Is MD/PhD right for me?

[MonkeyArrow]

I've been mulling more and more recently what my path looks like, and I wanted to write it all out here and hope to get some external feedback. I will be applying (for something) in the cycle starting this summer.

My background: currently in year one of a research post-bac. Four years of undergraduate at a big state school, B.S., four years of undergrad research in the same lab, four years of clinical employment at the same facility during undergrad. One middle-author pub from undergrad at the moment, a co-first author manuscript from my undergrad lab has just been submitted, and a manuscript from my current lab is being written.

Ever since I started research as a freshman, I became set on the physician-scientist training. However, I have also always never wavered in that I prefer clinical medicine over the lab. Put a gun to my head and make me choose clinical work or the lab, clinical wins 100% of the time. Of course, the issue is that's a false dichotomy, and you can at least pursue both. I know that I wouldn't be happy with the unicorn 80/20 research split. I'd want more clinical time than that; 50/50 or 60/40 clinical is ideal in my mind. However, I also know that a split like that means that I can't run a lab effectively. I won't have enough time to dedicate in lab, I won't have enough time to effectively mentor grad students/junior scientists, I won't have enough time to read all the literature I would want to, and I won't have enough time for the grant writing/administrative rigmarole. I know I'll likely never be a PI on a grant, but being a co-investigator or working out some sort of split lab setup would be ideal. Those are exceedingly rare-- no one wants to have a PhD trained scientist encroach in their space and eat up their resources while having scientific independence.

Why do I want to do a PhD? I greatly appreciate the training a PhD gives you. It teaches and builds a way of thinking and a thought process that is unique. You become an expert in a field. You grow substantially as a critical consumer of scientific literature. I think you learn a method of approaching and investigating a problem that is useful and transferrable to other facets of life. In many ways, I want for a PhD for personal reasons, I guess you could call it. I want to grow intellectually in this way and be rigorously challenged in ways that clinical medicine doesn't really do.

I think this may be coming across as me not liking research. I like research. I like the lab, I enjoy spending my day there (mostly), and I enjoy the academia of it all. I probably go to more lectures/seminars/talks than most of my colleagues, because I like that environment of being exposed to research questions outside of my own, seeing how other groups approach problems, seeing what techniques are transferrable to my own work, and hearing the questions that are raised at the end.

I think what has changed over the past few months has been my lab (obviously). I went in undergrad from a very translational lab working in a rodent animal model to my post-bac lab being very basic science. In some ways, this was what I wanted and what I was looking for. I wanted to be challenged in a basic science, elucidating mechanisms type of wet lab, and at least gain that very different experience. I like my lab currently, my mentorship and PI is absolutely phenomenal, and I have the relative freedom and independence to pursue the projects I want to. I just constantly get that itch of wanting to do something more clinical, wanting to be in the hospital. I am not as excited about the topic of my work now as I was about my undergrad work, for example. My current work is interesting and nuanced and complex and I enjoy grappling with it, but I still feel like something is lacking. I sometimes sit in lab and wish I was currently at the hospital. I think I liked the topic of my undergrad work more than my current work, but it is tough to say. I was in lab part-time as an undergrad, while also taking classes and while also working clinically on the weekends. That mix was really, really good to me, but I cannot say that if I was doing a full time post-bac in that lab, I would be any happier right now.

Just to throw a further wrench into things. My research has broadly been neuroscience to date. There is one disease process that is my true research passion, and I know I would be happy spending 4 years researching. I spend more time daydreaming about those projects than I do my own lab's; when I get bored, I read lit from that field. The problem is: it's a fairly niche field that has singular PIs scattered across the country. If I do apply MD/PhD, there is no guarantee that I end up in one of these handful of labs (whereas I am much more confident I can find a neuroscience lab that I am interested in pretty much anywhere in the country).

If you've made it through this meandering wall of text, thank you! I suppose my questions ultimately are:

• Is it worth it to pursue the PhD part of MD/PhD if your goal isn't to be a 80/20 PI?
• How can you stay engaged in meaningful research as a MD/PhD in academia without your own lab?
• How much of what I am feeling is me not liking the "science" (content of my current work) versus me not liking research? Will I be miserable for 4 years during my PhD work? Is this just one of the "lows" that comes with research or does this sound more sinister?
  • I say this because someone on the forums (Lucca, maybe?) says "Pick the PI, not the science". My current PI is incredible (both actually have been), but that doesn't seem like enough.

