Dropping out of the MSTP Program

[Tool_fan]

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Hi, I'm currently finishing my first year of med school at a top 20 institution. I am not looking forward to a summer of labwork, and with each passing day I realize I am just going to practice medicine for the rest of my life. I have already gotten a free year of tuition plus stipend ~ $60,000+ I am still going to rotate in labs this summer, but if I am not "feeling it" I think I may drop before second year starts. I feel it is more ethical than getting all of second year paid for + stipend, and then dropping. Anybody know of anyone who dropped or is considering dropping? I think I just may be getting that feeling that we all get when we look at where we are and go..man..8 more years? yikes

 

[Andrew_Doan]

I know several who dropped the MSTP funding and completed the MD degree only. Be prepared that this may be stated in your Dean's letter when you apply for residency. In the end, you'll have to do what is right for you.

 

[Neuronix]

I feel the same way... Except I'm still not sure that a medicine only track would be right for me. I don't know what to say about your situation, but you're not alone among first years.

All these years of schooling? It seems like nothing but hurdles. I don't even think much of it is very useful. I just do what they tell me because they say I have to do it. Then when we're done what do we have to look forward to? A life of heavy competition just to keep a lab? Working 24/7? The most common answer given when I ask a MD/PhD PI what they do for fun is "The lab IS fun!" unless they're really successful. Is that me? No.

 

[Maebea]

Hi, I'm currently finishing my first year of med school at a top 20 institution. I am not looking forward to a summer of labwork, and with each passing day I realize I am just going to practice medicine for the rest of my life. I have already gotten a free year of tuition plus stipend ~ $60,000+ I am still going to rotate in labs this summer, but if I am not "feeling it" I think I may drop before second year starts. I feel it is more ethical than getting all of second year paid for + stipend, and then dropping. Anybody know of anyone who dropped or is considering dropping? I think I just may be getting that feeling that we all get when we look at where we are and go..man..8 more years? yikes

My experience is that what you are experiencing is fairly common among individuals in MD/PhD programs. Unfortunately, it will get worse before it gets better; bidding adieu to your MD classmates while preparing to start the research phase of training will be tough. I would encourage you to talk with your program director or administrator about your misgivings, as they might be able to help you reach a decision.

It is very admirable that you do not want to accept funding for the second year if you have no intention of continuing in the program. Such ethical behavior is altogether too rare (and will probably cost you a lot of money if you persist in behaving in this manner throughout your life). 👍

Good luck with your decision!

 

[Gfunk6]

It is very admirable that you do not want to accept funding for the second year if you have no intention of continuing in the program. Such ethical behavior is altogether too rare (and will probably cost you a lot of money if you persist in behaving in this manner throughout your life). 👍

Amen, there is certainly no shortages of MSTP students willing to rip off programs for that extra 2nd year before they drop.

 

[NGN47]

Quote..."I am still going to rotate in labs this summer, but if I am not "feeling it" I think I may drop before second year starts."

Believe me, almost everyone in an MSTP feels this way at times. Eight years sounds like a lot, but once you have been with it a few years, it doesn't look so bad. And, afterwards, the extra degree, research experience, and training will boost your career in whatever path you take.

 

[tofurious]

Here's the emotional rollercoaster no one talks about when you are applying:

Year 1: Woo hoo, med school. I made it. Damn anatomy is hard. Maybe I should have gone to straight grad school. They are having happy hours all the time.
Year 2: There is too much learn and too few neurons between my ears to learn it all. Will this matter when I graduate in 6 years? USMLE study is so painful. Maybe I should have gone to grad school. Will I remember all this stuff that is in my head for 48 hours? Maybe I should go into 3rd year med school.
Year 3: Hmmm, my med school classmates are having so much fun. I wish I were there with them. Why am I taking these stupid classes with people who were in college when I was in med school?
Year 4: All my med school classmates are talking like they are real doctors, and I have to make my stupid experiments work. Why did I get into research at all? Maybe I should get a masters and go back to med school.
Year 5: All my med school classmates ARE doctors. I wish I had just two letters behind my name, and by now I am only half done with each. Am I going to get a PhD? Maybe I should have stuck with the masters last year.
Remainder PhD years: I'd better finish this because all other idiots in grad school have gotten theirs.
Remainder MD years: I am going to med school with babies - people who were in HIGH SCHOOL when I started med school last century. I'd better finish this because all other idiots in med school have gotten their degrees.
Residency: I can't believe I did that! But wait... shouldn't I get more respect from the janitors at least because of all the letters behind my name?

