MD/PhD and Residency

[RafMin]

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If i complete a MD/PhD program, can i practice as a physician afterwards or i will still have to complete a residency? If so, is there an accelerated way to do that?

Thanks!

 

[aSagacious]

If you got your MD/PhD you'd still have to do a residency in order to be a practicing physician as well as a research fellowship if you'd like to run your own lab. I do not know of any way to accelerate the process (and could not imagine doing so because all of the necessary steps are heavily time consuming endeavors).

Edit: You may also want to take a look at this thread, there are a couple gems from MSTP students in there

 

[alwaysaangel]

If i complete a MD/PhD program, can i practice as a physician afterwards or i will still have to complete a residency? If so, is there an accelerated way to do that?

Thanks!

Yes you have to complete a residency to practice clinical medicine. No there is no short cut. A PhD does nothing to prepare you for clinical medicine so there is no reason doing a PhD would shorten your residency.

 

[cowme]

Yes you have to complete a residency to practice clinical medicine. No there is no short cut. A PhD does nothing to prepare you for clinical medicine so there is no reason doing a PhD would shorten your residency.

Word. Unless you see research as a big (and I mean BIIG) part of your future career, there is really no reason to get a PhD. Your amount of debt will be more or less the same 5 years out of residency, but you will be 4-6 years older at this point if you get a PhD.

If your future goal is just doing some clinical research on the side, but mostly seeing patients/practicing your specialty, most schools have plenty of resources to give you plenty of research experience without getting the combined degree.

 

[RafMin]

Got it. Thanks guys.

 

[rockyrado]

Word. Unless you see research as a big (and I mean BIIG) part of your future career, there is really no reason to get a PhD. Your amount of debt will be more or less the same 5 years out of residency, but you will be 4-6 years older at this point if you get a PhD.

If your future goal is just doing some clinical research on the side, but mostly seeing patients/practicing your specialty, most schools have plenty of resources to give you plenty of research experience without getting the combined degree.

Pretty sure most MD/PhD students got free tuition, housing, and a stipend. If that's the case, then the amount of debt for an MD/PhD is obviously not the same. As an example, I just looked at COlumbia's MD/PhD info site (just the first school that popped into my head) which says this:

What is the annual stipend?
The annual stipend for the 2011-2012 academic year will be $32,064. In addition, all school-related fees such as tuition and health insurance costs are paid for by the program.

So, an MD/PhD would graduate with no debt, versus the average $200k+ for your average MD graduate.

 

[deleted357625]

If i complete a MD/PhD program, can i practice as a physician afterwards or i will still have to complete a residency? If so, is there an accelerated way to do that?

Thanks!

you still have residency. MD/PhD programs are obviously harder to get into and do a lot of research during med school, it helps a lot for them to apply to very competitive residency programs.

 

[boobelle]

Yes you have to complete a residency to practice clinical medicine. No there is no short cut. A PhD does nothing to prepare you for clinical medicine so there is no reason doing a PhD would shorten your residency.

OP, as alwaysaangel said, a PhD itself has nothing to do with shortening residency. That said, if you have a strong interest in research some specialties do offer "short-track" residencies. For instance, in internal medicine there is the ABIM Research Pathway (http://www.abim.org/certification/policies/research/requirements.aspx). You have to elect it early on, but it's a way to reduce your total combination of residency + postdoc research +/- fellowship training by a year (the subtracted year is the last year of IM residency). While having a MD/PhD would improve your chances of getting an ABIM research spot, I don't believe it's mandatory. I'm only familiar with IM, but I imagine other specialties may have short-tracking options.

 

[TexasPhysician]

Pretty sure most MD/PhD students got free tuition, housing, and a stipend. If that's the case, then the amount of debt for an MD/PhD is obviously not the same. As an example, I just looked at COlumbia's MD/PhD info site (just the first school that popped into my head) which says this:

What is the annual stipend?
The annual stipend for the 2011-2012 academic year will be $32,064. In addition, all school-related fees such as tuition and health insurance costs are paid for by the program.

So, an MD/PhD would graduate with no debt, versus the average $200k+ for your average MD graduate.

