MD only or MD/PhD

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tlaloc87

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Hey guys,

So when I signed up for the MCAT I checked the box that allowed AAMC to release my scores to the recruiting service, and, thus far, I have received a few emails from schools--no "heavy hitters" really, none previously on my radar. But today I got one about an MSTP program and it really got me thinking about the whole MD/PhD thing.

First off, I just need to say that I did NOT participate in undergraduate research in a "hard" science. Honestly, I haven't done nearly enough research thus far to justify even applying (i.e. wasting an admission committee's time) for an MD/PhD, but I've been starting parts of my PS for the AMCAS application and I stress the importance of research, particularly biostatistics, in my past experience and future goals. I have been considering a combined MD/MPH program for about 2 years now, but I never really thought much about a PhD in biostats. So I guess I just really want to know if it's completely insane to, even for a second, consider taking another year off (I'm already one year out of university) to do more research--the type of research I enjoy and would want to continue in the future--and apply to MD/PhD or MSTP programs.

Thanks in advance for the advice!
Ciao,
Tlaloc :)

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Most of the advice that you'll get on this forum, and probably other places as well, is that you really shouldn't apply for MD/PhD if you aren't positive that you love research and your career wouldn't be complete if it did not include a substantial amount of research. Minimally, to get into an MSTP or MD/PhD, you are going to have to be very prepared to answer why you are applying to that type of program, and have very clear goals for yourself and your future. My guess is this would apply for MD/PhD's in epi as well. If research, epi or public health or any kind, is interesting to you, and you just might like to include it, then I wouldn't suggest an md/phd. There are definitely still ways to get involved with research with an MD, or even and MD/MPH.

good luck!
 
I guess I already had my answer, but that really just solidifies it for me. In the end, the deciding factor is that having only an MD (or MD/MPH, as it may be) does not preclude me from epi research. Plus, as much as I love free tuition and stipends, I'd much rather get to practice a few years sooner. That's priceless. :)

Thanks!
 
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Im a current applicant who is planning to matriculate into an MD/PhD program and I had a similar dilemma. My research experience ranges from basic science to population genetics and I was debating if I should do an MD/PhD with research in an epi dept or do an MD only or MD/MPH. This is what I conclude based on my experience:

If you want to commit 70% or more of your long term career to research (of any sort, be it basic science or epi) then you should consider MD/PhD. There is a growing number of MD/PhDs going the epi/bio stat route for their research...But, if youre committed to a career that is 50% or more clinical care and public health you may not want to spend that much time in research only to lose years of earning potential.

You may also want to consider the 5yr programs at Pitt, Cleveland Clinic, and I think Columbia has one, might be a few others - You get tuition paid plus a research year where you can get an MS or MPH. This will prepare you well for clinically oriented careers in academia or public health and offers a bit of the financial compensation that is usually MD/PhDs.

It seems like youve got plenty of time to decide and those numbers will put you ahead of the curve regardless of which route you take. Good luck!
 
Apply to med schools with MSTPs that would allow to do a PhD in epidemiology/biostats/etc. Hopefully get into and go to one of such schools. Do some more research during M1 year and between M1/M2 during the summer. If you then feel like it is something you really want to pursue, then try applying to join the MSTP as an M2 or grad student. If not, do the MPH instead. You've got good numbers, use that to go some where that keeps your options open.
 
The only thing is that to apply for MSTPs with epi/biostats PhD I would need another year of research under my belt since I would be considered in the general pool of all MD/PhD applicants and my research experience would pale in comparison. I personally don't have a problem with that, but I think my parents would really start to wonder whether I've figured this all out.
 
Though the OP may have already made their decision, there are many ways to get research experience as a MD. Some, like the 5-year MD/MS or research MD programs, have already been mentioned. There are also the NIH (CRTP and HHMI) programs, as well as Sarnoff, Fogarty, CDC, Doris Duke, and others. The OP can take a look at the Research forum FAQ for more info (link in my sig).

There are also research residencies. These combine residency + protected research time +/- fellowship training. The most common programs are supported by Amer board of IM and Peds. These can also lead to a PhD if you don't have one already. Path may also support one, but I'm not informed on the options there.

Many institutions allow for residents to take protected time off during their training to do research. Look for places supported by NIH CTSAs. Some institutions with a strong history of research also have their own in-house research training programs.