 

[Newquagmire]

Remainder MD years: I am going to med school with babies - people who were in HIGH SCHOOL when I started med school last century.

 

[JD428]

This thread makes me nervous. Right now I feel confident about the MSTP path in general, and the school where I'm going in particular...but in 5 years will I look back and think, "Man, what an idiot I was for starting this program." Impossible to say, I guess.
Anyone else occasionally feeling this way, now that we are 1-2 months away from starting??

 

[ImmunoANT]

This thread makes me nervous. Right now I feel confident about the MSTP path in general, and the school where I'm going in particular...but in 5 years will I look back and think, "Man, what an idiot I was for starting this program." Impossible to say, I guess.
Anyone else occasionally feeling this way, now that we are 1-2 months away from starting??

ummmm.... I thought there's still ~3 months before school starts.
but JD, don't worry, you will definitely enjoy Vanderbilt. Dr. Dermody is a terrific director 👍 and man, are you going to be spoiled
Your future MSTP classmates are pretty cool too; Ali, she's just awesome!

 

[drdr2010]

this is the first time i have seen this kind of stuff mentioned on these threads. and honestly, it made me feel better because i have experienced feelings of doubt as well. at my program (non-MSTP, fully funded, but no money obligation for quitting) we go to med school part time (3 classes/year) during the 4 years of our PhD. i can't even tell you how many times i have thought of quitting the PhD and just going MD. then other days i seriously consider leaving medical school and just pursuing the PhD. i doubted my decision probably once a week for the first few semesters of the program. i hate watching my medical school classmates complete their rotations while i am still taking Anatomy/Physiology and struggling with qualifying exams for grad school.
so why i am still in the program? because i love it. i love my co-workers and my lab and even my rats. i like that i have so many different friends in all stages of medical school and that i get to work with so many amazing scientists. although sometimes the days individually are hard and weeks are just too busy to comprehend, and other times thinking of the future and all the hard work that lies ahead makes me just want to lie down and cry.....i can't imagine anywhere else i'd rather be.
i think the doubts are completely normal. for me, it was just sitting down and assessing my life satisfaction. if i am ever not truly happy here anymore, then i will leave. there is not that is worth making yourself miserable over for nearly a decade! and knowing that i can leave if i want, and taking the days one at a time and trying not to worry about what will happen and how i will feel 4 years from now is what keeps me going.

 

[byong_soo]

HAHAHA tofurious, that's really funny. I'm still a pre-MSTP but maybe I'll reconsider hahahha

 

[coldchemist]

That IS hilarious! The grass is always greener....

I read something on the MD/PhD director's site the other day (on aamc.org) that really rang true for me. They said that it's not enough to want a physician scientist's career...you actually have to be able to look forward to the training and enjoy the process while you're in the library/lab/clinic.

That probably doesn't help the OP very much, but it encouraged me a lot. I see the whole program not just as a means, but also as an end in itself. Of course, we'll have to wait until I'm in the middle of Tofurious' timeline to find out if I still feel that way. 😀

 

[biplane]

I think this is a good thread. Truthfully, this dual degree stuff is intellectually and emotionally challenging. You are constantly put in difficult situations and expected to thrive with less time and preparation than your single degree compatriots. Having just finished, I also was sitting in grad school with a stalled project during the middle of the dot-com era which idolized instant success.

The truth is that nothing worth doing is easy. The MD/PhD program will tack on 3-4 years extra, but for the majority of people this is not significantly different from people who go straight through time-wise. For anyone embarking upon a challenging career, it is easy to succumb to the feeling that it would be nicer to be sitting on a beach on vacation with your super-model girlfriend having recently deposited a 7-figure bonus from your investment banking job. But the person clerking for a Supreme Court justice or doing a neurosurgery residency or taking the outlandish risks needed to make a real scientific discovery--all these people could be doing something easier and more financially rewarding. However, I think most people with that degree of ambition would not be fulfilled going the path of least resistance.