ETA: I also can't exclude that this is all just a crappy winter. I leave lab when its dark and come home to an empty apartment where I stay until I do it all over again the next day. My lab is small, and we aren't allowed to have any in-person contact with anyone else due to covid restrictions. There are stretches of days where I haven't interacted with another human in-person the past couple of months.

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[Neuronix]

• Is it worth it to pursue the PhD part of MD/PhD if your goal isn't to be a 80/20 PI?

You should do a PhD with the goal of being a PI. I think 80% research is a good goal but good luck actually getting that. Sounds nice at interviews anyway. So sure you can do 50/50 and have a lab, many of us do it, but the difference is that I wish I could have more protected time for research and I spend a lot of my free time working on research. Do you have that passion?

• How can you stay engaged in meaningful research as a MD/PhD in academia without your own lab?

It depends on what is meaningful to you. If you don't want your own lab I'm not clear why you'd want a PhD. Your reasoning sounds immature to me.

• How much of what I am feeling is me not liking the "science" (content of my current work) versus me not liking research? Will I be miserable for 4 years during my PhD work? Is this just one of the "lows" that comes with research or does this sound more sinister?

Only you can answer that.

PhD training has a lot of lows also. If you don't see a goal to really use that PhD, it's a waste of time and energy for you and everyone training you. There's a good chance you won't even finish the program.

 

[MonkeyArrow]

It depends on what is meaningful to you. If you don't want your own lab I'm not clear why you'd want a PhD.

I wouldn’t say that I don’t want a lab. I’m worried about my ability to effectively run a lab at 50% effort. I guess I don’t want a lab enough to give up more clinical time than that.

 

[dl2dp2]

I wouldn’t say that I don’t want a lab. I’m worried about my ability to effectively run a lab at 50% effort. I guess I don’t want a lab enough to give up more clinical time than that.

Generally speaking, if you can get into any of the 3 pathways by numbers but are unsure of your final career outcome, MD-PhD is a good pathway. Most MD-PhDs will not run labs, but numerically it's more likely to run a lab with an MD-PhD than a pure PhD only or a pure MD only.

PhD-onlys have a very high variance of student quality, even at top programs. If you average across programs, you'll find that the overall student quality is lower vs. average MD-PhD. The average chance of securing independent research support with a PhD-only is between 5-15%. Plus this eliminates your option of practicing medicine at all, so this pathway can be eliminated for you.

MD-onlys have similar student quality vs. MD-PhD, and latter perhaps has slightly lower variance. However, the number of MD-onlys staying in academia and doing research (operationally defined as having their own independent research support at any time during their career) is very very low (~5% or less).

The average chance of securing independent research support for MD-PhD is roughly 15-25%.

Based on this, I would argue that if you REALLY want to run a lab, the best program is MD-PhD, as PhD-only programs have a lower overall success rate, and definitely a much lower salary to job ratio. Obviously, these outcomes are confounded by people who enter into these pathways being different at the outset, but numbers are numbers. Also, keep in mind that large prestigious medical centers generally produce more people who eventually secure independent research support regardless of pathways. Let's say that around 20% of high end program MD PhDs get independent research support 10 years in, and 10% of lower-tier programs get this.

As you can see, your concerns are almost entirely irrelevant at your stage. Even if you get into and graduate from an MD-PhD program, about 80-90% of people never get to a point where they have to ponder whether 50% is enough time to "run a lab". If you choose the other pathways, it's between a 90-95% of drop-out rate.

Financially, some argue that PhD is a loss because if you do an MD only you can graduate 3-4 years early and make it up quickly with an attending salary. This is a controversial point, as I've always maintained that this is NOT the case due to effects relating to compound interest, etc.

Other considerations: PhD is a good time to find a spouse. This is an important point for female physicians. Timing time-intensive MD/residency in your mid-late 20s is suboptimal for female physicians unless you have family wealth. Male physicians have more slack room in this regard, but it's still a consideration.

