Difference between MD/PhD and MD with post-doc research?

[ravupadh]

I'm wondering if an MD with a post-doctoral research appointment has the same opportunities as an MD/PhD? I'm not competitive enough for MD/PhD programs and am wondering if there are other routes of becoming a physcian scientist (besides the long way of doing the MD and PhD seperately.) Would an MD with a post-doc experience be able to do basic science research in the same depth as his MD/PhD counterpart? If so why do you need the PhD in the first place?

Thanks.

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[Enkidu]

I'm wondering if an MD with a post-doctoral research appointment has the same opportunities as an MD/PhD? I'm not competitive enough for MD/PhD programs and am wondering if there are other routes of becoming a physcian scientist (besides the long way of doing the MD and PhD seperately.) Would an MD with a post-doc experience be able to do basic science research in the same depth as his MD/PhD counterpart? If so why do you need the PhD in the first place?

Thanks.

After residency/fellowship you can do a post-doc and build up a publication record to apply for an R01. This pathway will not lead you anywhere far from where you would end up with an MD/PhD. This is a great option for someone who realizes that they love basic research after starting out on a clinical-only career.

It would be a big mistake to plan on this pathway at your stage, though. Here are some good reasons:

1) You will have lots of debt that an MD/PhD does not have
2) You will have to put in the same number of years either way, minus the added efficiency of combining the two programs (although not all MD/PhD programs have any added efficiency, so this is a little dependent)
3) You will embarrass yourself during your post-doc because you will make all of the mistakes that first-year graduate students make
4) Your early missteps and mistakes will occur in a much more sink-or-swim situation (being a graduate students affords some protection and resources that post-docs don't have)

But, once you have the publication record to get an R01, you'll be on the same plane as the MD/PhDs (minus a few hundred grand)

Probably it's better to apply to low-tier MD/PhD programs... I won't name any names, but not all MD/PhD slots are filled each year, so if you have a decent research background with okay grades/MCAT you may still be competitive somewhere. You can also consider applying DO/PhD... unless you're dying to do research in dermatology.

Good luck!

 

[ChemMed]

After residency/fellowship you can do a post-doc and build up a publication record to apply for an R01. This pathway will not lead you anywhere far from where you would end up with an MD/PhD. This is a great option for someone who realizes that they love basic research after starting out on a clinical-only career.

It would be a big mistake to plan on this pathway at your stage, though. Here are some good reasons:

1) You will have lots of debt that an MD/PhD does not have
2) You will have to put in the same number of years either way, minus the added efficiency of combining the two programs (although not all MD/PhD programs have any added efficiency, so this is a little dependent)
3) You will embarrass yourself during your post-doc because you will make all of the mistakes that first-year graduate students make
4) Your early missteps and mistakes will occur in a much more sink-or-swim situation (being a graduate students affords some protection and resources that post-docs don't have)

But, once you have the publication record to get an R01, you'll be on the same plane as the MD/PhDs (minus a few hundred grand)

Probably it's better to apply to low-tier MD/PhD programs... I won't name any names, but not all MD/PhD slots are filled each year, so if you have a decent research background with okay grades/MCAT you may still be competitive somewhere. You can also consider applying DO/PhD... unless you're dying to do research in dermatology.

Good luck!

I have a problem with some of your statements. You are right in your basic assessment of the OP's situation, however there are ways to deal with these problems.

1) You will have lots of debt that an MD/PhD does not have

You can try for pay back programs such as IBR and PLS. MD's only who want to go into research often take these as legitimate options to do this.

2) You will have to put in the same number of years either way, minus the added efficiency of combining the two programs (although not all MD/PhD programs have any added efficiency, so this is a little dependent)

Someone who is academically minded can learn what they need to in a three year post-doc. I've seen it done. It will, however, be harder for you OP.

3) You will embarrass yourself during your post-doc because you will make all of the mistakes that first-year graduate students make.

You will make mistakes. If you feel embarrassed, well this is just plane silly. You may be new to research when you start the post-doc but being embarrassed about it makes no sense. Show that you are as smart as you know you can be. Research is different but you are not stupid you can learn the techniques and mindset that you need to be successful at it. You will have to be proactive in doing this. I have known very successful MD onlys who have gone on to successful research careers.

4) Your early missteps and mistakes will occur in a much more sink-or-swim situation (being a graduate students affords some protection and resources that post-docs don't have)

Graduate school can be just as sink or swim as any post-doc. Look you need to find a great mentor who understands what your knowledge base is and is not. With this understanding the both of you can progress onto successful research projects. Mentorship is key, without a good mentor you can fail miserably.

