I?m a senior mudphud and my take on what?s been written here is this:
1. MD-PhDs most often, mostly because of historical reasons and presence of infrastructure, match in medicine, pathology and pediatrics. Ophtho, derm, rad onc are only recent trends. In terms of absolute numbers, path or medicine wins but that?s not important. Combined degrees I?ll call them (CDs) go into just about every field. There are two program I know of that study this and publish their data?Wash U and U Penn. Here?s the info for one of them:
Addressing the Needs of Basic and Clinical Research: Analysis of Graduates of the University of Pennsylvania MD-PhD Program
Peter Schwartz and Glen N. Gaulton
JAMA, 281:96-99
<a href="http://www.ama-assn.org/sci-pubs" target="_blank">http://www.ama-assn.org/sci-pubs</a>
2. The important number is not the absolute but the relative. One, the percentage going into a field should be in a larger sense of reflection of societal and professional need. But that is hard to measure. The ratio between the percentage of CDs going into a field and the percentage of all physicians in a field indicates a "representation" quotient of sorts. Path has the highest over abundance but med, peds, and neruo and a few others do just fine. Surgical subspecialties do poorly especially plastics as does ob-gyn. Someone more insightful than I am has already looked into this, bone setters of all folks:
The contribution of MD?PhD training to academic orthopaedic faculties
John M. Clark , Douglas P. Hanel
Journal of Orthopaedic Research, 19: 4: 505-510
(The data analyzed here actually covers ALL SPECIALTIES not just ortho)
3. Most specialties have realized that we are a valuable commodity and are interested in having us in their programs. Other things being RELATIVELY equal (board scores, grades, aoa, letters), the PhD WILL give you an edge of variable strength (depending on the specialty). In fact, our relative advantage is greater in fields that have a lower representation quotient?ortho, ent, plastics, ob-gyn etc. Also, a course for a faculty gig in medicine may be residency (3yrs/2 if fast track), "clinical" fellowship (1-2yr clinical work + 1-2yr "research", up to 5yrs I believe if you?re doing cards followed by electrophysiology, the big bucks), and in some cases a research fellowship of variable length on top of that before a faculty position. Structured, yes but not easy. Lets look at ortho: 5yr residency 1yr fellowship then faculty. There are some advantages in this although surviving as a research attending will be more difficult in surg specialties.
4. Myth: pathologists and radiologists don?t see patients.
Fact: Pathology is not one faceted. If you do clinical path, you can be pokin? more patients than a lot of other docs. Sure, forensics can be lots of dead folks. And surg path can be long hours with lots and lots of surgical samples and slides.
Radiologists do CT, fluoro, US guided biopsies and aspirations. And who do you think administers the lower GI barium and injects the contrast and starts a code in the CT suite if there is one? Who do you think says "this is going to be uncomfortable" to the patient before placing an intravaginal US probe at 3 am? Again, lots of potential for injecting and poking. And if you?re IR, you?re essentially a minimally invasive vascular surgeon.
The main source of confusion here is that these folks are doctors? doctors (a urgent consult service of sorts) so they don?t have to round on patients (except IR) and are not responsible for their overall care.
5. Be open minded and look into a field before dismissing it. Unless you?re one of those really curious or terminally indecisive, you probably don?t know much about what it?s like to 1) be a resident in any given field and 2) be an attending. Oh, and attendings are notorious for knowing little about what attendings in other fields actually do. Example: if a cardiology attending says orthopods only see surgical patients in clinic, give a little smirk because for every surgical patient there are typically10 MEDICALLY or NON treated patients. So, find out more and do what you really want and not what you think you want or what others think you ought to want.
The end, good bye.
