MD/PhD...is it worth it?

[ProdigyMD]

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Can anyone tell me some of the pros and cons of getting an MD/PhD? Also, what's the difference between MD/PhD and MSTP?

 

[szhao]

Can anyone tell me some of the pros and cons of getting an MD/PhD? Also, what's the difference between MD/PhD and MSTP?

if u want to do more basic science research it is definitely worth it, knowing histology is not going to teach you basic microbiology, and even less likely to teach you fourier optics. the difference is do you get paid or are you paying during your medical school years.

 

[Law2Doc]

Can anyone tell me some of the pros and cons of getting an MD/PhD?

It's really a question of what you want to do for a living, not pros and cons. If you just want to be a clinician, there is no reason to have a PhD. If you plan to be heavilly involved in the scientific aspects of medicine/research, you will want a PhD. The biggest con is it takes a long time.

 

[91Bravo]

MSTP (Medical Scientist Training Program) and MD/PhD are the same thing.

 

[ANCAdoc]

MSTP and MD/PhD for the most part are the same thing. However, many schools will permit students to go for a PhD while not accepting them into the fully-funded MSTP program. Thus, you can still do a PhD but they will only fund you for your PhD studies.

In my opinion, I do not think an MD/PhD is of much use. I know more MD's that do research, even basic science research, than MD/PhD's. Due to the time committment I don't think it is worth it. You can still do research going the MD route. Many medical residencies have a research year (the competitive ones) and if you are really dedicated to bench research then you can even apply for NIH postdoc funding (like what the PhDs can get).

A recent Nobel prize winner, Peter Agre, discovered aquaporins and he is only an MD. Just goes to show you DO NOT need a PhD to do quality basic science research (you just need to good science foundation which med school gives you in the first two years coupled with good ideas and a good mentor).

 

[melissainsd]

MSTP and MD/PhD for the most part are the same thing. However, many schools will permit students to go for a PhD while not accepting them into the fully-funded MSTP program. Thus, you can still do a PhD but they will only fund you for your PhD studies.

In my opinion, I do not think an MD/PhD is of much use. I know more MD's that do research, even basic science research, than MD/PhD's. Due to the time committment I don't think it is worth it. You can still do research going the MD route. Many medical residencies have a research year (the competitive ones) and if you are really dedicated to bench research then you can even apply for NIH postdoc funding (like what the PhDs can get).

A recent Nobel prize winner, Peter Agre, discovered aquaporins and he is only an MD. Just goes to show you DO NOT need a PhD to do quality basic science research (you just need to good science foundation which med school gives you in the first two years coupled with good ideas and a good mentor).

I totally agree. I was thinking of the MD/PhD route but was advised against it (quite heavily) by my PI. She is an MD and does a great deal of research. Actually every one of my teachers advised against it. It is up to you of course. How much time do you want to devote to research, do you want to go into academic medicine, etc.

 

[dl2dp2]

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[ThatOne]

Wow. This thread is pretty negative. If you scrolled down a bit on the front page of this subforum, you would find the following very helpful thread with some different opinions. http://forums.studentdoctor.net/showthread.php?t=349104

 

[RxnMan]

Can anyone tell me some of the pros and cons of getting an MD/PhD?...

As others have said, it is dependent on your goals. If you are interested in basic science research in an academic setting, there's no better training. If you want to do something else - pure clinician for example - then you don't need it. Given the opportunity cost of the extra 3-4 years, the funding for the MD/PhD makes it so that you break even, no more.

A couple of other random bits: if you decide to go get a PhD getting the MD, you can. I know of several fellowships (primarily after an IM residency) that allow fellows to get PhDs. While getting yourself a PhD may make you more competitive for residencies, it is, in my findings, not as good an investment of your time as simply getting good med school grades and good USMLE scores.

...Also, what's the difference between MD/PhD and MSTP?...

Where the money comes from, and sometimes the structure of the program. MSTPs are funded by the NIH, give you a full ride, and are given to a small number of schools with long histories in research. Any med school can have an MD/PhD program, and many do, but they are funded through the school, separate from a MSTP. At some schools you'll be logistically/financially no different than a MSTP student. Some schools have you pay for the first two years of med school and then fund you for the rest. Check with the schools your interested in for their MD/PhD program specifics.

Check out the FAQs on this board for more information on different programs (see top of this forum).

 

[DeadCactus]

I'm only an undergrad right now, but I am hoping for an MD/PhD. I've been debating the PhD/MD question with myself for awhile. Maybe some people here can give me some input on whether my reasons justify a PhD/MD. My mind may change in the remaining two years of my education, but my reasons are:

i) At this point, I believe I want to get into Academic Medicine.

ii) I'm an engineering major and enjoy it enough where I'd love to work it into a career in Medicine. A PhD in Biomedical Engineering seems like a way to do this.

iii) Doing some consulting work for Biotech firms would be nice.

iv) I would mention research, but it's possible to do that without a PhD.

Thanks all.

 

[TheCybermen]

MSTP and MD/PhD for the most part are the same thing. However, many schools will permit students to go for a PhD while not accepting them into the fully-funded MSTP program. Thus, you can still do a PhD but they will only fund you for your PhD studies.

In my opinion, I do not think an MD/PhD is of much use. I know more MD's that do research, even basic science research, than MD/PhD's. Due to the time committment I don't think it is worth it. You can still do research going the MD route. Many medical residencies have a research year (the competitive ones) and if you are really dedicated to bench research then you can even apply for NIH postdoc funding (like what the PhDs can get).

