the retreat this year, then? Just curious about your take on his take on things. 🙂

{For those keeping score at home, the speaker at the Penn annual combined degree retreat (an accomplished MD/PhD who shall remain nameless) spoke at length about how combined degrees outcompete all other degree "classes" at 10-15 years post graduation. His examples were funding, publication, heads of departments, and such. They were, however, largely anecdotal, but he intimated that he'd done some quantitative comparisons}

In the end, I just don't understand why this debate crops up so very frequently. It seems that many people want to take shots at the idea of a combined degree (even many who chose to undertake that training). If you (the general "you," not Neuronix or anyone else in particular) don't think the combined degree is useful, I'd suggest getting whatever training you feel is best and competing with others in your field. When all is said and done, that is ALL that will matter.

In the spirit of open discussion (ie, let's not get nasty),
P

 

[Neuronix]

I think MD only researchers and MD/PhD researchers share the same potential. What I also think is that I don't want to spend 200k+ getting the MD. Though there are still some good reasons for getting a PhD, hence my being here. 😉

It's interesting how this debate goes depending on who's around. Sometimes we have a very pro-MD/PhD crowd, and sometimes not. Sometimes I play the MD/PhD advocate, sometimes I don't. 🙂

 

[tofurious]

you'll realize that brevity is art.

Can MDs to basic research? yes.

Does any MD who wants to do research get a lab and 2 techs plus bonus money from either NIH or your institution? no.

Does any MD/PhD who wants his own lab get a lab and 2 techs plus free money? no.

It comes down to what you do with your own training. If you do well, nobody cares how many letters you have behind your name. If you do poorly, same thing. A PhD offers you protected time/space for in-depth training and an opportunity to shine. Statistically speaking, most people don't shine and just end up hanging up their diplomas. Data are interesting to look at but not guarantees. Take your life into your own hands and don't let people on this board tell you one way or the other.

 

[pathdr2b]

Originally posted by tofurious
It comes down to what you do with your own training. Take your life into your own hands and don't let people on this board tell you one way or the other.

Yada, yada, yada, I think THE point about MD/PhD training is that it gives you more CHOICES than either degree alone can. give you.

 

[tofurious]

MD-PhD programs don't give you choices. You give yourself choices. The only choice difference is a PhD not being able to apply for residencies. Otherwise, an MD is free to do medicine and/or research as an MD-PhD, and a PhD is obviously free to do research. MD-PhD is a training program that gives you skill sets, not a ticket to paradise.

I might add that I'm a 7th year and graduating. In case you want some qualification.

 

[pathdr2b]

Originally posted by tofurious
I might add that I'm a 7th year and graduating. In case you want some qualification.

Thanks , but the MD/PhD RESIDENTS I see everyday are plenty enough "proof" of the value of the combined program including multiple job offers in a variety of settings from industry to federal agencys (think Homeland Security) not to mention salary( I'm with you on the financial concerns, Neuronix 😉 , oh and did I mention that they just seem smarter than EVERYBODY else?

As for choices, I don't see any PhD pathologists around here doing any sign outs, but the MD/PhD (pathology) folks.........................

 

[tofurious]

That's like wanting to be a NFL player after seeing the success of NFL players. These residents are doing well because they are smart and hard working people to start with, not because they chose the MD-PhD programs. The programs may have given more training, but getting into one doesn't guarantee you jack. Smart and hard working MD students do just as well. And if you care to read carefully, I did say that the inability of PhDs to go to residency was the only limiting choice.

Many people starting the joint degree programs are too caught up in the hype of getting accepted into a prestigious program that you can't see how smart some of your MD classmates are. Yes, you are in. Now what are you going to do with it? Along with scientific skills and all that, I hope the programs help you work on humility too.

 

[pathdr2b]

Originally posted by tofurious
Many people starting the joint degree programs are too caught up in the hype of getting accepted into a prestigious program that you can't see how smart some of your MD classmates are.