 

[Lawpy]

MD only can run their own labs too. I’m honestly not sure if a PhD is even worth it unless you’re focused mostly on basic research

 

[SurfingDoctor]

I would also say that as a MD only physician scientist, even if you don’t do a PhD, you will still have to have extended training with some regards to research. R38, F32, T32, intramural NIH experience. Something because you don’t become an MD, finish residency or fellowship and just think you are going to get a lab and secure funding. No way in hell… there’s a lot of hurdles you need to deal with to become a scientist… specifically failure and persistence and it takes time to learn from those that medical school and post-graduate education don’t teach you.

 

[Lawpy]

I would also say that as a MD only physician scientist, even if you don’t do a PhD, you will still have to have extended training with some regards to research. R38, F32, T32, intramural NIH experience. Something because you don’t become an MD, finish residency or fellowship and just think you are going to get a lab and secure funding. No way in hell… there’s a lot of hurdles you need to deal with to become a scientist… specifically failure and persistence and it takes time to learn from those that medical school and post-graduate education don’t teach you.

I agree with this, but i feel like some med schools and residency/fellowship programs have specific research pathways to help alleviate these hurdles.

 

[SurfingDoctor]

I agree with this, but i feel like some med schools and residency/fellowship programs have specific research pathways to help alleviate these hurdles.

You agree with what? Yes, research programs exist at every level of training and require extra time and effort for them to be fruitful and usually (though not always) only utilized by people who want to do research as a career. Those grants I mentioned are exactly those programs.

 

[MonkeyArrow]

As you can see, your concerns are almost entirely irrelevant at your stage. Even if you get into and graduate from an MD-PhD program, about 80-90% of people never get to a point where they have to ponder whether 50% is enough time to "run a lab". If you choose the other pathways, it's between a 90-95% of drop-out rate.

Thank you everybody for the feedback thus far. It has been helpful in clarifying my thinking and what my dilemma is. The quote above actually does a good job of reframing things.

I'm not so concerned about what happens in the distant future (other than knowing I want to retain some clinical component). I am relatively at peace with finishing the MD/PhD and then not running a lab. That is an outcome I am well aware of and does not really worry me. I am a lot more worried about starting a PhD (in an MD/PhD program) and then not finishing it. That to me is a catastrophically bad outcome.

With that in mind, I think what I meant to ask was: how do you differentiate a transient "low" from a more persistent dislike for research? This is my first time in 4.5 years that I've felt this down on research; it just so happens that it is 5-6 months after I started a full-time research job. I don't want to get into a PhD program and then be absolutely miserable for 4+ years. I'm pretty sure that this is just a confluence of the winter season and nothing really progressing in lab right now and being impatient with waiting on things (journal submissions) that are out of my control now, but "pretty sure" is concerning to stake the next few years of my life over. My concern is that I chalk up my current mood to just a normal dip, and then get a year into a PhD and figure out that I actually just hate full-time research.

 

[dl2dp2]

am a lot more worried about starting a PhD (in an MD/PhD program) and then not finishing it. That to me is a catastrophically bad outcome.

Why is this catastrophic? Nobody cares if you drop out in the middle. You get 2 years med school paid and leave with a masters. Win-win-win.

 

[SurfingDoctor]

Thank you everybody for the feedback thus far. It has been helpful in clarifying my thinking and what my dilemma is. The quote above actually does a good job of reframing things.

I'm not so concerned about what happens in the distant future (other than knowing I want to retain some clinical component). I am relatively at peace with finishing the MD/PhD and then not running a lab. That is an outcome I am well aware of and does not really worry me. I am a lot more worried about starting a PhD (in an MD/PhD program) and then not finishing it. That to me is a catastrophically bad outcome.

With that in mind, I think what I meant to ask was: how do you differentiate a transient "low" from a more persistent dislike for research? This is my first time in 4.5 years that I've felt this down on research; it just so happens that it is 5-6 months after I started a full-time research job. I don't want to get into a PhD program and then be absolutely miserable for 4+ years. I'm pretty sure that this is just a confluence of the winter season and nothing really progressing in lab right now and being impatient with waiting on things (journal submissions) that are out of my control now, but "pretty sure" is concerning to stake the next few years of my life over. My concern is that I chalk up my current mood to just a normal dip, and then get a year into a PhD and figure out that I actually just hate full-time research.

