md or md/phd

[crimsonkid85]

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hi all, i really need some advice...so i'm applying to med school this cycle, and i really thought that i wanted to apply md/phd. but the thing is, i don't have any publications. i know that there was a thread on here that said that you don't need it...but will it prevent you from getting into the top top md/phd programs? i've worked in a bio lab freshman yr and an ochem lab for the past two years...and i will be a second or third author on one paper, and co-first author on another (both from the ochem lab)...which WILL come out, as good results are rolling in and the manuscript is being written, but won't come out in time for interviews, obviously.

odds-wise, it seems MUCH easier to get into a MD program straight up, espeically with my research experience, and other extracurriculars, awards, etc. so do you think it's worth shooting for top MD programs, and then applying to MD/PhD programs internally, just for the higher chances? i'm asking because of the non-conformity of schools in dealing with MD/PhD applications (if they'll also consider you concurrently as an MD applicant, or if they won't--like Vandy--or if they'll only consider as an MD applicant after you've been rejected as an MD/PhD applicant...)

sorry for the long-windedness. thanks for any and all suggestions! 🙂

 

[byong_soo]

Hey Crimson Kid,

You can check out mdapplicants, but there are lots of applicants who have made to top mstp without publications. It seems like being a firth author definitely will catch the attention from admission people but absence of it will not hinder your getting interview. I guess that's why we have 10,000 research essay, so that even without publication we can communicate them our ability as a researcher.

I do have similar dilemma of MD or MD/PhD. I have been debating for over two years now and can't seem to decide. Of course many factors come to mind, but I can't seem to answer three questions:
1. Can I imagine a career without a research? Do I really need a PhD to carry on my research? Many professors I have talked to recently have suggested getting specialty done and going to do research would also be a good path because I can then carry on research with knowledge of medical specialty as my background.
2. Am I competitive enough to get into schools of my choice? This was your question as well, and it also has crossed my mind that maybe I will get into medical school first and then decide whether to apply for MSTP, do PhD afterwards, or maybe not do PhD at all.
3. Lastly, will I be able to endure all the years of training. Academia MD/PhD career would begin at mid-late 30s. This aspect is definitely discouraging and daunting and is a question that is defintely difficult to assess.

After two years of long debate, I am leaning towards not applying for MSTP. I am planning to turn in AMCAS soon, and I hope to make decision soon. It sure is frustrating though. Especially the last question.

 

[byong_soo]

Oops and Crimson, I wanted to emphasize that you should apply to MSTP because if publication is the only concern. =)

 

[jonathon]

I recommend just getting your MD degree. You can always do research with an MD degree. If you go the MSTP route you will loose about 3 to 4 years of high income. This income loss could equal up to roughly 400,000 or 500,000 dollars (do the math…be smart). Just think about it, the people you start medical school with will be done with their residency and be making a good income and even be a professor by the time you are just starting residency. Just because you have an MD/Ph.D. does not mean you are any better then people with a straight MD or Ph.D. Your references and your own ability to do good research and being a good doctor is what gets you the funding. The degree is only something you put behind your name to impress lay people.

Get an MD degree in 4 years, do a residency in the range of 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and be a practicing doctor.

Depending on your age (I will assume you are 22), you will be all done with your training at about the age of 32 to 34 and start a lab and be making ~ 175,000 dollars per year (depending on your specialty).

Go the MSTP route and you are talking about 7 or 8 years of training in medical school, then you do a residency in the range from 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and being a practicing doctor. This would put you in the age range of 36 to 40 years old.

Let’s say you go the MSTP route and you lose 3 years of high income. You make 175,000 dollars a year. So if it takes you 3 or 4 years longer to get completed with all of your training, you are talking about not brining in an income in the range of 525,000 to 700,000 dollars. That is assuming you make in the range of 175,000 dollars when you start out.

So think about it hard and long.

Oops and Crimson, I wanted to emphasize that you should apply to MSTP because if publication is the only concern. =)

 

[solitude]

My advice is to never think about money when making decisions of this magnitude. This is a decision that will affect the rest of your life, and to give so much weight to monetary factors rather than personal ones seems, at least to me, myopic and disturbing.