Okay, I agree with you here but I think we're talking about 2 different issues. I'm saying that for a research career the best academic preparation is the MD/PhD. Furthermore, I'll probably attend a tier 3 school (by choice, btw), so obviously I'm not in it for the prestige

Originally posted by tofurious
[B I hope the programs help you work on humility too. [/B]

🙄

You didn't seem to have a problem casually mentioning that you were a 7th year student, now did you?😉 There's confidence and arrogance. Try not to get it "twisted" next time!!!

 

[tofurious]

Don't confuse experience with arrogance. I only said I'm old and have been around a little longer than most of you. I don't consider myself smarter than my regular MD classmates, but you seem to believe that you're better than them at doing research 10 years down the road before you even meet them. People make choices, and you make yours. Just don't go around and say that your choices make you better than everyone else.

 

[pathdr2b]

Originally posted by tofurious
I don't consider myself smarter than my regular MD classmates, but you seem to believe that you're better than them at doing research 10 years down the road before you even meet them.

Looks like this thread has become between you and me.😉

I've been around the block a few times myself, and as an African American female I can assure that my views were probably VERY different than yours. And what I've learned having been in the research game a measly 15 years or so (I guess this makes me arrogantly experienced) is that the people with the most "toys" seem to "win". The MD only versus MD/PhD game isn't necessarily about whose "smarter" which I think you must have noticed if you've spent any time at all in a "real" job with benefits, signing bonuses, 401k plans, ect., ect. It's about credentials ESPECIALLY in the research world. Like it or not the NIH data is clear with respect to the value of the MD/PhD.

Finally, It's not about whose "better" (still not sure where the hell this better than thou" stuff came from you keep referring to) it's about whose "better'" preparedfor a research career.


Okay, I'm done "preaching to the choir"😀

 

[Ms. Dawson DO]

Hey tofurious...what's with the 'hey kid' subject? I agree with Primate about not getting nasty and its pretty wack to assume you are older than other people on the forum who may disagree with you....


Path..girlfriend, I am not trying to blow up your spot...but don't you have a KID of your own, years of research experience AND are older than the average 7th year md/phd student??? I am thoroughly confused. 😕

 

[Vader]

Originally posted by Neuronix
I think MD only researchers and MD/PhD researchers share the same potential. What I also think is that I don't want to spend 200k+ getting the MD. Though there are still some good reasons for getting a PhD, hence my being here. 😉

It's interesting how this debate goes depending on who's around. Sometimes we have a very pro-MD/PhD crowd, and sometimes not. Sometimes I play the MD/PhD advocate, sometimes I don't. 🙂

Yes, very interesting how the debate sways. So far I've managed to abstain just to see how things progress. 😀

The bottom line is yes, as many have noted already, MDs can do basic research.

However, medical school does NOT prepare one for a career in basic science research. There are opportunities available to get research experience during medical school, but none of these are as extensive as formal PhD graduate training.

I find it particularly interesting that the PhD component seems to be quite undervalued among several of you who have posted. The fact that you see MDs who have become successful basic researchers is often mistakingly taken as evidence that the combined degree is a dispensible. While it is true that the combined degree is not REQUIRED, it does prepare students SIGNIFICANTLY BETTER for a career in research, as evidenced by the available NIH data.

Earning the MD and then doing a postdoctoral fellowship is NOT equivalent to an MD/PhD program. The expectations and goals for graduate students and postdocs are completely different. There are many components of any typical graduate program that postdocs often do not partake in (i.e. journal clubs, seminars, retreats, classes, etc).

Furthermore, there are K training grants available for individuals doing medically-relevant research, which MD/PhDs are typically extremely successful at procuring.

Finally, as an MD/PhD, you can have the option of fast-tracking through certain residency/fellowship programs, which reduces the total time spent in training.

Hope this adds to the already illuminating debate.. 😉

 

[Sonya]

unfortunately this turned into a stupid pissing contest behind my back... as SDN does ... 🙄 you both are, as brag to be, older and more experienced then me by far... why can 't you ACT like that?


Vader (or whoever else), what NIH data? I am interested in real DATA about differences in residency placement.


anyway.... the facts are out. This is a little more detail then i've seen previously, but basically we all know the same things and we are interpreting it differently. So, i meant to turn the conversation another way to get some substantial, otherwise unknown opinions out.

