Combined degrees: how to organize my seemingly infinite education

[hoya09]

---

Members do not see this ad.

Hello all-

I seem to have a bit of an issue deciding on how to proceed with my MD/PhD. Though the choice may ultimately be made on my behalf, I should have an idea of my preference before following up with the involved parties. I've thought about the issue for a few weeks but I still can't make up my mind about how I'd like to organize my combined degree program. I'd appreciate any advice you can offer.

Here's some background:

I've been accepted to an allopathic MD program and a PhD Linguistics program at the same school. Usually, this would make me an MD/PhD student, but because it's so rare to do an MD/PhD in Linguistics, there are some complications. Coordination and funding are the main issues. Beyond that, I have personal concerns about overloading myself or ending up in a situation where my success in med school is compromised by my pursuit of a second degree. While I was a boderline candidate for med school, I have been told by advisors that I'm extremely competitive for a Linguistics PhD (relevent to options where the PhD is completed at another school).

My options (for the sake of this discussion, I'm assuming that these scenarios are all viable from the perspective of both departments and that they would all take 6-7 years):

1. Integrate the coursework and receive both degrees from the same institution. I would take PhD classes alongside MD classes, using summer courses and waiver exams to spread out or eliminate some coursework.
Pros: Taking classes concurrently will balance out my science load with social science, highlight correlates between the two programs, and avoid lapses during which I may forget some of my undergrad background for either degree...
Cons: The waver exams (biochem, genetics, or a number of Ling courses) would hurt the quality of my education and possibly put me in a difficult place for boards/comprehensive exams. I may also lose my mind if the "spreading out the work" idea doesn't go as planned.

2. Same thing, but only integrating the MA (approx 5 yrs MD/MA) with the intent to do a 1.5 yr PhD extender at the institution of my choice.
Pros: Same as option 1 but with the additional perk of being able to choose a PhD institution and (in all likelihood) get a fellowship for the PhD.
Con: Same as option 1, plus if I do the PhD anywhere else, I'll have to spend that time away from my (then) husband. Also, how does postponing residency work? Does that make me less competitive?

3. 1 yr masters, 4 yrs med, 1.5 yrs PhD. I would focus on a single degree at a time with a 1 yr med deferral. The PhD could be completed anywhere.
Pros: Less stress at any given time, ability to choose a PhD institution, better funding (long story)...
Cons: (see option 2) and the idea of deferring after busting my butt to get in bothers me on a fundamental level.

Again, any suggestions would be extremely helpful. Thanks in advance!

 

[Decicco]

Definetly #3. I think that focusing on any coursework besides medical school when you are an MS1 and MS2 is asking for trouble. Also, do you really need a PhD in linguistics? Why not just take some summer courses or courses after you get your MD to satisfy what interest you have (ie, pursue the education, not the degree). Just an idea, good luck and go Hoyas!

 

[hoya09]

Definetly #3. I think that focusing on any coursework besides medical school when you are an MS1 and MS2 is asking for trouble. Also, do you really need a PhD in linguistics? Why not just take some summer courses or courses after you get your MD to satisfy what interest you have (ie, pursue the education, not the degree). Just an idea, good luck and go Hoyas!

Go Hoyas indeed! 😀 Though this season has been really disappointing. The final four days were amazing... I miss the electrifying atmosphere on campus. Anyway...

Thanks for the help! I'm actually leaning 3.. but each time I think I've decided, I focus on the deferral aspect and a little part of me dies. That being said, the issue of splitting my time and doing subpar in both programs concerns me in a deeper way than the deferral.

I guess I should give a little info on why Linguistics... My research is in Dr/Pt communication (see MDapps). I want to practice and do research before (eventually..) teaching. I think the PhD would make me much more competitive in academic medicine and give me an edge on grant applications. I love what I do in Linguistics and I think my research will contribute to both medicine and Linguistics.

Thanks again for the speedy response!

