Cold feet, post-acceptance?

[MedRower]

So, throughout the application process I often answered the question of why I am not concerned about the length of the combined degree program. Even in meeting current MD/PhD students, I was encouraged by their perspectives. However, now that I have acceptances (as it turns out, I applied MD/PhD but now hold offers of both MD+full scholarship and MSTP), I have strangely become nervous about committing to an MD/PhD program. It is normal to be worrying about making such a large commitment at this point, right?

I keep having seemingly implausible thoughts about entering the program and then realizing I'm interested in a completely different field for which getting a PhD doesn't make sense - although I can't name what that would even be! (Global health? Who knows!) I have wide interests and somehow worry about becoming prematurely focused - not that that is what I would be doing by entering a combined program.

I would hate to turn down such a great opportunity because of cold feet, but here I am having wild thoughts. Any input? Is this a red flag or just normal?

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[MSTPbound]

So, throughout the application process I often answered the question of why I am not concerned about the length of the combined degree program. Even in meeting current MD/PhD students, I was encouraged by their perspectives. However, now that I have acceptances (as it turns out, I applied MD/PhD but now hold offers of both MD+full scholarship and MSTP), I have strangely become nervous about committing to an MD/PhD program. It is normal to be worrying about making such a large commitment at this point, right?

I keep having seemingly implausible thoughts about entering the program and then realizing I'm interested in a completely different field for which getting a PhD doesn't make sense - although I can't name what that would even be! (Global health? Who knows!) I have wide interests and somehow worry about becoming prematurely focused - not that that is what I would be doing by entering a combined program.

I would hate to turn down such a great opportunity because of cold feet, but here I am having wild thoughts. Any input? Is this a red flag or just normal?

MD+ a full ride? Go for it.

Forget the MSTP. If you're not 100% committed, there's no reason to put yourself through the extra potentially unnecessary torture. You know you can become a great physician-scientist without a PhD down the road if you choose to, and you'll have other opportunities to pick up the scientific training if it turns out it is your calling.

What if science ends up NOT your calling? Just consider some of the benefits of dropping the PhD now:

• No regrets about accepting a gov't funded fellowship offer meant to train future biomedical researchers
• 3-4 years of your life salvaged to get an earlier start on your clinical career
• 3-4 years more to explore other interests
• 3-4 years MORE INCOME earned in clinical practice (in the highest income-earning specialties, this can easily amount to an extra 7 figures of compensation toward retirement)
• You can remain connected to your classmates from the beginning of the road to the end
• Your only debt is for living expenses so you come out ahead of the pack anyway
• You'll have the flexibility to add on other degree pursuits that might better fit your interests later on... like an MPH or an MBA, or a special qualification or degree in clinical research, etc...

So I say take the MD+ scholarship, and run with it!

Good and Congratulations!

-MSTPbound

 

[QofQuimica]

I would hate to turn down such a great opportunity because of cold feet, but here I am having wild thoughts. Any input? Is this a red flag or just normal?

Sometimes, in a way, having too many choices is worse than having too few. You worked hard to get all those acceptances, and every time you withdraw from a school, you are closing the door on one of your potential futures. But it's something that you need to do, because if you don't make a choice and go through one of those doors, you'll never go anywhere at all.

I think it's normal to have some fear of the unknown; that is just human. What you really need to decide is if you want a PhD or not. If you now realize that you are not really sold on a PhD, then take MSTP's advice and go for the MD. But if deep down, you really do want the PhD (which you could still do in fields like epi or infectious disease if you decide that you're into global health!), then write the withdrawal letter to the MD program and send it. Once you make up your mind, don't think about it anymore, and don't keep asking yourself "what if." Either way you choose will turn out all right in the end, so don't agonize too much about choosing the "wrong" opportunity. Best of luck to you.

 

[SplenoMegastar]

Umm, wow. Really sound (and even eloquent, Q) advice here. I was 100% committed this time last year, but now I am wavering. You'll always wonder what could have been. You won't be closing the door on research!

 

[MedRower]

Forget the MSTP. If you're not 100% committed, there's no reason to put yourself through the extra potentially unnecessary torture.

Well, I guess my problem is that while I can definitely see myself going into biomedical research in an academic setting, I also know that people's preferences change over time. I guess my main problem is this: I can't rule out that I would be interested in, say, public policy or business. So, I guess my question is, how sure is anyone that they want to do anything? I mean, I know many, many people who are "100% sure" they want a career in research, but by the time they finish their PhDs, they are fleeing from the lab (cough – half of Harvard physics grads go to wall street each year – cough).

3-4 years of your life salvaged to get an earlier start on your clinical career

I'm not really in a rush.

3-4 years more to explore other interests

Very true.

