MD/PhD...is it worth it?

[RxnMan]

I don't remember that class. I think I was sitting in the back asleep.

As much as I don't want to waste my tuition, this is probably the best way to "participate" in empathy classes! If you contribute in any way, class inevitably goes longer.

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[1Path]

For example, in urology I do not know 1 MD/PhD in my research area. They are all MD's or PhD's.

I've also found this to be the case in my research in prostate cancer. However, the one fact that can NOT be denied is that amoung the group that I worked with, the 1 MD/PhD's knowledge base was extensive and he was by far the brightest in the group.

I can sit in on medical conference/rounds and without knowing anything about anyone in the room, I can easily identify who the MD/PhD's are in the room during case discussions. Medicine is seen from a different lense when you have formally trained to be both and MD and PhD.

 

[QofQuimica]

I think you guys need to kiss and make up!

It's funny seeing posters jump to conclusions - "you must not know the agony I went through" - heaven forbid somebody empathizes with you! Looks like all those hours in med student empathy classes were wasted!

I concur. All y'all combined program people are getting off easy, if you ask me. I'm on a FOURTEEN year MD/PhD track here doing separate degrees, folks. I'll be starting my residency at age 35. You young'uns stop your fussin', you hear?

Ok, so now for the semi-serious pep talk. Those of you who are in the throes of quals or just finished them are hating life, and that's completely to be expected. That is a totally sucky time to be a grad student, the worst part of grad school without question. But Ecthgar, the reason why most people say they feel it was worth it after their PhDs are done is because we really feel it was in retrospect. The good news is that once you pass your quals, you are probably going to finish. I'm not promising you that it will be easy or that you'll be done in a year, but if you've made it that far, you are very likely to make it all the way. And in a few years, you can come on here and encourage the new group of frustrated grad students through their rough points.

Now that I'm in med school, I actually look back fondly on my grad school time, and, dare I say, miss being in the lab. Yeah, you can do research during your summers off in med school, and I did last summer and will again this summer, but it ain't the same.

1path, I met an MD/PhD urologist in an airport last year while I was going on interviews. We started talking while we were waiting in line at the security checkpoint. He was awesome. Guy had gone to grad school, got his PhD in physics. Then he went to med school, and now he's a urologist. Did research for a while, now mostly doing clinical stuff. I can't even remember what med school that trip was for any more, but talking to him seriously made my day.

 

[deleted127837]

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[jjmack]

you also are forgetting the people who don't really need money in the first place and can do research because they truly enjoy it.

I'm an MD/PhD student right now, and let me tell you, unless you are pressed for money and don't want a bunch of loans, it's a waste of time.

 

[Gyric]

Is it worth it? I will chime in as someone in residency.

IMO the answer depends on the length of time spent in graduate school training. It bears out that most individuals fresh out of college, who enter md/phd programs, do not in fact know exactly what they want to do with their professional lives and many choose the combined training as a way to keep open all possible options.

Combined training achieves that goal nicely to a point. With an MD/PhD (no matter the length) you will have your pick of residencies/locations and you will have research opportunities (and the ability to take adavantage of them) unique to an MD/PhD that can catapault you ahead of the single degree competition. Good Md/PhDs are not uncommonly offered lab technicians and other resources during residency and in many ways are treated as senior postdocs from the start. We also have access to noble prize winning laboratories for postdoc training (and all the benefits of that pedigree), something that is much more diffidult with a single degree.

That being said, the diversity of career paths becomes limited as training drags on. You most likely will start a family eventually and need real income. If you are stuck for 8-10 years in an md/phd, the clinical residencies that require longer training (6-8 years) will be less manageable for all but the most masochistic.

For me it was absolutely worth it, but then I finished in 6 years (age 27) with great publications and all opportunities open to me. I also found pathology, which feels like a natural extension of my combined training.

My advice, find someplace fully funded with a track record of getting people out in 7, after that people just get too burnt out and options are limited for most folks.

 

[Hohenheim]

How many MD PhDs are at the forefront of their fields in basic science research?

 

[Hard24Get]

My problem isn't with the MD. I think MD is great training. PhD is CRAP.
This ends my diatribe for the day, back to qualifer

P.S. O god, Peter Agre and Rod McKinnon are both MDs?!
where are the CHEMISTRY PhDs? huh? where??? More evidence that PhD is crap. MD is gold

for more information on why MDPhD is a waste of time
http://www.columbia.edu/~xsl2101/interests.htm#mdphd

So if you really feel this way, why take the quals? Why not quit and save yourself 2 years or so? If you are not willing to do this, the PhD couldn't be a total waste, could it? I think you are just frustrated, as others have said.

 

[dl2dp2]

.

 

[Circumflex]

You are only responsible for your education - the benefit to the lab is secondary. People come and go and PIs know this and should be able to deal with it. Life is too short. If you are unhappy, you are doing yourself a disservice.

