MD at one place, PhD at another

[research_sk]

Hi folks.

I am curious to get information regarding what the process is if, at the outset, I am interested in applying to an MD program at a particular school, and a PhD program at another school.

A bit more about the situation: I started a PhD program in biochem at Harvard, and decided that I was not happy doing experimental lab work alone. After doing my last rotation with a PI in genetic epidemiology in that program [I was doing the bench work part], I decided I wanted to go along a more statistical/epi route. Unfortunately, my program didn't allow this deviation from bench science, so I left the program [with blessings] and am currently getting my MPH in biostats in a different university close to my home [it's a top 5 institution in biostats].

As I've been working on my biostats degree, I've realised more and more that I want to do clinically oriented research, especially with randomised controlled trials, which has led me closer and closer towards medical school. After having been at Harvard, I also realised that I don't want to do my medical schooling there. I've met too many folks who are depressed and burnt out. However, I would like to go back to work with the same PI at Harvard whom I rotated with for my PhD, this time doing the epi/biostats part of the projects. He's eager to take me back as well.

Ideally, I'd love to do my MD at a west coast school (Stanford/UCSF -- both of which lack an SPH) and do my PhD in Epidemiology at Harvard's SPH.

My questions: How feasible is this process? If/when I apply to these programs, how do I indicate this interest? Also, what will the stipend situation be [i.e. will it be covered in a manner similar to an in-house MD/PhD program]?

I'm coming in as an older student into the program [I'll be entering at 30], and I want to prioritise my happiness--not just my academic happiness, but my emotional happiness as well. This would be a great situation, where I get to research what I want and pursue my medical education where I want. I just don't know how doable this is.

I would also appreciate any general advice on older students in their 30s entering MSTP programs, especially with prior degrees. I have wet-lab experience (3+ years) and publications as well. The duration does scare me, but I know the research topic that I want to work on, as well as the specialties I'd be interested in pursuing. I don't know how useful this is in lowering the duration, but hopefully the focus will be of help.

Thanks so much, and look forward to hearing from everyone 🙂

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[StIGMA]

Your best bet (if you want to finish the PhD) is to complete your PhD prior to entering medical school. You won't be accepted to an MD/PhD program with the intention to finish your PhD at a separate institution. You are basically asking them to just pay for your medical school and give you a salary. You could enter an MD/PhD program without this stated intention, but it is unlikely (but not impossible) that the school will let you "leave" for your PhD. It depends on the program whether they would allow it or not, and most probably wouldn't. Additionally, epidemiology is a very uncommon field for MD/PhD program matriculants, so you are further limiting the programs that would consider you.

You can do both degrees at different programs- but don't expect to do it as part of an integrated MD/PhD program. It is possible that you enter an MD program (applying MD, not MD/PhD) and then take an absence between M2/M3 to finish the PhD. Again, this would be situation/program-specific, and you would have to arrange this for yourself after you are accepted.

 

[ChEMD]

Assuming you could get into Harvard, I'm not understanding why would wouldn't want to do your medical education there. Medical students at any school are going to be stressed, Harvard isn't unique in that regard. You could pick out students at any medical school that are depressed, but that doesn't mean everyone is. If you want to do your PhD work at Harvard, your best bet is to either do the MSTP program at Harvard (maybe your PI has some pull?) or to finish your PhD and then apply to medical school after (in which case you would be paying tuition).

 

[MedStud!]

I'm finishing an MD/PhD program now. Only a director could accurately answer your question. Maybe Fencer could chime in? My gut response is that an MSTP would not let you leave to do a PhD elsewhere. They would basically be funding another institutes research. But I don't know for sure and you should seek advice from a director. I guess you could do your PhD separate if you are dead set on that mentor but then you lose the benefits of the MSTPs.

Don't worry about other med students being depressed and stressed. Med students are depressed and stressed everywhere. Tons were in my class. I entered school at age 27 and had that maturity on my side. Its the main reason I hated going to class because I had to listen to them complain. Med school is hard... just be grateful that you have that opportunity if you get in.

Also, those are two very competitive schools... in applying for medical school be sure you apply much wider than that. There are other MSTPs that allow Biostats/Epi research. Are you really dead set on this mentor? I've seen many a people fail at getting accepted due to pickiness...

The prior research experience will only shorten the duration by giving you the advantage of not making the same mistakes a junior person might make. This is usually required for MSTPs as they don't want you to flounder in the PhD. You will still have the same requirements as the other graduate students.

 

[ratherbefishing]

I don't see why you wouldn't just get your MD and do your research afterwards as part of your clinical practice.

 

[MedStud!]

I don't see why you wouldn't just get your MD and do your research afterwards as part of your clinical practice.

This is absolutely a path forward. You do not need a PhD in Biostats/Epi to write clinical trials. If writing clinical trials is your only end goal... then do you really need to spend 4 years in a PhD? Probably not but if you can get into a combined degree program you get the advantage of tuition reimbursement along with the training. Another option is just to go straight MD and do a residency with a Clinician-Investigator track built into it. You already have the background for it and could get into one of these tracks. Medical school has become significantly more competitive so there is no guarantee on the location you want to go to.

