Can't make up my mind about doing MD/PhD!

[sirvandy]

Hi all. I am currently applying for the entering class of '05 and checked only the MD boxes on apps. However, I have been doing undergrad research and enjoy that. Anyhow--and I know it's considered faux pas to say this--but I am also somewhat money-motivated. I would not be satisfied with any job unless I can earn WELL over $100k per year. No, I'm not greedy but I've got some family members who will be retiring and will depend on me for their livlihood. Now I know that researchers with MDs sit at the top of the academic salary pyramid, but I think it is also likely that their average income is less--perhaps considerably--than practicing doctors. Can anyone shed some light on researchers' salaries? Along with all this, I have some other questions:

1) What are the career possibilities of one who pursues a joint MD/PhD degree? Is it only a medical school professor? Is it only a career that is 100% research? Can a person hold a career that is part research, and part practicing medicine? Can you do research with JUST an MD, or do you need the PhD too? What are the average salaries for all of these options?

2) What is the average level of competition for obtaining an MD/PhD scholarship which covers tuition and living expenses for the length of the dual degree? Do all MD/PhD students receive this scholarship, or only a few? What, if anything, does the scholarship recipient owe to the school from which he is obtaining his degree (or to any other institution)? The reason I am wondering is that the tuition and living expenses for 6+ years is probably close to $200k, and I find it hard to believe that the recipient would not owe something for that amount of money.

3) Can a researcher or researcher/practitioner have significant free time to devote to a hobby(s) (and I mean AFTER obtaining the degrees and training)? To be honest, I really don't want to be working more than 40-45 hrs/wk--not so I can sit and loaf, but so I can have time to pursue my hobbies. Which career would give me more free time--research or practice?

4) Is it more difficult to obtain a scholarship for an MD/PhD degree if you apply for it AFTER starting medical school as a straight MD degree candidate?

5) I hear repeatedly--albeit anecdotally--that it does not matter where you go to med school, UNLESS you want to go into research or teach. Is this true?

6) What is the average length of the entire MD/PhD program? Someone on this thread said 7-8 years. Is that correct? How likely is it to go longer? After that, do you do a residency or not? Only if you want to practice some?

7) I had an admissions advisor from a med school tell me that applying as an MD/PhD was like a backdoor into med school, as in it's easier to get in as long as you have the research experience. Is this true?

Thank you!!

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[b&ierstiefel]

Hi all. I am currently applying for the entering class of '05 and checked only the MD boxes on apps. However, I have been doing undergrad research and enjoy that. Anyhow--and I know it's considered faux pas to say this--but I am also somewhat money-motivated. I would not be satisfied with any job unless I can earn WELL over $100k per year. No, I'm not greedy but I've got some family members who will be retiring and will depend on me for their livlihood. Now I know that researchers with MDs sit at the top of the academic salary pyramid, but I think it is also likely that their average income is less--perhaps considerably--than practicing doctors. Can anyone shed some light on researchers' salaries? Along with all this, I have some other questions:

Practicing doctors in the community will tend to make more money than academic physicians who devote most of their time to research. I don't know what the exact figures are but if you're a research PI who has small clinical responsibilities, your annual salary will be 6-digits...but the first number will most likely be a 1. Clinical work pays. Research doesn't. People who devote their time to research, it seems, have to really want to do it because the monetary rewards are nothing to call home to mommy about.

1) What are the career possibilities of one who pursues a joint MD/PhD degree? Is it only a medical school professor? Is it only a career that is 100% research? Can a person hold a career that is part research, and part practicing medicine? Can you do research with JUST an MD, or do you need the PhD too? What are the average salaries for all of these options?

MD/PhD gives you options options options. Having an MD gives you options options options. I know of plenty of MDs who do only basic science research. I know of MD/PhDs who do no research. Some do mainly teaching. Again, salary will go up if your work is comprised of clinical>research. If you do mainly research, your salary will be lower. Average salary #'s-wise, I can't quote exact numbers. Sorry.

