Current academic environment unsupportive of MD/PhD aspiration

[RK0913]

I am a prospective MD/PhD applicant (planning to apply 2021 cycle) currently working on a master's thesi at a somewhat small medical college. I've been trying to take advantage of the fact that I'm at a medical college by talking to admin, faculty, and admissions for career advice, suggestions on how to become competitive for MD/PhD programs, learning different people's perspectives on working in academia, etc.

My problem is that almost everyone I've spoken to falls into one of 2 camps: 1. people trying to talk me out of pursuing an MD/PhD to pursue just one or the other or 2. people who don't have any knowledge about reputable and well-established programs, the admissions process, career outcomes, etc. It should be noted that this school doesn't have a strong MD/PhD program (multiple administrators have emphasized that they try to downplay the program) and there are very few physician-scientists working here (I've reached out to the few that are here with limited success).

I feel like I'm lacking mentors who truly support my decision and can help guide me as I pursue this goal. Even my PI, who is somewhat supportive (doesn't have any experience with MD/PhD students/programs) wants me to just bump up to the PhD program, either exclusively as a PhD student or to do a PhD-->MD here.

I genuinely love research and medicine and really do think that the MD/PhD is the best path for me. And while this school technically has an MD/PhD program, 1. the research resources and opportunities here are extremely limited 2. the program only covers 2/4 years of med school tuition costs and only pays stipend during GS years and 3. having taken classes with both the medical school and the graduate school, I can definitively say this isn't a place I want to pursue an MD/PhD.

I'm feeling very discouraged at the moment and would appreciate any advice/perspective that people might have to offer.

Thank you for your time!

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[deleted728364]

I'm also from a small school where MD/PhD is a foreign idea. If the people giving advice aren't knowledgeable about MD/PhD, then what they're giving is not advice imo. I think the only opinion that matters is that of your PI. Specifically - does your PI think you can be a good scientist? If so, and you're truly motivated to both treat patients and do basic science research, then I think that's all that really matters (speaking as an applicant). From what I understand, scores are a threshold that you need to meet and Neuronix's sticky post is a good rule of thumb.

Is there any reason to think that your LoR from your PI will be worse once they find out you're applying MD/PhD? If not, I'd just not bring it up until it comes time to ask for a letter. If they ask about your future plans you can still talk about other labs/rsrch interests you're looking at etc - which doesn't preclude MD/PhD.

You're gonna have to apply broadly either way, so I don't think you're necessarily "attached" to your home MD/PhD btw

 

[RK0913]

Thank you for taking the time to reply to my post!

My PI thinks I could be a good researcher and knows of my plan (time and time again I've had to emphasize that my plan is to do an MD/PhD), but I don't think he would ever compromise the quality of a LoR for any reason. I think he just really wants me to stay at this institution, so he's trying to push me towards that option.

And of course, I don't feel attached to my home institution - it's just that the admins here have suggested that I could do the MD/PhD here without having to jump through too many hoops.

I guess I'll just focus on the improvements I can make to my application (pubs, shadowing of some kind, doing well on the MCAT, etc.) and see what happens when I apply.

Thank you again for your reply!

 

[Serac]

I know getting insight, advice, and encouragement can be challenging. I started a community college and then went to a four-year school and neither had any experience or knowledge of the dual degree training, and my PI wanted me to stay and do a standalone PhD, both of which made things harder for me as an applicant. I'm halfway through my MD/PhD now and am consistently glad I chose to do both, feel free to PM me and I'll happily share what I know and what I think...

 

[RK0913]

Thanks for your reply Serac - hearing your success story having come from a similar situation is really reassuring!

 

[Neuronix]

We didn't have a medical school in the state where I grew up, and I was first generation to go to college in my family. I was really clueless. That's why SDN was so important for me.

My undergraduate advisors were anti-MD/PhD. Like it was almost rabid sometimes. You can't do both, MD/PhD is MD/MS, you won't be a good physician... All the usual tropes.

Turns out the pre-med advisor faculty and PhD most against MD/PhD had a son in a strong MD/PhD program

I kid you not. I go to an interview, and a current student picks me up from the hotel in his car. He knew where I was from and asked me if I knew his dad. I was like wtf???? Do you know your dad is anti-MD/PhD? He said yeah and brushed it off with something light.

I don't understand people sometimes.

 

[AZDev]

Every person I've ever spoken to [who isn't an MD-PhD themselves] has said one of two variants:
1. "You want to do research? Why bother with the MD? Just be a PhD."
My response every time:
"If I pursue a PhD, no other school will consider my MD application while I'm there. Even then, THAT school wouldn't consider me if I got past year 3. I also want to work with patients."

2. "You want to work with patients? Why spend the extra 4 (they often don't understand MSTP/MD/PhD programs and say 7-11) years doing the PhD? Why bother with the PhD; MDs can do research too?"
My typical response: "I want a more significant role in the research process than a source of data. I'd like the flexibility of choosing a future that includes research after my medical education via postdocs if that's what I choose to do but I also want the potential to be PI if I find a project that is suitable. I want to work on designing new treatments and translating them out of the lab and into the clinic."