 

[antinomian]

the main reason i'm not quitting is that i have some nobel laureate on my ass and if i quit now all my active projects would have no where to go and i'd be fvcking everyone over.

while i'm possibly frustrated, i'm not completely devoid of all sense of moral responsibility

Ah, sluox, that sounds like the endless justification that en-sepulchers us into those institutional beings that we could become, those stony-winged creatures that inhabited the cornices of the buildings where you went to college.

The invocation of moral responsibility would make a sophist spin, but I hope you don't really believe such sententious rhetoric: you're making an equivalent, mutatis mutandis, of Pascal's Wager. As many others are as well, given that the experience of training is often different from what was expected, and no one knows exactly what lies on the other side.

Of a large set of individuals who matriculate into MD/PhD programs, fear, arrogance and intelligence are powerful impetuses: a fear of closing doors, a palpable sense of arrogance about simply having an MD, or for the truly brave, just a PhD, and the intelligence to sustain their misguided belief in the latter while providing the crippling foresight that is at the root of the former.

These factors may allow, nay, insist! on excellence during college and the training program itself, but this unhappy triad loses its coordinated flow forward as the options grow murky and real choices must be made: each is a master in its own right, each possibly leading down its own road.

Before that road grows murkier, students in MD/PhD programs are amongst the most opined about their own training and critical of those who have moved beyond it. Of the former trainee who forges into the world of basic research alone, foregoing residency training, they are admired for their intelligence and fortitude even if the wisdom of their decision is questioned--until they are established. Those who engage in "translational research" (the kind said with disdain) are criticized for their inability to close a door and just do one thing well - why be mediocre in both? Finally, those who leverage their degrees to join the upper echelons of academic medicine without doing real research, a competitive (read: well paying, reasonable hours) specialty, or private practice(!) are criticized for needing to be in an environment where their dual-degree status alone is heralded, while the cool pragmatism of their decision in a world of uncertainty can't quite be questioned. Admired is the trainee who becomes the revered physician-scientist--at the top of both fields--inspiring respect as they inhabit the role of the triple-threat physician-scientist-educator. And we know how rare that is; a good aspiration, surely, but what are the chances that things will turn out that way?

These sentiments, of course, don't represent the entire corpus of thought that drives MD/PhD's, but they are real currents that can be seen throughout the process. And while this would seem to be aimed at MD/PhD aspirants and trainees, I think it exposes some of the structural faults of training physician-scientists in this manner.

As cynical as this read of the situation can get, it's worth a pause to consider the qualities, besides fear, arrogance and intelligence (half-jokingly) that this set of people I've described possess. Living in NYC, I'm surrounded by people --friends, acquaintances, strangers-- who make up a broad spectrum of professions, thought, and ways of considering the world. And it isn't at all a given that they think the world can be made better, that it's worth their time to help someone (even if the remuneration makes it seem worthwhile), or that thought and creativity are to be valued. On occasion, this contrast puts my colleagues in medicine and science in high relief, and limns around them a common light of relative beneficence, reminding me that there is something about what we do that seems worthy of some self-absorption and focus. And that this latter point can succor us and supersede those negative sounding qualities in the paragraphs above.

But this doesn't mean that comments and complaints about the training are unwarranted, in fact, it's critical. To say, "if you find it so frustrating, why don't you leave" ("if you don't like what America does, why don't you leave?") ignores an opportunity, through the eyes of the frustrated, to see problems that may or may not genuinely exist. That, yes, this process is structurally inefficient, and there isn't an easy, obvious solution. That there is a great degree of uncertainty about what lies ahead, and we, half-breeds of romantics and pragmatists find our dual nature constantly wrestling within ourselves. That we see the opportunity-cost of choosing this route over others that maximize different qualities that we want: more family time, more money, more security, more flexibility, more creativity, more. That it is long, and we change over time, and the reasons we thought something made sense years ago may not persist as we grow. That simply continuing nearly guarantees a modicum of success that is difficult to turn away from. That the success might not be great enough.

MD/PhD... is it worth it? For you, I don't know. Know who in you is holding the reigns, and may your weaknesses never blind you. For me, I don't know. But I do know that these past years here have been full of life and all of its vicissitudes. My program has been a part of that. Living here has been extraordinary, I've met many life long friends, and I think differently. Those who know me would never describe me as panglossian, but despite not knowing if it will have been 'worth it in the end', it's worth it now. And that's worth something.

-antinomian

 

[gbwillner]

MD/PhD... is it worth it? For you, I don't know. Know who in you is holding the reigns, and may your weaknesses never blind you. For me, I don't know. But I do know that these past years here have been full of life and all of its vicissitudes. My program has been a part of that. Living here has been extraordinary, I've met many life long friends, and I think differently. Those who know me would never describe me as panglossian, but despite not knowing if it will have been 'worth it in the end', it's worth it now. And that's worth something.

-antinomian

I would like to subscribe to your newsletter. Does it come in an abridged format?

/J/K- that as great. It's good to reflect on the positives and negatives of the MSTP experience, and see them combined as a part of your life.

 

[1Path]

Ah, sluox, that sounds like the endless justification that en-sepulchers us into those institutional beings that we could become, those stony-winged creatures that inhabited the cornices of the buildings where you went to college.