I recommend just getting your MD degree. You can always do research with an MD degree. If you go the MSTP route you will loose about 3 to 4 years of high income. This income loss could equal up to roughly 400,000 or 500,000 dollars (do the math…be smart). Just think about it, the people you start medical school with will be done with their residency and be making a good income and even be a professor by the time you are just starting residency. Just because you have an MD/Ph.D. does not mean you are any better then people with a straight MD or Ph.D. Your references and your own ability to do good research and being a good doctor is what gets you the funding. The degree is only something you put behind your name to impress lay people.

Get an MD degree in 4 years, do a residency in the range of 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and be a practicing doctor.

Depending on your age (I will assume you are 22), you will be all done with your training at about the age of 32 to 34 and start a lab and be making ~ 175,000 dollars per year (depending on your specialty).

Go the MSTP route and you are talking about 7 or 8 years of training in medical school, then you do a residency in the range from 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and being a practicing doctor. This would put you in the age range of 36 to 40 years old.

Let’s say you go the MSTP route and you lose 3 years of high income. You make 175,000 dollars a year. So if it takes you 3 or 4 years longer to get completed with all of your training, you are talking about not brining in an income in the range of 525,000 to 700,000 dollars. That is assuming you make in the range of 175,000 dollars when you start out.

So think about it hard and long.

 

[Hard24Get]

You are forgetting th fact that getting a PhD trains you how to conduct research and MDs who get into academia usually have extended fellowhip time (at least 3yrs+ in the lab), etc, to play catch-up and still regret not having the formal training because it takes them much longer to achieve funding for basic research because they were never taught how to write a grant, etc. And I agree with solitude that this should not be about money.

I recommend just getting your MD degree. You can always do research with an MD degree. If you go the MSTP route you will loose about 3 to 4 years of high income. This income loss could equal up to roughly 400,000 or 500,000 dollars (do the math…be smart). Just think about it, the people you start medical school with will be done with their residency and be making a good income and even be a professor by the time you are just starting residency. Just because you have an MD/Ph.D. does not mean you are any better then people with a straight MD or Ph.D. Your references and your own ability to do good research and being a good doctor is what gets you the funding. The degree is only something you put behind your name to impress lay people.

Get an MD degree in 4 years, do a residency in the range of 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and be a practicing doctor.

Depending on your age (I will assume you are 22), you will be all done with your training at about the age of 32 to 34 and start a lab and be making ~ 175,000 dollars per year (depending on your specialty).

Go the MSTP route and you are talking about 7 or 8 years of training in medical school, then you do a residency in the range from 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and being a practicing doctor. This would put you in the age range of 36 to 40 years old.

Let’s say you go the MSTP route and you lose 3 years of high income. You make 175,000 dollars a year. So if it takes you 3 or 4 years longer to get completed with all of your training, you are talking about not brining in an income in the range of 525,000 to 700,000 dollars. That is assuming you make in the range of 175,000 dollars when you start out.

So think about it hard and long.

 

[OddNath]

1. Can I imagine a career without a research? Do I really need a PhD to carry on my research? Many professors I have talked to recently have suggested getting specialty done and going to do research would also be a good path because I can then carry on research with knowledge of medical specialty as my background.
2. Am I competitive enough to get into schools of my choice? This was your question as well, and it also has crossed my mind that maybe I will get into medical school first and then decide whether to apply for MSTP, do PhD afterwards, or maybe not do PhD at all.
3. Lastly, will I be able to endure all the years of training. Academia MD/PhD career would begin at mid-late 30s. This aspect is definitely discouraging and daunting and is a question that is defintely difficult to assess.

After two years of long debate, I am leaning towards not applying for MSTP. I am planning to turn in AMCAS soon, and I hope to make decision soon. It sure is frustrating though. Especially the last question.

1. The PhD gives you protected time to conduct thorough research with the guidance of a PI. No pagers going off, no clinical responsibilities, and time for you to do coursework in your specific field. Granted, I'm not far along in the program so take this with a grain of salt, but as a grad student you get superb research training in addition to producing good work, whereas an MD doing research during fellowship just needs to produce results. And if you hadn't done research in like 10 years, that could be daunting.

2. Apply and find out! This goes to the OP as well. Of course you can apply internally once you start an MD-only program, but if you want to do the MD/PhD, try to get in now. Not only that, but there aren't generally a whole lot of spots open for internal transfer.

