MD/PhD... is it worth it? PLEASE HELP!

[Danny Noonan]

I need some real insight from any of you out there that might have some perspective for me. I am at the tail end of my first year in a MD program in the midwest. My program also has an MD/PhD program that I have had my eye on. I spoke with my dean and he said I still have the option of joining on if I decide soon. Since it does involve an extra 3 years of education, I have a few burning questions and would appreciate some help:

1. What doors can an MD/PhD open than a regular MD cannot?

2. If my goal is to primarily be a great clinician with hopes that an MD/PhD might enhance my skills/opportunities, am I making a mistake?

3. Does an MD/PhD with similar grades, board scores have any more of chance of getting into competative residency programs than the traditional MD? Could it hurt my chances in any way?

4. Why should I or shouldn't I do it?

5. What sources can you recommend so that I can make this decision with my eyes as wide open as possible.

I would like to think that my motives are worthy, but please kindly correct me if I am wrong. I like to take advantage of good opportunities that could make me a better doctor and contribute the most to my field and my patients. I am happy with my decision thus far to go into medicine and am enjoying my time in school. I do not necessarily want to go into accademic medicine as my end goal, at least I dont think I do judging on my perspective at this point. Of course that could change, as i am sure to keep an open mind. I am interested in radiology, neurosurgery, OB/GYN (high risk perinatology), you know... the adventurous stuff. I kind of like the idea of being on the "front lines" of medicine, dealing with the complex cases that most are affraid of (including me at this point). I want to experience the rewards of contributing to the advancement of my field. I do have hobbies... music, hunting/fishing, sports... regular guy--married with a one year old daughter and an awesome, very supportive stay-at-home wife. So, if you have any pearls of knowledge for me, PLEASE help a brother out.

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[njbmd]

Moving to Physician Scientist Forum for expert opinion.

 

[mudphudwannabe]

I have to say, I'm pretty confused as to why you are even considering getting a PhD. You don't mention research at all. A PhD is only valuable if 4+ years of mentored, dedicated research time would benefit you in some what. In my opinion, this is only worth the time investment if you intend to use your research skills in some way in your medical career, whether it's spending a significant amount of time doing lab research, clinical research, or working in industry. MD/PhD's do not necessarily have an advantage over straight MD's -- for competitive specialties, you still have to have good grades and board scores. If the specialty/program does not value research, that you have a PhD might not make any difference. If the program does value research, you might have an advantage, but you will probably be expected to continue doing research -- so, again, if you aren't interested in research, you will be taking time away from your clinical work.

If you are interested in acquiring some research skills but don't intend to make it a major part of your career, there are other, more efficient ways to do it. I'm not an expert on the options, but I know many MD's do postdocs. If you're interested in clinical research or public health, masters degrees are available -- some of them in combination with residencies.

I'm sorry if this seems discouraging; however, the MD/PhD is a long haul, and it shouldn't be taken lightly. Ask yourself if you will really be happy with 4+ years away from clinical work. Good luck with your decision.

 

[Gfunk6]

Agree w/ mudphudwannabe. I am currently finishing up my first year of post-grad education after an 8 year MSTP. To answer your questions specifically:

1. MD/PhDs have an eaiser time (in general) in getting into more competitive residencies at top research-oriented institutions. The reasons for this are (a) many programs expect MD/PhD grads to enter research-dedicated tracks, (b) help improve the program by publishing papers, and (c) there is a general maturity one obtains after completing an MSTP.

2. Yes, you are making a big mistake.

3. You are really asking the wrong question here. If research is not your major goal, you don't really need to shoot for the same residencies as MD/PhD students. Each year, plenty of straight MD grads get into top residencies with a healthy sprinkle of MD-PhD grads. Being the latter will generally help you.

4. MSTPs are designed to produce physician-scientists not to make medical students more competitive for residency slots.

It sounds like you would do well with clinical research which is another way you could spend most of your time seeing patients and doing surgeries. On the other hand, you could advance the field and work in a high-tech academic setting if you wish.

Good luck.

 

[Circumflex]

I agree with everything said by the other posters. If you don't have a genuine interest in lab research, then don't do the PhD. You have a lot of time left to finish med school and residency +/- fellowship, so decide then if you want to go into academics. If you do want to do research, whether it be basic science or clinical, then you can seek out opportunities to specifically train you for what you want to do. Many fellowships include research experiences that allow you tailor your experience to your clinical practice.

 

[gstrub]

I will give you the honest answers you are looking for.

