Disparity between clinical and research interests

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ejay19955

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I'm at a top 20 MSTP that does PhD after the clinical rotations (I know it narrows down where I am to like 2-3 schools). I've done a couple clinical rotations so far and now I'm pretty set on doing either interventional or diagnostic radiology (pending how much I like the surgery rotation, which I will have in a few months). On the other hand, I am interested in computational research for my PhD. I guess I can do things like radiogenomics, image processing etc., with computational background, but my PhD topics will most likely be related to IM and its subspecialties. Haven't decided on my PhD mentor yet.

My MSTP director would tell me the PhD does not have to be in the clinical field I pursue, and I do agree with him, but I wonder at this point if I should even drop the PhD to just pursue my clinical interests, especially if I end up wanting to do IR, which will allow very little time for research, as opposed to DR. On the other hand, I really like research and would've gone into a PhD program (instead of MD) if I had gotten rejected from all the MD/PhD programs. I don't want to give up research, but now I don't want to give up clinical work either.

So my question in a nutshell is... for those of you who ended up doing either just research or just clinical after getting both degrees, do you regret getting the dual degree and why if so? I also hear things like MD/PhD's are considered "clinically weak," by certain PD's, especially by those in procedural fields, and I don't want that to bring me down if I end up pursuing IR.

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Also I just want to throw this in... unless there's a horribly wrong reason for pursuing the dual degree, I'd rather go for it because I am fine with the fact that I will be an attending in my late 30's, and it's not like I'm drinking away 4-5 years but actually gaining some academic attainment. Just want to hear about others' opinions before I commit to a path.
 
I wonder at this point if I should even drop the PhD to just pursue my clinical interests, especially if I end up wanting to do IR, which will allow very little time for research, as opposed to DR.

Even if you end up in DR, it's fairly rare to be sustaining a serious research career. Computational PhDs per se may bring a lot of transferrable skills, but regardless what you decide, statistically your chance of going on to a federally funded research career is minimal (i.e. less than 10%) if you decide to go into these "non-research friendly" clinical fields. This compares with a chance of 15%ish overall, and perhaps 20%+ in some cognitive specialties. Which admittedly are still not great odds, but hey who's counting...

As a reminder, a PhD only gives you about ~10% odds of getting such a job. Your odds of ending up in such a job with a PhD only is approximately the same as if you do an MD and end up in a "non research friendly" specialty.

However, in your case, the reason is not that you can't do it if you really tried, but the salary differential. If you do IR in a mostly clinical role, your expected salary is 500-750k+. If you do a K award -> R01, your salary will be around 150k-250k. Basically if you work 5-10 years in private practice you make the ENTIRE salary of a 30 year research career. You earn the $ of a Nobel prize every 2 years. Very few people are wealthy enough for this to not matter.

If you know 100% you want to do IR, the most efficient way to proceed is to just finish clinical training, then collaborate with a PhD and write some grants later on.
 
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Even if you end up in DR, it's fairly rare to be sustaining a serious research career. Computational PhDs per se may bring a lot of transferrable skills, but regardless what you decide, statistically your chance of going on to a federally funded research career is minimal (i.e. less than 10%) if you decide to go into these "non-research friendly" clinical fields. This compares with a chance of 15%ish overall, and perhaps 20%+ in some cognitive specialties. Which admittedly are still not great odds, but hey who's counting...

As a reminder, a PhD only gives you about ~10% odds of getting such a job. Your odds of ending up in such a job with a PhD only is approximately the same as if you do an MD and end up in a "non research friendly" specialty.

However, in your case, the reason is not that you can't do it if you really tried, but the salary differential. If you do IR in a mostly clinical role, your expected salary is 500-750k+. If you do a K award -> R01, your salary will be around 150k-250k. Basically if you work 5-10 years in private practice you make the ENTIRE salary of a 30 year research career. You earn the $ of a Nobel prize every 2 years. Very few people are wealthy enough for this to not matter.

If you know 100% you want to do IR, the most efficient way to proceed is to just finish clinical training, then collaborate with a PhD and write some grants later on.

Thank you for your input. Does IR actually make that much? I know the hours can be really bad for IR, but that's like neurosurgery salary. 500-750k is more for private group practice, right?
And what do you think of doing the PhD just to boost my chance for matching into IR? I have not taken Step 1 yet, but in case I bomb it. Practice NBME a few months ago was ~220, but I still have yet to finish the clinicals (~6 months remaining) and have 8 weeks of dedicated.
 
Thank you for your input. Does IR actually make that much? I know the hours can be really bad for IR, but that's like neurosurgery salary. 500-750k is more for private group practice, right?
And what do you think of doing the PhD just to boost my chance for matching into IR? I have not taken Step 1 yet, but in case I bomb it. Practice NBME a few months ago was ~220, but I still have yet to finish the clinicals (~6 months remaining) and have 8 weeks of dedicated.

These are questions for the IR forum. I'm quoting numbers I'm seeing there. Apparently it's *the* most competitive specialty in the past 3-5 years. My impression overall is PhD does not affect your chance for competitive specialties as NIH revenue constitute an extremely small revenue source for the department, and hence they have no incentive to "develop your career" with the hope of an eventual return on their investment.

You can always take your Step 1, start your PhD and leave with a masters (if your step 1 is good). This is essentially equivalent to a Doris Duke/HHMI etc. Do some research relevant to the area, publish something if you want. That should look positive and be fairly time efficient.

Salary numbers can change and sometimes quickly, so it's a risk to hedge against, though not typically in relative terms (i.e. high salary specialties will be still high salary, but maybe somewhat less so). More importantly job markets can change faster. Rad onc for example had its market tank in the last 5-10 years--salary is still good, but geographical restrictions are now very extreme, and the specialty is much less competitive. IR may or may not be able to effectively manage its labor force in the next 10 years. This is an argument against doing PhD, as the sooner you enter the better off you are if market changes and longer training makes thing unpredictable.
 
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