3. Once again, I'm too young [in the program] to really be able to comment on this..but it's a long road either way. And, if academia is where you want to be, isn't getting there at 35 better than being in private practice and hating it at 32?

Also, having both an MD and Phd should help when applying for grant funding (as opposed to having one or the other).

As for the money issue..yes, you lose out on a few years of good income, but you also don't have to pay a dime for school *and* get paid throughout the duration of the program. That means *not* having $200,000 of debt (or whatever the average med student debt is). So yes, you don't make as much money as you would if you went into private practice, but if you were going to do academic medicine anyways, not having debt is an awesome deal.

Basically, if you're interested in academic medicine/research, don't let the competitiveness for MD/PhD spots stop you from applying. It's less people applying for less spots, and they're looking for different students than the standard MD-only applicant.

 

[Neuronix]

hi all, i really need some advice...so i'm applying to med school this cycle, and i really thought that i wanted to apply md/phd. but the thing is, i don't have any publications. i know that there was a thread on here that said that you don't need it...but will it prevent you from getting into the top top md/phd programs?

I'm at a top tier (top top? I guess?) program and I didn't have any pubs as an undergrad. I know several other examples in my year alone.

odds-wise, it seems MUCH easier to get into a MD program straight up, espeically with my research experience, and other extracurriculars, awards, etc.

I would disagree with that statement. MD/PhD admissions are much more formulaic. If you have an otherwise strong application with 3.8+ GPA, 35+ MCAT, and a few years of research, you will probably end up with acceptances at at least half of the MD/PhD programs you apply to. I've seen many examples of this. If you do the same on the MD side, you'll probably end up with acceptances to one or two programs. On the flip side, if you have one major or several minor marks on your app, you'll struggle to get into MD/PhD. That being said, all your MSTPs are mid to top tier medical schools. So, are you really missing out if you land at a med school ranked in the 20s?!

so do you think it's worth shooting for top MD programs, and then applying to MD/PhD programs internally, just for the higher chances?

The problem is you don't give us the rest of your application. In general, I would say NOT to do this if you really do want MD/PhD. Over the years on the site, I've seen numerous examples through the years of people who didn't apply MD/PhD because they were afraid and ended up at bottom tier medical schools. Meanwhile, I've seen numerous borderline MD/PhD applicants pull out decent acceptances. In general on here, people tend to be more scared about MD/PhD admissions than they should be (I was!).

All this being said, what are your GPA and MCAT like? Any major strikes against your app?

 

[byong_soo]

MD vs. MD/PhD:

"I'm a hand model, mama. A finger jockey. We think differently than the face and body boys... we're a different breed."

-J. P. Prewitt from Zoolander

 

[Gut Shot]

You are forgetting th fact that getting a PhD trains you how to conduct research and MDs who get into academia usually have extended fellowhip time (at least 3yrs+ in the lab), etc, to play catch-up and still regret not having the formal training because it takes them much longer to achieve funding for basic research because they were never taught how to write a grant, etc.

Does the PhD also train you to write run-on sentences? Sheesh.

 

[RxnMan]

Does the PhD also train you to write run-on sentences? Sheesh.

Maybe, but I know that PhDs train to have run-on lectures!

 

[Gut Shot]

Maybe, but I know that PhDs train to have run-on lectures!

You're breakin' my balls, man.

 

[cadilakgrl]

I recommend just getting your MD degree. You can always do research with an MD degree. If you go the MSTP route you will loose about 3 to 4 years of high income. This income loss could equal up to roughly 400,000 or 500,000 dollars (do the math…be smart). Just think about it, the people you start medical school with will be done with their residency and be making a good income and even be a professor by the time you are just starting residency. Just because you have an MD/Ph.D. does not mean you are any better then people with a straight MD or Ph.D. Your references and your own ability to do good research and being a good doctor is what gets you the funding. The degree is only something you put behind your name to impress lay people.

Get an MD degree in 4 years, do a residency in the range of 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and be a practicing doctor.

Depending on your age (I will assume you are 22), you will be all done with your training at about the age of 32 to 34 and start a lab and be making ~ 175,000 dollars per year (depending on your specialty).

