MD/PhD or...?

[clarkalim]

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Hello!

My name is Kali and I'm interested in MD-PhD.

I was diagnosed with something called Cramp Fasciculation Syndrome during my freshman year of high school. (I'm currently a junior biology/pre-med major at university now, though.) It inspired me to want to do research into my disorder and other disorders such as fibromyalgia, chronic fatigue syndrome, multiple sclerosis, and ALS which have no cure and/or limited treatment options. I'm also interested in doing research into things like eczema and sickle cell anemia. But I'm thinking I'd probably do a Neurology residency.

I'm confused as to whether I should earn an MD/MS in Clinical Research, an MD/PhD in a field of my choosing, or a straight MD degree and just get into research somehow (?).

Based on my research interests, what do you think would be the wiser path to choose: MD/MS, MD/PhD, or straight MD?

I'm not sure if, based on my research interests, the MS would be just fine and the PhD would be a waste of time, or if any extra degrees above the MD be a waste of time.

Thanks so much for your advice.

 

[Neuronix]

Just based on previous experience, posting photos of yourself and your real name leads to unwanted attention on SDN and in the real world. I do not recommend it. My advice would be to protect your anonymity to a reasonable degree.

I'm confused as to whether I should earn an MD/MS in Clinical Research, an MD/PhD in a field of my choosing, or a straight MD degree and just get into research somehow (?).

Do you see yourself doing research a most of the time, some of the time, or a little bit of the time? Roughly I would guide your decision as follows:
Most of the time = MD/PhD
Some of the time = MD/MS
A little bit of the time = MD
Obviously this is not a hard and fast rule.

To better inform your decision you need to perform as much research as possible while maintaining a high GPA and MCAT score as an undergraduate before choosing the right path. Strong research experience is beneficial in the near-term no matter which path you choose.

 

[clarkalim]

Just based on previous experience, posting photos of yourself and your real name leads to unwanted attention on SDN and in the real world. I do not recommend it. My advice would be to protect your anonymity to a reasonable degree.



Do you see yourself doing research a most of the time, some of the time, or a little bit of the time? Roughly I would guide your decision as follows:
Most of the time = MD/PhD
Some of the time = MD/MS
A little bit of the time = MD
Obviously this is not a hard and fast rule.

To better inform your decision you need to perform as much research as possible while maintaining a high GPA and MCAT score as an undergraduate before choosing the right path. Strong research experience is beneficial in the near-term no matter which path you choose.

Thanks, advice taken!

One more question -- with the MD/MS, are you still able to do bench research? Or only clinical (translational?) research? Are you still able to get as many grants as an MD/MS that an MD/PhD would be able to get?

Thanks!

 

[Neuronix]

One more question -- with the MD/MS, are you still able to do bench research? Or only clinical (translational?) research? Are you still able to get as many grants as an MD/MS that an MD/PhD would be able to get?

It's not the size of the degree, it's how you use it. If you do bench research for your MS and then keep doing bench research through the rest of your training, you can certainly be a bench researcher if you so choose. There is nothing about having a PhD that intrinsically makes you more valuable for a basic research career with your MD.

That said, MD/PhD offers significant upfront training (coursework, extended basic lab work, and debt free status) that MD/MS doesn't exactly provide. That's not to say you can't pick up the extended lab time with your MS or that you really need that extra coursework to be successful.

Generally, a bench research career requires a full-time devotion to it on the order of 80% research time. Hence what I said earlier. If you plan on doing mostly research, MD/PhD makes sense.

 

[clarkalim]

It's not the size of the degree, it's how you use it. If you do bench research for your MS and then keep doing bench research through the rest of your training, you can certainly be a bench researcher if you so choose. There is nothing about having a PhD that intrinsically makes you more valuable for a basic research career with your MD.

That said, MD/PhD offers significant upfront training (coursework, extended basic lab work, and debt free status) that MD/MS doesn't exactly provide. That's not to say you can't pick up the extended lab time with your MS or that you really need that extra coursework to be successful.