The invocation of moral responsibility would make a sophist spin, but I hope you don't really believe such sententious rhetoric: you're making an equivalent, mutatis mutandis, of Pascal's Wager. As many others are as well, given that the experience of training is often different from what was expected, and no one knows exactly what lies on the other side.

Of a large set of individuals who matriculate into MD/PhD programs, fear, arrogance and intelligence are powerful impetuses: a fear of closing doors, a palpable sense of arrogance about simply having an MD, or for the truly brave, just a PhD, and the intelligence to sustain their misguided belief in the latter while providing the crippling foresight that is at the root of the former.

These factors may allow, nay, insist! on excellence during college and the training program itself, but this unhappy triad loses its coordinated flow forward as the options grow murky and real choices must be made: each is a master in its own right, each possibly leading down its own road.

Before that road grows murkier, students in MD/PhD programs are amongst the most opined about their own training and critical of those who have moved beyond it. Of the former trainee who forges into the world of basic research alone, foregoing residency training, they are admired for their intelligence and fortitude even if the wisdom of their decision is questioned--until they are established. Those who engage in "translational research" (the kind said with disdain) are criticized for their inability to close a door and just do one thing well - why be mediocre in both? Finally, those who leverage their degrees to join the upper echelons of academic medicine without doing real research, a competitive (read: well paying, reasonable hours) specialty, or private practice(!) are criticized for needing to be in an environment where their dual-degree status alone is heralded, while the cool pragmatism of their decision in a world of uncertainty can't quite be questioned. Admired is the trainee who becomes the revered physician-scientist--at the top of both fields--inspiring respect as they inhabit the role of the triple-threat physician-scientist-educator. And we know how rare that is; a good aspiration, surely, but what are the chances that things will turn out that way?

These sentiments, of course, don't represent the entire corpus of thought that drives MD/PhD's, but they are real currents that can be seen throughout the process. And while this would seem to be aimed at MD/PhD aspirants and trainees, I think it exposes some of the structural faults of training physician-scientists in this manner.

As cynical as this read of the situation can get, it's worth a pause to consider the qualities, besides fear, arrogance and intelligence (half-jokingly) that this set of people I've described possess. Living in NYC, I'm surrounded by people --friends, acquaintances, strangers-- who make up a broad spectrum of professions, thought, and ways of considering the world. And it isn't at all a given that they think the world can be made better, that it's worth their time to help someone (even if the remuneration makes it seem worthwhile), or that thought and creativity are to be valued. On occasion, this contrast puts my colleagues in medicine and science in high relief, and limns around them a common light of relative beneficence, reminding me that there is something about what we do that seems worthy of some self-absorption and focus. And that this latter point can succor us and supersede those negative sounding qualities in the paragraphs above.

But this doesn't mean that comments and complaints about the training are unwarranted, in fact, it's critical. To say, "if you find it so frustrating, why don't you leave" ("if you don't like what America does, why don't you leave?") ignores an opportunity, through the eyes of the frustrated, to see problems that may or may not genuinely exist. That, yes, this process is structurally inefficient, and there isn't an easy, obvious solution. That there is a great degree of uncertainty about what lies ahead, and we, half-breeds of romantics and pragmatists find our dual nature constantly wrestling within ourselves. That we see the opportunity-cost of choosing this route over others that maximize different qualities that we want: more family time, more money, more security, more flexibility, more creativity, more. That it is long, and we change over time, and the reasons we thought something made sense years ago may not persist as we grow. That simply continuing nearly guarantees a modicum of success that is difficult to turn away from. That the success might not be great enough.

MD/PhD... is it worth it? For you, I don't know. Know who in you is holding the reigns, and may your weaknesses never blind you. For me, I don't know. But I do know that these past years here have been full of life and all of its vicissitudes. My program has been a part of that. Living here has been extraordinary, I've met many life long friends, and I think differently. Those who know me would never describe me as panglossian, but despite not knowing if it will have been 'worth it in the end', it's worth it now. And that's worth something.

-antinomian

I don't know why but reading this reminded me of the Canterbury Tales.

 

[malchik]

Quitting an MSTP is not equivalent to having never begun one. The former is academic suicide, not easily explained to would-be program directors or employers at prestigious, research-oriented places. However, if one is prepared to abandon academics altogether, then quitting is certainly on the table.

I agree with whoever (Sluox?) proposed that the only benefit of a PhD is protected research time. But it is a real benefit, and one that is critical to succeeding in research. There are a lot of MD’s who are basically flops in the lab because they’ve never had protected time, on the order of 4+ years, to learn how to be an independent scientist. I think an alternative at least as beneficial as a PhD would be a research-heavy fellowship, if it were a protected (and protracted) chunk of time to be a quasi-independent researcher. It would give you a higher salary than a grad student gets, and the NIH would help you pay back loans. Aside from that, a PhD is just a credential. And I think the effect of this credential on one’s ability to procure grant money and jobs is overrated, and negligible compared with whether or not one has learned how to think like a scientist, which a PhD per se has no monopoly on.

So I would submit that most of us, at the end of the day, are just pathologically in love with credentials.