Go the MSTP route and you are talking about 7 or 8 years of training in medical school, then you do a residency in the range from 2 or 4 years, and then a fellowship of 2 years. Then you can start a lab and being a practicing doctor. This would put you in the age range of 36 to 40 years old.

Let’s say you go the MSTP route and you lose 3 years of high income. You make 175,000 dollars a year. So if it takes you 3 or 4 years longer to get completed with all of your training, you are talking about not brining in an income in the range of 525,000 to 700,000 dollars. That is assuming you make in the range of 175,000 dollars when you start out.

So think about it hard and long.

I wouldn't take this advice, especially coming from someone who is still in their undergrad. It sounds like something a premed advisor would dish out.

However, if the OP is concerned about money I would definitely advise against doing an MD/PhD. It will be a significant amount of time before you will be making a six figure salary. MD/PhD route is all about delayed gratification (in terms of your career position/salary and even with success in science and getting results/funding).

I really think 3-4 years doesn't make that much difference. If you lose 3-4 years of income who really cares? Like another poster mentioned at least you don't have $200,000 of debt from medical school which takes a lot of doctors more than just a couple years to pay off. Also in terms of training, an MD doesn't prepare you to do basic science research. You can go the MD route and do research, but most likely you will do 1 or 2 postdocs to before getting a faculty position which could be 4-6 years- so either way it could be the same amount of time as doing an MD/PhD then a combined residency/postdoc.

If you really want to do research and run a lab in the future then go for the MD/PhD. Publications are only one part of the application, there are lots of accepted students who don't have any. I think your letters of rec could testify to your research ability just as much as a publication. Having your name on a publication can mean a lot or very little. Some people get on them and contribute very little and others do all the experiments and manuscript writing. It really depends on your situation, and I think people who are science will know that. Also in terms of applying to an MD program then getting into the MD/PhD after your second year, I think this does happen at some schools but at others it is very rare. You would probably have to continue to work in the lab during your first two years of med school to show your committment, which wouldn't be too easy. If your application is more research-heavy you may actually have a better chance of getting into an MD/PhD program than a MD program. I would say go for it. Don't be intimidated

 

[CCLCMer]

hi all, i really need some advice...so i'm applying to med school this cycle, and i really thought that i wanted to apply md/phd. but the thing is, i don't have any publications. i know that there was a thread on here that said that you don't need it...but will it prevent you from getting into the top top md/phd programs? i've worked in a bio lab freshman yr and an ochem lab for the past two years...and i will be a second or third author on one paper, and co-first author on another (both from the ochem lab)...which WILL come out, as good results are rolling in and the manuscript is being written, but won't come out in time for interviews, obviously.

odds-wise, it seems MUCH easier to get into a MD program straight up, espeically with my research experience, and other extracurriculars, awards, etc. so do you think it's worth shooting for top MD programs, and then applying to MD/PhD programs internally, just for the higher chances? i'm asking because of the non-conformity of schools in dealing with MD/PhD applications (if they'll also consider you concurrently as an MD applicant, or if they won't--like Vandy--or if they'll only consider as an MD applicant after you've been rejected as an MD/PhD applicant...)

sorry for the long-windedness. thanks for any and all suggestions! 🙂

I think you need to decide first what your ultimate goal is, instead of focusing on how likely you are to be successful in one application route versus another. Speaking as someone who just went through the application process, I can tell you that it's extremely difficult if not impossible to predict ahead of time how your application will be received by various programs. You just don't know where you will get in until you try applying.

Concerning the MD-only versus MD/PhD debate, I wound up deciding to split the difference and do an MD/MS program at the Cleveland Clinic through Case Western. It will take me five years to graduate, and I will get a full year of flexible protected time to do research. I am not far enough along in school yet where I would be able to tell you how having an MD/MS will compare with having an MD/PhD. Maybe some MD/MS graduates in the forum could comment? But for what it's worth, I just wanted to tell you that options like an MD/MS exist, and you might want to look into that if you want the research training but you're not sure that you want to do an entire PhD.

 

[RxnMan]

Concerning the MD-only versus MD/PhD debate, I wound up deciding to split the difference and do an MD/MS program at the Cleveland Clinic through Case Western. It will take me five years to graduate, and I will get a full year of flexible protected time to do research. I am not far enough along in school yet where I would be able to tell you how having an MD/MS will compare with having an MD/PhD. Maybe some MD/MS graduates in the forum could comment?