Generally speaking you need 3 pieces to make research "fun" in the training stage. Honestly they can all be challenging to get, but when they all click, it’s definitely great doing research. 1) An enthusiastic mentor (which sometimes isn’t the most funded as the NIH would like you believe is the sole qualification of a great mentor) 2) A project that interests you (not just some pet project you mentor wants you to do to generate preliminary data for their next grant… unless you find that project interesting) and 3) Some positive data.

Specifically to the last one, everyone goes through cycles in research (and job satisfaction in general). When that has happened to me, but I get one cool piece of data, small or big or whatever, and realized that I generated that data myself (hypothesis —> experiment —> collection —> analysis) and it actually works, it always feels good. And I have definitely seen that happen.

All that being said, if you are generating even modest results (realizing you are only 5 month in) and not getting excited by that, then I don’t think generating more results that one can’t get interested and excited about is a good use of time.

 

[MonkeyArrow]

Generally speaking you need 3 pieces to make research "fun" in the training stage. Honestly they can all be challenging to get, but when they all click, it’s definitely great doing research. 1) An enthusiastic mentor (which sometimes isn’t the most funded as the NIH would like you believe is the sole qualification of a great mentor) 2) A project that interests you (not just some pet project you mentor wants you to do to generate preliminary data for their next grant… unless you find that project interesting) and 3) Some positive data.

Specifically to the last one, everyone goes through cycles in research (and job satisfaction in general). When that has happened to me, but I get one cool piece of data, small or big or whatever, and realized that I generated that data myself (hypothesis —> experiment —> collection —> analysis) and it actually works, it always feels good. And I have definitely seen that happen.

All that being said, if you are generating even modest results (realizing you are only 5 month in) and not getting excited by that, then I don’t think generating more results that one can’t get interested and excited about is a good use of time.

I'll apply your framework to where I'm at.

1) 10 out of 10, no doubt
2) 5. My project doesn't inherently excite me, but it could be worse.
3) I have been "productive", but not on my projects. I came in and took an unfinished project that was in the lab to completion by working on the final critical part. In many ways, this is a blessing, because it's an easy path to productivity. But also, I didn't really contribute intellectually or scientifically in any unique way; I spent a couple hundred hours processing and annotating already collected data, which yes someone had to do, but takes no unique skill or knowledge. That project recently finished, and I realized that I have gotten nowhere on my own projects. I've spent the past two weeks waiting for things to grow out (because I didn't plan far enough in advance), and pontificating with all the spare time I have. I haven't generated any useful data in 5 months, in part because of competing priorities, part technical issues, and part not pushing aggressively enough.

 

[SurfingDoctor]

I'll apply your framework to where I'm at.

1) 10 out of 10, no doubt
2) 5. My project doesn't inherently excite me, but it could be worse.
3) I have been "productive", but not on my projects. I came in and took an unfinished project that was in the lab to completion by working on the final critical part. In many ways, this is a blessing, because it's an easy path to productivity. But also, I didn't really contribute intellectually or scientifically in any unique way; I spent a couple hundred hours processing and annotating already collected data, which yes someone had to do, but takes no unique skill or knowledge. That project recently finished, and I realized that I have gotten nowhere on my own projects. I've spent the past two weeks waiting for things to grow out (because I didn't plan far enough in advance), and pontificating with all the spare time I have. I haven't generated any useful data in 5 months, in part because of competing priorities, part technical issues, and part not pushing aggressively enough.

Well, not knowing your science, it sounds like you are bored and it’s not intellectually stimulating because of that and therefore, research feels more like a chore than something you enjoy? Is that about right?

Well, you’re only 5 months in and sometimes it takes time for projects to mature. That being said, if you’re mentor is really 10 out of 10, consider yourself lucky. AND if they are really that good and approachable, you should be able to address your concerns with them and they should be able to brainstorm to help you out. That’s what a good mentor does, they actually have investment in your being success in this career, and part of that is finding what you like to study. Like I said though, that’s rare, so consider yourself lucky if that’s who youve found.