There are many ways to get research training or a full PhD as a MD, and you don't have to commit to one training path or another.

EDIT: The CDC has a great program for people interested in epi.
 
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MD/MPH and research residency. No doubt.
 
The only thing is that to apply for MSTPs with epi/biostats PhD I would need another year of research under my belt since I would be considered in the general pool of all MD/PhD applicants and my research experience would pale in comparison. I personally don't have a problem with that, but I think my parents would really start to wonder whether I've figured this all out.
Damn man we are almost in the exact same boat. I too have been getting those e-mails and am considering the MD/PhD. I've toyed with the idea before, but now I'm starting to realize this is something I would really like to do. Mainly because the only way medical advances (and even general knowledge) can progress is through research...

My problem is I don't have much research.

To anyone: Can I get in with this??

I mean, why would schools send recruitment e-mails based solely on an MCAT score if that's not even sufficient...
 
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My problem is I have only 1 summer of chemistry research.

To anyone: Can I get in with this??

Unlikely. You need several summers at a minimum. One of these "you should apply" notes does in no way guarantee you even an interview, let alone an acceptance.

I mean, why would schools send recruitment e-mails based solely on an MCAT score if that's not even sufficient...

$$$
 
Damn man we are almost in the exact same boat. I too have been getting those e-mails (3.8 gpa/39 mcat) and am considering the MD/PhD. I've toyed with the idea before, but now I'm starting to realize this is something I would really like to do. Mainly because the only way medical advances (and even general knowledge) can progress is through research...

My problem is I have only 1 summer of chemistry research.

To anyone: Can I get in with this??

I mean, why would schools send recruitment e-mails based solely on an MCAT score if that's not even sufficient...

Nice numbers! But no, one summer definitely not enough. Two summers would still be considered few. Research potential ultimately >> gpa and MCAT.

As to why schools would do this, it makes them look more selective if they accept the same number from a larger total # of applicants.
 
:laugh:

I really hate to say it, but there's a lot of "reflexive" communication in med school and residency. I got onto a FM mailing list at the beginning of MS3 (long story), and suddenly I was inundated with residency ads looking for MS4's to apply to their FP residency. The first one was nice, but by the 10th pamphlet, I realized they just had a name and an address.
 
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Ah, well, thanks for the responses. MD it is, then.
 
So great minds get blocked from obtaining an MD/PhD simply because they don't have enough research experience? Even though through an MD/PhD program they would obviously be acquiring plenty of experience?

Awesome system.
 
So great minds get blocked from obtaining an MD/PhD simply because they don't have enough research experience? Even though through an MD/PhD program they would obviously be acquiring plenty of experience?

Awesome system.

MD/PhD programs are designed to produce academic faculty who do mostly research. Yet, the research component of the MD/PhD program is frequently dropped. About half of all MD/PhDs don't go on to a majority research career. Thus, applicants need to have extensive research experience before starting the program so that they are certain a research career is right for them.
 
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So great minds get blocked from obtaining an MD/PhD simply because they don't have enough research experience? Even though through an MD/PhD program they would obviously be acquiring plenty of experience?

Awesome system.

Are you serious? "Great minds"?

First off, you're blocked from all sorts of opportunities because you don't have enough experience to go into them. You may be brilliant, but you certainly are blocked from law school if you don't take the LSAT. You're pretty much blocked from medical school if you didn't take organic chemistry. There are all sorts of requirements like this, some of which make more or less sense than the others.

In this regard, MD/PhD programs requiring a substantial research effort prior to entry actually makes sense, because they need to find people who have proven that they are interested enough in research to apply. If you haven't done 1+ years of research, you may not know what you're getting into. MD/PhD programs need people who understand what a research career means and who are willing to devote their training to that. They don't want people who quit in the middle of their PhD, and they'd prefer people who are still interested in research careers after finishing.

They are also interested in avoiding people who apply just because they like the thought of getting medical school for free. These people usually quit in the middle as well.

As for "great minds", a high MCAT and pretty good undergrad GPA doesn't mean you're a great mind. It means you're pretty intelligent, disciplined enough to get good grades, and studied for your MCAT well. These are all good things to have, and congratulations on your success so far. I hate to break it to you, but there are enough people with these credentials to fill every MD/PhD spot 5 times over.

