choice of PhD program vs. residency

[ermeyfan]

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So here's my problem. I'm about to start an MSTP. I know I'm really interested in basic neuroscience. However, I'm NOT sure I'm that into a career as a neurologist or psychiatrist. Have any of you considered/dealt with the problem of choosing a PhD program before completing clinical clerkships? It seems that PhD program selection influences clinical career, rather than vice versa.

Do you know of anyone who has a "mismatched" career - like an obstetrician who does non-developmental neuro research? It seems one of the main points of this physician-scientist endeavor is to produce people who conduct basic research related to a problem under their clinical aegis. But what if I spend 4 years getting a PhD in neurobiology only to discover that I really like thoracic surgery?

Sorry if this has been touched on before, but I think this is a huge issue for MSTP students.

 

[ermeyfan]

I mean, I guess this is why you should get a PhD in Physiology or Biochemistry, etc.

 

[physicsnerd42]

So here's my problem. I'm about to start an MSTP. I know I'm really interested in basic neuroscience. However, I'm NOT sure I'm that into a career as a neurologist or psychiatrist. Have any of you considered/dealt with the problem of choosing a PhD program before completing clinical clerkships? It seems that PhD program selection influences clinical career, rather than vice versa.

Do you know of anyone who has a "mismatched" career - like an obstetrician who does non-developmental neuro research? It seems one of the main points of this physician-scientist endeavor is to produce people who conduct basic research related to a problem under their clinical aegis. But what if I spend 4 years getting a PhD in neurobiology only to discover that I really like thoracic surgery?

Sorry if this has been touched on before, but I think this is a huge issue for MSTP students.

I think the main point of the PhD is that it teaches you HOW to do research and ask questions. The fact that you're an expert on one membrane protein in one type of cell isn't as useful as the fact that you've struggled with getting data and doing analysis and have set up experiments that get results. That's why it's unusual to do a post-doc in the same area you did your PhD: the fact that you know how to do research is more important than your area of expertise. I know one professor at my school, for instance, who did a PhD in condensed matter physics at Berkeley and then did a postdoc in neurobiology (and now does neurobiology/biophysics research). So, don't worry too much about your choice of PhD.

 

[Neuronix]

I'm about to start an MSTP. I know I'm really interested in basic neuroscience. However, I'm NOT sure I'm that into a career as a neurologist or psychiatrist.

I had the same conflict. What I learned after a few years of medical school and what you should keep in mind is there's a lot of clinical specialties that touch on neuroscience in a wide range of medicine. You brought up Neurology and Psychiatry, but what else?

If you want surgery, how about ENT, ophthomology, neurosurgery?
If you want less patient contact, how about Neuropathology or Neuroradiology?
You can even go into Anesthesia or PM&R and look at pain or stroke.

There's so many options from neuroscience that I wouldn't worry about some potential future career/research mismatch.

 

[ermeyfan]

I wonder how many MD/PhDs of all research stripes are primary caregivers. Anyone know any?

Most physician-scientists with whom I'm familiar are neurologists, due to my research interests, but I guess lots must do IM and a fellowship - which is sort of mind-boggling given the length of an MD/PhD program.

 

[Neuronix]

The data best data I have on this is here:

One MD/PhD student started compiling what residencies MD/PhD students are going into. This site can be found here:

http://www.dpo.uab.edu/~paik/match.html

It's not complete because as students we can't gather all the data for all the schools, however interesting trends emerge:

Top specialties for MD/PhD students 2004-2005
1. Medicine
2. Pathology
3. Pediatrics
4. Radiology
5. Dermatology

Partial data collected for 2006
194 matching graduates
-----------------------
Internal Medicine - 43
Pathology - 22
Pediatrics - 22
Radiology - 16
Dermatology - 13
Psychiatry - 11

Harvard hospitals - 33
Penn hospitals - 19
UCSF - 15
WashU - 9
Michigan - 8
U of Washington - 8
Johns Hopkins - 7
Chicago - 7
NYP Columbia - 7

That being said, I talked to a top of his game researcher here recently who did IM + Infectious Disease and what did he tell me? If he could go back and do it again, he would pick a specialty with less physician-scientists. This way you can make a bigger "splash". All of this taken into account, I wouldn't worry if everyone you know is an IM + subspecialty or neurologist. You have plenty of options in your future. If you're thinking about shaving years off of your training, there are "fast track" combined residencies and fellowships that take a year off of your residency in IM and peds. Even if you were to do a 3 year residency, you would need extra time to establish yourself in research to get a research position.

As for your question specifically of how many primary caregivers... I'm guessing the number out there who work in primary care and do basic science research is very low. It may be a bit more common to do outcomes-oriented research, and I have met some MD/PhDs who do this. It would be very cumbersome, however, to do the intended 90/10 research/medicine split in primary care, and the amount of time you could devote to patients in your area of research would likely be only a small fraction of that.

 

[ermeyfan]

Thanks, that's really helpful. What if it went on the FAQs sticky?

 

[QofQuimica]

Just to add to what previous posters have said, I recommend that you focus more on picking a good mentor than on picking a particular project or specialty. Talk to older students in the lab about what it's like working for that prof, check his/her publication record and graduation record. Once you have your PhD, you can do whatever you want with it. People switch fields for their post docs all the time. But if you get stuck with a lousy mentor who doesn't graduate most of his/her students and isn't supportive of your career aspirations, you'll be in much worse shape than you would be as a "mismatched" obstetrician doing neuro research.