MD or MD/PhD...help?

[Breazy]

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Hey all,

Without going into too much detail, I'll say that I've been accepted to MD and currently have the option to apply within the school for the MD/PhD with a supposedly almost-guarantee of getting it. Like the title says, should I go for the MD/PhD or just the MD?

I know everyone says "research = MD/PhD" but ultimately, I have no idea what I'll want 20 years from now - I need a crystal ball. I like the research I'm doing now (this is my 3rd summer in the same lab) and I could definitely see myself working in a lab for 3-4 years. What's nice is this would be protected research and I'd basically be getting a PhD out of it without worrying about getting funded and such. Also, the idea that you become an expert in a specific field that no one else is doing is truly awesome. From what I hear, mud phuds are like the "doctor's doctor" and essentially are authoritative in knowing the basic science behind the clinical aspects. This appeals to me the most.

However, I dont really see myself going into research as a career 100%, worrying about grants or if I'll be a good enough researcher to support myself, especially with the climate of funding these days. Rather, I could definitely see myself doing both the clinic work and the research, although probably most clinic (maybe like 60 clinic, 40 research? - I just have no idea right now). Even if I don't want to necessarily continue all the way (residency and beyond) with the basic science research (which I'm not saying at all is my intention), isn't it true that my background would still make me a better clinician? I feel like 20 years from now I might be looking back and thinking that I should have gone for the PhD and if there was anytime to do it, THIS would have been the time.

The MD that owns our lab (but doesn't do any research) has told my P.I. that he is often bored of just seeing the same kinds of patients day in and day out, but gets really excited when the rare "zebra" comes in. Would an MD/PhD help to break up this monotony and allow me to pursue multiple aspects of medicine more easily? Do MD/PhDs often get to see more of these "zebras" or at least get consulted more often on "zebras"?

I guess what I'm basically asking is, is it worth it for me to do an MD/PhD? (They also do land great residencies - the one I'm interested in and I've been doing research in is notoriously tough to match into.) In my case, since there are also just more ways to mix and match clinic and research, is it a good idea for me?

Sorry for the long post, and thanks in advance for the help!

 

[mdphd2010]

What's nice is this would be protected research and I'd basically be getting a PhD out of it without worrying about getting funded and such.

Is this at your home institution, and you would do your PhD in the same lab? If you would get your PhD in 1 year, it's totally worth it.

Also, the idea that you become an expert in a specific field that no one else is doing is truly awesome. From what I hear, mud phuds are like the "doctor's doctor" and essentially are authoritative in knowing the basic science behind the clinical aspects.

Uhh, I'm not so sure about that. IF what you worked on is clinically related, you might know more about *your particular problem* than most clinicians, but clinicians cover lots of different areas have experience in actually managing these diseases.

Would an MD/PhD help to break up this monotony and allow me to pursue multiple aspects of medicine more easily? Do MD/PhDs often get to see more of these "zebras" or at least get consulted more often on "zebras"?

I don't really think so, but it would help to know the particular area of research. Basic research tends to take years to make it into clinical practice, and a PhD doesn't always give you advantages over MDs in clinical research. I think of a PhD more as a way of thinking and doing experiments in a particular field, rather than clinical expertise in that field.

I guess what I'm basically asking is, is it worth it for me to do an MD/PhD? (They also do land great residencies - the one I'm interested in and I've been doing research in is notoriously tough to match into.) In my case, since there are also just more ways to mix and match clinic and research, is it a good idea for me?

First, indecisiveness is not a good reason to do an MD/PhD. More importantly, what do you want out of a PhD? What do you hope to gain that you cannot get from being an MD that does clinical research? Do you think you will be a better clinician than MDs who do it full time? Do you think you will be a better researcher than PhDs who do it full time?

 

[RxnMan]

...Like the title says, should I go for the MD/PhD or just the MD?...I like the research I'm doing now (this is my 3rd summer in the same lab) and I could definitely see myself working in a lab for 3-4 years. What's nice is this would be protected research and I'd basically be getting a PhD out of it without worrying about getting funded and such...are authoritative in knowing the basic science behind the clinical aspects. This appeals to me the most...I feel like 20 years from now I might be looking back and thinking that I should have gone for the PhD and if there was anytime to do it, THIS would have been the time.

I don't know about the doc's doc (the pathologists might argue with you on that one), but if you want to do research, especially basic science research, then go for it. You have some good thoughts, but realize that there are other ways to get research time and skills as a MD - year-off programs, the research-intensive MD programs like Harvard's HST and Cleveland Clinic, research residencies, fellowship, and so on.

...(They also do land great residencies - the one I'm interested in and I've been doing research in is notoriously tough to match into.)...

All anyone needs to get into the most competitive of specialties is to do well in school and do well on the boards. I think the folks who do it just for the extra doctorate are wasting their time, especially when they can earn more money with those extra years as an attending than they save during their program years (assuming they're all fully funded years).

...Would an MD/PhD help to break up this monotony and allow me to pursue multiple aspects of medicine more easily? Do MD/PhDs often get to see more of these "zebras" or at least get consulted more often on "zebras"?...

Eh. Specialist MDs get referrals all the time. But that's because their scope of practice is restricted so that the generalist's zebra is the specialist's bread and butter. So it's all relative.

If you don't want to be bored in clinical medicine or practice multiple aspects of medicine, then I would suggest practicing in broader specialties - IM, EM, Surgery, Path. That way you manage many different types of problems every day (or Dx, in the case of path). But I'm sure that everyone else has their own opinion.