 

[Gut Shot]

Again, any suggestions would be extremely helpful. Thanks in advance!

4. Four year MD, linguistics as a very devoted hobby.

Sincerely,

Gut Shot, PhD -> MD

 

[hoya09]

Gut Shot, PhD -> MD

I didn't know that you started as a PhD... May I ask what your PhD is in? Your version of option 4 is still a major consideration. I just wonder if I'll regret not doing the second degree while I'm young and sans dependents.. I don't really see myself going back for it post residency and, as I mentioned, I could see the PhD as a unique qualification for teaching patient interaction. Again, I truly appreciate your experienced perspective.

 

[135892]

4. Four year MD, linguistics as a very devoted hobby.

Sincerely,

Gut Shot, PhD -> MD

I vote this option 👍

 

[DrYoda]

4. Four year MD, linguistics as a very devoted hobby.

Sincerely,

Gut Shot, PhD -> MD

👍.

 

[hoya09]

Hmmm... for the option 4 people, is it because you don't think that my research is useful or because you don't think that the PhD would be useful? Do you think it's unnecessary personal stress or maybe some other possibility I haven't mentioned?

It's good to know that people are suggesting option 4... I need this kind of objectivity to make sure my ambition isn't hurling me toward a regrettable commitment (or to tell me that it is doing just that)...

 

[sleepy425]

I'm just curious, did you apply to any MSTP programs? I know it is too late to do that at this point in the cycle, but there are a few MSTP programs that allow social sciences PhDs. Actually, unlike many social sciences, I can actually see how there would be a niche for a physician linguist so I think MSTPs might be more willing to allow this than other social sciences. If you have been accepted to a school with an MSTP program that allows social sciences PhDs, you might want to consider going to that school and applying into the MSTP after the first year (actually, the MSTP that comes to mind for a physician linguist would be Harvard, since they allow social sciences PhDs and it's a combined program with Harvard-MIT, so you would have access to Chomsky at MIT which would be really cool). That way you could do the combined degree within a program and get funded for your medical school years. Anyway, good luck with everything!

 

[hoya09]

Thanks sleepy! 😀

I applied to one MSTP (Penn) and several non-NIH funded programs. The main problem with the MSTPs, as you noted, is that they tend to exist at research heavy, stat centric schools. I believe Penn is currently using my app to prop a coffee table on the basis of my sGPA. Harvard might get a good chuckle before setting my transcript on fire out of pure disgust. Nonetheless, I probably should have applied to Harvard for the hell of it. There's always the possibility that the Linguistics might have helped me a little. ... Even if, by some freakish chance or gross administrative error, I did get into Harvard, the mentor issue would not be completely solved. Chomsky is old and most likely approaching retirement. Even if he weren't, I doubt he'd entertain the company of a sociolinguist. Penn would have been nice, as their big name (Labov) is of a sociolinguistic persuasion... but as I said, that ship appears to have sailed. The program that I did get accepted into has a fully funded MD/PhD, but because they've never had a social scientist and they're not NIH funded, they couldn't offer me the traditional fellowship or even let me in the official MD/PhD club. They basically said that I can do it if I deal with the funding and the coordinating.

Your comment about the utility of a of a physician linguist means a lot to me, so again, thank you for that and the rest of your advice.. Good luck to you as well in your endeavors.

 

[Gut Shot]

I didn't know that you started as a PhD... May I ask what your PhD is in? Your version of option 4 is still a major consideration. I just wonder if I'll regret not doing the second degree while I'm young and sans dependents.. I don't really see myself going back for it post residency and, as I mentioned, I could see the PhD as a unique qualification for teaching patient interaction. Again, I truly appreciate your experienced perspective.

My PhD was in biomedical research, ostensibly related to my field of clinical practice, but in reality it does me little good.

I understand your outlook. When you are young your life stretches out like a vast horizon, and if you have myriad academic talents and interests it seems natural to include them in your plans.

