Family Issues and MD/PhD

[pathdr2b]

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OK, so this is a continuation of what was discussed in another thread:

Originally posted by Neuronix
There is nothing that says you cannot have a family while you are in training. Many students in MD or PhD programs have families when entering or have children during their programs. There is no reason you cannot do the same during a MD/PhD. Many students do it, and I am sure if you contact any program of decent size, you will be able to find at least one female contact with children.

Yes, "on paper" a person can make whatever family decisions they want. But there 's a huge difference what is allowed and what is tolerated. Many of the top MSTP directors I've spoken with or discussed with other applicants/students make it clear that they only want you to focus on your education not family matters. No they won't come out and say that and to think they will is very naive.

Originally posted by Neuronix
I don't understand why getting your PhD during residency is more flexible than getting your PhD in a MSTP? Residency is still very time consuming, and you will probably still end up putting the same amount of years into your training..

Having completed a Master's degree, I'd bet that anyone with an advanced degree knows exactly why getting a PhD in reseidency is "easier" than as part of an MD/PhD program. Quite simply, PI's are far less likely to bullsh*t a person they have to call Dr than someone whose highest degree is a BS/BA. Also, MD's for whatever reason take less time to get the PhD. I imagine some of this is respect for someone PI's view as an equal, some of it's the ability to "transfer" some coursewwork earned in an MD program to a PhD program. Some of it may be that for residency programs like pathology, a research portion is required anyway.

Also in the area of family issues I think female MD/PhD applicants/matriculants need to be especially careful about the speciality areas they want to pursue. For example, if you already know you'd like to have 6 kids, don't go into OB/Gyn and expect to maintain a lab and your personal life too. I think it's improtant to be realistic now about the sacrifices you want top make later. 7 or 8 years may seem like a long time now, but it really isn't. It will be over before you know it!

To MD 100212, please allow me to give all of you a wake up call. In most cases pregnancy cannot be timed no matter how much effort you put into it. That's why I think it's important that when you and your spouse feel the need to reproduce, start having sex right away. You may get lucky as I did and get pregnant in the first 6 months of trying( I was 29 at the time with lots of active trying 😉 ). There's no such thing as the "perfect time" no matter what career goals you have so don't feel obligated to put ANYTHING off for the sake of a career.

 

[Neuronix]

Thanks for moving this out of the other thread, as that one got sidetracked by this argument 🙂 I know we both respect each other very much, but we don't seem to see eye to eye on this issue. I'm not sure that we ever will. Nevertheless, I think there is two things that I can do to support my argument that MD/PhD does not significantly hinder one's ability to have a family. One is to get the opinions of those who have been through the MD/PhD program. Unfortunately, I do not know any MD/PhD females with families who post on here, however I can see if I can get Ophtho_Mudphud or FunnyBones to comment. My other option is to continue putting out my opinions. Of course we are colored by our experiences, and I think that the professional company we keep has differing opinions that have shaped our own. Further, I have been through the MD/PhD application process and gotten the applicant "spin" on everything, which is, I'm not sure how truthfully, bright-eyed and very pro-MSTP.

Perhaps I do have a naive outlook on the situation. The impression I have gotten from speaking with directors and applicants is that schools are accomidating of family needs. Of course, in some of their minds education comes first, but this is why you look at programs and choose wisely when it comes decision time. Many female students (both PhD and MD/PhD) look for a female PI with children (and they are fairly common) and I think that would be best for a young woman who is seriously concerned about balancing MD/PhD and children. However, the best source of information on this subject is someone who has actually been through the process and has had children. I have met some, and they have all been happy with their decisions. Although one wonders if that's just a recruitment pitch for their school. Regardless of that, I do believe we hold the power because we can always drop the program and cost them the first two years of medical school if they make things too difficult for us.

I cannot say I have seen the same sort of favoritism towards those who already have advanced degrees in my lab or in other labs. In fact, when some clinically-oriented residents walk into residency required lab work, I have heard ridicule for their often non-existant knowledge of basic science and inability to do basic bench work. However, I could see why someone with a master's or prior research might be more appealing to a PI, but only because that person will not take up alot of time in training. This same sort of appeal is shown for MD/PhD students, because it is often assumed that when they enter the program they are the best and brightest of the PhD crop and have extensive research experience.

I do agree with what you are saying about specialty and residency selection. Pathology and neurology are very popular for MD/PhDs because they allow the most amount of flexibility for research. I imagine that they would also allow flexibility for family.