The question you have to ask yourself is what do you like doing and what ambitions do you have for yourself. Of course, it would be nice to have more money or more free time. But on a time average basis, I can't imagine doing anything as interesting or valuable as what I've spent the last 8 years doing. I've had a chance to truly understand, think, and experience things that few people ever will. I've also been equipped with a solid basis for systematically thinking through interesting new medical problems and solving them. I find this kinda exciting. The fact that I will be amply compensated and have been aided in my goals during the Match are also plusses to me.

So if you decide to do something "easier," first carefully consider what you want to do. And also think about what sort of career you want. Having a career as a pure clinician is not exactly my idea of an easy way to go. For example, a cardiologist has plenty of stress/training fatigue.

If you can't see yourself enjoying working in the lab, that would be a very good reason to throw in the towel. Graduate school is hard enough as it is. Being bored or hating the lab will wear you down rapidly.

 

[mjs]

I think everybody has their problems. I love research and I enjoy clinical work, so for me the real challenge is sitting in for the rote memorizing of med school. What keeps me going are my mentors in the lab and in medical practice, although all of them make fun of me for having to wade through medical school 😉.

So if you're feeling bogged down, I sympathize and the best advice I can offer is do what got you to where you are: swing for the fences. Do your darndest to pick a bomb-ass lab for the summer. 8 or so weeks of titanically awesome work can make up for almost anything. My pathology and physiology classes totally did that for me last quarter, as did my pre-first year summer rotation.

Also, I've found that having hobbies like gambling, drinking and shady friends helps.

That last paragraph was a joke.

Later

 

[Primate]

I also started during the last century and had to endure my friends (and business school classmates - I'm a "bent arrow") racking up huge financial gains during the go-go '90's while I toiled in obscurity in a lab. I also had the disturbing circumstance of being called by recruiters fairly frequently with job offers (a result of the last company for which I worked before coming back to school). Talk about tough - friends with money; other friends who were finishing med school though we'd started together; babies (both as classmates and of my own); and offers of jobs with large salaries. It was enough to get my attention and make me question the wisdom (sanity?) of staying in. I also know that almost EVERYONE goes through this kind of calculus, and most stay in (though many will go on to private practice or leave medicine altogether in the end - which brings up the question of what one looks for in screening applicants, but that's a whole 'nother contentious thread).

Well, you don't go into a combined degree program to get rich. If you did, then throw in the towel NOW, no matter what stage of training you've completed. All I can say is that, while I could have made more money elsewhere and had what many would consider quite a fulfilling career, it wasn't for me. The combined degree has been a great ~decade (oof - that surely is a long haul) and has had far more ups than downs (the downs seem to cluster at the 4-5 year point). Although academic medicine is no bed of roses, it's all about picking one's poisons. If you don't "feel it," think hard before staying. If you're even moderately interested in the lab, think hard before leaving. It really is a great program for the right people.

Drinking, gambling and shady friends..... Well, having hobbies does help (for me it's kids, flying, boating/fishing, hunting). Definitely keeps me more, if not completely, sane.

Well, off to sign out some cases (surgical pathology is a blast - see, that's the geek in me that made the MSTP enjoyable).

Good luck with the decision. It's a tough one.

 

[Nuel]

This is what I think: you really have to love the seemingly socratic life of staying in the lab investigating arcane subjects and having all that stress and failures--honestly that is what motivates as I prepare to turn in my application this year or next.

aight.

 

[Mike22]

I have to say that I relished every bit of this thread. I, too, having graduated from an MD/PhD program and now finishing up my internship in medicine, could relate backwards in time to all the emotions, pent up frustrations, and desires to chuck it all in favor of a cozy little postdoc somewhere neither here nor there. I especially liked the reference to the research professor who said that "the lab IS fun", when asked what he did to relax. I have to say, I'M THAT GUY! Even now on my way into work in the morning nothing gives me more pleasure than to read a recent paper on one of my topics of interest and get some new ideas. This is how I know that I still love research and that it is my source of inspiration for the future. If you don't enjoy reading and thinking about new ideas, if you just want to know what everyone else ahead of you already knows, that's fine, but it's also telling you that maybe research isn't for you. Better to figure out that one sooner rather than later. And if you just want the MD training, which is fine, then just do that.