A recent Nobel prize winner, Peter Agre, discovered aquaporins and he is only an MD. Just goes to show you DO NOT need a PhD to do quality basic science research (you just need to good science foundation which med school gives you in the first two years coupled with good ideas and a good mentor).

unfortunately this is a misleading comment and i would caution against it.

in the past, when medical school curricula were vastly different than what they are today, there was an extremely rigorous training program in the basic sciences that comprised the first two years of medicine. this allowed most physicians-in-training to garner without much proactive effort a graduate student-level appreciation and knowledge of laboratory science as well as the modus operandi of bench and clinical investigation.

over the past 10-15 years, however, anyone who has seen the NIH funding statistics and the rampant reorganization of medical education knows better than to say that an MD is sufficient to conduct medical research today. on a purely financial level, PhDs are awarded the highest number of grants and that number is rising. MD grant awards, on the other hand, have been severely declining for years. MD/PhD grants are well above the level of MD grants and the rate at which grant awards are rising is a steeper function than the PhD rate. obviously, the purse-strings of the NIH suggest (correctly) the MD/PhD is the future of clinically relevant research.

on an educational level, one of my interviewers (a very accomplished MD who has brought tremendous insight into the field of human genetics) said that "back in his day" there was no such thing as the MD/PhD because it was expected that the basic science training of medical school was enough to train physician-scientists. these days, few students spend sufficient time in the laboratory during their medical school years toward an end that would allow them to take part in due investigations during their career. most medical students graduate without an understanding of the intricacies and nuances of laboratory techniques, as the "bench" component of medical training has been thoroughly overtaken by the "bedside" -- obviously in response to public outcry over the need for more compassionate clinicians (a good thing, in the big picture). finally, the great wealth of scientific knowledge has increased by so much in the past 30-40 years that medical science can no longer be captured in full by the first 2 years of medical school -- only the clinically meaningful science is discussed in this setting, while molecular medicine is left to the PhD students and proactive, lab heavy med students (again, far fewer in number than years ago).

MD-PhD students spent a long time in training, but they do represent the gatekeepers of translational research. the MD-PhDs of today and of the present are the consultants who dictate to the industry which drugs and interventions are worth pursuing with an eye toward improving the standards of care by which patients are treated. they are the ones who dictate FDA policy. they are the ones who bring clinical trials to hospitals, sit on scientific advisory boards, and who keep academic medicine thriving.

 

[Circumflex]

DeadCactus,

If you want to be a physician, do not get a PhD in Biomed Eng first. I don't know if you can do an MD/PhD with the PhD in engineering - you could probably work something out. It sounds like you have several interests in engineering.

You need to ask yourself how you would like to be spending your time later in life. Running a lab (successfully) and doing consulting work would leave very little time for practicing medicine. This is especially difficult for surgeons, who need to do a lot of procedures to get good and stay good at what they do.

Many people feel outside pressures and expectations to go into medicine rather than science or research. Be honest and true to yourself when evaluating what you want to do - in the end you will be happier and save yourself some hard times. Good luck.

 

[SpeakLittleB]

DeadCactus,

If you want to be a physician, do not get a PhD in Biomed Eng first. I don't know if you can do an MD/PhD with the PhD in engineering - you could probably work something out. It sounds like you have several interests in engineering.

You need to ask yourself how you would like to be spending your time later in life. Running a lab (successfully) and doing consulting work would leave very little time for practicing medicine. This is especially difficult for surgeons, who need to do a lot of procedures to get good and stay good at what they do.

Many people feel outside pressures and expectations to go into medicine rather than science or research. Be honest and true to yourself when evaluating what you want to do - in the end you will be happier and save yourself some hard times. Good luck.

Just wanted to say that there are a number of MD/PhD applicants that I have met this cycle planning to do their PhD in bioengineering. Look carefully at the different programs to find out which ones offer that degree.

 

[gbwillner]

DeadCactus,

If you want to be a physician, do not get a PhD in Biomed Eng first. I don't know if you can do an MD/PhD with the PhD in engineering - you could probably work something out. It sounds like you have several interests in engineering.

You need to ask yourself how you would like to be spending your time later in life. Running a lab (successfully) and doing consulting work would leave very little time for practicing medicine. This is especially difficult for surgeons, who need to do a lot of procedures to get good and stay good at what they do.

Many people feel outside pressures and expectations to go into medicine rather than science or research. Be honest and true to yourself when evaluating what you want to do - in the end you will be happier and save yourself some hard times. Good luck.

This is absolutely wrong. There are several Biomedical Engineering MSTP programs. It is a hot PhD right now. Engineers may not run a Lab per se, but can use their degree just fine in medicine. I know several MSTPs with Bioengineering degrees, and they go into a variety of specialties, including Rad Onc, Surgery, and Medicine.

 

[Circumflex]

I just said that it is difficult to run a lab, do consulting work, and do clinical work.

 

[chirurgino]

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.

Someone else earlier on this thread pointed out another thread with some more useful discussion on whether to MD-PhD or not to MD-PhD.

PLEASE PLEASE PLEASE do not apply for MD-PhD programs for the above reason!! I absolutely guarantee that you will be miserable if you spend the extra time for a PhD for monetary reasons alone. It's just too much of the best years of your life if you go in with this perspective.