 

[Neuronix]

Ideally, I'd love to do my MD at a west coast school (Stanford/UCSF -- both of which lack an SPH) and do my PhD in Epidemiology at Harvard's SPH.

My questions: How feasible is this process? If/when I apply to these programs, how do I indicate this interest? Also, what will the stipend situation be [i.e. will it be covered in a manner similar to an in-house MD/PhD program]?

Nobody is going to give you money towards the MD portion for this. Many places will let you take a leave of absence between second and third year to go pursue a PhD elsewhere, but it's typically not in your best interest to do so because your loans will continue to capitalize and you will typically begin to owe payments during the PhD when you cannot afford to pay them. Additionally, the training the PhD will give you is neither necessary nor particularly advantageous for writing clinical trials.

I want to prioritise my happiness--not just my academic happiness, but my emotional happiness as well.

Being an attending with the stability and resources that provides brings you emotional happiness. Training is often miserable and out of your control.

I don't know how useful this is in lowering the duration, but hopefully the focus will be of help.

This is not useful or of help. You want to get your training done in an efficient manner. Converting your MPH to a PhD is not going to be efficient. If you want to be a physician, at your age and if you want to start doing large clinical trials, my advice is to get going on that. You don't start right out of the gate writing good clinical trials no matter your training, and you don't want to start at age 45 doing them because you'll have little time to even see them through or build your career.

 

[QofQuimica]

Agree with the others that trying to do an MSTP in the way you're proposing is unlikely to be successful. You're already at a disadvantage for MSTP apps due to your age even if you go the traditional route. [I started medical school at age 31 too, but I had already finished my PhD by that point (did separate degrees).] To come in asking for special treatment for your PhD is unlikely to increase your desirability as a candidate.

You basically have three somewhat realistic options.

1) Do a PhD, then apply to medical school. This will allow you to do your degrees at two separate schools with no issues. However, the PhD-to-MD route has many disadvantages, not the least of which is that your MD will probably not be paid for. I was fortunate enough to be scholarshipped with stipend for my MD like an MD/PhD student, but this is not the norm, and you cannot count on this happening. It will also push back the time when you can become an independent PI or clinician, which, as Neuro pointed out, is a significant factor, especially since you probably don't even need a PhD to do what you want to do. (Alternatively, as some people have pointed out, you can do an MD program and take a LOA after your second year to go back to Harvard for your PhD, which is essentially the same thing as doing two separate degrees.)

2) Apply to MD/PhD combined programs. As I said, you will be at a disadvantage with being in your 30s, but it is possible that you can do this if your stats are very competitive and you apply broadly enough. Both degrees will then be paid for, and you will have the advantage of the support infrastructure of your MD/PhD program. But you will have to do both degrees at your home institution, which will mean that you cannot work with your mentor at Harvard unless you are in the Harvard MSTP.

3) Apply for MD-only and/or a clinical research MD/MS (or do an MD alone and then a clinical research MS during or after residency). This is the fastest and most direct route, and the most likely to result in a successful application and career given your background and age. May or may not be necessary to get the MS given that you will already have the MPH.

Of all these options, I would recommend that you go with #3. No matter what you do, this is a long road that you're starting down, and you're older enough than your peers that this is likely to be an issue if you try the first two options, especially #2. I can also tell you that doing residency in my late 30s has been challenging enough. Doing it in one's 40s would be even worse.

 

[Scottish Chap]

Agree with the others. I would not pursue MD/PhD combined program. With your age (sorry), you're going to easily be in your mid 40s by the time you get your first job. Think ahead. You are not going to be able to have a comfortable retirement on an academic salary after such a few years in the work force. Young people might not think that is relevant right now but, trust me, after being roasted in the medical community for years, you will complete the training a different person and you do not want to have regrets.

You don't need a Ph.D. to be competitive in research, I promise you. I'm a Ph.D. > M.D. who is applying for NIH grants now I'm finally through with clinical training, and applications at that level are all impressive. A Ph.D. adds very little. Your training environment and publication record (as well as the proposal) are more important.

Keep in mind that there are residency programs that will allow you to earn a Ph.D. as part of your residency/fellowship training if that clinical commitment comes with a 2-3 year research block. Yale is one that springs to mind. This is more common than you think. I know only two people who have interrupted the M.D. for a Ph.D. at another institution (one for a Ph.D. in philosophy and the other for a Ph.D. in the history of medicine). Both were ancient by the time they got back to medical school, and they were streets behind their peers who had just completed Step 1 of the USMLE. This is not a situation you want to be in as your third year performance and, more importantly, the perception of your third-year instructors determines your grades and ultimately what kind of residency you get.

Hope that helps. Stay away from starting a Ph.D. at another school unless you want to close the door on clinical medicine and become an academic investigator full-time (also a reasonable plan).