Questions 1 and 3 are related. If you plan on practicing medicine primarily (residency) then yes, you will be more competitive than a traditional MD student if you are applying to top programs (ones with strong research). There is simply no doubt about it. This is the biggest "door" that will open for you, for now. Later in life, depending on what you do, the PhD will open more doors for you. Looking for a faculty position in an academic setting? Well MD/PhDs will fare better in general. It will DEFINATELY NOT hurt your chances as long as you still do well in school and get some good research done.

2. MD/PhD is rarely, IMO, a mistake. Yes, it takes a little longer. However, even if you do very little to no research later, having the experience of basic science research will add great perspective to whatever you do. There is research behind every aspect of medicine...knowing how it is done, and having the training to think as a scientist, will undoubtedly help you.

4. You should NOT do the MD/PhD if finishing medical school in 4 years it a top priority. Also you should NOT do it if you hate doing bench research. You SHOULD do it for a laundry list of reasons. You mention you have hobbies, like to have a life etc? Well the PhD phase (for me at least) is the perfect time to do that stuff. I'm sure some will disagree with me but those people probably don't have lives anyway. Another reason is financial...no debt is very nice, plus you can still borrow FAFSA if you have other debts you need to consolidate, or just feel like living on 50K a year instead of 25. I do this.

In my opinion MD/PhD is well worth the extra time. If you really want to "be on the front lines" it may be for you. Something about creating the medicine as well as putting it to work is appealing to that type of personality. As far as resources go...try and find some MD/PhDs at your hospital and talk to them...they have much better understanding than the MD/PhD students.

Hope this helps.

 

[r1oid]

I'll throw in my 2 cents. Doing the PhD sounds like a bad idea if the they truly are for the reasons you listed.
1. The PhD will probably not only take 3 years unless your progam is one that has a set 3 year PhD program. The average for most programs is about 4.5 years for the PhD.
2. Your described eventual carrear goals especially with the outset of doing no academic or clinical reseach. Should be your clear indication to not do the program.
3. There are many things you can do to improve your CV that would take less time and probably be more fulfilling. PhD work is hard and depressing at times (ie. when your class graduates and matchs).
4. The MD/PhD is not a golden ticket. It is desireable for some areas of medicine and mostly departments with strong academic ties. I have known plently of MSTPs who did not match to top choices because of poor clinical rotation scores.
5. In the grand scheme of things the MD/PhD program is there to make physician scientists, if that is not what you want to be then please don't take the spot from somone for whom the program was created for.

 

[mudphudwannabe]

2. MD/PhD is rarely, IMO, a mistake. Yes, it takes a little longer. However, even if you do very little to no research later, having the experience of basic science research will add great perspective to whatever you do. There is research behind every aspect of medicine...knowing how it is done, and having the training to think as a scientist, will undoubtedly help you.

I have to disagree. Graduate school is a long time to be away from medicine if research is not a high priority for you. Even many people who have a strong dedication to research find the later years of graduate school to be frustrating -- they have a hard time wrapping up their research (experiments don't work, trouble with publications, PI's don't want to let them go) and moving on to finish the last 2 years of med school. If you want to get a flavor for research, do a summer project, and if you find you're really interested, there's always the option to pursue research without the PhD. You don't need the letters after your name and 4+ years of formal training to think like a scientist.

 

[Danny Noonan]

I surely appreciate the genuine feedback. I met with the MD/PhD program director today to further entertain the idea. I have not committed to anything yet, and considering the warnings I've recieved on this thread, I will definately be able to make a decision based on a better foundation. I will keep checking the thread and doing more research on the option on my own before I go any further. At this point I am just taking in all the advice I can. Thanks to you all for taking the time.... much appreciated.

 

[greg12345]

The primary function of an MD/PhD degree is to train someone who can (and hopefully will) conduct translational research in the future. It is possible to do this as a straight MD, but the PhD training certainly puts you ahead of the game and gives you a skill set to be more successful at research.

The primary thing that you need to find out is WHETHER YOU WANT TO DO RESEARCH IN THE FUTURE, AND IF SO, HOW MUCH. Since you are a 1st year, I would recommend getting into a lab this summer and seeing how you feel about research. If you absolutely love it and want to make it the focus of your career, then by all means go for the MD/PhD. If you are ambivalent about it after your experience, forget the PhD! If you change your mind in the future, you can always pursue research again and get training during your fellowship years. All the reasons you have listed are NOT good reasons to pursue the MD/PhD; the only good reason to pursue one is if research will be an integral part of your future career.

 

[bayberry]

hey everyone! I am in sort of the same situation as Danny and would appreciate some advice. I have been accepted to both MD-only and MD/PhD programs. My first time applying I applied to only MD/PhD programs, but after getting nothing but rejections and getting older (25 now), I decided to apply to both programs this year.