Whatever defines a "great mind", that's not what MD/PhD programs are looking for anyway. They are looking for relatively bright, disciplined people who have a proven interest in careers in medical research. They are also willing to give up a lot of extra time to learn the skills. If a person is really interested in MD/PhD programs, this includes potentially spending some extra time after undergrad getting some extra research experience.

If this defines you, then apply this year or take some extra time and get more experience before applying. If you're not willing to take the extra time now, I guarantee you're not willing to spend the extra 4-5 years in medical school anyway.
 
MD/PhD programs are designed to produce academic faculty who do mostly research. Yet, the research component of the MD/PhD program is frequently dropped. Most MD/PhDs don't go on to a majority research career. Thus, applicants need to have extensive research experience before starting the program so that they are certain a research career is right for them.

Yes exactly.
 

Thanks for the response, but I found it interesting how defensive you got over the "great mind" comment, and how quickly you attempted to downplay a 38 MCAT/3.77 gpa as "pretty intelligent" and "disciplined."
 
...In this regard, MD/PhD programs requiring a substantial research effort prior to entry actually makes sense, because they need to find people who have proven that they are interested enough in research to apply. If you haven't done 1+ years of research, you may not know what you're getting into. MD/PhD programs need people who understand what a research career means and who are willing to devote their training to that. They don't want people who quit in the middle of their PhD, and they'd prefer people who are still interested in research careers after finishing...
This is one of the reasons why I don't believe MD/PhD are the answer to the physician-scientist problem. It's a big commitment right off the bat, and most applicants don't know what they're getting into with the MD, let alone the PhD. /rant

Thanks for the response, but I found it interesting how defensive you got over the "great mind" comment, and how quickly you attempted to downplay a 38 MCAT/3.77 gpa as "pretty intelligent" and "disciplined."
You haven't been denied anything. You haven't even applied. A 38/3.7 is a nice scholastic achievement, but if you get in, nobody will care what your stats were. There will always be a next step, another thing you have to prove.

Lastly, folks, don't feed the troll wandering in from WAMC.
 
Well alot of schools have fall-through app systems, where if you are rejected MSTP, you effectively auto-apply MD.

I do not know if you are looked worse upon, but it may be worth your while if you are interested in research, can show that you have made good use of whatever time you have had, etc.

I would say that if you are not 100% sure research is for you, do not go MSTP though.
 
Is this true? I thought that 70% of the MD/PhD grads will end up with >50% research.

Data from http://pdfs.journals.lww.com/academ...D_PhD_Programs_Meeting_Their_Goals__An.35.pdf

67% of grads were in academics, 4% in research institutes, and 8% in industry (80% total somehow). Of the remaining 20%, 16% were in private practice.

Let's assume (big assumption) that the 12% in institutes or industry are doing majority research careers. We'll assume the 20% are not doing any research, or at least not majority research.

Of the 67% in academics, 64% were doing 50% research or more. So then we have:

43% + 12% = 55% doing 50% or more research.

So it's right around half, again assuming that all research institute and industry positions are mostly research positions. Also this assumes that the collected sample data accurately reflects all program graduates. So yeah, you got me, saying *most* graduates is incorrect.
 
43% + 12% = 55% doing 50% or more research.

Unfortunately, I think the particular set of data from this paper are not that powerful since they lack a control.

The results come from surveys conducted by 24 schools. I'm not sure if there is a standard phrasing that these schools use, but even if they do, a question like "What percentage of your time do you devote to research?" is ambiguous.

For example, most academics devote time to teaching, administration, random BS that they complain about non-stop, etc. So how are they answering this question? Are they automatically assuming you're getting at how much time do you spend in the clinic vs how much time do you spend in the lab, and thus answering 80:20 (if they are a "ideal" MD-PhD)? Or are they treating their teaching and other academic duties separately and knocking that number down to 50 or 60?

If so I wonder what percentage of time PhD researchers devote to research. The paper says "many of us advise our students and prospective students that they will need to spend 75% to 80% of their time on research-related activities," but how many pure researchers would say that they spend 75% or 80% of their time on research in response to a survey question, particularly considering how fashionable it is in academia to gripe about administrative or teaching duties pulling you away from lab.

