MD/PhD clinical practice

[deleted647690]

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Would there be a point in getting an MD/PhD if I'm only interested in clinical practice? Are there benefits for doing this type of program if your aim is to get into a competitive specialty, which requires research? Is this a valid reason for why people do these sorts of programs?

From the little bit of research I've done, it seems that I should just aim for MD if I my goal is patient care. I guess my question is, do people do MD-PhD to get some kind of competitive benefit for those top specialties? Or would that not be worth it, and they should just focus on getting high board scores,etc.?

 

[eteshoe]

Would there be a point in getting an MD/PhD if I'm only interested in clinical practice? Are there benefits for doing this type of program if your aim is to get into a competitive specialty, which requires research? Is this a valid reason for why people do these sorts of programs?

From the little bit of research I've done, it seems that I should just aim for MD if I my goal is patient care. I guess my question is, do people do MD-PhD to get some kind of competitive benefit for those top specialties? Or would that not be worth it, and they should just focus on getting high board scores,etc.?

There really isn't an inherent advantage to doing a PhD for competitive (or any) specialties. In fact it can hurt one's chances in many community-based programs since they may question how seriously you want to be a clinician. At the end of the day step scores and clerkship grades (and probably AOA) will position you better for those competitive residencies. Of course there are MD/PhDs in top programs and specialties, but their scores were what got them those positions, not some publication from grad school (though a couple Nature/Science/Cell papers don't hurt lol).

The dual degree program was designed for those who want a primarily research based career but it's not the only way to become a physician scientist. From your post I would say only do the MD since it will take some serious level of commitment to get through the PhD portion (which is why research experience is such a major prerequisite for these types of programs). I would recommend you do research during med school and if you so choose maybe a research year (typically after your pre-clinical yrs is what I've seen) at the NIH or HHMI or whatever.

There are different reasons to do these types of programs so I can speak for no one but myself. I chose to do the MD/PhD since I figured having protected research time to build up my knowledge base and research skills in cancer bio would benefit me as an oncologist (in the future). Plus the type of translational research I would like to conduct requires I have the MD so I can see patients and have better access to samples (not impossible with just the PhD but can be tougher depending on the institution).

Hopefully that clarifies some of your concerns/questions.

 

[BurghStudent]

Would there be a point in getting an MD/PhD if I'm only interested in clinical practice? Are there benefits for doing this type of program if your aim is to get into a competitive specialty, which requires research? Is this a valid reason for why people do these sorts of programs?

From the little bit of research I've done, it seems that I should just aim for MD if I my goal is patient care. I guess my question is, do people do MD-PhD to get some kind of competitive benefit for those top specialties? Or would that not be worth it, and they should just focus on getting high board scores,etc.?

I would say either no one does, or no one should get a PhD to boost their resume only. Getting a PhD is hair-pulling work. You have to balance a lot of expectations, manage multiple experiments that are just itching to not work, and you need some level of luck to make sure what you posit to the scientific community is of some (usually positive) substance. The people I know who went MD/PhD were always inclined to do this sort of work. They love knowing how things work down to the amino acid. Think of it this way, every sentence in First Aid is at least one person's PhD thesis.

Your typical wham-bam-thank you ma'am MD route can get you anywhere you need to go. Except MGH neurosurgery. But basically anywhere.

 

[Levo]

Would there be a point in getting an MD/PhD if I'm only interested in clinical practice? Are there benefits for doing this type of program if your aim is to get into a competitive specialty, which requires research? Is this a valid reason for why people do these sorts of programs?

From the little bit of research I've done, it seems that I should just aim for MD if I my goal is patient care. I guess my question is, do people do MD-PhD to get some kind of competitive benefit for those top specialties? Or would that not be worth it, and they should just focus on getting high board scores,etc.?

Even if a PhD would be helpful to get into a top residency program in a specific field (which wouldn't surprise me), you don't really need to go to a top residency program if you want to go into clinical practice. The biggest thing that separates mid-tier and top-tier residency programs is the caliber of the research/academics. Your clinical skills and employment potential would be just fine after either.

 

[efle]

When people say competitive residencies want to see research, they don't mean you need to spend ~4 years getting a freaking PhD. Go for just MD, with a research year if you really want that on your resume

 

[deleted647690]

I'm going to work at the NIH during my gap year, and I was just thinking about the potential of doing an MD/PhD program because the research I'm going to be doing is kind of cool. But I haven't really seriously considered it. Also, I guess I could see it relating to certain medical specialties. But how would it work if you decided to do research in some field that you were interested in but then couldn't get into your favored residency that you were shooting for all along which was highly related to the research you did? Would you have to find some other field that somehow relates to your research? Or maybe just drop research altogether?

 

[Lucca]

I'm going to work at the NIH through the IRTA program during my gap years, and I was just thinking about the potential of doing an MD/PhD program because the research I'm going to be doing is kind of cool. But I haven't really seriously considered it. Also, I guess I could see it relating to certain medical specialties. But how would it work if you decided to do research in some field that you were interested in (say it was very specific and related to neurosurgery), but then couldn't get into your favored residency that you were shooting for all along which was highly related to the research you did (neurosurgery residency)? Would you have to find some other field that somehow relates to your research? Or maybe just drop research altogether?

This thread is a must-read for anyone who is thinking about MD/PhD or is simply curious as to why there are so many crazy people who would willingly submit themselves to such a thing.

https://forums.studentdoctor.net/th...tist-forum-readme-faqs-updated-3-21-10.64282/

It has links to *a lot* of threads for almost any question you might have.

