If you can do this all over again, would you still choose MD/PhD?

[ejay19955]

Lots of comments here are pretty depressing. Worse funding climate. Lack of physician scientist jobs, etc, with deceiving statistics that many of those who are in "academia" are not really physician scientist positions.

But looking at the chart from the AAMC report, many people said they would do it again. What are some positive things you gained from the MSTP training, and for those who regret why do you regret?

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[gonogo]

One the main downsides is all the lost income potential when you go into the MD/PhD route, especially if you pursue a long residency/fellowship. Many times you don't start working until you're in your late 30s, and therefore it is difficult to put aside anything for retirement early on. I didn't think much of this when I started my MD/PhD, but along the way I got married and started a family. When I was done with all my training I was already in my late 30s with very little retirement savings, so it's been playing catch up every since. I think this is the one thing I've found most challenging.

 

[Lucca]

One the main downsides is all the lost income potential when you go into the MD/PhD route, especially if you pursue a long residency/fellowship. Many times you don't start working until you're in your late 30s, and therefore it is difficult to put aside anything for retirement early on. I didn't think much of this when I started my MD/PhD, but along the way I got married and started a family. When I was done with all my training I was already in my late 30s with very little retirement savings, so it's been playing catch up every since. I think this is the one thing I've found most challenging.

Training is 4 years longer but is anyone other than the rly rich able to save anything graduating with 200-300k in debt?

 

[mstphopeful1]

To be honest with you, I really do think we get the best of both worlds. If I was just getting a PhD, I would personally be extremely worried and scared of my future (making money/etc). But the MD degree gives me a peace of mind.

And for me it was never about MD vs MD/PhD. It was always a question of PhD vs MD/PhD.

 

[tortuga87]

The MD/PhD is great at making physician scientists but not so great at securing you that faculty job with significant research everyone seems to talk about. Most people will not get the latter even if they work very hard. That does not mean that you cannot do science; I think it means that you will most likely have to find a non-traditional solution.

I personally enjoy the science. I have to admit that the glory is nice (e.g., the long CV, respect), but I treat the faculty job as just a dream. In the meantime, I fit in research during the weekends, after work... basically whenever I can just because it is fun. The PhD trained me to discover cool things during my free time.

I'm not sure if this is just me, but people worrying about tenure, number of publications, number of grants, etc. has always struck me as odd; shouldn't we be more excited about the discoveries themselves? It seems that most people shooting for glory end up burning out because they are subjectively evaluated by older folks who are very picky in giving out awards, grants, tenure, etc. If you are worried about money, I feel like that is what the MD is for. I just make sure that the MD doesn't overwhelm me so much that I don't have time for research, because she can be very demanding.

 

[Neuronix]

Uncertain: the MD/PhD didn't give me the opportunities that I thought it would. I'm still struggling to find my way. It has not been easy.

 

[emiko]

Uncertain. As someone who is now a 7th year MD/PhD student doing clerkships, I am pretty sad seeing lots of peers from college or even medical school having an established career while I am just a third year med students getting attitudes from everyone in the hospital. I always loved science in college and was considering PhD vs MD/PhD rather than just medical school. However, my graduate school experience was horrible and in the end of the PhD, I hated my advisor and left the lab without really publishing a paper (still pending submission at this point). I regret my thesis lab choice up to this day. Some days I wish I would have not pursued graduate study post college. I think what I didn't realize when I matriculated was the value of my time and youth. Even though we don't have debt, all those lost time working in the evenings and on weekends will never be compensated. Surely I loved doing research but I also realized I like my time to be respected and have a profession that allows me freedom and a reasonable income. Thinking about the road ahead and the potential of spending my 30s as a "trainee" in academia/hospital again and have 0 control over most of my time awake just makes me want to vomit. I am seriously thinking about not pursuing further training and start a career in business/industry instead. Thinking back, I think if I would have to do it all over again I probably would still do the MD/PhD. I would however be much much more selective in choosing my PhD mentor and spend that 4+ year in a lab with good, career promoting environment.