Will a typical research inclined practicing MD have TIME for basic science research? Is it feasible to do basic science research part time?

Notice I am saying:
Feasible (not possible).
Do/Lead research (not "run a lab"; which means as the MD you don't need to be the only PI).

because, obviously the person who gets only a MD wants to do clinical practice, probably a fair amount.

Sonya

 

[Vader]

Check out:
http://www.nigms.nih.gov/news/reports/mstpstudy/mstpstudy.html

In most cases, the nature of basic research necessitates a hefty time committment. Most MD/PhDs or MDs that do both basic research and clinical medicine split their time in favor of the science (80%-20% is the prototype). There are several reasons for this, not the least of which is that in order to keep up with a scientific field as a PI these days requires that one spend a great deal of time reading papers, going to meetings, attending seminars, and managing the lab. So I would say realistically it is very difficult to do quality basic science research only part time.

It sounds like you have the idea that you can be an MD and do bench research without running your own lab. Certainly, this is a possible route (though not a very common arrangement in the U.S.), but it does carry various disadvantages. For one, you would never be a truly independent investigator and would likely be at the whim of your PI's interests. This means you would likely not have the creative freedom of running your own lab and forging the direction of your investigation. Also, it is difficult to get any significant bench research done if you spend a minority of your time on it. The situation is totally different for clinical research, as those types of projects are often very amenable to clinical schedules.

I don't want to discourage you from pursuing your interests/goals, but just want to give you a realistic picture of what to expect.

Hope this helps.

 

[tofurious]

I don't think that anyone should list 401k as a reason to go MD-PhD rather than MD alone. This is starting to sound like "should I do general surgery or neurosurgery because one makes more money". If you want to prove to the world that you can do better than the next person even from a disadvantaged background, best wishes. People should really do this joint degree thing because they like the nature of the training and the prospect of combined work down the road, not the success factor. Chances are, you're not going to win the Nobel Prize, nor are you going to be a department chair. Can you still be happy with your bread-and-butter science?

To the original poster: if you really want an answer of whether you can do research as an MD, this is not the forum to be in. Everybody in here is either on their way to getting both degrees or extremely biased towards it (or both). Maybe you should visit some MD researchers at your local university/medical school and hear what they have to say. Data are good for policy makers, but quite useless for the individual. Good luck with your decision.

 

[pathdr2b]

Originally posted by Sonya
unfortunately this turned into a stupid pissing contest behind my back... as SDN does ... 🙄 you both are, as brag to be, older and more experienced then me by far... why can 't you ACT like that?

If a heated debate troubles you this much, may I suggest that you NOT pursue the PhD. You'll never make it pass your oral exams.

Tofurious, let me preface this by saying this is my LAST response to you. Where you get the idea that most of us in this forum are in this for the money, I'll never know (I'm referring to your 401K;MD/PhD comment). And these frequent references to being "better than anyone"? You appear to de a very disheartned future MD/PhD.

Ms. Dawson, DO, girl what can I say. You know the old argument, some **** just never changes but yes at 37 years old I think I'm the most mature (NOT oldest) in this forum. Now will someone pass me my Justin Timberlake and 50 cent CD's😀

 

[xanthines]

I don't think that's true. My PI only went to medical school because that's what her father wanted. She currently avoids clinical work as much as she can (1 out of 5 weeks). She is also currently one of the very few women professors here and pretty successful by any measure.

I know some other PI's who kind of meandered their way to research as well. In my opinion, I think the MD/PhD track is for people who are SURE they want to do some kind of research. Someone isn't so sure can get a garden-variety MD and then can run a lab later if they want.

Just my $00.01. (I have hlaf a brain.

-X

Originally posted by Sonya

because, obviously the person who gets only a MD wants to do clinical practice, probably a fair amount.

 

[Primate]

... I'll kick the horse while it's down. And so it begins....... and maybe ends?

A few observations (in memorium of George Plimpton):

Money is not a good reason to do the CD. If you want $$, rock in med school and pick your specialty carefully.