 

[AHDCard]

That is an outcome I am well aware of and does not really worry me. I am a lot more worried about starting a PhD (in an MD/PhD program) and then not finishing it. That to me is a catastrophically bad outcome.

Agreed with @dl2dp2, in what way is this a catastrophically bad outcome? It sounds like an amazing outcome to me: You spend 2 years doing research (maybe get a Masters), clarify your career interests, (hopefully) get a co-authored pub to boost your residency app, get two years of med school paid for, and get a rec letter if you maintain a good relationship with your PI. The people I have known that dropped the PhD ended up matching to residency at great programs too.

 

[wondervisions]

If you want to do a PhD, then do it. It won't hold you back in your career. The only potential downside is the 3-5 years of sunk time if you end up hating it. Not everything in life has to be part of a grand utilitarian calculus.

 

[Neuronix]

Agreed with @dl2dp2, in what way is this a catastrophically bad outcome? It sounds like an amazing outcome to me: You spend 2 years doing research (maybe get a Masters), clarify your career interests, (hopefully) get a co-authored pub to boost your residency app, get two years of med school paid for, and get a rec letter if you maintain a good relationship with your PI. The people I have known that dropped the PhD ended up matching to residency at great programs too.

I totally disagree with this attitude. This is glorifying failure. You go in to get a PhD. Yes you can still have a career if you don't finish your PhD program, but calling an MD/PhD dropout an "amazing outcome" is bizzare. If you're going to spend 2 years doing research, why don't you just finish out your PhD? Also, getting that master's is not a guarantee (not all programs/departments will allow this), and why would you maintain a good relationship with your PI if you drop out of their lab?

It's an okay thing to start the program with good intentions and have things not work out. It's a bad thing to not go in fully committed with the mindset that "it's just as good an outcome if I dropout". If that's your attitude, please do PhD or MD and let someone committed to MD/PhD have that spot.

 

[AHDCard]

I totally disagree with this attitude. This is glorifying failure. You go in to get a PhD. Yes you can still have a career if you don't finish your PhD program, but calling an MD/PhD dropout an "amazing outcome" is bizzare. If you're going to spend 2 years doing research, why don't you just finish out your PhD? Also, getting that master's is not a guarantee (not all programs/departments will allow this), and why would you maintain a good relationship with your PI if you drop out of their lab?

It's an okay thing to start the program with good intentions and have things not work out. It's a bad thing to not go in fully committed with the mindset that "it's just as good an outcome if I dropout". If that's your attitude, please do PhD or MD and let someone committed to MD/PhD have that spot.

Fair, "amazing outcome" was not the right choice of words. However, I disagree with OP's mindset that dropping out of the PhD is "catastrophically bad". I agree that you should only go into an MD/PhD program if you have a genuine interest in research and a vision for how the PhD will help you achieve your goals. However, if a student discovers that the PhD doesn't match their goals and interests, or their goals change, then I think they should strongly consider dropping the PhD without feeling like a failure and/or stigmatized. I saw several fellow MD/PhD students realize by end of their 2nd year of grad school that they weren't going use the PhD, yet continue to trudge along. It seemed like a waste of their time, and the NIH's money, through G3, G4, G5, and even beyond.

It's like divorce - yes, it's not what you hoped for when you got married, but if you don't have a future with your spouse, then the correct decision is to do it sooner rather than later. Hopefully the experience taught you something about yourself that you didn't know beforehand, and afterwards, you can still have a career in clinical medicine, which is a great career for many, in its own right.

 

[SurfingDoctor]

Fair, "amazing outcome" was not the right choice of words. However, I disagree with OP's mindset that dropping out of the PhD is "catastrophically bad". I agree that you should only go into an MD/PhD program if you have a genuine interest in research and a vision for how the PhD will help you achieve your goals. However, if a student discovers that the PhD doesn't match their goals and interests, or their goals change, then I think they should strongly consider dropping the PhD without feeling like a failure and/or stigmatized. I saw several fellow MD/PhD students realize by end of their 2nd year of grad school that they weren't going use the PhD, yet continue to trudge along. It seemed like a waste of their time, and the NIH's money, through G3, G4, G5, and even beyond.