Of course you can do some research with an MD. The purpose of getting a PhD in addition to an MD is not to give you a "research license." Dual-degree programs are for people who want to make *serious* basic science contributions to their respective clinical fields, who fully intend to practice medicine in an academic setting, and who envision spending 40-60% of their time running an NIH-funded research lab. Realize that this is entirely different from being an MD in an academic dept. who does a few PCRs during his/her one post-call "research afternoon" per week. There's nothing wrong with wanting that career either--it's just totally different from what an MD-PhD will prepare you to be able to do. I would characterize it like this--an MD will probably prepare you to be able to identify some markers for a disease, while the PhD will prepare you to figure out how those markers are mechanistically related to the disease. That's a gross oversimplification, but it gives a flavor of the difference between the two types of training.

Realize also that many MDs who have made important basic science contributions in the past worked in a time when PhDs were often just 2 years and faculty positions were usually obtained without further post-doctoral training. The requirements for serious molecular biology training are obviously radically different today. Beyond this, many of these MDs were also physician-scientists in the sense that they worked for a while as physicians and became scientists later in their careers--they rarely have done both together. I'm sure that there are exceptions, but for the most part I think this is true. [how easy it is to do both today is a different, very large and contentious topic]

Obtaining a PhD is important because the current state of biomedical research requires expertise with the basic tools of molecular biology and how they can be used, from simple molecular cloning to generating cloned/knockout mice--this takes time, dedication, and willingness to fail. More importantly, it also requires a sense of what interesting questions are and the ability to design experiments to answer those questions. This usually requires starting ambitious projects, solving their inevitable technical issues and problems, and seeing them through to completion--best done in the context of a PhD.

Is it possible to make important (even Nobel-prize winning) contributions without getting this training? Sure, it's just a lot less likely to happen, and rapidly becoming even less so, in my opinion.

 

[Dr.Watson]

just to echo what a few people have said - the academic world ten years ago, the academic world today, and the academic world in the next 10-15 years when we're looking for faculty positions are all VERY different.

anyway what follows is my opinion and some hearsay etc and is probably riddled with errors, so take it with a grain of salt and here goes:

the mst program began in the 60s and churned out their first graduates in the mid-70s. where are these people now? most are probably in their late-40s, early-50s and have climbed high on the adminstrative ladders etc. now, the swells of md-phds reaching high positions in academia is growing and will only continue to do so as the MSTPs expanded and graduated more people.

so early 90s - first md/phds graduates are settled in their faculty positions; most researchers have either an MD or PhD; most of today's nobel prize work conducted at this time and much earlier

today - early md/phds have climbed the academic ladder, numbers are small; are a growing number of md/phds researchers; many competitive residencies are increasingly going to md/phd graduates; current NIH budget cuts make it a harder for all to get grants, but i've heard especially MD-onlys trying to start out

in ten-fifteen years - md/phds #s in top ranks will be much higher; # of md/phd researchers at all levels will be higher; niche of mdphds will likely be better defined (ie more initiatives like the recent translational medicine funding); even harder for MD-onlys to compete for funding, especially at the early investigator stage, as well as for some academic appointments

maybe it's my history background, but don't make decisions in life based on the expectation that the future will be the same as today. things will be different in a decade. i think success as a physician-scientist in the next decade will be much more difficult with an MD-only than with an MD/PhD.

also remember that you will have to learn how to do research at some point. in an MSTP it's grad school; with an MD, it's a long post-doc. getting funding on your own, to me, seems easier with a PhD and a solid post-doc rather than just a long post-doc

 

[specialflava]

does the trend you're talking about apply to surgical specialties as well? (with regards to difficulty in obtaining a faculty position without the phd)

 

[Newquagmire]

I just said that it is difficult to run a lab, do consulting work, and do clinical work.

It's difficult to do any one of these well, let alone all three at the same time.

A recent Nobel prize winner, Peter Agre, discovered aquaporins and he is only an MD. Just goes to show you DO NOT need a PhD to do quality basic science research.

On a recent visit to my campus, Peter Agre gave his perspective by stating that an MD-PhD program was the best preparation for a career in clinically relevant basic science research.

That said, sometimes I wonder how necessary the MD is to do the same. Everybody here seems to assume the PhD is optional, when it may be the MD instead.

 

[Hohenheim]

I totally agree with Dr. Watson. In 20 years time - do you honestly think that someone who went through the basic MD hoops will be competitive vis-a-vis an MD PhD? I dont think so. As more MD PhDs are minted, MD only folks are going to face stiffer and stiffer competition.

 

[Dr.Watson]

does the trend you're talking about apply to surgical specialties as well? (with regards to difficulty in obtaining a faculty position without the phd)

I'd guess the trend applies, but more delayed that, say, internal medicine. Few MD-PhDs currently go into surgical specialties so the numbers rising through the ranks are rather low. Plus, many of the surgical speciality residencies (from my understanding) include a significant amount of time doing research. I'd talk to surgeons in academia more about this (it's not an area I'm planning on going into), but super-speciality surgery can be a ridiculously long track without adding the PhD and the benefits in garnering a faculty position with a PhD might not be worth it time-wise. I think the career of an MD-PhD in surgery is probably of a different nature than MD-PhD in medicine and I'm not sure what that surgical career ideally would be. Spending one morning a week seeing clinical patients and the rest in lab is more feasible than performing surgery one morning a week (b/c in surgery, the # of a specific type of surgery you perform is almost a direct correlation to how successful/"good" you are). An MD-PhD in surgery is do-able, but I've only met one so I don't know much about it. Anyone considering surgery have a more informed perspective?