2) What is the average level of competition for obtaining an MD/PhD scholarship which covers tuition and living expenses for the length of the dual degree? Do all MD/PhD students receive this scholarship, or only a few? What, if anything, does the scholarship recipient owe to the school from which he is obtaining his degree (or to any other institution)? The reason I am wondering is that the tuition and living expenses for 6+ years is probably close to $200k, and I find it hard to believe that the recipient would not owe something for that amount of money.

MSTP fellows go through the MD/PhD program for free; all expenses paid. No payback. Even if you drop out of MSTP, no payback. The MSTP scholarship covers tuition and gives you a yearly stipend of which you spend to live your life. At an MSTP program, all students should be fully funded. At non-MSTP programs, you may get full support or only full support during grad school and clinical years. EAch school does it differently. There are some institutions which have MSTP funded folks and non-MSTP funded folks. It gets confusing.

3) Can a researcher or researcher/practitioner have significant free time to devote to a hobby(s) (and I mean AFTER obtaining the degrees and training)? To be honest, I really don't want to be working more than 40-45 hrs/wk--not so I can sit and loaf, but so I can have time to pursue my hobbies. Which career would give me more free time--research or practice?

Research is something that PIs tend to live and breathe. Hours are more amorphous and more flexible but tend to be quite hefty. Practice hours tend to be more managable and predictable. Residents work like dogs but attendings tend to have a better schedule. After you finish all your training, I would venture to say that as a practicing physician (in a lifestyle specialty especially such as dermatology), you could dictate your hours better.

4) Is it more difficult to obtain a scholarship for an MD/PhD degree if you apply for it AFTER starting medical school as a straight MD degree candidate?

If you go to one of the MSTP institutions, it doesn't matter when you join the program. Once you get into the MD/PhD, you get the scholarship just like everyone else in the program. If you join late, you still lose money for the year or two you spent in med school that you paid tuition for.

5) I hear repeatedly--albeit anecdotally--that it does not matter where you go to med school, UNLESS you want to go into research or teach. Is this true?

School matters a bit but what REALLY matters is the quality of the work you do AT the school. If you plan to do a postdoc, it matters significantly less where you did your MD/PhD training. Your future employers will be looking at how long it took you to complete your PhD, your letters of recommendations, and your publication list.

6) What is the average length of the entire MD/PhD program? Someone on this thread said 7-8 years. Is that correct? How likely is it to go longer? After that, do you do a residency or not? Only if you want to practice some?

Your estimate is correct. However, some people finish in 6, some people finish in 10. It mainly depends on you and your PhD adviser. I would say it is more likely to go longer than 8 than it is to go shorter than 7. Most MD/PhDs do residency after training. But it certainly isn't required. I know folks who went on into industry and postdoc right after medschool. If you want to do any amount of clinical practice, you should do a residency.

7) I had an admissions advisor from a med school tell me that applying as an MD/PhD was like a backdoor into med school, as in it's easier to get in as long as you have the research experience. Is this true?

Yes. That's how I got into med school. This guy did no volunteer work or didn't work in soup kitchens. This guy did well in school and spent sophomore-senior year working in the lab and being productive. Straight MD programs all waitlisted me. Once the MSTP programs accepted me, the med school had to take me!

Thank you!!

Hopefully my answers were helpful. Hopefully others will chime in with their input because different people have heard different things and have differing experiences.

 

[Caesars0331]

Very informative response!!

Thanks Andy

 

[b&ierstiefel]

Very informative response!!

Thanks Andy

You're welcome.

 

[tedrik]

Always on top on things AndyM! Those were some great responses.

To OP: I am currently going through the application process and I feel that MD/PhD training perfectly fits my goals of entering a research career. Despite this, going on interviews and talking to various faculty members and MSTP program directors has been pretty scary. Countless times I've been told how difficult and tiring the process is and several MD/PhDs have told me that it was not worth it. I was recently on an interview where a well-known faculty member told me that he would not have gone through the MSTP if he could do it over again because his career did not benefit from the combined training. People always change their minds about what they want to do and it might turn out that in the end, you could end up doing something where either an MD or a PhD was all you needed. Hearing these types of negative opinions--from people who have much more experience that I do--of the dual degree training has shaken my own confidence in my decision at times. If I felt as though I was planning to do this for money, then I would have changed my mind by now, but I know that I’ll still be happy with my decisions even if I’m still struggling financially when I’m 40. That might be a bit of an overstatement, but my point is that if someone goes into this because their going to increase their salary, then you might be in for some serious disappointment.