Harvard also offers a 5-year MD/MS (HST) program. Many schools offer a 5-year MD with a gap year between MSII and MSIII, during which you can pursue a MS (or MPH). Many fellowships (especially for IM folks) allow for protected research time, during which you can get a grad degree.

A n = 1 survey result here. A doc I worked with (PGY-IV) had many more research opportunities offered to him because of his MS. I know the directors of his ortho residency give priority to applicants with grad degrees, and his research projects (he's required to complete 2 during residency) went much more smoothly (higher quality for less time/effort spent,) than his peers' because of his MS training.

 

[Hard24Get]

Does the PhD also train you to write run-on sentences? Sheesh.

No, that joyful lesson was specific to my advisor 😀

Ditto on the lecture comment. Sheesh!

 

[Gabujabu]

Regarding the extra 3/4 years, it is a bigger deal for some people than others. An MD/PhD grad from Yale in his mid 30's came to our campus to speak, and he had decided to forego residency training in order to complete a postdoc because he felt the training was becoming too long (he had also taken time off before MD/PhD). He mentioned that he wanted to get married and start a family, yet said that he didn't have enough money (our school is in a really expensive area). He was saying that the "Ramen noodles" lifestyle that may suit a 23 year old may not be sufficient for a 32 year old with a family, especially if they live in a really expensive area (i.e. Palo Alto, Cambridge, etc). Money should definitely not be someone's main concern, but it is not unreasonable for it to be an important consideration. It's about balance.

 

[Vader]

Regarding the extra 3/4 years, it is a bigger deal for some people than others. An MD/PhD grad from Yale in his mid 30's came to our campus to speak, and he had decided to forego residency training in order to complete a postdoc because he felt the training was becoming too long (he had also taken time off before MD/PhD). He mentioned that he wanted to get married and start a family, yet said that he didn't have enough money (our school is in a really expensive area). He was saying that the "Ramen noodles" lifestyle that may suit a 23 year old may not be sufficient for a 32 year old with a family, especially if they live in a really expensive area (i.e. Palo Alto, Cambridge, etc). Money should definitely not be someone's main concern, but it is not unreasonable for it to be an important consideration. It's about balance.

As a more senior MD/PhD student living in an expensive city, I definitely agree with this. While we have had stipend raises the past few years, the stipend still does not provide sufficient income to start a family. It is necessary to have other resources available (i.e. a spouse's income) to even begin to think about a family here. It is interesting too that the program does not technically allow students to hold outside jobs. So basically one has to find other ways of supplementing income.

One idea would be to institute a pay scale similar to the NIH PGY scale, with increases each year. This would provide more financing on the back end of the training, when students are more likely to have families.

 

[SaltySqueegee]

As a more senior MD/PhD student living in an expensive city, I definitely agree with this. While we have had stipend raises the past few years, the stipend still does not provide sufficient income to start a family. It is necessary to have other resources available (i.e. a spouse's income) to even begin to think about a family here. It is interesting too that the program does not technically allow students to hold outside jobs. So basically one has to find other ways of supplementing income.

One idea would be to institute a pay scale similar to the NIH PGY scale, with increases each year. This would provide more financing on the back end of the training, when students are more likely to have families.

3rd year MD/PhD student here...

I can feel this concern becoming more obvious and pertinent to my life as well. My wife and I would like to start having kids sooner than later, and as we see our friends starting their families, it is definitely becoming more and more frustrating. My thoughts have been as such:

1) Apply to a research oriented residency --> Thinking Pathology with Clinical Path as a starting focus.

2) Make sure that I am going to be living in an area that is in one of two situations:
2a) Prestigious/Inexpensive/Away from Family --> So that I can get good training and have the abilitiy to have a family on a Residents wages, and my wife won't have to work too much/at all.
2b) Prestigious/Expensive/Near Family --> So that if my wife has to work, we can off-load the kids on to "Grandma/grandpa" or Auntie and Uncles.
2c) Non-Prestigious/Inexpensive/Away from Family --> Again for the reasons in 2a.

So yeah, I agree with the above line of thoughts.

-Salty