So I will see if I can get some more informed contacts to state their opinions here. I can try to argue the pro-MSTP viewpoint all I want, but my credibility is shaken by the fact that I haven't even begun program yet.

 

[pathdr2b]

Originally posted by Neuronix
Thanks for moving this out of the other thread, as that one got sidetracked by this argument 🙂 I know we both respect each other very much, but we don't seem to see eye to eye on this issue. I'm not sure that we ever will.I can try to argue the pro-MSTP viewpoint all I want, but my credibility is shaken by the fact that I haven't even begun program yet.

I think your opinions are credible based on your expereinces and there's nothing wrong with stating the facts from your point of view. However, I have been through the MD/PhD admission process, was admitted to a Tier 3 school with FULL FUNDING, but declined to go when my father was diagnosed terminally ill with cancer.

I'm simply trying to state that for women who are considering addressing family issues during training, MSTP may not be the way to get the MD/PhD because the program appears to be so rigid. In an MD/PhD program where the student pays for the MD portion, I believe that schools are more likely to be flexible and this is the example I've seen from my current mentor a UPenn grad and another friend currently at GWU.

Finally, I think it's important that while the prestige of an MSTP funded program may be good for some, this may not be good for others. People like me who could care less about prestige/debt need to see that there's another equally good route to obtaining both degrees.

 

[md_student10021]

To MD 100212, please allow me to give all of you a wake up call. In most cases pregnancy cannot be timed no matter how much effort you put into it.

I don't remember my exact words, but I think you missed my point. During the course of your thesis research, should you feel the need to become pregnant, your training is far more flexible than what you experience during MS1-4, or during residency for that matter.

You'll know several months in advance of your delivery, and will be able to plan your lab work accordingly. That way, you can time experiments such that you will be mostly engaged in data analysis (which you can do from home) during the appropriate time period (e.g., 1 month before, and a couple months after you have the kid, and yes, I know everyone is different re: time off).

Just trying to help you put it into perspective. Think of PhD training as a "regular job," ie, one that is relatively flexible; you should be able to work out personal matters (whatever they may be - pregnancy, illness, etc) without much trouble (unless your PI is a total a-hole).

Best of luck

 

[Andrew_Doan]

Pathdr2b,

I'm sorry to hear about your father. Your position is tough, and I understand your point of view.

I must have to disagree that the high-powered MSTP programs frown upon students having families during their training. I know many students who have started families during their PhD studies. I think that the PhD training is a good time to have children because your time is flexible. I can speak of this firsthand because my son was born during my second year of grad studies and my daughter was born during the fourth year of PhD work. I took time off for both children. My wife also worked full-time; thus, my kids were in day care while my wife and I worked. I never received any negative remarks or discouragement. I finished my MD-PhD program in 8 years. Another student in my lab had three kids while in school. I also know women who have worked in the lab while pregnant. I realize that my position as a man is different than yours; however, given that my wife and I both worked, I think that I had to contribute to the family as much as she did.

I also went to Hopkins were I think the environment is fairly intense. Regardless, people were definitely starting families while in graduate school.

I must also disagree with you about getting a PhD during residency. I have never heard of people getting PhDs in a combined residency-PhD program. If you want a PhD, then you'll have to do it after or before a residency program. Therefore, a combined MD-PhD program is definitely faster. In a combined program, people can finish in an average 7 years because some of the requirements for the MD and PhD programs are fulfilled by coursework in one or the other program. Furthermore, in a combined program, MD-PhD candidates also do research rotations during their first 1-2 years of medical school. This allows them to pick a thesis lab quickly and start on their PhD work. If you do the programs separately, then you are locked into a 4-year MD program and a 5+ year PhD program. Formal PhD programs often require 1-2 years of course work and completion of 3 research rotations before the student is allowed to pick a research lab. Most PhD students start dissertion work in their 3rd year and often spend three or more years completing the research.

My degrees took longer than the average 7 years because my PI left my institution half-way into my PhD work. I had to switch labs. Most of my colleagues finished in 7 years.

 

[MacGyver]

I've heard of those combined residency-PhD options and I think there are total crap. There's not very many of them (about 10 in the whole country) and I hope it stays that way. None of those programs are affiliated with elite academic medical institutions.

Most of those "programs" give away PhDs like candy. You dont have to take any courses, you dont have to do any TA work, you dont have to take oral qualifying exams. Most people "complete" a PhD in only 1 or 2 years at most in these programs. They are total shams and I've heard several higher up figures in academic medicine say that these kind of PhDs are watered down versions of the real thing.

