How to know if Medical School or PhD is right for you?

[coriander1998]

Hi, I am making a thread on something that likely has been asked a million times. Thank you in advance for your help.

I am really struggling with the question of whether I should pursue a clinical psych PHD or a medical school degree (from where I plan on becoming a psychiatrist or a neurologist). I graduated from undergrad about 3 years ago with the idea that I would become a psychological researcher, and I wanted to pursue clinical psych specifically as I know that it is difficult to achieve a TT position and thought that counseling would be a good fall-back strategy for me. I love research and I am naturally a very curious person; I love learning and I love school. That being said achieving a clinical psych phd appears to be very difficult. I applied to two different cycles – once right out of undergraduate (complete failure and probably a mistake to apply with no experience) and once now. I knew I was not going to get in now as I still do not have ANY publications but my father who believes in me convinced me somehow that I would be successful. I feel that it was a mistake and waste of thousands of dollars in application fees to apply and I feel like a ***** to have wasted the time of some many of my recommenders (I applied to like 15 schools). I also however applied to a few masters programs, and have been accepted to my least preferred choice for a 2-year program in low/midtier school that would involve me moving to a location about 5 hours away from friends and family, but which would guarantee me research experieince and at least one publication (via the masters thesis). I have not heard back from two schools yet but I assume by this time they are likely rejections (they are both competitive schools). I have until May 1 to respond to this school and state whether I am accepting the MA position or not.

For the record I have been in a number of research labs (3 in undergrad and 2 post-grad) and have worked (and currently work again) in a position where I directly encounter and counsel clients/patients over the phone or in-person for med observation. I graduated undergrad with a 3.8 gpa and I believe I had strong letters of rec.

Slowly after undergrad I have been considering medical school more and more. I am interested in neuropsychiatry specifically and lately the role of stress, neuroscience, and biology in the development of mental illness. I am interested more and more in the intersection between medical and psychological interests, I suppose. Of note I worked in a biology-based wet lab (in a facility where lot of biomedical research is done) for about 2 years, from where I gained a stronger appreciation for science and medicine. I used to think I was bad at math, hence why I took NO med school prereqs in undergrad, abut evidently I used it well in the lab and had an interest in it. I have an interest in medical topics, diseases, and the human body and would enjoy learning about different conditions even if I do not enter that area as a career.

However a few years ago when I was last considering medical school I had the opportunity to speak with a alumni of the nearby med school (who studied psychiatry) regarding his experience and I found it to be a bewildering conversation which made me think that medical school is not for me. When I asked about finding out if medical school is the right place, he told me that I would find my place in medical school as the “jocks” tend to go into orthopedics and the “nerds” tend to go into psychiatry, and that med school is hard as he had to sometimes go without sleep for two days (boohoo??? I’ve gone without sleep for longer simply due to the pressures of undergrad or working a rotating shift job). However when I asked why he liked psychiatry he said that he enjoyed the treatment of patients (ex: seeing the difference in an individual’s functioning and presentation following the administration of electroshock therapy), and I think perhaps this is why I initially chose a path of research instead of medicine – because I am interested in the why more than the how, and would be unhappy administering treatments without fully understanding what I was doing, how things could be improved, etc. However I have an interest in and would enjoy the diagnostic process, and have been told by others that I have good clinical judgement (through my current position, etc). I think as a psychiatrist I would enjoy working with patients and administering treatments if I could to do research on the side, which I am not sure is possible.

Regarding research, however, I am worried that I will not get into a phd program following my master’s (if I do accept it), and will be stuck working lower-level research coordinator jobs making ~45k for the rest of my life. I struggle with the thought of moving 5+ hours away from my friends and family and for two years of time (length of program) and spending money on a program which may only help me somewhat. Additionally, I worry about being stuck in the lab of a potential toxic PI who is extremely mean and treats me as a slave (I have worked in a lab like this). I also worry about, if I do get a PHD, having difficulty finding a position and having to be a fulltime therapist instead – something that I do not want to do (I would rather do mainly research with short therapy appointments). I worry that I will have to constantly move to follow my career (masters, phd, clin psych internship, post-doc, etc) and my life (friends, family, relationships) will not follow with me. Additionally, even though I have worked like a dog it has been hard enough for me to get a publication/the necessary experience for a clinical psych phd -- will this truly get better with time?

Becoming a psychiatrist or a neurologist sounds interesting but everyone speaks about how stressful the medical school process is. I have been stressed and sleep deprived my entire life and I don’t know if this will change in either medical school or grad school but I am worried it will get worse. I would have to take all the prereqs and pay out of pocket for them, which is expensive and I fear I would get bad grades in STEM classes (though I have been historically a good student in general). I have met many pre-med students and worked directly with them through my positions as lab manager/research coordinator and while many are great, I have been shocked by the lack of intellectual curiosity many of them had towards the topics of the labs, and worry that what interests them to go to medical school (ex: an interest in anatomy? A basic interest in biology an a more significant interest in working with patients? I don’t know) is not the same thing that interests me. Additionally I worry that I will spend an enormous amount of money and time on pre-reqs, fail them, and be stuck back at square one. Or that I will go through medical school and be stuck doing 15-minute psychiatric med checks for the rest of my life.