If you want to do research, the MD/PhD does make monetary sense. This is one BIG reason why the gov't ponies up the dough in the first place.

If you want to do research, the CD makes sense because it both provides unique training (as mentioned, you get things in a good CD that you won't in even a very good post-doc) and opens MANY more doors than either the PhD or MD alone (more $ available, more departments that can hire you, etc.).

No one has really said that MDs CANNOT do quality research, just that the CDs may have advantages that make it easier to do so. (FYI, my boss is a tenured basic researcher at a good school - and he's JUST an MD - horrors!! He did, however, have to work harder to do it and has said several times that he sometimes regrets not having done the CD).

The question, to me, seems to be whether "you" want to do research primarily. If so, the CD makes sense. If not, why even bother with all the hassles attendant to a CD program? Why even follow this thread???

I have "hlaf" a mind myself to just delete this post as I feel that it's adding little useful. However, I just finished my peds rotation and am jonesing for some SDN. 😀

As to maturity/age/etc - well, let's just say I'm no spring chicken either. 😛 I've always thought, however, that age is no more a definite indicator of maturity than letters after a name are indicators of intelligence.

Lastly, and more personally, I'm doing the CD because I really do want to be a translational scientist. I've tried (to good effect - sorry for the self horn-honking) some other careers before this one and really love what I'm now doing. The CD is a great opportunity to set you up for a career as a physician scientist (well named program, I suppose). I truly do hope that others going this somewhat long route feel the same. While misery may love company, I've found that happy people seek their own level as well.

Yadda yadda yadda.

Blah blah blah.

All work and no play makes Homer a something something.

My car was totalled in a tornado on Tuesday.

I really like sardines.

P

 

[chef]

hey tofu and primate (and other 4th yrs), what fields r u guys goin into?

 

[dl2dp2]

I just want to throw in a few words. The following is actually my own brainstorm/calculation as I've been in med school for ~1 month.

My personal goal is to get a tenured position in a basic science department and/or a primarily basic science research position in a clinical department. Here are my calculations,

(1) MD/PhD takes ~6-7 years to complete, which compares very favorably with most bioscience PhD programs.

(2) MD classes are MUCH better than Phd classes. I didn't realize this until I started both. Personally I think most of the biosci phds are UNDERTRAINED. Unlike physics/chemistry/engineering phds, who take a LOT of foundemental classes, biosci majors have most of the time very flexible cirricula. One class that I see as being VERY necessary for bio phds of ANY specialization is GROSS ANATOMY. GA is approximately equivalent to quantum mechanics/thermodynamics in physics/chemistry. Most of the research in physics/chemistry (particularly experimental) hardly use any QM/THERMO, but it's still required for the "culture" (for a variety of very good reasons).

I think this accounts for the fact that many MDs performed much better prior to the rise of PhD programs in basic science research. As far as "cirriculum based training" in the biological sciences, the MD program is still, in my opinion, the best option one could have.

(man, i don't know if you guys can get this somewhat subtle point)

(3) It's possible for an MD/PhD to do an internship and go directly from there to a post-doc. In fact, many very prominent MDs did that in the hay days of molecular biology (i know of SEVERAL people right now as examples). The advantage: you can practice academic medicine in a hospital, collaborate with pharmacutical companies, write prescriptions, do clinical research. This OPENS up TONS of oppurtunities in hospitals that PhDs don't have.

I think for all intents and purposes, if you get into ANY MSTP (NIH funded) program and did reasonably well, it shouldn't be too hard to get a tenured position SOMEWHERE (worst case scenario, your research doesn't pan out, you finish your residency, you'll get tenured as a clincial faculty). I absloutely cannot say the same thing for a PhD grad from a TOP program. Even from the BEST programs, only about 1/3 eventually secure primary investigator status. This is PARTICULARLY true for Biosci phds, where there is a HUGE overflow of both domestic and international students.

 

[dl2dp2]

sorry i think i have to split my post into two parts

Summary:

I think there is a definite advantage for MD/PhDs over PhDs (that is, in getting the tenure, and in getting the tenure in the best departments) in research in biological sciences, particularly molecular/cellular biology and/or clincially relevant biology. It's harder to say whether the advantage is as strong if the candidate is pursuing PhD in organic chemistry or engineering related fields.

