Life as an MD/PHD vs. MD

[RocuROMANium]

How much busier are people who pursue MD/PHD in medical school, residency, and life as an attending? Obviously I know their educational pathway is much longer but in general are their days busier than people who only pursue an MD?

---

Members don't see this ad.

 

[Blueprint Med School]

For the most part, your MD years will be as busy as any other medical student's and your PhD years will be as busy as any other PhD's. Typically, you'll apply to PSTP residencies which have a research component, but from what I've seen, you're not busier than any other resident, you just spend your time differently. As an attending, how much time you spend using the MD or the PhD (or, how much time you spend doing research vs. seeing patients) depends on the job and your personal interests.

 

[Lucca]

Varies based on practice/research split and setting, specialty. That said, outside of 100% research in industry, no physician scientist job is going to have as much free time / lifestyle perks as, say, a PP dermatologist. A TT PI doing 80%+ research is on average very busy but can have a lot of control over their lifestyle day-to-day and week-to-week compared to a practicing full-time clinician. a 50/50 Neurosurgeon-PI will effectively not exist outside of work. I'm kidding about that last one, but not really (our previous chair of neurosurgery runs a lab and famously only had 1 half-day off where he was not operating, mentoring, writing, or chair-ing which he reserved for his wife on friday afternoons; he has stepped down as chair and now has two afternoons off for his wife).

 

[RocuROMANium]

Have either of you ever heard of someone pursuing a PhD after earning their MD? I know that sounds incredibly inefficient and a huge lost of income potentially but does it happen?

 

[KnightDoc]

Have either of you ever heard of someone pursuing a PhD after earning their MD? I know that sounds incredibly inefficient and a huge lost of income potentially but does it happen?

I'd bet most people can't afford to indulge in it. The rationale behind free tuition for the MD/PhD is the reduced earnings. If you have to pay for med school, most people simply couldn't afford to take the loss of income, unless they come from wealthy families and don't have to worry about paying back loans.

There are loan forgiveness programs to encourage people to work in under served areas. I'm not sure they exist for those going into research. If they did, why wouldn't med schools steer MD/PhD candidates into them rather than underwriting their tuition?

 

[zorcandpals]

Have either of you ever heard of someone pursuing a PhD after earning their MD? I know that sounds incredibly inefficient and a huge lost of income potentially but does it happen?

It's common enough. The people who do that definitely know its a financial hit but sometimes you develop career goals where you need the PhD. Usually they try to get loan repayment programs. There are a few that are for people doing research.

 

[Banco]

Have either of you ever heard of someone pursuing a PhD after earning their MD? I know that sounds incredibly inefficient and a huge lost of income potentially but does it happen?

I've heard of this in academic surgery residencies, where they use their dedicated research time (usually 3 years) and pursue a PhD. However it usually occurs after one has matched and is heavily program dependent. Would not recommend that you graduate from medical school and then do a PhD and then apply for residency.

 

[LizzyM]

It may be far more common for a physician interested in research to pursue a fellowship after residency during which one builds the skills that others build during their PhD work. It is still possible to have a lab, get funded, be published in Science or Nature, etc with only the MD.

 

[Orims]

From my experience in the research world, mostly basic science research, it seems that everything an MD/PhD can do can also be done by an MD. A couple of our most well known researchers at our school are MDs who decided to pursue research and only do that now. One of my defense committee members is an MD/PhD that is a full time researcher.

 

[RocuROMANium]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

 

[Doctor-S]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

Can be done ... especially after MD establishes a strong relationship with an AMC (e.g., secures a clinical faculty and teaching appointment and establishes a solid and credible track record as an MD with the AMC). Academic Medical Centers can provide opportunities for physicians and physician-scientists to work together, at least mine does, and we have adjunct clinical faculty involved in different research projects, related to all medical specialties.

 

[Orims]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

MDs can even do postdocs , something that is traditionally done by PhDs following their student years in order to strengthen and diversify their publication and research record. Also, as it has been pointed out here, many residency programs have protected research time and I have interacted with lots of residents who decide to do basic science during those research months or years, quite a few end up hunting for research tenure track positions.

 

[LizzyM]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

Someone in just about any specialty could get into bench research related to epigenetic and pharmacogenetics of disorders and their treatments in a specific speciality. Pharmacology and in vitro effects of compounds on moledules and cells is another possibility as well as half-life and drug-drug interactions. Studies of muscle cells (cardiomyocytes), nerve cells and receptors could all be reasonable for a cardiologist who was drawn to bench work.

 

[Banco]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

I've seen it done by a few but they all did at least a post-doctoral fellowship during residency.

 

[Lucca]

So how often do MD only physicians do basic science research and how the heck do they go about having their own lab? It would seem to me that certain specialties would be more conducive to basic science research than others like cardiology vs. psychiatry correct?

Re: specialties being more conducive you are correct. Check out this article. It’s about MD/PhDs but I bet the same can essentially be said about MDs. Any specialty will support basic science at the right institution if you can raise funds and bring in $$$ for the department. Getting that $$$ is not trivial.

JCI Insight - The national MD-PhD program outcomes study: Relationships between medical specialty, training duration, research effort, and career paths

insight.jci.org

Critically, the average age to first R01 is effectively the same for whatever degree path you choose. There’s no escaping training and the academic grind But each path has its pros / cons, costs and benefits.

There are also some residencies that will sponsor you to get a PhD during residency. For example:

Overview

med.stanford.edu

50% of physician scientists are MD only but only 1-5% of MDs do research, compared to a majority of MD/PhDs, unsurprisingly there is a lot of self selection in the pipeline and a lot of incentives to not do research if you are an MD but options exist and are generally more abundant post residency than MSTP slots are at app cycle.

 

[RocuROMANium]

Re: specialties being more conducive you are correct. Check out this article. It’s about MD/PhDs but I bet the same can essentially be said about MDs. Any specialty will support basic science at the right institution if you can raise funds and bring in $$$ for the department. Getting that $$$ is not trivial.

JCI Insight - The national MD-PhD program outcomes study: Relationships between medical specialty, training duration, research effort, and career paths

insight.jci.org

Critically, the average age to first R01 is effectively the same for whatever degree path you choose. There’s no escaping training and the academic grind But each path has its pros / cons, costs and benefits.

There are also some residencies that will sponsor you to get a PhD during residency. For example:

Overview

med.stanford.edu

50% of physician scientists are MD only but only 1-5% of MDs do research, compared to a majority of MD/PhDs, unsurprisingly there is a lot of self selection in the pipeline and a lot of incentives to not do research if you are an MD but options exist and are generally more abundant post residency than MSTP slots are at app cycle.

Thanks for those links. So if you are MD only and want to pursue cardiology, for example, you would go through medical school, residency and then try to get into an integrated fellowship program where you do specialty training and research like the ARTS program at Stanford, correct? What if you dont match into an integrated fellowship? Would you just complete your fellowship specialty training and then do another fellowship but for research?