It seems like you are putting some good thought into this, so I’m sure you’ll be happy with whatever you decide to do. Good Luck!

 

[solitude]

Great responses to these common interest questions. AndyM, if an applicant is sure that he is interested ONLY in MD/PHD programs (while admittedly this is often not the case), is it a good admissions strategy to neglect the traditional-M.D. pre-med activities like founding clubs and volunteering in favor of nailing down great grades, MCAT, and research? I don't mean to be a gunner by avoiding service activities, but my undergrad school's classes are tough and I feel like to maintain a 3.9+, I have a limited amount of time to devote to extracurriculars. Therefore, I would be allocating that limited time according to my interests (research and MD/PHD) and what will be best for admissions. Because at this point I haven't totally decided between MD and MD/PHD, this semester I will be volunteering in a clinical setting at the hospital. In the future, though, assuming that I have decided on MD/PHD, should I forget about the other volunteering and focus on GPA, MCAT, and research? Do you wish that you had spent more time on the M.D. pre-med activities like volunteering, non-research activities, etc.?

Sorry for this disjointed post and thanks in advance.

 

[b&ierstiefel]

Great responses to these common interest questions. AndyM, if an applicant is sure that he is interested ONLY in MD/PHD programs (while admittedly this is often not the case), is it a good admissions strategy to neglect the traditional-M.D. pre-med activities like founding clubs and volunteering in favor of nailing down great grades, MCAT, and research? I don't mean to be a gunner by avoiding service activities, but my undergrad school's classes are tough and I feel like to maintain a 3.9+, I have a limited amount of time to devote to extracurriculars. Therefore, I would be allocating that limited time according to my interests (research and MD/PHD) and what will be best for admissions. Because at this point I haven't totally decided between MD and MD/PHD, this semester I will be volunteering in a clinical setting at the hospital. In the future, though, assuming that I have decided on MD/PHD, should I forget about the other volunteering and focus on GPA, MCAT, and research? Do you wish that you had spent more time on the M.D. pre-med activities like volunteering, non-research activities, etc.?

Sorry for this disjointed post and thanks in advance.

I've been asked this question a lot. Although, I was able to "get away" with minimal volunteer/clinical opportunities and was still fortunate to get into a solid MSTP program, I will always hesitate to advocate total neglect of these activities. This is because if you can take part in limited service activities, without sacrificing grades/scores/research, this can only make you more competitive in the long run. I think MD/PhD applications have been going up for some time now...when I applied, it wasn't uber competitive as it is now. Nowadays I have seen and heard of some pretty sick (i.e., very impressive) applications.

If you're dead set on MD/PhD, I think research should be the biggest "extracurricular" focus as this part of your record will be scrutinized the most. In the long run, just because you played super nintendo with orphans, worked in soup kitchens, organized canned food drives, etc. doesn't necessarily mean you're gonna be a good physician-SCIENTIST.

Another piece of advice I have given is that it is good to do some sort of clinical activity...because again, MD/PhD programs want to produce physician-scientists and not just scientists. But that gets into what is being emphasized...does a certain school want to train PHYSICIAN-scientists or physician-SCIENTISTS. This has been discussed ad nauseum in other threads. But if you have some clinical activity, even if it's temporary and limited, you have something to talk about in your MD/PhD essays to address the physician side of the physician-scientist equation.

My personal experience...I was a president of an honors society on campus and a social chair for a community service club. My duties were very limited and didn't take much time. For applications purposes, I put all my eggs in one basket...I focused on research, made sure I got straight A's, studied my balls off for the MCAT, and made sure I had several publications. Publications are never guaranteed, especially for undergraduates, so focusing mainly on lab work during junior & senior years of college was a risky move on my part. My application was by no means well-rounded and it was very lopsided (kinda like what my residency application is looking right now ...good scores, not so great clinical grades, lots of publications).