Now, let's compare MD/PhD with MD with regard of research.
IF money is No object, then i cannot see ANY advantage of doing MD/PhD over MD, except a possible integration of cirriculum that is somewhat cool but definitely not necessary.

(1) Suppose MDs spend the same amount of time doing research after one year of internship as a post-doc, they'll have exactly the same sort of experiences/track record as a PhD postdoc. Qualitatively the research an MD postdoc does is comparable to the research a PhD student does. But I think overall postdocs tend to be MORE productive because they have a much more compact schedule. This is ANOTHER reason why many prominent basic science researchers were MDs. A lot of biology is dumb luck--being a Phd student gives you time to be creative, but biology isn't necessarily about creative...a lot of times it's about doing this much experiments in this much time.

(2) MDs enjoy the same level of benefits MD/PhDs enjoy in clincially related resources.

(3) As I've said, personally I think (and I've come to the rather anti-intuitive conclusion that) the MD course cirriculum is a better training for basic research than most of the biosci Phd cirriculum.

Summary:

MD/PhD programs are essentially *pre-organized* MD+Post-doc programs with a bit more flexibility as well as financial renumeration. To get tenured, you need this much research this many papers, it doesn't matter where you did them or as what you've done it. In essence, Neuronix is RIGHT in saying that money is potentially the biggest advantage in this game. But there is also another he ignored, which is the amorphous *PhD experience*.

I've come to the conclusion that in order to get tenured as quickly as possible, the best pathway is the following:

lots of money to pay for the MD program at one of the *new cirriculum schools*

2 yrs of MD basic science + 1 yr clincial rotation + 1 yr research = MD

MD + 1 yr of internship + 2 yrs of postdoc = P.I. (tenure track assistant professor)

3+1+1+1+2=8 yrs

compare that to a regular PhD program

6 yrs =PhD + 3 yrs post doc = 9 yrs....most of time must do two postdocs before getting on the tenure track = 12 yrs.

or MD/PhD program

7 yrs = MD/PhD + 1 yr internship + 2 yr postdoc = 10 yrs (i've heard of md/phds getting PIs after 1 yr internship as well, or after residency without a postdoc) so that would be 8 yrs, equivalent to an MD

Summary of all summaries :

(1) MD pathway is the most expensive, demands the most self-decipline, but also the fastest (i.e. best suited for the most driven/best work ethics etc)

(2) MD/PhD pathway is probably the safest pathway and probably where the students have the most fun having BOTH MD and PhD experiences LOTS OF FUN!!!!! (and not to mention the spending money during MEDICAL SCHOOL doing nothing but studying cool **** and spending money) and it sounds best on paper (this could be an edge in getting dept chair/dean at a clincial dept in a second tier institution) LOTS OF FUN!!!!!

(3) PhD pathway is the most risky (if your research doesn't pan out, you basically have to look for a job in the industry which sucks most of the time), but is not limited to a specific set of research fields (indeed, in certain (unpopular) fields, i.e. chemistry, the tendency is to get on the tenure track immediately after a 5 yr phd + a 2-3 yr post-doc)...some fields are even FASTER (i.e. math, try Charles Fefferman, who was tenured at 21 and got the Field Medal at 25) PhD is for the mad wiz ultra super talented/creative, but not the most focused/driven.

sorry to write such a long response 😛 but for me personally, i trust that my talent is such that which program i choose wouldn't matter in the end. so i picked the program in which i can have the most fun.

peace, btw, i'd love to hear your (harsh) opinions regarding my calculations

 

[CrazyCarl]

Personally, I had a terribly difficult time choosing between MD and MD/PhD programs, not because I am on the fence about research but because I see myself involved in a variety of projects once I am out in the real world (thought, in my case, the "real world" will be the ivory towers of academic medicine). Right now, I like reseach but am unsure of whether I want to make it my #1 professional commitment. Maybe I will want to give more time to practice, teaching, administration, or writing (of the non-scientific journal type). Chances are, if I do all that AND try to run my own research, my lab work will not be as productive, paradigm-breaking, etc, but that will be my choice. The point is, the option to research will never be unavailable to me as an MD, wheras I think an MD/PhD program will be more restrictive with regard to anything outside of the basic sciences.