 

[RxnMan]

does the trend you're talking about apply to surgical specialties as well? (with regards to difficulty in obtaining a faculty position without the phd)

I would think that surgical specialities would be more resistant to requiring PhDs of their faculty for the plain reason that it takes a lot of time in the OR to be a surgeon and to remain a good surgeon. You need to be able to churn out those patients. Similarly, they don't have as much time to run a research lab (hiring/firing, writing grants, writing papers). That's not to say that they aren't productive researchers; they just have someone else do the dirty work! 😎

And before too many people get the impression that the only way to do research as a physician is to go MD/PhD, remember there's many opportunities for physicians and surgeons to get advanced degrees during the course of their training.

 

[gbwillner]

Is it worth it? Depending on what you want to do with your life. If you really love science and research, but want to carve a path for yourself through medicine, then yes.
Also, if you love frustration, years of being a slave in a lab with little financial reward, recognition or prestige, while working long hours while you med school friends are finishing their residencies in Orthopedic surgery, from which they will earn 4x what you will ever make with your fancy degrees... Then it's TOTALLY worth it.

 

[1Path]

I would think that surgical specialities would be more resistant to requiring PhDs of their faculty for the plain reason that it takes a lot of time in the OR to be a surgeon and to remain a good surgeon. You need to be able to churn out those patients. Similarly, they don't have as much time to run a research lab (hiring/firing, writing grants, writing papers). That's not to say that they aren't productive researchers; they just have someone else do the dirty work! 😎 .

I briefly worked with a surgeon who published pretty regularily and was in the OR about 3 days/week and had 2 days/week of "admin"/research work. He had an excellent admin staff that handled all the "paperwork" aspects of his academic position. His science was tight as was his medicine, but unfortunately he was a micromanger to the nth degree, along with all those other endearing qualities of surgeons Time didn't seem to be his issue as he worked at 2 different hospitals on top of that however his wife may have a very different story.

 

[chirurgino]

does the trend you're talking about apply to surgical specialties as well? (with regards to difficulty in obtaining a faculty position without the phd)

I'm applying in ENT right now (finishing a 9-year MD-PhD). The short answer to your question is no, in part because of the reasons listed above. Certainly I haven't observed a dramatic shift toward MD-PhDs on ENT faculty...although having both degrees has definitely opened up a lot of doors during the interview process.

Some surgical sub-specialties are nerdier and have more MD-PhDs, like neurosurg and ENT. Some have fewer and tend to de-emphasize research overall, like ortho and plastics. Surgical fields are (perhaps surprisingly) ahead of medical fields in requiring research during residency--for example, almost all gen surg and neurosurg programs have 2 years of research required during residency. I think that surgeons have a lot to offer in medical research, both in terms of personality and clinical perspective, but it's true that they tend to be busier clinically and have less time to run a lab.

 

[RxnMan]

...Some have fewer and tend to de-emphasize research overall, like ortho and plastics. Surgical fields are (perhaps surprisingly) ahead of medical fields in requiring research during residency--for example, almost all gen surg and neurosurg programs have 2 years of research required during residency. I think that surgeons have a lot to offer in medical research, both in terms of personality and clinical perspective, but it's true that they tend to be busier clinically and have less time to run a lab.

If you think about it, IM's been doing something similar all along. Most specialists will have to go through a 3 year fellowship before they can call themselves a cardiologist, hematologsit, etc., or six years (3 + 3), most of which have research requirements. Surgical specialities are 5 + 1 for fellowship specialization, and both residency and fellowship require research. To me it seems to be a wash.

I am surprised with what you say about ortho - I've met a number of former engineers who became orthopods, and there's a great deal of stuff in the field to be nerdy about. 😎

 

[chirurgino]

If you think about it, IM's been doing something similar all along. Most specialists will have to go through a 3 year fellowship before they can call themselves a cardiologist, hematologsit, etc., or six years (3 + 3), most of which have research requirements. Surgical specialities are 5 + 1 for fellowship specialization, and both residency and fellowship require research. To me it seems to be a wash.

I am surprised with what you say about ortho - I've met a number of former engineers who became orthopods, and there's a great deal of stuff in the field to be nerdy about. 😎

OK, fair enough--hadn't thought of it that way. I think that having two years of required research in gen surg and neurosurg programs is still a lot more than one would get in a medical fellowship.

Haha, hope no one got offended about my comment about the lack of nerdiness in ortho...certainly there's enough in all these fields to be nerdy about, if one were so inclined...my impression of ortho was just that it tended to not attract people who were hard-core basic science types, but I could be wrong.

 

[strangeglove]

Someone else earlier on this thread pointed out another thread with some more useful discussion on whether to MD-PhD or not to MD-PhD.

Of course you can do some research with an MD. The purpose of getting a PhD in addition to an MD is not to give you a "research license." Dual-degree programs are for people who want to make *serious* basic science contributions to their respective clinical fields, who fully intend to practice medicine in an academic setting, and who envision spending 40-60% of their time running an NIH-funded research lab. Realize that this is entirely different from being an MD in an academic dept. who does a few PCRs during his/her one post-call "research afternoon" per week. There's nothing wrong with wanting that career either--it's just totally different from what an MD-PhD will prepare you to be able to do. I would characterize it like this--an MD will probably prepare you to be able to identify some markers for a disease, while the PhD will prepare you to figure out how those markers are mechanistically related to the disease. That's a gross oversimplification, but it gives a flavor of the difference between the two types of training.