...I guess what I'm basically asking is, is it worth it for me to do an MD/PhD?...

Feel free to read the FAQ entires - they contain entries from but MD researchers and MD/PhDs. It's a personal descion, but see if any of the entries in there resonate with you.

 

[Neuronix]

From what I hear, mud phuds are like the "doctor's doctor" and essentially are authoritative in knowing the basic science behind the clinical aspects. This appeals to me the most.

From what you hear? From who, MD/PhDs patting their own backs? MD/PhDs don't get more respect just because they're MD/PhDs. Most MDs don't really care about basic science and most PhDs won't see you as a real researcher.

However, I dont really see myself going into research as a career 100%, worrying about grants or if I'll be a good enough researcher to support myself, especially with the climate of funding these days. Rather, I could definitely see myself doing both the clinic work and the research, although probably most clinic (maybe like 60 clinic, 40 research? - I just have no idea right now).

This is NOT what the MD/PhD program is intended for. MD/PhD is intended to produce 80%+ researchers who are independently funded.

isn't it true that my background would still make me a better clinician?

No. PhD has nothing to do with clinical practice if you aren't using the PhD within research.

Would an MD/PhD help to break up this monotony and allow me to pursue multiple aspects of medicine more easily?

The big research guys tend to be super subspecialists in medicine so they can do a lot less clinical work and get away with it. So no, you will persue a narrow focus of medicine if you are doing serious research.

Do MD/PhDs often get to see more of these "zebras" or at least get consulted more often on "zebras"?

Depending on your subspecialty, this could be you if you focus on a narrow range of diseases or such.

(They also do land great residencies - the one I'm interested in and I've been doing research in is notoriously tough to match into.)

What does the PhD have to do with landing a competitive residency? I'm soon to apply in a competitive residency, and almost all they care about are step I scores and clinical grades. Research is relatively unimportant compared to those two things, and you can get significant research they will care about in med school without a PhD.

 

[JHopRevisit]

For the first time ever I fully agree with the entire contents of a Neuronix post. 😱

 

[Breazy]

Thanks for the feedback, although I'm still wondering about a couple things (sorry I'm a n00b and cant figure out the quote button):

First, it wouldn't be just 1 more year, it would be the standard 3-4 years (which here, it sounds like they force you out in a maximum of 4 years, 5 will basically never happen, thank God) for the PhD.

Is indecisiveness really a bad reason to go into the MD/PhD? A mud phud in my lab told me that it gives you a lot of time to not only figure out what you want to get out of it (obviously a lot of research should be the primary goal) but also what specialty to go into and really just sort things out. The med school part (from what mud phuds have been saying, please dont flame me) is much more intense and difficult time-wise (but also in a different way) and the PhD part helps break it up.

Also, contrary to what people replying have said - the PhD can definitely substitute for an average boards score and surely help match into competitive residencies. According to the mud phuds here in the lab, all alumni have matched into either (or both) competitive specialties and individually competitive programs, even with mediocre board scores.

Again, I don't have a crystal ball for the long distance future, but if I can see myself doing lab research for 4 years, isn't that basically worth doing the mud phud program? I really like doing research, but I'd have no idea if I'd enjoy it more than clinic work until I'm "there". It seems that mud phud keeps the options open a lot better too - I'd basically be trapped into clinic work coming out with an MD with a piss-poor research background and a ton of debt. I really don't care about money, but this would obviously deter many people considering doing research at this point from actually doing it, especially with no skill set or basis to write grants and get funded. I understand that 80%+ of time should be spent for research for mud phud graduates, but is it really necessary to have that expectation for myself if I ended up going into the program? It just seems like an awesome and unique opportunity, regardless.

As to the question about how would the MD make me a better researcher or the PhD a better clinician: I definitely think the PhD would help out clinically as it gives that different way of thinking - even if it's bench work that helps figure out a basic science question - it gives a unique perspective to clinical pattern recognition, right? How could this perspective not be valuable for the clinic? I think if I did do clinic work I would definitely like to sub-specialize quite a bit into a very narrow and focused field where this PhD would be even more likely to help out. (The MD for the PhD researcher seems pretty obvious - it seems like it would give a better background for actual medical research that would be more applicable to progress in figuring out diseases and their treatments).

Again, sorry if I'm coming across as a complete noob, I dont mean to insult anyone's intelligence or work, I'm really just trying to figure this stuff out. Thanks again!

 

[Ariodant]

Many MDs do basic reasearch, and often do it well. It seems that you already have strong opinions about some of the questions you asked, and I doubt our responses would make any difference. In that case, you should feel free to apply internally, and leave it to your school's MD/PhD program to decide if you are ready for that route.

 

[gstrub]

Well, you can be a plain old doctor (MD), or a total bad-ass (MD/PhD). Seems like an easy call for me.

Haha...

And I also agree with Neuro as I do most of the time, except the part about what the MD/PhD programs are "intended for" as a means of determining what you want to do. While I understand that programs may be intended to produce physician scientists that do primarily research, if you get through the program and decide you like plastic surgery and hate research, you shouldn't let what the programs intentions are influence your decision.

 

[nonamesleft]

I've heard the saying that MDs are the ones that want do clinical work, PhDs are the ones that want do research, and MD/PhDs are the stat-robots that have no clue what they want to do, but can do both.

..I'm applying MD/PhD to a few schools, but I definitely don't have the stats..so I dunno how truthful the above statement actually is.