Alas, there are only so many hours in the day, and only so many years of grinding poverty one can self-inflict. Unless you are one of those rare modern renaissance types who can test pilot land rockets, play lead guitar in a band, and be a neurosurgeon, you are setting yourself up for mediocrity.

Medicine is a fairly time consuming endeavor. If you want to get a residency and practice you had best not let your knowledge and skills atrophy while you're jerking it in some unrelated PhD program. I'm not trying to be negative, I'm trying to keep you from kicking yourself in about five years, when you realize you're wasting a large chunk of your youth without any cogent purpose.

 

[hoya09]

That's a very valid point. Wow.. I'm now more confused than when I started this thread haha ... But that's probably a good thing. I'd rather be confused now than extremely sorry later. Skill atrophy is a concern that I hadn't really considered, but it's obviously a huge issue. I realize that medicine is lifelong commitment and that I'm probably exceedingly naive when it comes to appreciating the amount of time and dedication it requires (along with most if not all premeds). Thanks again, gutshot, for shaking things up a bit for me.

 

[lord_jeebus]

Get the MD, and hire someone with a PhD in linguistics to help you with the work you want to do

 

[Gut Shot]

Allow me to briefly elaborate, in case I came off a little harsh.

PhDs are very long, and very difficult. The anticipation of being unfulfilled without one is just naivety talking. The only two legitimate reasons to suffer through one are 1.) you have a defined goal that requires one (such as becoming a professor at a college or university), or 2.) you are independently wealthy and completely insane.

You don't seem to fit either category. For the purposes of being a physician with linguistic knowledge, a PhD is akin to swatting a fly with a Buick. Since there are few to none MD/linguistic PhDs in existence, you are competing against virtually nobody. If you read two linguistics books a year between now and the end of residency, and a linguistic issue ever arises in your hospital, you will be the go-to guy, I can assure you.

In summary, unless you are planning on being a professor of linguistics with a side medical practice, can it and just go to med school. Trust me, you will be plenty entertained between now and 2013.

 

[Gut Shot]

One more thing. I started my PhD in a cloud of naivety at 21. Now I'm 35, $150K in the hole, and I live in a shoebox apartment with zero retirement savings. The payoff will come, but it has been a long, hard road of delayed gratification. With the benefit of hindsight I should have just worked for two years after undergrad, rather than spending six in grad school Hell. What I would not give to have those four years back.

But that's just me.

 

[Habeed]

Swatting a fly with a Buick...awesome job, Gut Shot. What was the OP thinking? Let's hope he doesn't become the second MD/linguistics PhD in the country (I'm guessing that one might already exist)...

I mean, seriously, why would you need both degrees to know that it's hard to communicate with a patient who doesn't speak your language? And a PhD in linguistics is not something practical like "learn to speak these 5 languages competently." It's more akin to 'slave away for years doing boring ass work researching some arcane subject and write a theses on it'

 

[hoya09]

Re jeebus, medical discourse specialized linguists are relatively rare... there are very few in the world doing what I do. In fact, my advisor is the preeminent scholar in medical discourse from the interactional perspective. She isn't for hire 😉 But I understand what you're saying...

Re gutshot, I'd have to respectfully disagree on the point of me not having a specific goal. I stated that do intend to teach. I suppose I should have been more assertive on that point. I'm not just doing this for the hell of it. I also have a chronic illness to consider. I want to have the opton of taking time off from practicing to research or teach should I get sick. As for being independently wealth or insane, I agree that i fit into neither category though some might argue the former 😛 Your point about debt resonates with my lack of a guaranteed funding source. I may be overdoing it and I am definitely naive (hence the seeking of advice)... Maybe just the masters would be enough? I am looking to stand out as a professoral candidate, so I guess a better question is how might I resonably accomplish that and continue my medical discourse research as a clinician. The answer seemed to be a dual degree, but I'm open to any ideas people might have.