This statement deserves som clarification. In most medical schools, there are two academic tracks: 1) the physician scientist track, in which one spends 40-60% of one's time doing research, either basic or clinical and 2) the clinical track, in which one devotes one's time to teaching medical students and residents and does little or no research, basic or clinical. In the physicial scientist track, your promotion depends upon how much money you bring in through grants. The research can be basic or clinical - the department that hires and promotes you does not care which you do, as long as you bring in the money. The amount of medicine you are obliged to practice depends on how much money in addition to the salary provided by your research grants you wish to make. In the clinical track, your promotion does not depend on your research output. Instead, it depends upon how much money you can make for your department by seeing patients and on your ability to train medical students, residents and fellows how to practice medicine. A clinical track physician may spend an afternoon in the lab once per week, but this does not fulfill any job requirement or help to advance one's career. Remember, as far as academic medicine is concerned, it's all about the money - not how much you'll make, but how much you can make for your department.

 

[Vader]

This is an important question... The MD/PhD pathway, and in particular the NIH-funded Medical Scientist Training Program, was designed to train highly qualified physician-scientists who are able to bring basic scientific discoveries from the bench to the bedside to help patients. This is a broad goal and encompasses many different specialties and areas of expertise.

There are numerous advantages to having this second-to-none type of training, as others here have pointed out. However, I will echo what others have said or implied, that it is very important to consider whether this long pathway is right for you. The program is designed to give you excellent training in both science and medicine. Medical school does not prepare you adequately (or at all) to do basic science. Biological PhD education by itself is lacking in the diverse range of anatomy, physiology, pathology, pharmacology and other subjects you learn during medical school, in addition to lacking significant patient contact. Therefore, the combined training gives you the best of both worlds, allowing you to develop a patient or disease-centered perspective that should inspire and inform the basic science you will do.

The main drawback is the length of training, both in the MD/PhD program itself (7-8 years on average) and the post-graduate training (3-7 years of residency and 1+ years of postdoctoral work, depending on your career pathway). Also, even straight out of college, you will be a student well into your late 20's, and will get paid like a student throughout that time.

For more information on the MD/PhD pathway, I would direct you to:
http://mdphds.org/

On that site, there is a guidebook for MD/PhD applicants, interview feedback, and other valuable information for prospective "Muddphudders". Good luck! 🙂

 

[tinkerbell10]

hi guys,

i was thinking about neurosurgery and getting a doctorate in neuroscience. if i do the md/phd would i still be taking part in the clinical roles or spending most of my time in the lab.

 

[gbwillner]

hi guys,

i was thinking about neurosurgery and getting a doctorate in neuroscience. if i do the md/phd would i still be taking part in the clinical roles or spending most of my time in the lab.

It would be extremely foolish IMHO to go 6-7 years of neurosurgery residency after a 8-10 yr MSTP and NOT do clinical work. Most neurosurgeons I know with a PhD spend most of their time doing surgery. If you want to do mostly research a neurology residency is 3 years (after internship, I believe).

 

[RxnMan]

It would be extremely foolish IMHO to go 6-7 years of neurosurgery residency after a 8-10 yr MSTP and NOT do clinical work. Most neurosurgeons I know with a PhD spend most of their time doing surgery. If you want to do mostly research a neurology residency is 3 years (after internship, I believe).

👍

As much as we med students are masochists, there has to be a payoff eventually. You can only delay gratification and train and study for so long until you get tired of it.

 

[Vader]

👍

As much as we med students are masochists, there has to be a payoff eventually. You can only delay gratification and train and study for so long until you get tired of it.

👍 Well said!

 

[Vader]

hi guys,

i was thinking about neurosurgery and getting a doctorate in neuroscience. if i do the md/phd would i still be taking part in the clinical roles or spending most of my time in the lab.

Really depends on what you want to do. There are other clinical specialties that are more conducive to a career in basic neuroscience research (i.e. neurology, psychiatry, neuroradiology).

You really won't know for sure what specialty you will do until after the experience of 3rd year clerkships and 4th year sub-Is and electives.

 

[dl2dp2]

.

 

[Circumflex]

Obtaining a dual MD/PhD is not necessary to do research later. For me, the advantage is that it is protected time to focus on learning how to do research. But, it is important to make the experience your own. I see many students go to a lab and the PI tells them what experiments to do. That is just a waste of time, except for the PI. You have to use this time to do some solid, safe research that will get you out, but you also need to be able to try some cool, long-shot projects, get practice writing grants, and give a lot of seminars. If you treat it more like a post-doc, it can be very rewarding, but you have to be aggressive.

Doing a post-doc later, after med. school to learn basic science research is more difficult. You have to ask yourself, "When will I do this post-doc?" After med. school, after residency, after fellowship. Some fellowships incorporate protected research time, but it is nothing like the time you would have in a true post-doc. Just food for thought.

 

[RxnMan]

...Either way right now at least the MDPhD *feels* like a waste of time even for someone like me who has already some moderate success in research...In fact, all it gives me is all bunch of B.S. procedure like qualifier and committee meetings...