Generally, a bench research career requires a full-time devotion to it on the order of 80% research time. Hence what I said earlier. If you plan on doing mostly research, MD/PhD makes sense.

Okay, that makes sense.

Now, with the PhD...what's the point of having a MD if you're doing 80% research? Is the 20% clinical just to make extra income on the side, or does it help you in your research at all? Would it be more beneficial to earn PhD-only?

How does 80 research/20 clinical look in a typical work week? Do you have to devote most weekends to doing work as well? Or can you relax and just enjoy your family on the weekends?

 

[Neuronix]

These are some pretty basic questions about MD/PhD. I'd refer you to my two standard pieces of literature about MD/PhD to read.

http://www.mdphds.org/guide/ (the student-to-student guide)
https://www.aamc.org/students/considering/exploring_medical/research/mdphd/ (the official program director's guide)

How does 80 research/20 clinical look in a typical work week? Do you have to devote most weekends to doing work as well? Or can you relax and just enjoy your family on the weekends?

As for how 80/20 looks in a typical work week, it's highly situation dependent. One model is clinic one or two days a week and research four or five. Another is where you're "on service" ~2 months a year in the hospital with your own inpatients and you're dedicated to research the rest of the time. Or there's some blend of those two. This is sort of an MD/PhD "ideal" that you will see most program directors doing and promoting.

It's certainly difficult to ever relax in this pathway. It's difficult to have weekends. The training is long and hard. Even when in medical school, graduate school, and residency you are often being pushed to do things faster and do multiple things at once--i.e. when in medicine, must keep up your research projects and vice versa. If you start MD/PhD without any breaks you're looking at being an "attending" physician (not a trainee) around the age of 35, and even as junior faculty your position is very insecure. Thus, it's a life of instability and hard work to establish yourself in two areas for which most dedicate their whole lives to just one.

That said, there's a lot of different ways people make it work or don't make it work. Some percentage never use their MD again, some never use their PhD again. Some do clinical research that you can balance more in a 50/50 research/clinical style without terrible hours (though do you need a PhD for this?). It's up to you what you do with the degree. I just think it's important that people coming in have the right idea about the traditional MD/PhD model even if they change their minds down the road.

 

[clarkalim]

These are some pretty basic questions about MD/PhD. I'd refer you to my two standard pieces of literature about MD/PhD to read.

http://www.mdphds.org/guide/ (the student-to-student guide)
https://www.aamc.org/students/considering/exploring_medical/research/mdphd/ (the official program director's guide)



As for how 80/20 looks in a typical work week, it's highly situation dependent. One model is clinic one or two days a week and research four or five. Another is where you're "on service" ~2 months a year in the hospital with your own inpatients and you're dedicated to research the rest of the time. Or there's some blend of those two. This is sort of an MD/PhD "ideal" that you will see most program directors doing and promoting.

It's certainly difficult to ever relax in this pathway. It's difficult to have weekends. The training is long and hard. Even when in medical school, graduate school, and residency you are often being pushed to do things faster and do multiple things at once--i.e. when in medicine, must keep up your research projects and vice versa. If you start MD/PhD without any breaks you're looking at being an "attending" physician (not a trainee) around the age of 35, and even as junior faculty your position is very insecure. Thus, it's a life of instability and hard work to establish yourself in two areas for which most dedicate their whole lives to just one.

That said, there's a lot of different ways people make it work or don't make it work. Some percentage never use their MD again, some never use their PhD again. Some do clinical research that you can balance more in a 50/50 research/clinical style without terrible hours (though do you need a PhD for this?). It's up to you what you do with the degree. I just think it's important that people coming in have the right idea about the traditional MD/PhD model even if they change their minds down the road.

Thanks so much, Neuronix. This was a great help and I will definitely check out the two links you posted above.