MD/PhD and General Surgery Residency

[California]

The Question
I was wondering if individiduals in this forum could weigh in on my desire to pursue MD and PhD degrees (as part of the MSTP at the UC Irvine College of Medicine) and complete a residency in general surgery.

Background Information
I have a strong desire to be a surgical oncologist, which (as I understand it) doesn't necessarily require a fellowship after residency since "surgical oncology" isn't a board-certified specialty. General surgeons can function as surgical oncologists if they feel comfortable performing such operations. (I mention this because I heard this valuable information directly from a surgical oncologist.) At the same time, the reason I want to obtain a PhD degree along with an MD degree is because I enjoy participation in cancer research. I feel that having both degrees will allow me to be a more effective physician and scientist. Also, I am hoping I could obtain a PhD in two to three years.

What Should I Do?
At this moment in time, I can't decide if I should just go for it (obtain MD/PhD degrees and pursure a general surgery residency) or just forget about getting a PhD degree. The number of years I will be in training really scares me, which is the only downside in my opinion!

Thank You
Thank you in advance for your comments and votes. I am sure I will find all of them to be helpful. (I posted a duplicate thread in the Surgery Forum. I apologize in advance for being repetitive.)

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[shamus1]

A PhD in two to three years is highly unlikely (kind of like the Bulls winning the NBA championship next year). You should figure 4 to 5 years for the PhD. In your situation, I would probably skip the PhD and find time to do research in med school (maybe take an extra year) or do something after residency.

 

[Gradient Echo]

If you are very time conscious, then MD/PhD is probably not for you.

I agree with shamus1, getting the PhD in 2-3 years is somewhat unlikely. Not impossible, but unlikely. The average is 4 years.

 

[California]

I want to thank Shamus and Gradient Echo for their comments. However, I think I should add some clarification.

The reason I think I can obtain a PhD in two to three years is because, if I pursue the degree, I plan to work with a PI that I know quite well. This is because I've worked in her laboratory for the last four years in the field of molecular genetics, which is the same field I would like to obtain a PhD in. She told me there is no reason why I couldn't complete a PhD in three years given my experience in her laboratory. I hope this clears up any confusion as to why I assume I can obtain a PhD in two to three years. Without this background, I agree with all of you; earning a PhD degree takes four to five years.

As far as being time conscious, I am to a certain point. I don't mind taking three extra years to complete a PhD, but I've gotten the impression that the six or seven years (it takes to complete a residency in general surgery) makes the hybrid MD/PhD-surgeon a kind of rarity.

Also, I was wondering if anyone can comment on my desire to pursue a residency in general surgery. Given my interest in cancer, do you think I would be more fulfilled in a field like hematology/oncology? Let me know what all of you think. I know this is a question I have to really ask myself, but maybe some of you can give me a kind of protocol to follow in trying to answer this question on my own. Thank you.

 

[exigente chica]

I also want to do my residency in General sugery, California! I actually don't mind the time commitment. If you really want the Ph.d go for it, if your just getting it to have another peice of paper, then don't do it.

 

[DarkChild]

i dont think its worth it to do the PhD. the time commitment of an MD/PhD is already bad enough, but to combine it with a residency in surgery... keep in mind that you have to plan for changes to your preferences (wife... kids...) over the length of your training. I know it seems strange to be thinking of things like that now - but I believe it is appropriate given the time horizon.
On top of that - what good is the PhD going to actually do you? I think the point of any educational experience, more so with graduate school. If you, and I dont think that it does, cant see the PhD advancing your career - dont do it. Spend the time working on what will actually further your career.
Just my $0.02

 

[exigente chica]

For me the Ph.d will actually help. I want to get my Ph.d in artifical organs, and then work with the patients to do the implants. There are several doctors at Yale who do this.

 

[wgu]

There was a MD cancer PI in my last lab who also spent part of her time in surgery. She was in her early 30s and doing great research, so it is possible to be a MD only researcher even when current studies show them to be on the decline.

 

[California]

I think another reason why I wish to pursue both MD and PhD degrees has to do with the fact that I will be attending the UC Irvine College of Medicine. Since I've done research here in the past, I feel that I would be short-changing myself if I didn't pursue the PhD. With a little bit more hard work, the PhD will really be in my graps. Another factor that plays into the equation is the fact that I turned down a top 15 and a top 20 medical school for UC Irvine. I think by attending UC Irvine I have made it a little harder for myself to become the professor of medicine I want to be. Yes, UC Irvine is a decent school and quite cheap as far as tuition is concerned, but I feel like I might have to earn a PhD to stand out more when it comes time to look for a position as part of a medical school's faculty. I guess a fault in my thinking is that I haven't considered residency. I am sure if I get a residency position at a good institituion, then my qualms about attending UC Irvine will definitely be less of a factor.

Any thoughts, opinions, or criticisms? I hope my comments don't lead anyone to believe that I regard the PhD degree as just another piece of paper that will excel my career. I truly love basic science research and asking questions in the framework of a human biological problem.