True, but the phd will take an extra 3-4 years. In the 3-4 years extra it takes this person to complete everything, I will have been making 200K+ for 3-4 years. 😀

 

[cowme]

Pretty sure most MD/PhD students got free tuition, housing, and a stipend. If that's the case, then the amount of debt for an MD/PhD is obviously not the same. As an example, I just looked at COlumbia's MD/PhD info site (just the first school that popped into my head) which says this:

What is the annual stipend?
The annual stipend for the 2011-2012 academic year will be $32,064. In addition, all school-related fees such as tuition and health insurance costs are paid for by the program.

So, an MD/PhD would graduate with no debt, versus the average $200k+ for your average MD graduate.

32k ( before taxes) is not going to get you very far, especially if you are living in a city. Most MD/phds I know have a good deal of debt too. Sure you won't be racking up the same debt as an MD, but by the time you finish your PhD, your MD colleagues with 200k in debt have been making 200-300k per year for 4-5 years, and have largely paid it off. So, you are pretty much at the same stage financially but 4-5 years older with a combined degree vs an MD alone (maybe even worse off financially if you are not living very modestly for those 8 years)

 

[BadHorse]

32k ( before taxes) is not going to get you very far, especially if you are living in a city.

Know how much Columbia offers in financial aid for 10 months of living in NYC? $18,715. That's all the loans you'll be entitled to for food, housing and miscellaneous expenses.

Conclude from that what you will.

 

[hot sauce]

Sure you won't be racking up the same debt as an MD, but by the time you finish your PhD, your MD colleagues with 200k in debt have been making 200-300k per year for 4-5 years, and have largely paid it off. So, you are pretty much at the same stage financially but 4-5 years older with a combined degree vs an MD alone (maybe even worse off financially if you are not living very modestly for those 8 years)

While I would agree that you shouldn't do md/phd simply for the tuition waiver and stipend, I think you are overstating the financial drawbacks.

It sounds like you are saying that the combined degree student will be 4-5 years older than the people he started medical school with but he would be the same age as the people that have been practicing for 4 years when he is finishing residency. Still the value of your 4 phd years (assuming you take 4 for the phd) is probably $60-100k / year which is obviously less than the attending paycheck. (For the high end estimating 4 years of medical school tuition and fees of $40k /yr and a stipend of $30k /yr for 8 years). So straight MD is probably a better choice for a dollars and cents standpoint.

 

[dragonbush]

While it is not necessarily financially beneficial to do an MD/PhD, it is also really not hard to live on 20k-30k a year. If you can't manage that, its a little pathetic. The only place where I could anticipate it getting difficult is if you opt to have children during that time (common) but ideally then you would have some sort of spousal income as well. Plus, that normally happens during PhD years when the stipend goes up a few thousand a year, which helps.

But honestly, if you can't easily live on 20-25k a year (or 32k in an expensive city) that is just sad.

 

[Raziela]

I also think this the financial drawbacks are oversimplified. MD/PhD students aren't living in debt in their 20 and 30s, and many buy condos and can save for other purchases (cars, etc) since they do not have to take out or pay back student loans. Certainly, they make less money in the long run, but there is something to be said for not racking up 200k in loans and not living like a student for another 4 years during medical school. In any case, I don't think anyone pursues the md/phd for the money--people pursue md/phd because they love research and want the phd.

 

[cowme]

Well, you cannot live comfortably in NYC with 20K/year...

Whatever, we got sidetracked in the financial discussion. The OP's question made it seem like he/she didn't really understand how the combined degree would affect one's career. My main point originally was that the only reason to get a PhD is if you consider research a HUGE part of your future career. It is a huge commitment, and there are plenty of opportunities to learn what you need for a life of research without the degree.

 

[LizzyM]

I could be mistaken but I seem to recall that as long as one is registered as a student, the stipend is not taxed. We always have a big push to be sure students in the doctoral program are registered by a specific date so that they don't have taxes taken out of their stipends. In many expensive cities, such as NYC, there is subsidized housing available to students so the cost of living for a student is lower than it would be for a regular Joe.


The MD/PhD is a good choice if you can't see yourself doing anything except being a physician - scientists working in an academic setting (or industry), doing research and mentoring the next generation of investigators. That path is not the road to riches and it is made a little more palatable by eliminating most or all of the debt that usually goes with the territory.

 

[Lil Mick]

We're in the lowest tax bracket, so anything we do have to pay, we usually get back. I doubt you could live on that stipend in NYC, but some programs in cheaper cities allow students to purchase house/car... without much problem.