3-4 years MORE INCOME earned in clinical practice (in the highest income-earning specialties, this can easily amount to an extra 7 figures of compensation toward retirement)

That doesn't really interest me now. Given that I've never had money, I don't know what I'm missing, so I wouldn't miss not having it. Again, looking ahead, it seems that as people age they begin to care more about money.

On the other hand, getting a PhD certainly helps people secure spots in competitive specialties. I definitely think that that isn't a good enough reason to do one by itself. However, since what I think I'm interested in would involve a PhD, it isn't a bad side effect.

You can remain connected to your classmates from the beginning of the road to the end

Ok, I suppose.

Your only debt is for living expenses so you come out ahead of the pack anyway

Very true. The debt I would have as MD only doesn't worry me.

You'll have the flexibility to add on other degree pursuits that might better fit your interests later on... like an MPH or an MBA, or a special qualification or degree in clinical research, etc...

This is my biggest reason, as described above.

What you really need to decide is if you want a PhD or not. If you now realize that you are not really sold on a PhD, then take MSTP's advice and go for the MD. But if deep down, you really do want the PhD (which you could still do in fields like epi or infectious disease if you decide that you're into global health!), then write the withdrawal letter to the MD program and send it.

How does one know if they want a PhD? What does that feel like, anyway?

I have many motivations for wanting an MD-PhD, and to me it is pretty convincing. But, I'm nervous to make this commitment to specialized training. I know if I don't focus, I wouldn't accomplish anything that I want to do with my life. On the other hand, I have wide interests (not that getting an MD-PhD would preclude me from doing them, in the remote chance I decide to, but it would be an extra 4 years or so delay).

Umm, wow. Really sound (and even eloquent, Q) advice here. I was 100% committed this time last year, but now I am wavering. You'll always wonder what could have been. You won't be closing the door on research!

Are you in an MD/PhD program now? What is causing you to waver?

 

[MSTPbound]

I have many motivations for wanting an MD-PhD, and to me it is pretty convincing. But, I'm nervous to make this commitment to specialized training. I know if I don't focus, I wouldn't accomplish anything that I want to do with my life. On the other hand, I have wide interests (not that getting an MD-PhD would preclude me from doing them, in the remote chance I decide to, but it would be an extra 4 years or so delay).

OK. So my original post was meant as devil's advocacy - I was trying to push you over the edge in case you just wanted a reason to turn down the MSTP.

Here is another perspective - my own:

The MSTP, IMHO, may not be the only way to become a physician-scientist, but it is the best way. It is a protected, well-funded opportunity to become a scientist within the context of preliminary clinical training.

How does one know whether (s)he wants a PhD? It might seem a philosophically elusive question but the way I approached it was by taking time to define what the PhD is/means to me; so my premise was that knowing that I want a PhD is a corollary to my definition of a PhD.

A PhD is a degree conferred upon an individual who has devoted several years to learning how to investigate a particular area and, of course, investigating that area. If you have the desire to learn how to investigate and the willingness to devote the time required for the education - then you want the PhD. If you lack either, then you don't.

If what troubles you is the opportunity cost of pursuing the PhD, then clarify and rank your values regarding the other pursuits vs. the research training. Once you do that, your values should make the decision for you.

Again, Best of to you and Congratulations!

-MSTPbound

 

[greg12345]

I would personally go with the MD+full scholarship. There are plenty of chances to get research training down the road when you are older and your career goals are better defined.

 

[Fay]

I would go to the school (considering the location, how far from home,...etc) that I like better. I don't think the MD school will stop you from getting a PhD if you want one later, so I think the MD+full scholarship and MSTP are the same offer. If you can't decide base on the schools, I suggest you pick the MD+full scholarship because if you drop out MSTP, you may have to pay for M3 and M4, right?

 

[mercaptovizadeh]

Does the full scholarship cover living expenses or only tuition? If you are being offered a *full scholarship* (i.e. stipend for living expenses and tuition covered), and are wavering on the PhD, I would seriously consider the MD + scholarship. Are they at different schools? Having gotten accepted into an MSTP, your science qualifications are likely to hold up should you reapply internally. You would thus have 1-2 years to decide whether you want to commit to the PhD. The one major caveat here is that you will probably have to excel in your med school curriculum courses to keep up a competitive internal application...if this is not something you are willing to commit to (i.e. excelling in the 1st and 2nd year courses), then I would go into the MD + scholarship without any expectation of internal MSTP admission later on.

Just for your information, you can do a PhD in epidemiology, psychology, or certain other social sciences that interface with medicine. Many schools allow this - just check which do and which don't.

 

[MedRower]

Does the full scholarship cover living expenses or only tuition?

Just tuition, although it is in a cheap area of the country.