By the way, if you view this poll, then please take the time to vote and offer your opinions. I would really appeciate any insight I can get from all of you. I can clearly tell the individuals who visit this forum are very intelligent and, surprisingly, wise beyond their years.

 

[energy_girl]

California,

If you had asked me just a few months ago whether getting MD/PhD and then going into surgery is a good idea, I would have told you no. This summer, though, after conducting research in collaboration with the surgery dept and speaking with many of their faculty, I have come to the opposite end of the spectrum. An MD/PhD is highly valuable in a field like surgery where research is done on a constant basis and where such skills in critical thinking and laboratory work are crucial.

I am not saying, of course, that every successful surgeon who wants a research lab should have an MD/PhD. I am only pointing out that surgeon-scientists are very highly valued because of their training and because of their rarity. Surgery residents usually have to do several years of research, and most of them lack basic lab experience and experience in designing experiments. An MD/PhD student applying to surgery residency programs is highly valued commodity, because he/she will be able to contribute something to the field that other MDs may not.

In short, California, go for it! If you think the research will benefit you in the long run, do it! Even if you choose not to go into surgery (although it sure seems like you're set on your career path , you don't sound like you will regret the years you spend in the lab and the experiences you will obtain there.

energy_girl

p.s. Several of our MSTP graduates have gone into surgery... so it definitely has been done before!

 

[Bikini Princess]

I think that you should continue your efforts for the PhD, i think it will help you stand out, and i understand that many residencies welcome MD/PhD applicants.

I don't know that you need to be committed to gen surg. yet. After all, you have little idea if you'll like it.

Until you do your clerkships, maybe you might prefer to postpone any commitment to a particular clinical field (esp surg).

btw, i'm curious to know how your medical genetics PhD, cancer interests, and surgery interests all link together...it sounds interesting!

 

[FunnyBones]

MD-PhD in 6 years
Very difficult but has been done. You need the right kind of project, luck and/or preliminary data like you seem to have.

Research as surgeon
MD only - many successful surgeon have done this but you pay the price when you're starting up your lab
MD-PhD program - solid option. You can, of course, do a 5yr general surgery (instead of the 7 which usually includes 2 years of research) or do a surgical subspecialty (ENT, ortho, etc. generally 5 yr residency).
Residency-PhD program - also a solid option, although some would argue that you're short-changing the PhD. A number of residencies are offering this option. For G surg, some folks can finish the PhD in the 2 yrs research built into a 7 yr program.

If you want to do it, go for it.

Ortho in 2003 and future surgeon-scientist

 

[Gradient Echo]

Originally posted by FunnyBones
Residency-PhD program - also a solid option, although some would argue that you're short-changing the PhD. A number of residencies are offering this option. For G surg, some folks can finish the PhD in the 2 yrs research built into a 7 yr program.

So you get a PhD in general surgery or what?

I wasnt aware you could get a PhD in a clinical field (i.e. surgery, radiology, internal med, etc)

 

[Centrum]

No, the Phd is for the scientist portion. To be a general surgeon she would have to do a residency in general surgery.

 

[FunnyBones]

Originally posted by Gradient Echo


So you get a PhD in general surgery or what?

I wasnt aware you could get a PhD in a clinical field (i.e. surgery, radiology, internal med, etc)

I believe that there are some clinical departments that grant PhDs/equivalents (doctor of phil is a doctor of phil is a doctor of phil but I don't know specific places off hand). For the most part though, the PhD is granted by a basic science department or by graduate groups and the logistics are worked out in conjuntion with the residency program. Not that much of a stretch to get a PhD studying vasculogenesis and endothelial repair etc if you're going in to vascular, cytokine function or wound healing if you're doing trauma, developmental biology if you're doing peds surg, neuronal regeneration in neurosurg, chondrogenesis in ortho etc.

 

[nuclearrabbit77]

I think if you want to do research in oncology, i'd go down the Hematology oncology route. An overwhelming majority of cancer research takes place under this specialty, especially if you are approaching it with a bio/molec. approach. Yet, the term surgical oncologist is an undefined term. I think maybe you should clarify what type of surgical oncologist you want to be. Most "surgical oncologists", don't go general surgery, they end up going in a specialized residency program, and then do an additional fellowship to specialize in the cancerous aspect of their speciality. The general surgery route is necessary if you want to go pre-cardiothoracic, pre-vascular, plastic, etc. It isn't the traditional route if you want to be a specialized surgeon who treats cancer, surgically.

So if you want to go into a surgery intensive specialty that isn't g. surgery, like otolaryngology, orthopaedic, neurosurg.. your md/ph.d degree can be very helpful, and in fact you may be heavily recruited since you'll have a solid research background that most people don't have going into those fields.

The essential question is, how do you want to spend your time?
If there is no time pressure, and you have the opportunity to do the research you want, go for it!
But realize,..national averages for MSTP are 7.5 years, then a typical surgical subspeciality will take 4-5, then with a surgical oncology fellowship, another 1-2.

I guess i'm going through the same questioning as well. I can probably get tracked in the MSTP at Northwestern if i want (1st year entering MD), but i'm not sure if i'll be happy that i did it if i end up going down a surgical route as well.

Good luck!