That's why it'd be nice to compare these survey responses to PhD or MD control groups, or at the very least, be very careful and consistent with your wording and explicit about what you mean by research time. Maybe they were, but my understanding is that all of these surveys were conducted ad hoc by the different schools.

Lots of the other figures in the paper are really interesting though. And its great that they're finally publishing data like this that we know they've had all along.
 
Unfortunately, I think the particular set of data from this paper are not that powerful since they lack a control...
It's a survey. It's descriptive and doesn't require a control.

Using MDs and PhDs as controls would be a waste of time - there is a greater breadth of types of PhD (research in engineering is not the same as medicine) and many use their degree in other ways (education, journalism, writing, industry, etc.) which would invalidate a comparison. Similarly, MDs would not be informative because the vast majority go into clinical private practice. There are very few MD schools with the stated goal of training physician-scientists like MD/PhD programs.

...The results come from surveys conducted by 24 schools. I'm not sure if there is a standard phrasing that these schools use, but even if they do, a question like "What percentage of your time do you devote to research?" is ambiguous...
No it is not. Every grant or fellowship I've seen has stated requirements for "protected time" or "time devoted to research." Junior faculty, the target of this survey, are particularly cognizant of how much research time they have, as they are constantly under pressure to be in the clinic.

...Maybe they were, but my understanding is that all of these surveys were conducted ad hoc by the different schools...
Good point. The data could also be inflated. Particularly since this was written by MD/PhD PDs to justify MD/PhD programs:

The data that were provided allow us to address issues raised in recent editorials calling for an evaluation of MD-PhD training programs...
 
Seriously. I was relatively well prepared for it, and I had no idea what I was getting into.



Indeed.

Wasn't trying to troll/be a dick, I just honestly don't think high stats should be discounted so readily. But if they don't count for as much as I wish they did, then that's just the way it is. I appreciate the reality check.
 
Wasn't trying to troll/be a dick, I just honestly don't think high stats should be discounted so readily. But if they don't count for as much as I wish they did, then that's just the way it is. I appreciate the reality check.

It's cool man. We were just trying not to get the thread too far off track.

38 and 3.7 give a person plenty of opportunities for a lot of good career paths. However, you shouldn't choose a career path because your scores make it available to you. Choose your career for what you are interested in.
 
Wasn't trying to troll/be a dick, I just honestly don't think high stats should be discounted so readily. But if they don't count for as much as I wish they did, then that's just the way it is.

High stats aren't discounted here. They are required. But, for MD/PhD three things are required:

1) GPA
2) MCAT
3) Research experience

A sub-par in any one of these can sink your application.
 
Ah, well, thanks for the responses. MD it is, then.

Or you could take one or two years off.

If the delay is not palatable and you're not necessarily interested in basic science research, also consider 5-year programs, like the ones at Stanford, Harvard (HST + 1 year), and the Cleveland Clinic.
 
It's a survey. It's descriptive and doesn't require a control.

Using MDs and PhDs as controls would be a waste of time - there is a greater breadth of types of PhD

Yes, its descriptive, but thats not really how its being used. The paper is relatively careful about not overstating their findings, but even in that paper and definitely on this message board their is an implicit argument that these numbers mean that MD-PhDs don't spend very much time on research. There is an implicit comparison being made to a full-time researcher.

But before you say that 50% research time is low or high, I think its fair to ask what kind of "protected research time" a regular PhD gets. Its definitely not 100%. And considering how much people in academia love to b***** about "how little time [they] get for research," I think you'd find the numbers for a survey response to be surprisingly low.

I agree with you that using a broad pools of PhDs or MDs might be a waste of time. It would be difficult to find an appropriate comparison group. But that doesn't mean the original data are helpful.

On the other hand, you could just say huh, thats interesting, MD-PhDs claim they spend 50% of their week doing research, but I'm not going to make any inferences about whether thats more or less than the average researcher, and not draw any conclusions about what this means for the success of MD-PhDs programs in training physician scientists. That also seems fair.
 
Or you could take one or two years off.

If the delay is not palatable and you're not necessarily interested in basic science research, also consider 5-year programs, like the ones at Stanford, Harvard (HST + 1 year), and the Cleveland Clinic.

What other schools have 5-year programs?
 
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