Are they at different schools?

Yes. Both are respectable medical schools, similar amounts of NIH funding, level of prestige, etc. The MSTP is in a better location, as far as I am concerned, and is a public school. The MD is neither of those (And my anonymity begins to slip away... meh), and historically internal applicants have a excellent chance of being accepted.



I'm mainly struggling with this epistemological question of whether I know that I want to get a PhD. I've been reading about other opportunities for doing research, such as fellowships (Doris Duke, HHMI). I still don't know much about how competitive they are, how valuable, etc.

It seems that if one is planning on a career in research, MD-PhD training is going to be the best way of going about that. Such a career path is what I have been desiring for quite a while and I still intend to do. But, I know that I will learn much and be exposed to much during medical school; I know that preferences change. Do I "know" that I want a PhD in this case? :sigh:

So, I have shadowed doctors and worked in (a couple of) labs a goodly amount. Perhaps if my MCAT score wasn't going to expire, I should have shadowed an epidemiologist, a psychologist, etc. before applying. Meh. What I do know is that, while I do want to see patients, given my current set of preferences, I would not be happy with a career as a clinician only. I want to do research. It just so happens that my interests are wide and constantly shifting. And I'm rather pessimistic about this funding environment, so I suppose at some point it could simply be no longer worth it for me to be a researcher (and eventually any American...).

 

[mercaptovizadeh]

Just tuition, although it is in a cheap area of the country.



Yes. Both are respectable medical schools, similar amounts of NIH funding, level of prestige, etc. The MSTP is in a better location, as far as I am concerned, and is a public school. The MD is neither of those (And my anonymity begins to slip away... meh), and historically internal applicants have a excellent chance of being accepted.



I'm mainly struggling with this epistemological question of whether I know that I want to get a PhD. I've been reading about other opportunities for doing research, such as fellowships (Doris Duke, HHMI). I still don't know much about how competitive they are, how valuable, etc.

It seems that if one is planning on a career in research, MD-PhD training is going to be the best way of going about that. Such a career path is what I have been desiring for quite a while and I still intend to do. But, I know that I will learn much and be exposed to much during medical school; I know that preferences change. Do I "know" that I want a PhD in this case? :sigh:

So, I have shadowed doctors and worked in (a couple of) labs a goodly amount. Perhaps if my MCAT score wasn't going to expire, I should have shadowed an epidemiologist, a psychologist, etc. before applying. Meh. What I do know is that, while I do want to see patients, given my current set of preferences, I would not be happy with a career as a clinician only. I want to do research. It just so happens that my interests are wide and constantly shifting. And I'm rather pessimistic about this funding environment, so I suppose at some point it could simply be no longer worth it for me to be a researcher (and eventually any American...).

Epistemology or not, sometimes you must be practical. If you are seriously interested in research and would not be content doing only clinical work or even clinical research, then the MD/PhD is for you. Needless to say, there's the difference in med-school funding which may influence the kind of residency you choose and when/whether-or-not you do research. Furthermore, having the PhD will help in securing a top-level residency (given the MD-component of the application is competitive), which would support a career in academic medicine. The MD/PhD offers unrivalled versatility (all research, mixed, all clinical, industry, etc.) but you will have to commit to it and the years it will take (the PhD can take anywhere from 3 (don't count on it) to 5 or even 6 years).

I think it's better to go with what you have than count on something in the future. There's no guarantee of internal acceptance to an MD/PhD program and HHMI's are rather competitive, from what I've heard. I had a difficult decision in choosing a top 10-20 MSTP over a top 5 MD-only (but no scholarship) admission. It was tempting to go for the prestigious school and harbor hopes of internal admission, but I'm glad I went with the MSTP.

 

[ClarinetGeek]

I have been wanting to chime in for awhile and give my two cents. MedRower, based on the comments you provided in your last post, I am quite confident that you should do the MD/PhD. You seem to be caught up in the fact that you dont' really "know" if you want to do the PhD. Unfortunately in life, there is a certain amount of uncertainty in every decision we make. Very few of us are 100% that we want to do the MD or 100% we want to do the PhD. Heck there is a certain degree in which we do both because we are certain about one over the other. You seems quite sure that you want to be physician and scientist in whatever regard that may occur. Go with that! Take the plunge and don't look back! Best of luck.

 

[deleted174262]

You should just do a full-ride MD, why not? You're not closing the door to doing the MD/PhD. Don't worry about it so much. Go to med school for free for two years, figure out what you want to do. and then do it. simple.

 

[MedRower]

Thank you for all of your input. I have tentatively decided that I will join the MD program. It seems to be the case that the MSTP has the largest potential downside. It is very difficult to give up a spot in a program like this, but life is long, I suppose.

Thanks again.