Also, a PhD in Linguistics doesn't only have application in communications research. Psycholinguists research Alzheimer's, autism, and other neuro conditions involving language production. Most (n=<5) pre-existing MD/PhD linguists are in neuro.

Habeed- I am a 'she' and I do happen to speak 5 languages... aside from that, I believe you're confusing a degree in Linguistics with one in communication. They're not the same... also, please read my book segment about the discourse of adverse drug reactions. I'd argue that such research is practical (and see my point about psycholing above).

 

[calnation]

I have absolutely no experience with the subject matter of this thread but I'm going to throw in my 2 cents anyways.

It's cool that you want to study a lot but I'd advise making sure you really enjoy it before you set out for this kind of endeavor. You should be the type of person that foregoes other pleasures during your free time just to study. Otherwise, the climb up top just isn't worth the view.

 

[qmcat]

hoya, do you know what level of teaching you want to do (college or med school level)? The PhD would only help you more if you really wanted to teach at the college level. If you want to teach med school and do research in psycholinguistics, you can do that with just an MD.

Yea, it would be nice to have the PhD, and I think it's a reasonable thing to consider, but I think there may be another way to get to where you want to be with less effort. I also think that, depending on what exactly you want to be doing in linguistics, getting a PhD in linguistics might be overkill, as in you might be getting more of the linguistics stuff than you might actually need to do what you want.

I've heard that many academically geared people just get their MD degree and take a year or two to do some research fellowship afterwards to get that research experience. Perhaps you can consider some of these things. I'm not an expert on the academic medicine path, but just wanted to throw some ideas out there.

 

[hoya09]

hoya, do you know what level of teaching you want to do (college or med school level)? The PhD would only help you more if you really wanted to teach at the college level...

I've heard that many academically geared people just get their MD degree and take a year or two to do some research fellowship afterwards to get that research experience...

qmcat, that was really helpful!! I want to teach at the med school level.. one of my advisors and coatuhors is an adjunct professor at a research heavy med school. She's a PhD in Linguistics (no MD) and she had originally planted the idea of an MD/PhD making me more competitive for academia. I think that it varies substantially though, and as you suggested, the PhD would be more of a requirement for teaching at the college level.

I hadn't thought of the research fellowship idea... that's actually really attractive.. If I were to stop at the MA level, I could do a fellowship later (post residency) rather than going for the full PhD. That might save some time and spare some less applicable theoretical coursework. Hmmm.. There are a lot of options... I'm trying to keep calnation's comment in mind as I work through this in my mind. I know I love what I do, but gutshot and co. have certainly made an impression on me. I'm so glad that I started this thread. You've all been a huge help.

 

[Habeed]

I agree. Look, from what I've seen at my med school, you don't need the PhD to make yourself competitive. At least at my school, there are way more PhDs than MDs, and it kind of feels like the MD lecturers are "more important". They usually have better lectures with less random nitpicky fact memorization, and they usually only show up to present 'special problems'.

So, I seriously doubt that you need that PhD. An MA in linguistics would be enough : I mean, if you're going to teach at the med school level, there might be enough room in the schedule for one lecture or a short elective on medical linguistics.

I don't know what exactly that is, but it sounds like, from your description above, the study of how to communicate with patients better.

Personally, I think the real problem isn't communication, but motivation...but that's another story. (aka a lot of lives could be saved if doctors had a way to help at least some of their patients actually lose weight/quit smoking/ect...but it's not that patients are bad, it's that the brain is highly resistant to letting go of addictions)

 

[Gut Shot]

A few things, then I'll shut up.

First, in medicine, you absolutely do not need a PhD to teach or do research. Most faculty in academic centers are MD-only.

Second, there are myriad opportunities to learn and do research after you have an MD. It's up to you whether you want to go down that road. I seriously doubt there is any branch of neuro you cannot settle into if you have the desire.