Basically they give you a PhD for publishing one paper and thats all you have to do.

A total joke if you ask me.

 

[pathdr2b]

Originally posted by Ophtho_MudPhud
I must have to disagree that the high-powered MSTP programs frown upon students having families during their training. I know many students who have started families during their PhD studies.

I think we all know that choice of PI is important here. And my opinion was based on my own personall experiences with adcoms of various MSTP porgrams and women in such programs.What I'd really like to hear is what a current female MSTP MD/PhD student really thinks of the process.

Originally posted by Ophtho_MudPhud
I never received any negative remarks or discouragement.

No offense, but I've also can't think of any expereinces where the male MD/PhD student was hassled. But women MD/PhD students, completely different story. I can think of a few examples including a classmate at Carolina that was encouraged to get an abortion by her PI. Does anyone believe that a man would be encouraged to terminate the pregnancy of a SO? Life is different for women (especially in academia)and I t hink it's important that we not sugarcoat or loose track of this important fact.

Originally posted by Ophtho_MudPhud
I must also disagree with you about getting a PhD during residency.

I'm specifically referring to myself and others in the same position (I think Fonzy has an MS already too) being that I already have an MS in a basic science and want to do pathology.


The key point I need to emphasize is that my expereinces are from the point of view of a wife, mother, and now single parent. For all the viacariuos expereinces men have through their spouses and significant others it just doesn't compare. The lives of men are very differetent especially at this level a fact that young women considering the MD/PhD option need to be keenly aware of.

Finally, MacGyver brings up a valid point. Many PhD's obtained in residency are considered to be watered down. However, I hear the same comment from PhD's referring to MD/PhD programs too ie the PhD's obtained are watered down.

Obviously, there's no right or wrong way to do this program. One must get the MD/PhD in the way that is suited for the indiviaual but this doesn't have to be only MSTP. This is my main point especially for females applicants.

 

[Vader]

Pathdr2b,
I would also have to agree with what others have said here previously. From my experience at UCSF, I have met several women MSTPs who had children during the program. One just graduated last year, in fact, and brought her little one to the farewell reception. 🙂 I spoke with a couple of graduates of our program who are here for residency or fellowship about the issue and asked how difficult it was to start a family, do they ever wish they had waited, etc. The response was that first of all, there is no "best" time to have a family life, that the graduate years did provide them with enough flexibility to start their families, and that that they definitely don't regret having children during the program. They also said that yes, it wasn't easy, because of having to juggle their schedule more, but that ultimately their PIs were understanding and they had good social support systems.

I realize that it is an especially difficult task to have children during a challenging time like during an MD/PhD program. However, there are successful examples and you should definitely seek them out. If you would like to correspond with someone directly who has been through this, I could put you in contact.

As for the combined residency-PhD programs, I don't know much about them. However, I know they do have a combined clinical fellowship/basic science training program at UCLA (the STAR program http://www.star.med.ucla.edu/ ). Perhaps this is the type of program you are looking for?

At any rate, I wouldn't let anyone discourage you from applying MD/PhD if that is your goal. There is really little difference between MSTPs and other MD/PhD programs in terms of supporting or discouraging family life, and really has more to do with the individual program and especially PI. Definitely go somewhere and work with someone who will be supportive of your goals.

 

[pathdr2b]

Originally posted by Vader
Pathdr2b,
I would also have to agree with what others have said here previously.

I guess I must be somewhat confused here. I'm not arguing that a woman can't survive or thrive in any particular MSTP program.

 

[Vader]

Originally posted by pathdr2b
I guess I must be somewhat confused here. I'm not arguing that a woman can't survive or thrive in any particular MSTP program.

I understand. I think for someone in your situation, doing the PhD after residency might be a good idea, especially since you have already done a masters and have some research know-how.

However, my point was to highlight the fact that a family life is not discouraged at least here at UCSF, and in fact the program, administrators, and individual PIs can be very accomodating. I suspect the same is true for many other "top" programs as well. While I'm sure there are still "good ole boy" PIs that actively discourage family life, I suspect these are in the minority and certainly are not supported by administrators (at least those living in the 21st century).

The reason the programs do not focus on family life, is that this is considered a non-academic, personal issue. Perhaps they should discuss this more openly. One of the major concerns at the NIH has been how to increase the number of women in science, especially in MSTPs. For starters, major efforts have been made to shorten the length of training. Harvard, Columbia, and my alma mater got put on quasi-probation for students taking too long. Consequently, a bunch of changes were made to significantly shorten the program duration at all three schools.