To answer your question: The biggest determinant of what specialty you can go into is clinical metrics by all of the evidence I've seen and anecdotes from just about everyone on the other side of the pipeline. In terms of being "pushed out" (e.g. step not high enough) of certain specialties, if you do real basic science the problems you study will likely be relevant in way more than a single specialty. If you do something *really* specific, well, that's a different story and brings its own challenges. What I've read / heard a lot of physician scientists say is that many of them end up merely putting on their scientist hat and then taking it off and replacing it with their physician hat another day; i.e. their research and clinical practices are not necessarily aligned.

If you want to do something very specific and related to neurosurgery...then you best get into neurosurgery, I guess XD.

IMHO there's no point to the dual degree if you do not want to run a lab. There are a billion other ways to get research training if you do want to "break into" research later. Many of them are not in any way inferior to the PhD path if you want to do something more clinical in nature where the MD training and maybe a fellowship is more than sufficient. The primary downside is that academics and research don't pay and you will have debt from your undergraduate medical training weighing you down but there are loan repayment programs for physicians interested in pursuing clinical and basic research careers. There is also something to be said for pursuing research training after your clinical interests are well defined (i.e. after finishing the MD or residency) and some in the Physician Scientist forum have even argued that the NIH ought to abolish MD/PhD programs entirely and shift more resources to lower the barriers to entry and create more opportunities for junior clinician scientists to kickstart their careers / pay off loans ASAP / sustain funding from early to mid career.

Something I also really suggest doing while at the NIH is talking to actual MD/PhDs actually doing the physician scientist thing. At the NIH they are fairly common and it's a valuable opportunity afforded by the environment to learn more about the path; doing this with MD/PhDs and MD-"only" (I've always found the "only" addition to this funny) physician scientists is what convinced me to do the dual-degree as opposed to something else. Because you are interested in neurosurgery, I especially recommend talking to this guy. Very excited about what he does, but also very candid and will give you straight answers and advice about your career plans.

also this post is old but also worth a read
http://www.neuronix.org/2011/07/nrmp-puts-out-charting-outcomes-in.html

 

[deleted647690]

This thread is a must-read for anyone who is thinking about MD/PhD or is simply curious as to why there are so many crazy people who would willingly submit themselves to such a thing.

https://forums.studentdoctor.net/th...tist-forum-readme-faqs-updated-3-21-10.64282/

It has links to *a lot* of threads for almost any question you might have.

To answer your question: The biggest determinant of what specialty you can go into is clinical metrics by all of the evidence I've seen and anecdotes from just about everyone on the other side of the pipeline. In terms of being "pushed out" (e.g. step not high enough) of certain specialties, if you do real basic science the problems you study will likely be relevant in way more than a single specialty. If you do something *really* specific, well, that's a different story and brings its own challenges. What I've read / heard a lot of physician scientists say is that many of them end up merely putting on their scientist hat and then taking it off and replacing it with their physician hat another day; i.e. their research and clinical practices are not necessarily aligned.

If you want to do something very specific and related to neurosurgery...then you best get into neurosurgery, I guess XD.

IMHO there's no point to the dual degree if you do not want to run a lab. There are a billion other ways to get research training if you do want to "break into" research later. Many of them are not in any way inferior to the PhD path if you want to do something more clinical in nature where the MD training and maybe a fellowship is more than sufficient. The primary downside is that academics and research don't pay and you will have debt from your undergraduate medical training weighing you down but there are loan repayment programs for physicians interested in pursuing clinical and basic research careers. There is also something to be said for pursuing research training after your clinical interests are well defined (i.e. after finishing the MD or residency) and some in the Physician Scientist forum have even argued that the NIH ought to abolish MD/PhD programs entirely and shift more resources to lower the barriers to entry and create more opportunities for junior clinician scientists to kickstart their careers / pay off loans ASAP / sustain funding from early to mid career.

Something I also really suggest doing while at the NIH is talking to actual MD/PhDs actually doing the physician scientist thing. At the NIH they are fairly common and it's a valuable opportunity afforded by the environment to learn more about the path; doing this with MD/PhDs and MD-"only" (I've always found the "only" addition to this funny) physician scientists is what convinced me to do the dual-degree as opposed to something else. Because you are interested in neurosurgery, I especially recommend talking to this guy. Very excited about what he does, but also very candid and will give you straight answers and advice about your career plans.

also this post is old but also worth a read
http://www.neuronix.org/2011/07/nrmp-puts-out-charting-outcomes-in.html

Thanks for the great response and thread links! I'm not necessarily interested in neurosurgery at this point (I just meant it to be a random example of a competitive specialty, I mean, maybe I'm interested, idk). I think I'm leaning now towards just MD, because at this point, I'd like to just do clinical work I think. Maybe that will change though.

Also, I thought the biggest determinant for what specialty you go into is how you do in med school/board exams? I thought your clinical experience and recommendations are important, but still less so than scores

 

[Lucca]

Thanks for the great response and thread links! I'm not necessarily interested in neurosurgery at this point (I just meant it to be a random example of a competitive specialty, I mean, maybe I'm interested, idk). I think I'm leaning now towards just MD, because at this point, I'd like to just do clinical work I think. Maybe that will change though.

Also, I thought the biggest determinant for what specialty you go into is how you do in med school/board exams? I thought your clinical experience and recommendations are important, but still less so than scores

by clinical metrics I meant board scores + clerkship grades