Third, convoluted educational plans have a tendency to make life very hard. I strongly advise you to put your head down, start the MD, and reassess your goals when it comes time to apply for residency. An MD is a helluva credential to possess, if you were a borderline candidate then you should put your mind to doing it and doing it well.

To do two things at once is to do neither. &#8212; Publilius Syrus, Roman slave, first century B.C.

 

[hoya09]

So, I seriously doubt that you need that PhD. An MA in linguistics would be enough : I mean, if you're going to teach at the med school level, there might be enough room in the schedule for one lecture or a short elective on medical linguistics.

I don't know what exactly that is, but it sounds like, from your description above, the study of how to communicate with patients better.

Personally, I think the real problem isn't communication, but motivation...but that's another story. (aka a lot of lives could be saved if doctors had a way to help at least some of their patients actually lose weight/quit smoking/ect...but it's not that patients are bad, it's that the brain is highly resistant to letting go of addictions)

Thanks Habeed and Gutshot.

You've made your point very clearly Gutshot. I needed someone to tell me what you did and I'm sincerely grateful for your impassioned responses.

Just as an fyi, I'd like to respond to what Habeed said with some clarification... I don't intend to lecture on medical linguistics. In fact, I'm sure that 99% of MDs don't give a flying crap about Linguistics. I want to lecture about the role of language in patient care. In other words, what does it mean to be patient centric? How can one work towards establishing a productive patient relationship through communication? A lot of primary care programs (several I've applied to and I'm sure many others) have classes dedicated to these subjects. My research is targetted at applying linguistics to the problems of medicine and in that regard, I think I could contribute a scientific bend to these stereotypically mushy courses. There's also the psycholinguistic route that I mentioned before. Something like that could provide supplemental lectures in a neurosci class... Anyway, thanks for your take on it Habeed and, for what it's worth, I agree with what you're saying on motivation... the patients aren't bad or at least that mindset is extremely unprodctive in helping them make healthy lifestlye choices.

 

[chewsnuffles]

No need for that PhD. Do research as a fellow. Get your masters somewhere along the line, and the option to extend it to a PhD is a nice option that I bet you won't end up using (but you might!)

 

[Neuronix]

Your point about debt resonates with my lack of a guaranteed funding source. I may be overdoing it and I am definitely naive (hence the seeking of advice)... Maybe just the masters would be enough?

It is unlikely you will get any funding for your work. If you can make your PhD biomedical enough there is a chance you will be able to get a F30 and also a chance you could get the last two years of medical school funded through that grant. Odds are slim. The linguistics degree will not raise your earnings power or really help you get a job in medicine. Consider very heavily the amount of time it will take you to earn that PhD as well. I think the times you are giving are very optimistic, but I don't know how the department is at your school.

The pragmatic choice would be not to do it. You could apply for year out funding for medical school related research in linguistics. A common path would be studying language in stroke patients as one of many examples. If you are still serious about it later on, you could continue doing this work in fellowship.

In summary, unless you are planning on being a professor of linguistics with a side medical practice, can it and just go to med school.

I agree with most of what Gut Shot had to say. I think even this scenario is somehwat implausible. The best scenario someone could hope for with this kind of training is being an academic neurologist or other linguistics related specialty doing mostly research. I don't think the PhD is necessary for this and it would be a long and difficult battle to get there and get funded.

 

[hoya09]

It is unlikely you will get any funding for your work. If you can make your PhD biomedical enough there is a chance you will be able to get a F30 and also a chance you could get the last two years of medical school funded through that grant. Odds are slim....

I'm applying for an NSF grant and a few other external funding sources. I'm also eligible for departmental fellowships should I do the PhD rather than the masters. The masters would probably go unfunded. The consensus from the Gtown grant advisors is that I can patch together the money if I play up certain aspects of my work for specialized funding sources. It's not unreasonably to think I could pull some funding, having published multiple times across disciplines but you are definitely right when you say it would be a long, difficult path. There is the slight plus that my hubby to be is a year ahead of me in medicine and relatively uncomplicated, but still, a resident's salary won't help too much...

