Help me decide MD vs MD/PhD

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Jul 10, 2020
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Hi everyone! I hope to get some outside opinions in regard to deciding between an MD and an MSTP program. The two schools are similar and the main difference comes down to me deciding which path I want to take.

I applied to both MD and MD/PhD since I am a big research person and I know I want to have it as part of my future career (but I do want to be a clinician more and that's a priority for me). I know that as an MD, I also can do research during residency/fellowship. But it'd be more on the clinical side since MDs are not trained for wet lab (Not that it's not doable but for sure it takes time to do translational research as an MD- only). Although I have been involved in research a lot during my undergrad, I'm not sure what type of topic I want to get my Ph.D. in and that scares me a bit since if I get my Ph.D. in a specific field, then I also need to do my residency based off of that (let me know if I'm thinking about this in a wrong way!). I'm interested in a variety of specialties (mostly surgery) but I don't think it's doable to do surgery as an MD/Ph.D. and I need to explore my interest in other more traditional specialties for physician-scientists (or at least I don't think I can do this due to the age factor; I know other people do this all the time and I really admire them for that!!).

MD Program-
- Close to family/friends
- Great match list
- Opportunities for concentration and building my application for residency
- Relaxed environment
- Diverse
- True P/F

- Fewer opportunities for research but for sure can find interesting things if I look for it (I'm taking a gap year and also can continue doing research in my current lab as well)
- less chance for competitive residencies
- Location (the city this med school is located in is not that great)

MD/PhD Program-
- Close and collaborative community
- more chances for competitive residencies
- Smaller class size (for the MD also)
- A higher-ranked med school
- I love the location of this med school but I'll be far away from my support system
- Free tuition (I know this shouldn't be the focus since in the long run, MDs actually have higher income and can pay off their debts pretty fast considering they are four years ahead and get to that attending paycheck faster)

- Just changed their curriculum
- Not that much clinical involvement during the grad phase
- Less diverse
- extra four years (I enter residency much older and by the time I come back to research, the field has changed so much, and need to again figure out how to incorporate this side of my career into my overall practice)
- It's P/F but has internal rankings

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How strong is the support system at the MD/PhD program? If you are positioning yourself for academic leadership in a medical school setting, it is hard to turn down free tuition at a high-ranked med school. It's only worthwhile if the support for the MSTP students over the 8-10 years is solid, and I would expect that it would be.
I think my concern is that if I can achieve the same result by going to an MD only program ( in another words, what would I gain from going to an MSTP program that I can’t from an MD only with the focus on research)?
I'm an M1 with a very heavy research background before medical school. I considered MSTP programs but ultimately only applied MD and am very happy with my decision.

When you are in medical school, your coursework will be your full-time job. Therefore, research will be a lower priority than your grades, and acing your exams will take time. People also have different definitions of "research." Presumably you know what it's like to do research as a full-time job (40+ hours per week)--that is going to be very difficult as a medical student, except over the summer where you might get to do 2.5 months of full-time research. When people say "oh, you can do research in medical school" that is what they are referring to, but that is not the "research" that a PhD who does research full time does.

An MD/PhD would give you 4+ years of 40+ hours/week of research. An "MD only with the focus on research" will not. If you think you'd be content with doing part-time research while balancing medical school coursework (which has to take priority) and then doing 2-2.5 months of research full-time in the summer, then MD-only is a good option. If that is not going to be enough for you then get the PhD.

I came to medical school enthusiastic about research, but as time goes on my interest is decreasing. It takes me 40 hours/week (+/-) of studying to get the grades I want on exams, and I genuinely enjoy learning the material. I've also gotten involved with a few more clinical extracurriculars that I discovered I enjoy more than research. You are obviously not me, but be aware that interests can change. At this point you know more about being a researcher than you know about being a physician, and as you learn more about being a physician and interacting with patients as a future physician your passion for research may or may not continue to be strong. Just something to think about.
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All great points thank YOU so much!
Do you think that if I’m thinking about competitive surgical residency then I’d be able to have a chance by doing the MD route and obviously focus a lot on research to boost up my chances ( I know so many people who take a research year to increase their chances of getting into a competitive specialty) OR I would have a greater chance by doing the MD/PhD (obviously this shouldn’t be my only reason for choosing this path since it’s four years of my life and I need to make a holistic decision)? I’m just not sure if MD/PhDs are more favored compared to MDs from PDs perspective?
There are MDs who match into surgical specialties without PhDs. That being said, go look through some of the programs you’re interested in applying to. I was surprised to see that one neurosurgery program had not accepted an MD only applicant in its entire history until this year, with everyone else being an MD PhD. Whether that is the result of PhD applicants having more research, or if that is a preference of PD’s, I don’t think anyone knows and is highly program dependent.

Getting into a competitive surgery speciality is, well, competitive. If you are set on something like that now, I feel like a PhD can only help your chances of matching into a competitive residency and won’t hurt your chances. But it is an additional 4+ years between medical school and residency, and that’s before the 7+ years of residency (neurosurgery as an example). However, you will have zero med school debt and a higher chance of matching into a high paying surgical specialty.

The md/phd program is higher ranked and tuition free. You’ve made it this far in the process so you’re committed to a life in medicine and research. I would personally have a hard time turning down that opportunity.
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