Certainly, more work needs to be done in terms of recruitment and addressing the needs of women in science. Nancy Andrews (at Harvard) has been a national leader in this quest. At UCSF, we have some great examples of very successful, strong women who excel in both science and personal life (in the area of neuroscience: Cori Bargmann, Ulrike Heberlein, Donna Ferriero, Cynthia Kenyon, come to mind).

By the way, I know of a particular power couple that are both busy surgeons and somehow managed to have 6 kids. I don't know how well the kids will turn out, but I guess this is just meant to illustrate that quite a bit IS possible. It just depends on your particular goals, willingness to make sacrifices somewhere, and ability to withstand extreme sleep deprivation (I'm still working on the latter one 😀 )

 

[pathdr2b]

Originally posted by Vader
While I'm sure there are still "good ole boy" PIs that actively discourage family life, I suspect these are in the minority and certainly are not supported by administrators (at least those living in the 21st century).

Let me preface my statement by saying that I'm mainly referring to atitudes in the South since that's where most of my direct expereinces in academic life occured. If you think that the "good ol boy" attitude isn't alive and well in the 21st century in many parts of the country but especially the South, then you're sadly mistaken. Sure you have institutions like Duke that manage a diverse class of students with women MSTP students but those types of supportive environments are in the minority at quite a few Southern institutions. Your expereinces are from UCSF an institution that is by the way on my "list", but attitudes in California differ greatly from the rest of the US (especially in San Francisco which is where I was born and raised). Let me assure you that at least in the South, sexism and racism is alive and well and academia reflects the good ol' boy" attitude in many ways in my opinion. This is the main reason I no longer live in this part of the country. Hence, women that are considering the MD/PhD and are planning to start a family during their traioning need to be especially careful about which schools at which they matriculate.

Originally posted by Vader
The reason the programs do not focus on family life, is that this is considered a non-academic, personal issue.

I'm not sure I see the relevance here. By definition, no career "supports" family life in my opinion.

Originally posted by Vader
For starters, major efforts have been made to shorten the length of training.

I believe that shortening the program will dilute the credibility of the combined degrees in the eyes of many scientists. MacGuaver remarked earlier that depending on when you get the PhD, some in the scientific world will not think of the PhD as credible. Shortening the problem will add to this problem in my opinion. I'm also not sure why a conversation about shortening the program should be mentioned in the same conversation about women MSTP students as if by gender alone women need "alternative" programs of study. I'm arguing for flexibility in MD/PhD pursuits not a completely different standard which quite frankly would not be fair to men..

Originally posted by Vader
Nancy Andrews (at Harvard) has been a national leader in this quest. At UCSF, we have some great examples of very successful, strong women who excel in both science and personal life (in the area of neuroscience: Cori Bargmann, Ulrike Heberlein, Donna Ferriero, Cynthia Kenyon, come to mind).

One need only do a survey of women in academia to see that most of them not only are single but do not have children.
While the success stories are to be celebrated, lets not forget that this is the exception not the rule. This again highlights my point to future female MD/PhD students to find a program/mentor that emulates the life you'd like to eventually have. I haven't seen many at MSTP programs which of course does not mean they do not exist.

 

[Vader]

Pathdr2b,
First let me say that you have brought up many relevant and important points regarding MD/PhD programs, concerns of female students, and attitudes expressed by a number of individuals.

I am well aware of the existing sexism, racism, and other negative aspects of society. Academia is certainly no exception, and perhaps even enhances discrimination in many respects. This is not just an issue for the South, but an issue for everyone (yes, even in progressive San Francisco). At UCSF, there have recently been various women's leadership seminars, articles in the papers, and other forums to address some of these issues. A recent survey showed that a majority of women faculty members have felt sexual discrimination in hiring and promotion at UCSF. You really cannot escape these issues, no matter where you go. I agree, however, that applicants need to be aware of the attitudes at different schools regarding personal family life.

To say that no career "supports" family life is not really accurate. Yes, for many people, a career gets in the way of or detracts from family life. But this doesn't necessarily have to be the case. I have interacted with numerous faculty members who are members of either single or 2-parent households. They devote considerable time to work, but also somehow manage to balance things with home life. UCSF is fairly supportive in this, providing day care for the children of faculty members, health insurance packages, and other benefits. So I wouldn't necessarily characterize a career so negatively.