And since many of you here are trying to guess what you're going to be thinking years from now, allow me to really stir the pot. The next big ass-kicker that you can't fathom yet is, "Okay, so now I have almost finished my progam and I have this nebulous but probably bright future ahead of me. Holy crap?! But what am I going research for the rest of my life?" A very real scenario, and unlike medical and graduate school, sweeties, this one doesn't run on a guaranteed timetable. Pleasant dreams...

 

[Neuronix]

If you don't enjoy reading and thinking about new ideas, if you just want to know what everyone else ahead of you already knows, that's fine, but it's also telling you that maybe research isn't for you.

That's the fun part you're relating. There's plenty of not so fun parts too. Will I enjoy competing for publication and funding when I'm in the lab 80+hours/week? Maybe I'm just being pessimistic...

 

[Mike22]

That's the fun part you're relating. There's plenty of not so fun parts too. Will I enjoy competing for publication and funding when I'm in the lab 80+hours/week? Maybe I'm just being pessimistic...

I think that you raise a good point. What I ask myself now is would I rather spend 80+ hours in a lab or 80+ hours in a hospital? I'll take the lab any day, and of course the answer to this question will vary from person to person. However, IMHO research competing is not like when you're sitting in class and all of the competitors are directly in sight. Psychologically, it's a lot less intimidating. And anyway, I really don't think of it in that way anymore. You won't let a little competition scare you away if you really love the work, i.e. it's a labor of love. Geez, how corny am I?

 

[Tool_fan]

I dropped out. It was painless and easy, and the director(s) reassured me and supported me on my decision. I feel like a HUGE weight has been lifted off my shoulders, and that I can learn/think without worrying about the pressure of finding a lab/mentor/wasting time,etc. I may take a year off to do research, but for now, I'm gonna LOVE my summer upcoming summer with lots of guitar, soccer, bball, going out, and oh yes a trip to europe. Im freeeeee!

thanx for all the replies and advice 😀

 

[Res-J]

I know several who dropped the MSTP funding and completed the MD degree only. Be prepared that this may be stated in your Dean's letter when you apply for residency. In the end, you'll have to do what is right for you.

Even if this is stated in your letter, is that necessarily a bad thing?

 

[Andrew_Doan]

Even if this is stated in your letter, is that necessarily a bad thing?

It can be. A residency director may not want to pick someone who committed to a program and then quit. What if that candidate has a change of heart about residency too, e.g. during a 7-year neuro-surgery program?

 

[Tool_fan]

the director said it is NOT going into me dean's letter or transcript/permanent record since I never enrolled in the graduate school in the first place

 

[Habari]

It can be. A residency director may not want to pick someone who committed to a program and then quit. What if that candidate has a change of heart about residency too, e.g. during a 7-year neuro-surgery program?

i certainly don't know if this is true - but that sort of logic is foolish. the candidate probably had the change of heart in order to pursue the neuro-surg program with greater focus. regardless, it is hardly unreasonable that someone enjoys what they are doing, wants to commit to it fully or pursue another direction in lieu of a research phd. there are enough excellent residencies out there that i would not bother with a program that subscribes to that line of thinking.

i know andrew was just putting the idea/possiblity out there - but fear of this strain of reprecussion should never force one to stay in a path that isn't for them [chances are that the lack of strong interest in the phd would result in a longer stay and much more unpleasant experience]. there is much more tolerance in these systems for doing things differently than students/faculty often think.

 

[Andrew_Doan]

i certainly don't know if this is true - but that sort of logic is foolish. the candidate probably had the change of heart in order to pursue the neuro-surg program with greater focus. regardless, it is hardly unreasonable that someone enjoys what they are doing, wants to commit to it fully or pursue another direction in lieu of a research phd. there are enough excellent residencies out there that i would not bother with a program that subscribes to that line of thinking.

i know andrew was just putting the idea/possiblity out there - but fear of this strain of reprecussion should never force one to stay in a path that isn't for them [chances are that the lack of strong interest in the phd would result in a longer stay and much more unpleasant experience]. there is much more tolerance in these systems for doing things differently than students/faculty often think.