This is my reason for not doing a MD/PhD. I got a ton of research experience through my job that I took to support my masters (yes, it's backwards, and no, my advisor did not fund me). At this point I'd have to start over from scratch, do a bunch of political maneuvering (advisor appeasement) and write another thesis. For what? More research freedom? My MD + MS + prior work will work fine for the amount and level of research I want to conduct in my career. The only (and admittedly bad) benefits would be ego appeasement, a 3-year vacation from med school, and "selling out."

...Top grads go to third rate schools to become faculties that will never get anything significant done. It's really depressing. NIH needs to restructure and standardize PhD program. How about the Cold Spring Harbor Model? 4 yrs and you are OUT. How about the European model?

I don't know if going to the European model will work - as is, US PhDs are the envy of the world. Bio PhDs are not the only ones that can take 4+ years - engineering and science PhDs can take a long time too.

I was never interested in a bio PhD (if I did one, it would be in hard sciences or engineering), so it's interesting to see the perspective. Are all of you only doing/considering bio PhDs?

 

[Shatterstar17]

You seem like you're in quite a bad mood, but many good, and well-respected researchers get their PhDs from less reknowned schools and do fine. The woman I'm rotating with this summer got both her BS and PhD at Penn State, but also happened to do some very good research. She now has two R01s, a full Professorship, and a good publishing record.

It's obviously easier if you start off from one of the big established PhD programs, just based on who you know, but I think it'd be misleading to be so absolute about it.

(4) if you are interested in doing basic research but don't hate patients, do not ever do a PhD only. Important. (in Chinese accent): No Job for PhD. If you do a PhD only, do it in math and physics. Don't do it in bio. If you do it in bio, do not go to anywhere but the big five: Harvard/MIT/MGH complex, UCSF/Berkeley/Stanford complex, Rockefeller, Caltech and (somewhere else depending on your specialty, i.e. neuroscience maybe UCSD and Columbia, etc). Anything coming from a less well regarded PhD gets you NOWHERE. and by NOWHERE i mean NOWHERE. Academia is this pretentious little pothole, if you go to StateU USA you won't even get to be invited to all the important conferences. NOBODY TALKS TO YOU, literally. Give up now. Don't be an outcast. You got into science to stop being the only nerd who get bullied. Don't let it happen to you again!

 

[TheCybermen]

You seem like you're in quite a bad mood, but many good, and well-respected researchers get their PhDs from less reknowned schools and do fine. The woman I'm rotating with this summer got both her BS and PhD at Penn State, but also happened to do some very good research. She now has two R01s, a full Professorship, and a good publishing record.

It's obviously easier if you start off from one of the big established PhD programs, just based on who you know, but I think it'd be misleading to be so absolute about it.

to those who have attached the dual degree as being "useless" on this board and who do not seem to "get" the reasoning behind why others have elected to pusue this path:

please understand that there are many personal reasons that motivate future physician-scientists. just as an example: anyone who has ever worked in an oncology clinic knows that there remains an enormous number of cancers that are treatment resistant or refractory and for which physicians prescribe the same medications that they have been for the past 10 or more years. furthermore, many of the newer drugs that are being developed have horrendous toxicity profiles, making the scenario not unlike that of a howitzer being directed at a beehive. many other diseases -- like ALS and Alzheimer's -- are similarly grossly debilitating and no treatment or standard of care truly exists in these settings. simply seeing and treating patients may not fulfill the personal and professional goals that some of us have at this point in our lives -- there may be more that we want to contribute to our and future generations that clinical research or clinical practice alone cannot encompass. this is not any "better" or "worse" than the MD degree. it is simply "different' and, with all due respect, a necessary component of the medical and scientific community.

 

[Ecthgar]

This is a good point. I concede to it.

However, nobody has a crystal ball and can foretell the future. Either way right now at least the MDPhD *feels* like a waste of time even for someone like me who has already some moderate success in research. I JUST DON'T FEEL as if the PhD is getting me anything that I can't get from straight Postdoc. In fact, all it gives me is all bunch of B.S. procedure like qualifier and committee meetings.

Granted, what I'm doing now requires some mathematical skills and a fair bit of background knowledge, but it's not something that can't be picked up quickly on the fly (if you are no good at math to begin with, you'll never do the kind of research i'm doing ANYWAY). And in the molecular world that is even truer, you follow protocols and get results. As a postdoc you are more focused and work harder and get paid more.

My problem isn't with the MD. I think MD is great training. PhD is CRAP. The American educational system use the PhD program to get cheap labor from abroad, knowing that there will be NOT ENOUGH jobs once they get out. Top grads go to third rate schools to become faculties that will never get anything significant done. It's really depressing. NIH needs to restructure and standardize PhD program. How about the Cold Spring Harbor Model? 4 yrs and you are OUT. How about the European model?

And let me tell you, once you are ready to file an R01, it is NOT the PhD that gives you an edge. It's the MD degree. How much HARDER the PhDs have to work? How unfathomably horrific their odds are? Years and years of tedium and low wage and politics? Why do you think PhD programs, even at top places, are comparably easier to get into? Why do you think the best American students go to med school, law school and b-school?