That being said, super-kudos you people who, at the ripe old age of 22 or so, know you want to devote your career to basic medical science research. If I were in your shoes, I would be all over a MD/PhD.

 

[chef]

sluox, i didnt read your LONG posts but i gotta say that majority of mdphds do not finish in 7. most finish in 8, many in 9.

the ones who finish in 6-7 are ones who did research all during first 2 yrs (thus their grades & step1 suffered). sad thing is that if your step1 and grades arent good u won t match at top residencies and u will therefore not get tenured at top programs.

 

[Primate]

(yes, I can make a quick point)

The MD/PhD absolutely does not limit your flexibility outside of "basic sciences." I know of MANY people who are doing very cool stuff, WAY outside basic science (though roughly still within translational medicine). Some entirely outside of even clinical medicine, some very much inside of clinical only medicine (look at the last 10 years of Derm and who lands those residency spots).

P

 

[CrazyCarl]

Maybe I overstated - my point is not that MD/PhD programs are *absolutely* restrictive; someone doing immunology research will still have the time to play tennis, learn mongolian, or play the violin. However, they are *relatively* restrictive, compared to an MD at least. The latter will have more time to pursue interests outside the basic sciences, simply by virtue of the fact that they spend less time learning about and doing science.

 

[pathdr2b]

Originally posted by CrazyCarl
That being said, super-kudos you people who, at the ripe old age of 22 or so, know you want to devote your career to basic medical science research. If I were in your shoes, I would be all over a MD/PhD.

Ahem, but I think the MD/PhD is as viable an option for a 22 year old as it is for someone (like myself) WAY over 22. Please don't use age as an excuse, if you want to do it, then just do it😀

 

[dl2dp2]

This maybe true...however, most of the programs are pushing towards being shorter than longer.

When I was at Duke, Sal (the MSTP director) mentioned the three flavors of MD/PhD

(1) Johns Hopkins (along with a few other east coast schools such as Columbia, Cornell, Pitt). Basically they cut the last year of optional clincial rotations, condense clincial clerkships into 13 months. Average length, 6-7

(2) The California Way (along with Univ of Chicago and Univ of Washington in Seattle, and a few others) Full MD, Full PhD. Average length: 8 years

(3) Duke's innovation (several others possibly, Rochester, or maybe Yale): one year basic science, two years clinical. Average length: 6-7

Sal believes (obviously) that Duke's program is the best. However, Duke's program is obviously the best catered for PHYSICIAN-scientist rather than physcian-SCIENTIST.

----

Now, to answer your question, most kids who finish the program in 7 at Columbia do not do research in yr 1 and 2. Secondly, at many schools (such as columbia), there are NO grades (P/F). Hence clearly grades can't "suffer" should you choose to do research. Whether someone does very well on the boards is very difficult to estimate and depends on a variety of factors. On average, MD/PhDs do not need to do as well on boards to get into a competitive residency. I can tell you now that if you are focusing your energy as an MD/PhD on preparing the boards it'd be a waste of time. Instead you need to ponder how and when can you get that first author Nature paper out 😛

That being said, what I'm doing now as a first yr med student is to take grad school classes. Compare to my grad school conterparts i have fewer course requirements and no required lab rotations. Therefore, it DOES actually save time.

Originally posted by chef
sluox, i didnt read your LONG posts but i gotta say that majority of mdphds do not finish in 7. most finish in 8, many in 9.

the ones who finish in 6-7 are ones who did research all during first 2 yrs (thus their grades & step1 suffered). sad thing is that if your step1 and grades arent good u won t match at top residencies and u will therefore not get tenured at top programs.

 

[dl2dp2]

just to add something 😛 i'm being really really chatty:

I have come to the personal conclusion that many bio PhDs programs are basically crap. 🙂-p sorry for being immodest) If you want to do research in molecular biosciences, I say get an MD, get a loan, and go do a post-doc at NIH. This is especially applicable for someone who's vacillating between an MD and an PhD. If you have the grades/scores to get into a top 20 med school, GO. I say this because JUST ABOUT EVERYTHING in molecular biosciences is now funded through medical research.