Perhaps students should investigate the MD-PhD program before signing the dotted line. Just a different perspective.

 

[Spacedman]

Perhaps students should investigate the MD-PhD program before signing the dotted line. Just a different perspective.

i definitely hear that-- but i gotta say that in retrospect i had *no* idea what i was getting into. i'm starting my 5th year now, and when i applied i'd done ~two years of bench work + a couple summers. the previous posts really do cover a lot of things that have been going through my head, but the thing i was least prepared for is definitely getting direction once i got to lab--

i spent the past two years in a pretty horrendous lab with a PI that was not interested in being a mentor or teaching. he's really smart, and does amazing research, but unfortunately he was kind of a dick. i was his first and probably last grad student. anyway, even having worked in a few different labs, it took me a long time to realize that you can't get a phd in a lab like that, unless you already know exactly what you have to do and how to do it. so, bottom line, i thought i hated research. the last few months, i switched project, lab and departments. 12 hour days, but i love it--

anyway, the best favor you can do yourself is find a PI you like to work with, coz as others have said, it's f*in depressing to watch your classmates graduate.

later,
spaced

 

[pathdr2b]

anyway, the best favor you can do yourself is find a PI you like to work with, coz as others have said, it's f*in depressing to watch your classmates graduate. later,
spaced

I for one, have always appreciated the candor and frankness of Dr.Doan's post. But you bring up a very good point, one that frequently gets "lost" in the MD/PhD thread and that is the ENTIRE grad school expereince, from pitfalls to positives.

I personally think its a good idea for applicants to MD/PhD to have have spoken to at least one researcher at each school expereinced with MD/PhD students LONG before pressing submit and I know from personally expereince that this helps tremendously when interview time comes. Additionally, I think it's important to make sure there's a grad program of interest too. Getting a feel for a departments commitment to MD/PhD students through ALUMNI of that department/the number of MD/PhD students in a department, the timeframe for graduating students is crucial, IMHO before matriculating.

Although I'm sure there will be some dissagreements about this, I have to say that the people I've met along the way that seemed most unhappy with their MD/PhD expereinces were the ones that no idea about what they wanted to do in the program or afterwards, when they started. Of couse most of the people I've met were nontraditional like myself, so perhaps that has something to do with it.

 

[Habari]

Perhaps students should investigate the MD-PhD program before signing the dotted line. Just a different perspective.

While I agree with the sentiment ...

Either people are wise well beyond their years, or they make what seems like the best decision based upon interests that a majority formalize in their last 2 years in college and perhaps one more of research. I empathize with those who have had a change of heart, even from a priorly completely committed state, not because i'm about to drop out of my program, but because in the last year my interests have been broadened and taken an unexpected, but much more fulfilling direction than I had originally set out on when I signed 'the dotted line'. I can assure you that this was not from a lack of investigation in the mdphd, as evidenced by intransit.us [evidence in my eyes at least] which was created prior to my decision, but before my 'change of interests'. Perhaps this change of interest speaks to a lack of exposure, and indeed it was, however, it was also dependent on being in the context that I am in now.

I feel fortunate that my interests are still consonant with staying in the program, or the training will be useful for what I would like to do later - but this could have easily not have been the case. Anecdotes are only so useful, I know.

It would certainly irk me if people joined the programs on whim, perhaps with even more than that, just to take the free ride for a while and then jump off the train. Nevertheless, I just wanted to underscore that while there is an implied binding element to this non-trivial decision - people change, and with it, the path they take.

 

[freddydpt]

Are there MD/PhD programs that are non wetbench programs that just do clinical trials. I hate test tubes and lab procedures etc but I wouldn't mind going for a PhD that I enjoyed if it payed for med school.

Thanks

 

[Nuel]

Are there MD/PhD programs that are non wetbench programs that just do clinical trials. I hate test tubes and lab procedures etc but I wouldn't mind going for a PhD that I enjoyed if it payed for med school.