 

[ak6819]

Uncertain. As someone who is now a 7th year MD/PhD student doing clerkships, I am pretty sad seeing lots of peers from college or even medical school having an established career while I am just a third year med students getting attitudes from everyone in the hospital. I always loved science in college and was considering PhD vs MD/PhD rather than just medical school. However, my graduate school experience was horrible and in the end of the PhD, I hated my advisor and left the lab without really publishing a paper (still pending submission at this point). I regret my thesis lab choice up to this day. Some days I wish I would have not pursued graduate study post college. I think what I didn't realize when I matriculated was the value of my time and youth. Even though we don't have debt, all those lost time working in the evenings and on weekends will never be compensated. Surely I loved doing research but I also realized I like my time to be respected and have a profession that allows me freedom and a reasonable income. Thinking about the road ahead and the potential of spending my 30s as a "trainee" in academia/hospital again and have 0 control over most of my time awake just makes me want to vomit. I am seriously thinking about not pursuing further training and start a career in business/industry instead. Thinking back, I think if I would have to do it all over again I probably would still do the MD/PhD. I would however be much much more selective in choosing my PhD mentor and spend that 4+ year in a lab with good, career promoting environment.

I know several md/phd students who feel the same way and are looking towards business/industry, granted, there are specialties where the residencies are not extremely strenuous and more lifestyle friendly, with great career outlooks after training. Just wondering, is it common for thesis committees at your school to allow graduation without publishing? And do they think this will have an effect on residency/job applications after school? I know several students who have had difficulty graduating without at least 2 papers, since faculty believe an unproductive PhD is actually a red flag, and as a result end up taking 6+ years just to finish their PhD.

 

[mstphopeful1]

Uncertain. As someone who is now a 7th year MD/PhD student doing clerkships, I am pretty sad seeing lots of peers from college or even medical school having an established career while I am just a third year med students getting attitudes from everyone in the hospital. I always loved science in college and was considering PhD vs MD/PhD rather than just medical school. However, my graduate school experience was horrible and in the end of the PhD, I hated my advisor and left the lab without really publishing a paper (still pending submission at this point). I regret my thesis lab choice up to this day. Some days I wish I would have not pursued graduate study post college. I think what I didn't realize when I matriculated was the value of my time and youth. Even though we don't have debt, all those lost time working in the evenings and on weekends will never be compensated. Surely I loved doing research but I also realized I like my time to be respected and have a profession that allows me freedom and a reasonable income. Thinking about the road ahead and the potential of spending my 30s as a "trainee" in academia/hospital again and have 0 control over most of my time awake just makes me want to vomit. I am seriously thinking about not pursuing further training and start a career in business/industry instead. Thinking back, I think if I would have to do it all over again I probably would still do the MD/PhD. I would however be much much more selective in choosing my PhD mentor and spend that 4+ year in a lab with good, career promoting environment.

any advice on picking a good mentor?

 

[emiko]

I know several md/phd students who feel the same way and are looking towards business/industry, granted, there are specialties where the residencies are not extremely strenuous and more lifestyle friendly, with great career outlooks after training. Just wondering, is it common for thesis committees at your school to allow graduation without publishing? And do they think this will have an effect on residency/job applications after school? I know several students who have had difficulty graduating without at least 2 papers, since faculty believe an unproductive PhD is actually a red flag, and as a result end up taking 6+ years just to finish their PhD.

Regarding graduation without publishing, it is unfortunately very common. However, most people do end up with papers published, just not necessarily at the time of defense. Don't get me wrong, I will have a paper and it is in the works. On the contrary, my PI wants to submit my project to a top journal and that is the reason why it is so delayed. If my advisor would have been okay with publishing just in a clinical journal, I could probably have several publications already.

Defending without a first author paper even for PhD student is unfortunately rather common. I know many people who have done this simply because they have spent the maximum number of years that's allowed at my school to gain a PhD. As a result, they stayed on in the lab as postdocs after graduation to finish the publication process. Committees act dependent on the situation and if you have done a PhD you will understand there's really no one standard that is absolutely inflexible. They will not let the student go if they sense that you have not done anything and simply want to escape the grind. However, if there's more to the story then they will decide dependent on your specific situation.

 

[eteshoe]

any advice on picking a good mentor?