With regard to the comment about shortening time to degree having a negative impact on the quality of the PhD, this is frankly an old argument that has never held water. First, MD/PhD programs used to graduate students in much shorter time periods. Over the last few decades, there has been a gradual lengthening of time to graduation, concomitantly with the lengthening of standard PhD programs. The obstacles to graduating in reduced time were severalfold and not necessarily associated with an increased "quality" of PhD: increased number of required graduate classes, rotation requirements that didn't fit the goals of MD/PhD students, a too-heavy teaching requirement, and lack of coordination between the medical schools and respective graduate programs. In addition, lack of oversight and poor administration were also partially responsible for an increased duration. Therefore, with recent changes by many programs (i.e. UCSF, Harvard, Columbia), students will take less time to graduation (to average 7 years), without sacrificing the quality of the PhD.

I was not arguing that the program training should be shortened solely for the sake of encouraging women to apply. Instead, a reasonable program duration (7 years) benefits both men and women. One of the major concerns I have heard from many female applicants is the length of the program. With changes being made, this will pose one less barrier. The high-quality PhD standard would be the same for both men and women.

That there are too few examples of successful women scientists is testimony to the fact that more needs to be done at several levels to ensure that we have those role models in the future. I think that women should not be discouraged, but should seek out role models to emulate and one day become role models themselves. The chain has to start somewhere.

Anyway, I have taken way too much time here... I am taking Step I in a week and need to study. I would be happy to discuss this further though and if you would like, I could put you in contact with former or current women MSTPs who could give you more direct personal experiences.

 

[mjs]

It's great that people are speaking frankly about this!

My two cents are that in science departments everywhere, this discrimination is a huge problem and it gets worse further down the career path. One of the most interesting voices in this debate is Debra Rolison, who gave a seminar on it in my department (Chemistry at Penn State, so please excuse the numbers not relating to medicine; I think the message still makes sense). The statistics Dr. Rolison presented are astounding- it's great that half of all B.S. in chemistry are now awarded to women, it's great that 1/3 of all PhDs go to women, but there are very few female assistant professors and virtually no (less than 5 OVERALL at the most) African-American assistant professors at any of the top 25 chemistry departments in the country as ranked by federal funding. I've been told that in another department in the College of Science here none of the female professors who have tenure received it here.

Make no bones about it: the academic scientist's career path and the tenure track system are biased against women and people of color. While some places are better than others, it's a huge problem. The numbers speak for themselves.

In any case, Dr. Rolison's ideas are articulated in a very neat editorial published in the C&E News awhile back. Everybody interested in this debate should check it out.

A Title IX challenge
Rolison DR
CHEMICAL & ENGINEERING NEWS
78 (11): 5-5 MAR 13 2000

Here's a link: http://pubs.acs.org/isubscribe/journals/cen/78/i11/html/7811edit.html

 

[MacGyver]

mjs,

outcomes by themselves mean nothing.... discrimination is a process, not an outcome.

Look at PA schools for example. Over 70% of admits are women. Now does that men that PA schools discriminate against men? No.

If you are going to make allegations of discrimination, you'd better find evidence in a process.

 

[mjs]

Yeah, you're correct. I shouldn't have said discrimination- I wish I had caught that in editing. But my point remains the same. A lack of diversity in research faculty is something that needs to be discussed and dealt with more openly.

 

[pathdr2b]

Vader, thanks for taking time out of your busy schedule to contribute to this thread. I think it helps a lot to present alternative points of view.

I also know there are more young women reading this thread. I'd be real interested to hear what you have to say since the power to change the way things are in regards to women in academia starts with us!

 

[memoryless]

Originally posted by pathdr2b
I also know there are more young women reading this thread. I'd be real interested to hear what you have to say since the power to change the way things are in regards to women in academia starts with us!

😀 I like your last sentence, path. Although academia still being such a male-dominated arena will make things much harder on women attempting to enter, it's exciting that we will be setting the precedent for future females. Plus I'm always up for a challenge.

I've been refraining from posting in this thread since I am really unable to add anything insightful to it. I am planning to enter med school at 26 and am very strongly considering applying MD/PhD. "Family issues" is the only reason for my uncertainty. Although I love research, and love the idea of splitting my time between clinical and research work for the rest of my life, I do have to take into consideration that I will be 33 when I graduate if I go MD/PhD, and 38 once I finish my residency. I want to have 2 or 3 kids, and am now trying to figure out how they would fit into all of that.

No matter what I hear about the difficulty of having kids while pursuing an MD/PhD, I will most likely still go that route, since I really am making a decision that will affect my entire life/career. However, I'm worried that I'll regret that decision once I start my family.