List of bio PhD programs that are probably bad training standing on its own without an MD:
Immunology
Virology
Molecular Biology
Molecular Neurobiology
Microbiology
Cell Biology

These programs basically give you an intro to mol biology course, then let you into labs to run gels or do in situ hybridization for six years. BAD TRAINING!!!

If you want to go into systems sciences/computational biology/hard core biochemistry/biophysical chemistry/evolutionary biology/genetics, do a PhD. But then for these individuals MD
was really never an option to begin with.

Good phd programs 😛:
Molecular Biology and Biochemistry (leaning towards biochemistry)
Biomedical Engineering
Biophysics (basically crystallography...soooo easy to get tenured...mmm)
Systems Biology (the new one at Harvard)
Evolutionary and Organismal Biology
Chemistry
Applied Physics

Generally they include a larger core course and teach you some very classical science tehcniques

If you want to do research, aren't sure if you want to do MD or PhD or MD/PhD, go with the MD (or the MD/PhD) route. Do not go the PhD route.

 

[Nuel]

Originally posted by sluox


If you want to go into systems sciences/computational biology/hard core biochemistry/biophysical chemistry/evolutionary biology/genetics, do a PhD. But then for these individuals MD
was really never an option to begin with.

Good phd programs 😛:
Molecular Biology and Biochemistry (leaning towards biochemistry)
Biomedical Engineering
Biophysics (basically crystallography...soooo easy to get tenured...mmm)
Systems Biology (the new one at Harvard)
Evolutionary and Organismal Biology
Chemistry
Applied Physics

Generally they include a larger core course and teach you some very classical science tehcniques

If you want to do research, aren't sure if you want to do MD or PhD or MD/PhD, go with the MD (or the MD/PhD) route. Do not go the PhD route.

Seems you are referring to me 🙂 , but your last two statements do not necessarily coincide with my contemplations. But I do not have to state my reasons for my plans here . . . Anyways, I rely on my bias that the best researchers of the future will be those who have the hard-core quantitative skills as well as broad medical knowledge.

 

[Vader]

sluox,
It would probably take me a lifetime to refute all of the claims you have made regarding PhD programs and reasons to do the MD instead. Suffice to say, although you may think many of these programs "crap" and have taken broad strokes at disparaging them, there are many who would disagree with you.

To give you a fair chance, however...
Which schools are you talking about specifically?
Why are the programs you have mentioned "crap"?
What makes you think medical and graduate courses are anything alike?

From my experience, medical classes provide absolutely NO training whatsoever for thinking about problems and ways of approaching them. Instead, classes like anatomy, microbiology, etc are virtually solely focused on the memorization of huge volumes of information, which leaves very little room for thinking. Graduate classes, by contrast, often focus on problems, analysis, and quantitative/mechanistic ways of thinking. These involve learning how to test hypothesis, interpret data, and draw conclusions based on the results.

Memorizing huge volumes of information does not prepare you for scientific research. What medical classes do provide is a nice fund of knowledge that may be useful later on in research in thinking about problems in a larger context or making leaps across systems/fields. In addition, having clinical experience (i.e. clerkships, preceptorships, etc) allows one to focus his/her research in certain directions that may not have been apparent otherwise.

 

[pathdr2b]

Originally posted by Vader
From my experience, medical classes provide absolutely NO training whatsoever for thinking about problems and ways of approaching them. Graduate classes, by contrast, often focus on problems, analysis, and quantitative/mechanistic ways of thinking. These involve learning how to test hypothesis, interpret data, and draw conclusions based on the results.

Vader brings up a good point about graduate versus medical training.

I am currently enrolled in a "graduate" course in Pathology(which is kicking my butt, btw). Next semester, I take Pathology courses (systems based) with the medical students.