It's like divorce - yes, it's not what you hoped for when you got married, but if you don't have a future with your spouse, then the correct decision is to do it sooner rather than later. Hopefully the experience taught you something about yourself that you didn't know beforehand, and afterwards, you can still have a career in clinical medicine, which is a great career for many, in its own right.

Not me… I’m a masochist. I’m seeing this fooker to the bitter end. Kinda like research.

 

[mszzeta]

I've been mulling more and more recently what my path looks like, and I wanted to write it all out here and hope to get some external feedback. I will be applying (for something) in the cycle starting this summer.

My background: currently in year one of a research post-bac. Four years of undergraduate at a big state school, B.S., four years of undergrad research in the same lab, four years of clinical employment at the same facility during undergrad. One middle-author pub from undergrad at the moment, a co-first author manuscript from my undergrad lab has just been submitted, and a manuscript from my current lab is being written.

Ever since I started research as a freshman, I became set on the physician-scientist training. However, I have also always never wavered in that I prefer clinical medicine over the lab. Put a gun to my head and make me choose clinical work or the lab, clinical wins 100% of the time. Of course, the issue is that's a false dichotomy, and you can at least pursue both. I know that I wouldn't be happy with the unicorn 80/20 research split. I'd want more clinical time than that; 50/50 or 60/40 clinical is ideal in my mind. However, I also know that a split like that means that I can't run a lab effectively. I won't have enough time to dedicate in lab, I won't have enough time to effectively mentor grad students/junior scientists, I won't have enough time to read all the literature I would want to, and I won't have enough time for the grant writing/administrative rigmarole. I know I'll likely never be a PI on a grant, but being a co-investigator or working out some sort of split lab setup would be ideal. Those are exceedingly rare-- no one wants to have a PhD trained scientist encroach in their space and eat up their resources while having scientific independence.

Why do I want to do a PhD? I greatly appreciate the training a PhD gives you. It teaches and builds a way of thinking and a thought process that is unique. You become an expert in a field. You grow substantially as a critical consumer of scientific literature. I think you learn a method of approaching and investigating a problem that is useful and transferrable to other facets of life. In many ways, I want for a PhD for personal reasons, I guess you could call it. I want to grow intellectually in this way and be rigorously challenged in ways that clinical medicine doesn't really do.

I think this may be coming across as me not liking research. I like research. I like the lab, I enjoy spending my day there (mostly), and I enjoy the academia of it all. I probably go to more lectures/seminars/talks than most of my colleagues, because I like that environment of being exposed to research questions outside of my own, seeing how other groups approach problems, seeing what techniques are transferrable to my own work, and hearing the questions that are raised at the end.

I think what has changed over the past few months has been my lab (obviously). I went in undergrad from a very translational lab working in a rodent animal model to my post-bac lab being very basic science. In some ways, this was what I wanted and what I was looking for. I wanted to be challenged in a basic science, elucidating mechanisms type of wet lab, and at least gain that very different experience. I like my lab currently, my mentorship and PI is absolutely phenomenal, and I have the relative freedom and independence to pursue the projects I want to. I just constantly get that itch of wanting to do something more clinical, wanting to be in the hospital. I am not as excited about the topic of my work now as I was about my undergrad work, for example. My current work is interesting and nuanced and complex and I enjoy grappling with it, but I still feel like something is lacking. I sometimes sit in lab and wish I was currently at the hospital. I think I liked the topic of my undergrad work more than my current work, but it is tough to say. I was in lab part-time as an undergrad, while also taking classes and while also working clinically on the weekends. That mix was really, really good to me, but I cannot say that if I was doing a full time post-bac in that lab, I would be any happier right now.

Just to throw a further wrench into things. My research has broadly been neuroscience to date. There is one disease process that is my true research passion, and I know I would be happy spending 4 years researching. I spend more time daydreaming about those projects than I do my own lab's; when I get bored, I read lit from that field. The problem is: it's a fairly niche field that has singular PIs scattered across the country. If I do apply MD/PhD, there is no guarantee that I end up in one of these handful of labs (whereas I am much more confident I can find a neuroscience lab that I am interested in pretty much anywhere in the country).