Here are some GOOD reasons for getting the PhD. I'm not being sarcastic, just cynical. I have begun a strict no B.S. policy for a while. And for the most part I think my opinion is actually, shockingly, non-controversial on the "inside", if you know what I mean.
(1) if you are dumb, the PhD makes you learn how to do research like a kindergartener. Usually taught by some slave-driving postdoc who's gunning for his first Nature paper. Even though thankfully this is not happening to me, it happens to many. Ask yourself if you are dumb, seriously, if you go into a biosci phd program. If the answer is NO, go with MD+postdoc.
(2) lots of time off. lots of pot. lots of liquor. lots of sex with gf/bf/escapades. lots of "gosh darn my experiments aren't working out i'm going to Cambodia to ride a crack boat for three months."
(3) (a little bit) of money
(4) great residency placement without lots of work during 3rd year or step i. very useful. do a crap PhD, have some time traveling and having fun in your 20s and a great lifestyle later with the likes of derm, rads, optho and dare I say ENT. This is officially called "selling out," and I do still despise those folks out there (but really when like 30% of your class sells out, what can you say?! And let me tell you it's not just my school. In fact, the worse the school is, it more frequently this phenomenon occurs. We should just eliminate all MDPhD programs below the rank of 50 at this point. All the non-NIH funed MDPhD programs? They shouldn't be allowed to exist.), some really very smart people who would have been great researchers. But then again that's just my Jewish/Asian guilt talking. Says more about me than about them.

Here are some contraindications for MD/PhD...and yes it is a drug. I've heard many a driven Asian/Jewish/immigrant kids at the tender age of 16 telling me that they want to do MDPhD, just cause it's like, oh my god, so many doctorates:
(1) if you are over the age of 25 at the time of matriculation. Strongly contraindicated.
(2) if you were wavering between MDPhD and MD only, go with the MD only.
(3) if you are not interested in doing basic research (i.e. only interested in translational/disease oriented research), go with the MD only.
(4) if you are interested in doing basic research but don't hate patients, do not ever do a PhD only. Important. (in Chinese accent): No Job for PhD. If you do a PhD only, do it in math and physics. Don't do it in bio. If you do it in bio, do not go to anywhere but the big five: Harvard/MIT/MGH complex, UCSF/Berkeley/Stanford complex, Rockefeller, Caltech and (somewhere else depending on your specialty, i.e. neuroscience maybe UCSD and Columbia, etc). Anything coming from a less well regarded PhD gets you NOWHERE. and by NOWHERE i mean NOWHERE. Academia is this pretentious little pothole, if you go to StateU USA you won't even get to be invited to all the important conferences. NOBODY TALKS TO YOU, literally. Give up now. Don't be an outcast. You got into science to stop being the only nerd who get bullied. Don't let it happen to you again!
(5) if you have lots of money. (on the other hand, you might want to do a PhD just to waste some time.)

Honestly, it really makes you think sometimes. Why is it that every MD/MDPhD researcher you meet is smarter, cooler, has a bigger picture and every PhD researcher you meet is some socially incompetent vainglorious lunatic? (doesn't count the real PhDs like evolutionary bio, physics, math, chem, engineering etc. A string theorist can be as interesting to talk to.) Bio PhD programs are labor camps! They are toxic!


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

Slu, we must have been separated at birth dog (although, I'm neither Asian nor Jewish).......I feel your pain, dear God I feel your pain. I'm 4.5 years into this and I just finished my quals this past summer. I have to say, it seems like all of the older/about to graduate med school-MD/PhDers look back and say "Wow, that was totally worth it.....I'd do it again in a heart beat!", while those of us in the midst of PhD hell are much more cynical. As of today, I feel the exact same way that Sluox does......from this side of the mirror, the outlook is gloomy at best. Dude, hang in there.......something's gotta give eventually......or at least that's what I tell myself in order to get out of bed in the morning.


"No job for PhD!"........that's classic man! I love it....

 

[Dr.Watson]

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

Hmm, based on that link:
"1) MD pathway is the most expensive, demands the most self-discipline, but also the fastest.
2) MD/PhD pathway is probably the safest pathway and probably where the students have the most fun having BOTH MD and PhD experiences
3) PhD pathway is the most risky."

So, MD may be faster than MD/PhD, but it's more risky and quality of life might suck to get to where you want to be. MD/PhD is safer, a bit longer, but quality of life will be nicer. I dunno, I take better lifestyle and security than a few yrs faster to tenure.

"Waste of time" it may be, but heck, it's our 20's - I want to have a life (ie a more laid back MD and life in grad school) and semi-secure future. I quit being in a hurry during college when I burned out with a heavy courseload and knew a year off was mandatory for my sanity.

Also, it's a waste of time depending on your interpretation. Having a life, to me, isn't a waste of time. Plus, a PhD is time to network/make valuable connections within the field and it can help you secure a better post-doc/eventual faculty position. As you mention with the big 5, politics/who you know is important in science.


Anyway, can we maybe make distinctions in this thread between the various pathways. We seem to be making arguments against each other that may not be valid/relevant to another career path. The big pathways seem to be:
*An internal medicine/biology-based MD/PhD
*A math-physics-engineering-based MD/PhD
*A surgical residency-based MD/PhD

My perspective is from the first one and I believe MD/PhD is definitely "worth it". For various reasons (namely i'm not informed about 'em), my views probably don't apply to whether an MD/PhD is "worth it" for the last two.

If you're reading this thread trying to decide, think hard about what career you really eventually want and then evaluate if the path is worth it. Consider each step, the end goal, the quality of life through it all, the time each step takes/how old you will be, and talk to people who have done it/are in it.