I came into this application cycle thinking I will only do an MD-only program but the financial incentives is causing me to SERIOUSLY consider MD/PhD again. Here are my thoughts on MD/PhD....please tell me if these are valid reasons to commit to MD/PhD or stick with MD-only:

Pros:
1. I like research...not love, but enjoy (I have 3 years of undergrad experience, 1.5 years at NIH, few pubs)
2. debt free + 3 years is a HUGE turn-on vs. ~300k debt
3. academic medicine is a definite possibility for me -- too early for me to descide what life is at 40

Cons:
1. not too keen on teaching -- teaching MCAT right now...not loving it
2. I'll be in my late 30s finishing residency vs. mid 30s
3. I want to travel/work with Docs w/o Boarders/have a life -- this may be my committment phobia talking!

Thanks so much!

 

[greg12345]

I would recommend not doing the MD/PhD. Financial reasons (while they seem utterly compelling before you start) are the worst possible reasons to pursue the combined degree. Yes, that is a huge amount of debt but most docs (even those in low paying specialties) still have significant earning potential. Academic medicine is very much a possibility without the PhD, as has been reiterated numerous times.

On another note, your cons are not that big. "Teaching" in an academic setting (e.g. as a hands on attending in the hospital) is probably way different than teaching some MCAT review course to a bunch of stressed out premeds. 4 years difference in when you finish residency is not huge in my opinion.

 

[Mountain Cow]

Can anyone else comment on bayberry's post. I share some of these feelings and would like to hear some additional perspectives. Thanks

hey everyone! I am in sort of the same situation as Danny and would appreciate some advice. I have been accepted to both MD-only and MD/PhD programs. My first time applying I applied to only MD/PhD programs, but after getting nothing but rejections and getting older (25 now), I decided to apply to both programs this year.

I came into this application cycle thinking I will only do an MD-only program but the financial incentives is causing me to SERIOUSLY consider MD/PhD again. Here are my thoughts on MD/PhD....please tell me if these are valid reasons to commit to MD/PhD or stick with MD-only:

Pros:
1. I like research...not love, but enjoy (I have 3 years of undergrad experience, 1.5 years at NIH, few pubs)
2. debt free + 3 years is a HUGE turn-on vs. ~300k debt
3. academic medicine is a definite possibility for me -- too early for me to descide what life is at 40

Cons:
1. not too keen on teaching -- teaching MCAT right now...not loving it
2. I'll be in my late 30s finishing residency vs. mid 30s
3. I want to travel/work with Docs w/o Boarders/have a life -- this may be my committment phobia talking!

Thanks so much!

 

[Ultra7]

In my opinion, many of the reasons listed in this thread for pursuing the MD/PhD are sort of misguided. I don't want to say that there is a right or wrong reason for doing the dual degree, because clearly there are many reasons and what it really comes down to is making yourself happy.

But...the PhD is going to involve (probably) about 4 years of research. It is not worth doing if research is not something you enjoy at least about as much as practicing medicine. The main benefit of getting a PhD is to qualify you to be a physician-scientist, combining clinical work and research at an academic institution. There are some side benefits (looked on favorably by some residencies, less debt, better doctor because you can think scientifically and have better understanding of scientific process, etc.) but all of these are minor and can be MUCH more efficiently achieved in other ways (for example, higher step I and clinical grades are more important than PhD for most residencies; you can get out of debt in less than 4 years working in private practice in some fields).

There is no potential benefit that will make up for those "lost" years of your 20s if you are merely tolerating your research years as a means to an end. If you like seeing patients substantially more than you like pipetting, a PhD is not for you.

This may sound contradictory, but I do think MD/PhD is a reasonable choice if you are in no hurry to stop being a student and just aren't sure whether or not you want to do academic medicine. If you enjoy research, doing a PhD is fun (most of the time). And the minor benefits listed above can be looked upon as a consolation prize if you decide not to stay in academic medicine and be a physician scientist at the end of your training.
I hope that makes sense. Good luck with your decision!

 

[bayberry]

because clearly there are many reasons and what it really comes down to is making yourself happy.

I totally agree with this!!! However sometimes finding out what will make you happy today vs. in 7 years uv. in 20 years is hard to figure out.

This may sound contradictory, but I do think MD/PhD is a reasonable choice if you are in no hurry to stop being a student and just aren't sure whether or not you want to do academic medicine. If you enjoy research, doing a PhD is fun (most of the time). And the minor benefits listed above can be looked upon as a consolation prize if you decide not to stay in academic medicine and be a physician scientist at the end of your training.
I hope that makes sense. Good luck with your decision!

I got a very similar advice from a MD/PhD mentor/friend of mine. Thanks for your honest oppinion! Medicine is such a long career path, that I have come to my own personal thought that there is no point in rushing it! You can't fight time. Might as well make sure that you will enjoy the process.