If you've made it through this meandering wall of text, thank you! I suppose my questions ultimately are:

• Is it worth it to pursue the PhD part of MD/PhD if your goal isn't to be a 80/20 PI?
• How can you stay engaged in meaningful research as a MD/PhD in academia without your own lab?
• How much of what I am feeling is me not liking the "science" (content of my current work) versus me not liking research? Will I be miserable for 4 years during my PhD work? Is this just one of the "lows" that comes with research or does this sound more sinister?
  • I say this because someone on the forums (Lucca, maybe?) says "Pick the PI, not the science". My current PI is incredible (both actually have been), but that doesn't seem like enough.

ETA: I also can't exclude that this is all just a crappy winter. I leave lab when its dark and come home to an empty apartment where I stay until I do it all over again the next day. My lab is small, and we aren't allowed to have any in-person contact with anyone else due to covid restrictions. There are stretches of days where I haven't interacted with another human in-person the past couple of months.

"I also know that a split like that means that I can't run a lab effectively. I won't have enough time to dedicate in lab, I won't have enough time to effectively mentor grad students/junior scientists, I won't have enough time to read all the literature I would want to, and I won't have enough time for the grant writing/administrative rigmarole. I know I'll likely never be a PI on a grant, but being a co-investigator or working out some sort of split lab setup would be ideal. Those are exceedingly rare-- no one wants to have a PhD trained scientist encroach in their space and eat up their resources while having scientific independence."

This is actually not main reasons for 80/20. The main reason is that most major grants explicitly require at least 75% research time for recipients.

 

[mszzeta]

I totally disagree with this attitude. This is glorifying failure. You go in to get a PhD. Yes you can still have a career if you don't finish your PhD program, but calling an MD/PhD dropout an "amazing outcome" is bizzare. If you're going to spend 2 years doing research, why don't you just finish out your PhD? Also, getting that master's is not a guarantee (not all programs/departments will allow this), and why would you maintain a good relationship with your PI if you drop out of their lab?

It's an okay thing to start the program with good intentions and have things not work out. It's a bad thing to not go in fully committed with the mindset that "it's just as good an outcome if I dropout". If that's your attitude, please do PhD or MD and let someone committed to MD/PhD have that spot.

It really depends on your career goal. If you do not plan to be a 80/20 physician scientist, this is totally fine. The door to most career opportunities (different specialties, private practice, clinician in an academic center, clinician educator, etc) is completely wide open, because these don't require your PhD skillsets at all.

If you still want to be a 80/20 physician scientist, drop out might be a red flag......

 

[mudfud26]

Why is this catastrophic? Nobody cares if you drop out in the middle. You get 2 years med school paid and leave with a masters. Win-win-win.

The paid part is absolutely not true for MD-PhD programs. At least for internally funded programs, if you quit your PhD, you have to pay the school back, WITHOUT loans, and cannot return to M3 until you have repaid in full. Quitting is absolutely a lose-lose situation: lose your paid tuition and stipend and lose you MD enrollment until you come up with $100k+ cash.

If you love clinic and clinical research, the MD pathway is a great fit. The goal of MD-PhD programs is to produce physician-scientists that go into academia and do a 75-25 or 80-20 split with translational research. You need to be able to troubleshoot and persist for months after many failed experiments and rejected papers and grants. You have to fully commit and not quit halfway through. Physician-scientists are like Spider Man. They always, always get back up.

 

[AHDCard]

The paid part is absolutely not true for MD-PhD programs. At least for internally funded programs, if you quit your PhD, you have to pay the school back, WITHOUT loans, and cannot return to M3 until you have repaid in full. Quitting is absolutely a lose-lose situation: lose your paid tuition and stipend and lose you MD enrollment until you come up with $100k+ cash.

This is definitely NOT true at any MSTP program, or at any of the non-MSTP MD/PhD programs I am familiar with.

 

[reveries]

This is definitely NOT true at any MSTP program, or at any of the non-MSTP MD/PhD programs I am familiar with.

I have heard of a non-MSTP where someone was required to pay the school back after leaving the program, but nothing about being unable to use loans.

 

[mudfud26]

This is definitely NOT true at any MSTP program, or at any of the non-MSTP MD/PhD programs I am familiar with.

It was at one I interviewed with/was WL at. All of my other interviews strongly cautioned against quitting as well.