For the sake of reference

• 21 CFR 812.43 (a): A sponsor shall select investigators qualified by training and experience to investigate the device.
• 21 CFR 312.53 (a): A sponsor shall select only investigators qualified by training and experience as appropriate experts to investigate the drug.

On the other hand, every MD/PhD I've interacted with has had a totally opposite response. Generally, they understand the value of the day-to-day patient experience in tandem with the value of being experienced and trained in the science side as well. The training and experiences involved on both sides of this cannot be understated.

The issue is, there are always going to be people who do not understand multidisciplinary / hybrid paths because they are either more used to or more familiar with simpler or more straightforward / more popularized paths. This lack of experience with why those things have value leads to a bias against being multidisciplinary despite the clear benefits to having training in two fields / areas. We live today in a society of specialization. When people start discussing being multidisciplinary, it is thus not so surprising that we are met with resistance.

EDIT:
To illustrate a related point, there was at one point a PI who tried to strongarm me into pursuing purely a PhD path and who acted like they understood the MD-PhD programs (but in actuality had no experience with them, as was evidenced by their words and behaviors). Do not take advice from people who don't understand the process. Do not let people playing 4D chess in the academia / healthcare world forcibly shape your future. It is your future to shape, and no one elses.

As an additional note, no matter what sort of hybrid field you ever pursue, you will almost always be the minority. You will likely be misunderstood because you will be treading ground that may never have been treaded before or perhaps only been lightly treaded before. You need to learn to be the judge of your own actions by analyzing points from both sides and coming to your own conclusions about what makes sense.

If you need guidance, go to conferences. Make friends with MD/PhDs there and talk to them about their work. Contact MD/PhDs near you to learn about what it is like. Shadowing one could always help too. Moreso even if you can do research alongside one.

 

[Patros]

I'll provide some comments based on my experience when I was a pre-med and now as a MSTP student:

1) You will have to get used to not having much encouragement or good advice when applying to MD/PhD programs, this is a fairly common scenario for most of my MSTP colleagues with whom I have discussed this. The fact is that MD/PhD programs are relatively niche, and people who are invested into a purely medical or purely scientific career will simply not understand the appeal of doing both.
2) You will frequently hear "You can't do both" in regard to a dual research/clinical career, but this is largely a myth. I am in NYC and there are so many MD or MD/PhD physician-scientists here that it is baffling to me that people make such an obviously false claim. However, this is admittedly extremely institution-specific. You have to plan on being in an environment that supports research training for clinicians, which is generally the case at the larger and more prestigious places. I cannot stress how important it is to be in a supportive environment even as a student, it'll make or break you.
3) There are definitely benefits to having dual training. I work mainly with PhD colleagues, and they lack any detailed understanding on the pathophysiology or broad view of disease processes. And while it is technically possible to pursue a basic science career with a MD-only, the vast majority of my med student classmates have no real understanding of a research-based career (and to be fair, it doesn't matter for them). The types of "research" most med students get involved in are largely meaningless fluff for padding resumes and not actual research training. So I think the rationale for dual training is sound. But the single biggest downside is the time investment (expect to invest 6-8 years of additional research training, including both medical school and post-grad training). You will have to ask yourself if that is worth it to you.

 

[RK0913]

I just wanted to thank all of you that have taken the time to reply - your advice and anecdotes are really reassuring and mean a lot to me

 

[mestielest]

We didn't have a medical school in the state where I grew up, and I was first generation to go to college in my family. I was really clueless. That's why SDN was so important for me.

My undergraduate advisors were anti-MD/PhD. Like it was almost rabid sometimes. You can't do both, MD/PhD is MD/MS, you won't be a good physician... All the usual tropes.

Turns out the pre-med advisor faculty and PhD most against MD/PhD had a son in a strong MD/PhD program

I kid you not. I go to an interview, and a current student picks me up from the hotel in his car. He knew where I was from and asked me if I knew his dad. I was like wtf???? Do you know your dad is anti-MD/PhD? He said yeah and brushed it off with something light.

I don't understand people sometimes.

I don't understand them quite often People are usually very good at creating a problem or agitating an existing one. To solve a problem or make an improvement is often tried to be blocked.


This applies even to research. Most of my energy is spent on the ethical board application papers, to convince a professor or a board member etc etc. Some of them living twenty years behind contemporary practice. Uh. Maybe this problem warrants a separate thread

 

[AZDev]

I don't understand them quite often People are usually very good at creating a problem or agitating an existing one. To solve a problem or make an improvement is often tried to be blocked.

This applies even to research. Most of my energy is spent on the ethical board application papers, to convince a professor or a board member etc etc. Some of them living twenty years behind contemporary practice. Uh. Maybe this problem warrants a separate thread

I would be very interested in a thread on the topic of methods for dealing with obstacles of this sort, if not a category thereof.

 

[mestielest]

I would be very interested in a thread on the topic of methods for dealing with obstacles of this sort, if not a category thereof.

Not about methods for now, but I have just posted a thread about my problematic situation