Some other points that were made I don't agree with:

But, once you have the publication record to get an R01, you'll be on the same plane as the MD/PhDs (minus a few hundred grand)

Probably it's better to apply to low-tier MD/PhD programs... I won't name any names, but not all MD/PhD slots are filled each year, so if you have a decent research background with okay grades/MCAT you may still be competitive somewhere. You can also consider applying DO/PhD... unless you're dying to do research in dermatology.

Some of this may be true but I know several people who are not the traditional MD/PhD path who have progressed onto successful full filling careers. You do not need an MD/PhD. You can get an MD/MS and this will allow you to be introduced to research. I know of some programs that will actually help pay for most of medical school. Also, OP what you make of your career is up to you. The traditional MD/PhD route will make your life easier in many ways. But there are plenty of other options if it is not the route you end up taking. Research will not be closed to you.

I have to agree with Enkidu though, if you can and are seriously interested in getting an MD/PhD the MSTP programs are the way to go.

 

[KPCOFGS]

The traditional MD/PhD route will make your life easier in many ways. But there are plenty of other options if it is not the route you end up taking. Research will not be closed to you.

This has been a question I've been considering as well, so thanks to you and Enkidu for the two very informative points. I was just wondering, though--you refute his/her points but then still say that MD/PhD will make life easier. Would you mind elaborating on why MD/PhD trumps the post-doc route, in your opinion? Thanks again for your insight! 👍

 

[ChemMed]

I felt as though his response did not go sufficiently in depth, on the main points he is right. There are many roads to the same end but they are all a little different and others will be easier. If you want a PhD then the MSTP offers you that. If you want to just be involved in research with out a PhD then an MD/MS is not a bad way to go. Either one can be paid for. The biggest difference is debt and for this reason I say take the MSTP route if you know what you want.

Life is not always linear, things happen and if you decide later that what you want is to be a physician scientist then there are other ways to get to that goal that are very feasible.

This has been a question I've been considering as well, so thanks to you and Enkidu for the two very informative points. I was just wondering, though--you refute his/her points but then still say that MD/PhD will make life easier. Would you mind elaborating on why MD/PhD trumps the post-doc route, in your opinion? Thanks again for your insight! 👍

 

[Jorje286]

One major pro for MD-postdoc that is often overlooked: you will do your research in the exact field/topic of your interest, and can fully complement research with the clinical training and perspective you already have built. The graduate years of an MD-PhD will most likely end up to be not very related to their research topic of interest and hence won't contribute much to their first grant, even though obviously the training is an important reason in itself.

The major obstacles for MD-postdoc are the loan and the fact that the PhD is often a dedicated time to hone one's research skills without the same pressure you're under as a graduated MD and most likely with more help from a number of people in the research department you're in.

So in essence I don't really agree that MD-PhD is the "obvious" pathway. It's a close call.

 

[ChemMed]

True about the MD-postdoc being one who does research in their field of study. It does make your research more relevant to your career path.

One major pro for MD-postdoc that is often overlooked: you will do your research in the exact field/topic of your interest, and can fully complement research with the clinical training and perspective you already have built. The graduate years of an MD-PhD will most likely end up to be not very related to their research topic of interest and hence won't contribute much to their first grant, even though obviously the training is an important reason in itself.

The major obstacles for MD-postdoc are the loan and the fact that the PhD is often a dedicated time to hone one's research skills without the same pressure you're under as a graduated MD and most likely with more help from a number of people in the research department you're in.

So in essence I don't really agree that MD-PhD is the "obvious" pathway. It's a close call.

 

[Sinclaire]

A loan repayment research program like the ones offered by the NIH would be great if you can get one after medical school.
http://www.lrp.nih.gov/about_the_programs/index.aspx

 

[Neuronix]

I have a few issues with the LRP:

1) Maximum $35k per year repaid for up to 4 years of service. This is only $140k. Many students graduate with far more debt than that, and that's not including the interest that will accrue before the LRP kicks in.

2) It is competitive. Not everyone will get it. Of course who knows if it will exist and in what form in 10 years.

3) The guidelines clearly state that the LRP is for "clinical research". I have talked to a professor who has sat on the scoring committee for LRP applications, and they seem to find basic science that is applicable to/guided by clinical medicine acceptable, but that clinical research stipulation still freaks me out a bit for basic science leaning MDs.

(see: http://grants1.nih.gov/grants/guide/notice-files/NOT-OD-10-105.html)