 

[solitude]

So I get the sense that I can get into MD/PHD programs with either a moderation of clinical and research activities, or an emphasis on research, but not an emphasis on clinical/volunteering/other non-research activities? I guess in my particular situation, having not decided on MD vs. MD/PHD, a balance would be best.

I'll look for those other threads you mentioned.

Thanks again.

 

[tr]

So I get the sense that I can get into MD/PHD programs with either a moderation of clinical and research activities, or an emphasis on research, but not an emphasis on clinical/volunteering/other non-research activities? I guess in my particular situation, having not decided on MD vs. MD/PHD, a balance would be best.

Dude, there's no reason to view volunteering as resume padding. Whether you want to train as a physician or a physician-scientist, it's still a good idea for you to have at least some vague idea of what life in the clinic is like. You'll be spending a lot of time there during the next few years, even if you ultimately decide that you want no part of it in your future career.

You don't need to do it every semester or anything: while the benefits of research experience are cumulative, with volunteering you're just looking to get a feel for what 'doctoring' is like. Doing research every semester may eventually get you a paper, or at least a really good recommendation. Volunteering every semester probably isn't that much more useful to you than volunteering for one semester.

But either way, the point of volunteering is so when somebody asks you why you want to be a doctor, you might actually have a concrete reason for your answer. Or maybe you'll convince yourself you don't want to be one. Either way, the experience will be of direct benefit to you.
And you'll be able to put it on your resume.

And by the way, AndyMilonakis is totally right about program competitiveness right now. Somehow interest in MSTPs seems to have mushroomed over the last five years. The applicants I've interviewed this year (our school has a student interview for each applicant) have uniformly been superstars. Don't leave any holes in your application, because right now the adcoms are just scraping for any tiny reason to be able to put someone's file in the 'reject' box. They've got more stellar applicants than they know what to do with.

 

[solitude]

TR,
I agree that volunteering is a worthwhile experience. Sorry if I came across as simply a resume-padder, because that is definitely what I do not aspire to be and I am sorry that the pre-med process seems to encourage this practice. I guess the gist of my question was that, with limited time for extracurriculars, is research more important than clinical experience? That being said, this semester (my second of freshman year) I will be volunteering at the hospital and then starting research in the summer.

On a side note, and I don't mean to totally hijack this thread, but why do you think interest in MSTP programs has ballooned in the last five or so years? Could you give an example of a "superstar" applicant so I could get a sense of the competition?

Thanks.

 

[tr]

TR,
On a side note, and I don't mean to totally hijack this thread, but why do you think interest in MSTP programs has ballooned in the last five or so years?

I don't have a clear answer for you. I think part of it is what AndyMilonakis has mentioned in other threads: the credential inflation that is rampant these days, not only in biomedical research but in many other fields as well. I guess people are looking to get a leg up on the competition.

Other than that, I think we're in a biomedical boom generally. We've gotten to the point where logical, engineered solutions to health problems are becoming a reality, so the field is becoming more attractive to bright young people. (In the mid-20th-century, for example, I think smart kids were more likely to go into chemistry and physics, because interesting things were happening in those fields at that time. But I think we're now in the era of biomedicine, and even many people who start their training in the physical sciences are moving over to biology because there are so many interesting problems there right now.)

Could you give an example of a "superstar" applicant so I could get a sense of the competition?

Thanks.

Sure. I guess the thing that most impresses me is these superstar letters of recommendation people have. I see recs stating "this is the most talented student I've encountered in my career" too often for it to be strictly true, but nevertheless the kids have got to be pretty amazing.

In their interviews, they also usually come across as motivated, bright, meticulous, independent workers with a real interest and passion for research.