After only about a month or so in this course, I can tell you that without a doubt what I'm required to know in the graduate course has more to do with "thinking" and is therefore much more challenging, than memorizing. The approach to pathology is from the point of view of a scientist (i.e. experimental design and analysis) NOT physician (who got what , where, when and why). Having this background first, I fully expect to "breeze through" the medical school courses since I believe thinking through a problem is a better way to learn than memorizing tons of facts.

 

[Habari]

sluox,
what they feedin' you up there in The Heights? makin' you talk all crazy.😉

 

[pathdr2b]

Originally posted by sluox
List of bio PhD programs that are probably bad training standing on its own without an MD:
Immunology
Virology
Molecular Biology
Molecular Neurobiology
Microbiology
Cell Biology

In defense of Sloux, I can tell you having recently been in the "looking for a job" market, that these PhD's are more likely to be in the unemployment line because they're a "dime a dozen".

 

[Sonya]

This thread has got some interesting info (albeit all biased ) and discussions going on.

sluox:

I just interviewed at Pitt a few days ago (day before yesterday). Their average is 8 years, they said. but, they USED to be bragging about finishingin six years.
----
now with your amusing subject qualification, i differ on this:
If you want to go into systems sciences/computational biology/hard core biochemistry/biophysical chemistry/evolutionary biology/genetics ... for these individuals MD was really never an option to begin with.
----
nope, i do want to go somewhere here (or BioEng) but doing plainly a PhD was NEVER an option.

programs, not people can be classified. So, where would you put physiology/neursocience BTW?

I very much agree with Vader: PhD training is essential to make you think critically. all the volume of material in MD classes forces you to just memorize.

Now, i'll just play devils advocate. A lot of researchers have told me undergradaute (and any other opportunity you get) is the place to learn about things OUTSIDE your field. And that learnign about those is very important to suceed with research. These were NOT people preaching "well roundedness" either. The point is, research require problem solving (occasionally). And problem solving often requires drawing from who-know-what discipline, often FAR from your discipline. So, in that case, the medical degree is helpful. Also, the medical degree helps you focus on what is useful (read: what get grants).

BTW, in my conversation with professors it came to the point:
to practice you need an MD.
To do research, you need training in the lab. A good ~4 years. You can get it through your PhD or a post doc. it doesn't really matter. The more years of trainign you get, the better your training. But, there are subtle advantages in getting PhD training.

path.. "challenging" in the good or bad sense? of course grad school is more challenging then medical school. I interpret challenging to mean interesting, and therefore easier. Medical school does not require much thinking, BUT there is a TON TON more stuff to remember, thus it's plainly time consuming.

y'know the expression "Anatomy: it's not hard, it's just lots"
that applies for medical school, i think.

why do people think MDPhD saves money. Lets compare MDPhD (8 years) vs MD with 4 years of post doc.
Let's assume:
Tution = 20K/yr. I know this is a fallacy. But, once you consider public school, maybe not.
MSTP Stipend = cost of living= 20 K/yr =
Post Doc/Fellow/Whatever avenue you pursue research after MD salary = 50K /year.
Practicing Physician Scientist (MD with Post doc or MSTP grad) salary = 120K/year.
Interest: 0%. Okay, that's my only fallicy. tell me if you believe that is all that will make it or break it.

So, let's look at how much people owe 8 years after starting medical School
MSTP grad: $0.
MD w/ postdoc:
- 20K * 4 = -80 K (tuition)
-20K * 8 = - 160 K (cost of living)
+ 50K * 4 = + 200 K
NET: ------------------
-40K
So, if you do the post doc, MSTP saves ~40K

Now, if you just do the MD. Four years after you MD you will be at this state compared to MSTPs:
-20 K * 4 = -80 K (tution)
-20K * 8= -160K (cost of living)
+120K * 4 = + 480 K
NET-----------------------------------
+ 240 K

so... MSTP doesn't save money if you're not interested in research.

 

[Primate]

Originally posted by Sonya

so... MSTP doesn't save money if you're not interested in research.

WHAT KIND OF PERSON DOES THE MSTP IF THEY KNOW APRIORI THAT THEY DON'T WANT TO DO RESEARCH?!?!?!?!?

I just don't get this.

P