As for residency, there are research residencies in many areas of medicine that allow you to do research while giving you enough clinical experience to be fully licensed. Internal medicine, pathology, radiology, and preventive medicine seem to be some hot areas for these sorts of residencies (at least from what older students have mentioned in my program).

 

[Ombret]

I could be mistaken but I seem to recall that as long as one is registered as a student, the stipend is not taxed. We always have a big push to be sure students in the doctoral program are registered by a specific date so that they don't have taxes taken out of their stipends.

This is incorrect; MD/PhD stipends, graduate stipends and any other cash a university might put in your pocket are absolutely taxed just like other personal income. They are exempt from other payroll taxes (Social Security/Medicare), but on the other hand your MD/PhD years do not help you reach your 40 quarters for Social Security as a result. The reason everyone thinks stipends are tax-free is that medical schools usually do not report them to the IRS or make any withholdings. That does not mean the income is tax-free, it just makes it easier to evade the taxes if you are unscrupulous.

The only exceptions, i.e., money that comes to you tax free: (1) money that the university pays to itself on your behalf ("tuition is $50K but we will pay it for you"), (2) money you get, but later pay out for REQUIRED elements of the educational program (mandatory books and fees, etc.).

 

[LizzyM]

This is incorrect; MD/PhD stipends, graduate stipends and any other cash a university might put in your pocket are absolutely taxed just like other personal income. They are exempt from other payroll taxes (Social Security/Medicare), but on the other hand your MD/PhD years do not help you reach your 40 quarters for Social Security as a result. The reason everyone thinks stipends are tax-free is that medical schools usually do not report them to the IRS or make any withholdings. That does not mean the income is tax-free, it just makes it easier to evade the taxes if you are unscrupulous.

The only exceptions, i.e., money that comes to you tax free: (1) money that the university pays to itself on your behalf ("tuition is $50K but we will pay it for you"), (2) money you get, but later pay out for REQUIRED elements of the educational program (mandatory books and fees, etc.).

I stand corrected. LizzyM learns something new today.

 

[deleted393595]

This is incorrect; MD/PhD stipends, graduate stipends and any other cash a university might put in your pocket are absolutely taxed just like other personal income. They are exempt from other payroll taxes (Social Security/Medicare), but on the other hand your MD/PhD years do not help you reach your 40 quarters for Social Security as a result. The reason everyone thinks stipends are tax-free is that medical schools usually do not report them to the IRS or make any withholdings. That does not mean the income is tax-free, it just makes it easier to evade the taxes if you are unscrupulous.

So the money you would be paid in a research internship would be taxed too?

 

[mauberley]

So the money you would be paid in a research internship would be taxed too?

Certainly. But in all likelihood you should be in a pretty low tax bracket.

 

[TexasPhysician]

Certainly. But in all likelihood you should be in a pretty low tax bracket.

Exactly. Just start learning tax loopholes.

 

[sleepy425]

While it is not necessarily financially beneficial to do an MD/PhD, it is also really not hard to live on 20k-30k a year. If you can't manage that, its a little pathetic. The only place where I could anticipate it getting difficult is if you opt to have children during that time (common) but ideally then you would have some sort of spousal income as well. Plus, that normally happens during PhD years when the stipend goes up a few thousand a year, which helps.

But honestly, if you can't easily live on 20-25k a year (or 32k in an expensive city) that is just sad.

😀 It is true. One of the hazards of MD/PhD programs is that babies do tend to happen during the wild PhD years. Apply at your own risk...

Oh, and I totally agree, most MD/PhD stipends are plenty of money. There are a couple of schools with kind of lousy stipends (I wasn't too thrilled when I heard about Harvard's) but the vast majority give you enough money to live comfortably in a nice place.

 

[Y88]

Solution to financial drawbacks: I'll marry a physician and have her pay for our vacations and house. Simple as that.

 

[URHere]

The reason everyone thinks stipends are tax-free is that medical schools usually do not report them to the IRS or make any withholdings. That does not mean the income is tax-free, it just makes it easier to evade the taxes if you are unscrupulous.

Good information here. One thing to add: recently, most schools have started reporting graduate and MD/PhD stipends to the IRS. I believe that this had to do with one program being absolutely slammed by the federal government for failure to report. Everyone is more careful now.