Other than that, they mostly seem to have pubs nowadays, frequently first author. Strictly in terms of numbers (I don't usually pay that much attention to these, but don't know how the adcom weights them) GPAs are usually around 3.7 to 3.9, MCATs range anywhere from about 32-40+. I think to some degree these can compensate for each other: a stellar MCAT can make up for a thin publication record (but not an actual lack of experience, please note), while a super research track record can counterbalance an MCAT in the lower end of the competitive range. There doesn't seem to be that much leeway on grades; as I mentioned, pretty much everyone is over 3.7.

 

[solitude]

Wow. It sounds extremely difficult to gain admission to MSTPs.

 

[marionseven14]

It's not impossible to get admission to an MSTP without the statistics listed as long as you are dedicated to the MD/PhD career path and it shows. I definitely did not have a 3.7 GPA, especially during the beginning of college, and I do not have any publications. I did get a lot of exposure to many types of research and community service, mostly to test myself and see if this path was something I really wanted to do and was capable doing. I challenged my comfort level in stressful interpersonal and research situations through my extracurriculars and found it incredibly fulfilling. They helped me make the decision to apply to MD/PhD programs, and I was admitted this year . I highly recommend getting exposure to both research and clinical settings because MD/PhD programs are more than an admissions game - they are also a 7+ year commitment and a career.

 

[tr]

It's not impossible to get admission to an MSTP without the statistics listed as long as you are dedicated to the MD/PhD career path and it shows...

Okay, I didn't mean to imply that it's impossible to enter an MSTP if you don't have a first-author publication and a 40 on the MCAT. Of course that's not true; and I didn't have any pubs either when I applied. My research pattern was similar to what marionseven14 describes: I bounced around from lab to lab, just trying different things that interested me & seeing where I could get paid. It didn't even occur to me that I should be trying to get published at that point. But that was five years ago, and I do think things have gotten stiffer since then.

If I can give you any advice about making yourself more competitive, I'd echo AndyMilonakis and say, pick a lab you like and stick with it. You'll get a much more solid foundation, be able to talk about your research more intelligently, and make a more significant contribution than if you dilettante around like I did. And you might get published.

Also, I was asked for an example of a 'stellar' applicant. This is what I've been seeing this year, at my home institution. I know my institution had a big uptick in applications this year; maybe next year it will be down again. The numbers of applicants and places are so small (relative to MD programs) that the statistics are pretty fluctuant. And there are plenty of other programs out there, each with different emphases (e.g., certain schools seem to place more importance on GPA/MCAT than others).

 

[b&ierstiefel]

It's not impossible to get admission to an MSTP without the statistics listed as long as you are dedicated to the MD/PhD career path and it shows. I definitely did not have a 3.7 GPA, especially during the beginning of college, and I do not have any publications. I did get a lot of exposure to many types of research and community service, mostly to test myself and see if this path was something I really wanted to do and was capable doing. I challenged my comfort level in stressful interpersonal and research situations through my extracurriculars and found it incredibly fulfilling. They helped me make the decision to apply to MD/PhD programs, and I was admitted this year . I highly recommend getting exposure to both research and clinical settings because MD/PhD programs are more than an admissions game - they are also a 7+ year commitment and a career.

marionseven, i don't think that you are necessarily an "exception." if you got in, you deserved it! plain and simple. congrats on your acceptance and i agree with your last comment. one caveat though...even if you DO get clinical experience as an undergrad, this is only the tip of the iceberg. when you go THROUGH medical school, people change for the better or worse. medicine, IMHO, is something where you get the true perspective when you're already waist-deep in it. another caveat...if you are absolutely sure about what your career goals are (for example, you want to be a biomedical researcher hence MD/PhD), then it DOES become a game because you need to maximize your chances of getting into these programs. that's the way the real world works. yes, it is disenchanting and disingenuous but it is a game and many play it. this is what med school and MSTP applications (and residency applications) have been like for some time. it sucks but as my mentor told me one day, "life isn't fair. deal with it."

and that is one utility of these forums...something i didn't have at my disposal when i applied a long time ago. it is valuable to hear opinions of people who are going through the process and have gone through the process. but, in some ways this forum is bad for people who are neurotic this forum also represents a pandoras box sometimes too...ignorance is bliss.