The pragmatic choice would be not to do it. You could apply for year out funding for medical school related research in linguistics. A common path would be studying language in stroke patients as one of many examples. If you are still serious about it later on, you could continue doing this work in fellowship.

What does "apply for year out funding mean"? How would that work? These fellowship options seem very attractive. My advisor (again, a big deal in medical linguistics) has already expressed interest in working with me no matter what form the rest of my education takes.

Oh, and re the time frames... I've taken some PhD level Linguistics coursework that I can transfer from ugrad. Because I'm graduating from one of the best ugrad programs in Linguistics, I have much more experience in the theoretical courses than a number of people entering Linguistics grad programs. I also have a lot of data ready for research. Maybe I'm still being conservative, but those are the numbers that my advisors quoted me.

I agree with most of what Gut Shot had to say. I think even this scenario is somehwat implausible. The best scenario someone could hope for with this kind of training is being an academic neurologist or other linguistics related specialty doing mostly research. I don't think the PhD is necessary for this and it would be a long and difficult battle to get there and get funded

The truth is that there are a lot of "if"s in this. I supposed that's the way it always is when attempting to do something that few if any have done before. I don't think it would be impossible to realize gutshot's scenario, but that's a huge bet to place (in terms of time and money) on a low probability. That being said, part of this goes beyond the pragmatic, indivudual aspects. In a broad sense, I think (and a few respected people in medicine and medical linguistics have told me) that I can do something wildly novel and interesting for linguistics and medicine should I actually pull this off. A lot of this boils down to where my priorities lie, which is something I'll ultimately have to figure out myself. Nonetheless, this discussion is really helping me work through some of that. Thanks, Neuonix.

 

[Neuronix]

I'm applying for an NSF grant and a few other external funding sources.

I was referring to funding for the medical school portion. It is almost always possible to have graduate school funded. Though the amount of stipend one gets as a social science graduate student is highly variable and often less than a biomedical science student. The medical loans are likely going to be very significant and will accrue interest during your PhD.

What does "apply for year out funding mean"? How would that work? These fellowship options seem very attractive. My advisor (again, a big deal in medical linguistics) has already expressed interest in working with me no matter what form the rest of my education takes.

http://www.hhmi.org/grants/individuals/medfellows.html
http://www.ddcf.org/page.asp?pageId=292

There are others available as well. This way you can take a year off in medical school and get paid for it.

Oh, and re the time frames... I've taken some PhD level Linguistics coursework that I can transfer from ugrad. Because I'm graduating from one of the best ugrad programs in Linguistics, I have much more experience in the theoretical courses than a number of people entering Linguistics grad programs. I also have a lot of data ready for research. Maybe I'm still being conservative, but those are the numbers that my advisors quoted me.

We all go into our PhD programs expecting it to take a certain amount of time. But, PhD durations are getting out of control and are not at all guaranteed. MD/PhDs are typically encouraged by the fact that they are often well qualified and previously well trained. Unfortunately, data is sometimes out of our control and bad things happen. You may get scooped. Things may not work. Your advisor could die (god forbid). The IRB could hold you up for months on something you thought would be trivial, etc etc etc...

The smartest, best trained guy I know is fighting like heck to get done in 8 years (total combined program duration) with one publication, and even that seems iffy at this point. I set up everything I could to get done in 7 years and then had to fight like heck to make it happen (including bringing my MD/PhD advisor into the fray and making enemies out of PI and committee).

Like I said, you may be right. Hope for the best, plan for the worst. By taking it out of a combined program you're on your own. The MD/PhD program has to step in to help a certain percentage of students move out of their PhDs or mediate disputes. You won't have that help. Without it I would probably still be in graduate school.

Thanks, Neuonix.

Sure thing. Sometimes the right choice isn't the pragmatic choice. It's about your goals and priorities. I'm just letting you know what you're up against.