I don’t know, honestly I am worried sick. Every day I get older. Has anyone been through this and can anyone offer advice?

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[ablanco]

Well getting into medical school is difficult much like getting into a competitive PhD program if not moreso. I honestly would advise you to get some shadowing and actually see what working in the psych field is like both with psychiatrists and clinical psychologists. Liking research doesn't necessarily mean either of those two roles are particularly aligned as their core work is patient-centric. I think after learning what the day-to-day of those jobs look like, you will have a much clearer idea of which (if either) path to pursue.

Also you seem pretty stressed, may benefit from looking into resources for that available at your institution.

 

[AJS59]

I was in your shoes once (although not for a psych phd) when debating between a PhD in Chemistry and Med School. For me, even though I like the wet-lab work of chem research the goals seem nebulous at times...after all, only rarely does that work directly translate into a new drug or process, whereas I felt I could make a deeper impact in medicine by directly affecting patient's lives.

As mentioned above, I'd first start by shadowing professionals in both fields (and within the medical field, don't just limit yourself to psychiatry!) to really get a feel for things. Once you've figured that piece out, then you can sit down and figure out that puzzle pieces.

Also to your point about worrying about moving a lot...reality is that's no different in med school. More often than not you move for residency, again for fellowship, and again for your first attending job.

 

[Goro]

Medicine is a calling, like being a cop or a priest.

What does your heart tell you???

 

[Mr.Smile12]

The choice isn't about medical school vs. Ph.D. It's more about the life you gain if you go to either direction. Schooling to get there is going to be extremely trying. If you want to stay in mental health, going to medical school is an inefficient route because the training goal is to get you to be at least generally competent to be a doctor, short of the licensing required to practice.

Basically would you rather be a CEO or be a four-star general? The paths are very different and relatively undefined to get to the end, but which one appeals to you better? That's how I would think of the question.

 

[JAK2-STAT3]

Hey, I'm a fellow neuroscience junkie that worked as a full-time research assistant and am now an M1. I struggled with the same decision and have zero regrets about going to medical school.

Before I get on my soapbox, the bottom line is that you need to shadow MULTIPLE physicians across different specialties (especially Neurology, Psychiatry, and most importantly, primary care) before making any decisions.

I think perhaps this is why I initially chose a path of research instead of medicine – because I am interested in the why more than the how, and would be unhappy administering treatments without fully understanding what I was doing, how things could be improved, etc. However I have an interest in and would enjoy the diagnostic process, and have been told by others that I have good clinical judgement (through my current position, etc). I think as a psychiatrist I would enjoy working with patients and administering treatments if I could to do research on the side, which I am not sure is possible.

In medical school we learn physiology, pharmacology, pathology, histology, anatomy, etc that are more geared towards what is clinically relevant. In a PhD program you could study whatever science you want without regards to whether it's clinically relevant today. Here's a random example: you may have heard rumblings about the weight loss drug Ozempic being potentially beneficial for addiction and Alzheimer's. A basic scientist could write a grant and explore that in cells and/or animals, laying the groundwork for potentially millions of patients to benefit. But a physician could not just give a patient struggling with addiction Ozempic because that would not be evidence-based medicine. Instead, a physician would understand Ozempic's mechanism could discuss its risks and benefits with an obese and/or diabetic patient and monitor that patient throughout their treatment.

In other words, physicians know a lot of stuff and use that knowledge to help individual patients with their health. Researchers have an incredibly in-depth knowledge in their area of interest and are not constrained by what is clinically relevant. They can explore whatever they want if they can get funding to do so. While their day-to-day work might be far removed from patient care, there is a chance for that work to revolutionize medical care decades from now--just think of all of the scientists who worked on mRNA technology years before Covid.

Becoming a psychiatrist or a neurologist sounds interesting but everyone speaks about how stressful the medical school process is. I have been stressed and sleep deprived my entire life and I don’t know if this will change in either medical school or grad school but I am worried it will get worse. I would have to take all the prereqs and pay out of pocket for them, which is expensive and I fear I would get bad grades in STEM classes (though I have been historically a good student in general).

I think that once you figure out what you truly want to do, you can make it happen. Being stressed and sleep deprived is something that you can work on now, and since it sounds like this is a chronic problem for you, it will follow you wherever you go unless you are proactive about making changes. Medical school is stressful but the preclinical years can be treated as a 9-5 job--you study hard but still have time for other interests. Once you are 100% certain you want to go to medical school you can try taking one prereq to see how it goes and then add more once you can handle it. It is a long road but if you are smart and methodical about how you approach it (i.e. break everything down into doable chunks) the time will fly by and you can get into medical school. One day at a time!

Here was my reasoning for why NOT a neuroscience PhD, in no particular order

• I wanted a broader knowledge base instead of spending my career studying a couple of proteins
• I disliked studying a particular disease in the lab while having no concept of how patients lived with that disease
• Moreover, I just couldn't see myself spending the next 10 years in a lab and then the rest of my career chasing grant money while trying to climb the academic ladder
• I liked the idea of talking to patients and counseling them with their health
• I liked how medicine offered the ability to work with patients while still doing some sort of research on the side if I was interested
• Like you, I was worried about spending 5+ years of grad school with a bad PI
• Multiple post-docs I worked with told me they regretted not going MD

Feel free to DM me if you want to talk more.