 

[gbwillner]

Slu, we must have been separated at birth dog (although, I'm neither Asian nor Jewish).......I feel your pain, dear God I feel your pain. I'm 4.5 years into this and I just finished my quals this past summer. I have to say, it seems like all of the older/about to graduate med school-MD/PhDers look back and say "Wow, that was totally worth it.....I'd do it again in a heart beat!", while those of us in the midst of PhD hell are much more cynical. As of today, I feel the exact same way that Sluox does......from this side of the mirror, the outlook is gloomy at best. Dude, hang in there.......something's gotta give eventually......or at least that's what I tell myself in order to get out of bed in the morning.

Dude, that's freakin' sad. You're only 4.5 years in and you're already burned out? You haven't even STARTED your thesis work probably. It will get 10x more frustrating. No way do you finish.

/save the cynicism for 6th/7th year- that's when it will come in the most handy.

 

[Ecthgar]

Dude, that's freakin' sad. You're only 4.5 years in and you're already burned out? You haven't even STARTED your thesis work probably. It will get 10x more frustrating. No way do you finish.

/save the cynicism for 6th/7th year- that's when it will come in the most handy.

1. Actually, I have a SIGNIFICANT amount of my thesis work done.......I'm finishing up grad school in another year or so.
2. Once you're actually accepted to med school (or even dare I say an MSTP) you'll see what we mean little grasshopper.
3. By 6th or 7th year I assume you mean 3rd/4th year of med school......dude, med school is cake. Again, you'll see what I mean when you get there.

 

[gbwillner]

1. Actually, I have a SIGNIFICANT amount of my thesis work done.......I'm finishing up grad school in another year or so.
2. Once you're actually accepted to med school (or even dare I say an MSTP) you'll see what we mean little grasshopper.
3. By 6th or 7th year I assume you mean 3rd/4th year of med school......dude, med school is cake. Again, you'll see what I mean when you get there.

Uhh... I'm a 7th year MSTP- be careful who you decide to talk down to. I'm in my 5th year of the PhD, and I am finishing up now, and hopefully returning to clinics in February.
If you are 4.5 years in, that means you are in your 3rd year of the PhD, and saying that you know when you will be done means 1) you have a BS PhD or 2) you have had everything go right, so what could you possibly be so burned out about?

 

[antinomian]

Dude, that's freakin' sad. You're only 4.5 years in and you're already burned out? You haven't even STARTED your thesis work probably. It will get 10x more frustrating. No way do you finish.

/save the cynicism for 6th/7th year- that's when it will come in the most handy.

Uhh... I'm a 7th year MSTP- be careful who you decide to talk down to. I'm in my 5th year of the PhD, and I am finishing up now, and hopefully returning to clinics in February.
If you are 4.5 years in, that means you are in your 3rd year of the PhD, and saying that you know when you will be done means 1) you have a BS PhD or 2) you have had everything go right, so what could you possibly be so burned out about?

Callow and churlish despite your years. Congrats.

 

[gbwillner]

Callow and churlish despite your years. Congrats.

Hey, don't blame me- blame the MSTP program for making me that way.

Ecthgar needs to EARN his contempt. He's only a 5th year!

 

[RxnMan]

1. Actually, I have a SIGNIFICANT amount of my thesis work done.......I'm finishing up grad school in another year or so.
2. Once you're actually accepted to med school (or even dare I say an MSTP) you'll see what we mean little grasshopper.
3. By 6th or 7th year I assume you mean 3rd/4th year of med school......dude, med school is cake. Again, you'll see what I mean when you get there.

Uhh... I'm a 7th year MSTP- be careful who you decide to talk down to. I'm in my 5th year of the PhD, and I am finishing up now, and hopefully returning to clinics in February.
If you are 4.5 years in, that means you are in your 3rd year of the PhD, and saying that you know when you will be done means 1) you have a BS PhD or 2) you have had everything go right, so what could you possibly be so burned out about?

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! 🙄

 

[gbwillner]

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

 

[1Path]

Hmm, based on that link:
"1) MD pathway is the most expensive, demands the most self-discipline, but also the fastest.
2) MD/PhD pathway is probably the safest pathway and probably where the students have the most fun having BOTH MD and PhD experiences
3) PhD pathway is the most risky.".

After almost 20 years in/around academia/medical schools, this sums the situation up quite nicely!👍

The big pathways seem to be:
*An internal medicine/biology-based MD/PhD
*A math-physics-engineering-based MD/PhD
*A surgical residency-based MD/PhD.

IMHO, the most logical and obvious career path for an MD/PhD is pathology. Pretty easy to do your translationla medicine thing w/o sacrificing clinical or research time.

Consider each step, the end goal, the quality of life through it all, the time each step takes/how old you will be, and talk to people who have done it/are in it.

As a person in her 40's, I don't think it makes much sense to make ANY career decision based age with the exception of a career in neurosurgery. I think it's reasonable to assume that most MD/PhD folks tend to attract people with similar ambition, so assuming you don't marry a person with 10 kids, establishing financial security will be no problem if you're level headed.

 

[ANCAdoc]

Many have stated that in the future the gap between MD's versus MD/PhD's getting an RO1 will widen. I don't agree with this, though if true it will be field dependent. For example, in urology I do not know 1 MD/PhD in my research area. They are all MD's or PhD's.

If you are an MD, then you can be a successful researcher so long as you have good ideas, a colloborative research group (with PhD's), and devote enough time to it. (note, i am assuming the individual is doing clinical research not bench research)