Thanks

Probably you might love computational biology or biophysics. Well, if you love math and those nice integrals--the computer does the job anyway, but theory is also essential--this might be a good touch. Besides that I can't think of any other thing that's non wetbench.

As for clinical trials, based on external opinions, MD/PhD students don't do clinical work. If they do that could be rare.

Others advanced persons may have better opinions on this.

 

[Neuronix]

Are there MD/PhD programs that are non wetbench programs that just do clinical trials.

Not to my knowledge. If there are spots for this, it is rare. The MSTP (the federal funding component) was designed for bench researchers. MD/PhDs get their med school paid for because they will probably make 1/4 or less than their private practice components in subspecialties.

Investigators who do clinical trials very often do a significant amount of clinical work along with them. There are programs for this, but they do not provide a PhD (most), nor will they pay for medical school.

If you want to indenture yourself to pay for medical school, try the military or the various primary care programs.

 

[Mike22]

Someone made a comment about changing labs after 2 years. First, congratulations, that took a lot of courage. Second, it's good to find a mentor with a good track record of graduating students to aviod this problem. Before I entered my lab, my mentor had trained 6 PhDs and the last 2 went on to postdocs at Harvard and Yale. And yes, this proved to be a good lab. Third, don't be too freaked out if after a year your project is failing and you have to switch. I know a lot of people that this has happened to, including myself. Luckily, the experience you gain in the first year is usually very helpful (although you may not realize it until you llok back at the end of graduate school).

 

[tofurious]

People are mixing the issues here. One is the commitment to complete a combined 7-8+ year training program, and the other is lab/mentor selection. The OP decided to drop out of the combined path because he wanted to finish sooner and not deal with the PhD stuff. That is a totally different cause/reason for attrition than the student/mentor/lab mismatch. The issue with the commitment is in the application/selection process, and one could argue that students need to look into this further and schools need to do a better job screening applicants. I personally think that students who decide to drop out before 4 years of combined training should have to pay back both tuition and stipend they have received. However, the issue with lab/mentor selection has to do with two people whose working relationship is often maintained by the likelihood of success of the student's thesis project. Mentoring is an issue all institutions of higher learning struggle with. Scientists and physicians are not trained nor hired for their teaching/mentoring abilities. Their qualities as mentors are often personal qualities that make them good PEOPLE in the first place, and not necessarily the same set that make them good SCIENTISTS. This issue is not one institutions of higher learning LIKE to talk about, as it challenges their abilities to educate - which is these institutions' fundamental goal rather than research. Even students who have done the most looking-around and "interpersonal research" can end up in the wrong lab, despite how many graduates the PI has sent to Harvard for post-docs. The graduate education system so far has no way to compensate these students' for their time and achievements, and the students are always the victims of any mentor/student tension. (I count myself lucky to not have been through this situation, but I have seen a few cases myself) There is no reason that students who have not succeeded because of PIs who are dicks should be grouped with those who simply make the wrong choice in life.

For those considering MSTP or in early parts of your training: as with advice and opinion in real life, online advice is only as reliable as your source. Be careful with advices from people who are not past the half-way points of their MSTP training, or people who are not even in MSTP programs.

 

[pathdr2b]

Are there MD/PhD programs that are non wetbench programs that just do clinical trials.

Another area to consider for a non wet bench PhD is Epidemiology and I know that UPenn, Hopkins, and Harvard are very strong in this area. Epidemiologists can also participate in clinical trials.

I should also mention that once again a distinction needs to be made between MD/PhD which can allow a tremendous amount of flexibility for PhD options. However, funding for MD/PhD programs can range from only the grad school years to all years in the combined program.
MSTP MD/PhD programs which as others have said is very wet-bench oriented are completely funded.

Good Luck!

 

[prostate]

so what is the consensus on one's dropping being put into the dean's letter?
i am considering dropping and would like to approach this issue with the director about it.
thanks

 

[Reckoning]

Cool thread. Personally, I think the topic needs to have meaning for you, otherwise labwork is thirty minutes of thinking/planning followed by a whole day of repetitive tedium. I am exagerating here but the edison quote of "Invention is 5% inspiration and 95% perspiration" comes to mind.