Consider their prior trainees, see how they interact w/ their lab members, and have chats w/ various trainees/employees in the labs (e.g. grad students/mstp students, postdocs, UGs, techs, staff scientists, etc).

Consider their "mentoring" style (e.g. hands on vs hands off) and how you feel you would best succeed

Pick a lab where the science holds some interest to you but I wouldn't set it as the most prominent factor. You can come to love/tolerate a subject. But if a mentor drains the very life from you w/ every interaction, no amount of love for the science will make that experience worth it. Find someone who you could deal with on your worst days in lab (who wouldn't make the situation worse)

These are some of the things I learned from my path since I switched mentors early in my second year of my PhD.

 

[MSTP18]

Consider their prior trainees, see how they interact w/ their lab members, and have chats w/ various trainees/employees in the labs (e.g. grad students/mstp students, postdocs, UGs, techs, staff scientists, etc).

Consider their "mentoring" style (e.g. hands on vs hands off) and how you feel you would best succeed

Pick a lab where the science holds some interest to you but I wouldn't set it as the most prominent factor. You can come to love/tolerate a subject. But if a mentor drains the very life from you w/ every interaction, no amount of love for the science will make that experience worth it. Find someone who you could deal with on your worst days in lab (who wouldn't make the situation worse)

These are some of the things I learned from my path since I switched mentors early in my second year of my PhD.

The bold was said to me constantly as a first year ("Pick the PI, not the project" was the axiom my school used). I like to say to incoming/younger students: your project can change very drastically in the 3-5 years your PhD takes. Your 50-60 year old PI, will not change much, if at all in that time.

 

[Maebea]

"Pick the PI, not the project" - my student joke about me getting that tattooed on my forehead.

 

[MSTP18]

"Pick the PI, not the project" - my student joke about me getting that tattooed on my forehead.

It truly is one of the most valuable pieces of advice for future/young MD/PhD students. Along those lines I tell applicants that if you were to rate each faculty member's research interests in your department(s) of choice at each school from 1-10 and one school has a ton of 7s but nobody higher than that and another school has a 10 and the rest are duds, always choose the school with the 7s because the 10 might not have space/funding for you, might turn out to be someone you hate, etc and then you have screwed yourself whereas if you have a bunch of 7s to choose from you'll be ok pretty much regardless of what happens.

 

[Maebea]

It truly is one of the most valuable pieces of advice for future/young MD/PhD students. Along those lines I tell applicants that if you were to rate each faculty member's research interests in your department(s) of choice at each school from 1-10 and one school has a ton of 7s but nobody higher than that and another school has a 10 and the rest are duds, always choose the school with the 7s because the 10 might not have space/funding for you, might turn out to be someone you hate, etc and then you have screwed yourself whereas if you have a bunch of 7s to choose from you'll be ok pretty much regardless of what happens.

It sounds like you have the makings of a fine MD-PhD director one day.

 

[SurfingDoctor]

I think this pie chart is missing (or is at least excluding) what is the age, funding status and stage of the investigator, being asked the question.

There is a clear trend toward funding senior investigators, which most junior investigators are painfully aware of. I have no specific qualms with that approach, but if one rode the late 90s wave and stuck with it long enough into the current era, maybe was less successful at grant overall, but got an endowed position in academia (or better yet, got the golden parachute into industry), the answer was probably a resounding "yes".

If one however started at the point of sequestration or a down turn of funding and never got to see the golden age of funding, especially in their early career, and likewise struggles for that first R01 or a renewal despite senior investigators having 2+, then the answer would probably be "no". There is unfortunately a lot of politics that play into success independent of science and one's ability to climb up that political ladder likes colors ones opinion quite heavily as to whether it was "worth it".

As mentioned above, the beauty of having an MD is there is no glut of revenue from that source. Of course, it may not be as intellectually fulfilling... but well, there it is.

 

[maxknux]

Thanks for posting these experiences as I am considering this route but I see that it might eat into my planning for retirement later in life.

 

[tr]

I am in that survey and I answered 'definitely yes' because of course I would do MSTP again. It was an amazing learning opportunity and gave me an education that continues to inform both my clinical work and such research as I am now able to fit in. If I had the opportunity for a do-over, I would have changed the lab I chose for my PhD work.