MD/PhD-Psychology

[cort888]

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Ok I am having a major "mid college crisis". Heres the deal I came to Rutgers all geared up to be a psych/bio major. Well semester #1 I dropped the whole bio deal & picked up on Psych. I currently am 2nd yr & now have a departmental honors psych & most of my days are spent working in my research lab looking at eating disorders.Over the last 2 years I have come to the realization that I have a profound interest in both psychology & medicine. But the field of psychology im interested in is clinical health psychology, so basically looking at medical disease from a psychological aspect. My conflict is that I dont know if I want to be an MD or MD/PhD. I thought about PhD alone but I just cant see myself being happy in grad school & for the rest of my life just with the practice of psychology alone. And thinking about going to medicial school soon knowing I will never get the chance to take psychology courses & do the type of research Im doing now breaks my heart. I havent been able to find anyone to get good advice from since all the MD/PhD-psych are psychitrists and thats def not what I want to do. For instance my senior thesis is looking at bariatric surgery patients and the psychological aspects of pre/postop time periods. I want to be that surgeon & be able to conduct psych research behind it.So im not sure if the PhD in psych would be nessesary to do that? Also Im very concerned about the time committment to MD/PhD with a potentail surgical residency I dont want to be 50 when I complete my training.... Any advice?

 

[dl2dp2]

It is NOT necessary to do get a PhD in psychology to do the type of research you described. However, without an MD, you'll NEVER be able to practice medicine (including and not limited to bariatric surgery).

So, in light of these facts, I strongly recommend against a PhD in psychology (which is in itself useless, just like any other PhD degree). MD/PhD-in psychology may not be feasible, as the NIH funding currently does not cover social sciences. If you want to go the MD/PhD route, I suggest you looking into PhD in medical anthropology and related disciplines, which is funded through private funding in a handful of institutions. You can find old threads on this topic. The only advantage of this route is a possible fully paid medical school education--usually this type of PhD is relatively short.

For people like you who are undecided my default recommendation is MD. Go to medical school like your mom told you to gives you the widest possible future career possibilities in the shortest amount of time.

 

[itsallthesame]

go to your local med school, shaddow, and ask Qs... but...

training as a surgeon is at least 5 years post grad as a resident of 80 hr weeks. in your free time you take home call, sleep and study. (and have a little fun with friends). probably 2 years of fellowship where you work even longer hours.

i think you are a bit confused about both md/phd programs and psychiatry. a psychia can do anything a psycholo can do, but can ALSO perscribe meds, but the more talk therapy and research you do the less money you make. thats all. the md/phd route is generally geared towards a phd in basic science research (not that the research youre would be impossible). but it would be silly to use the phd to learn clinical psych. two clinical degrees = waste.

now, think about how much your pi works in his/her job. do you really think you could be a successful surgeon on top of that? it's one thing if your research is directly based on what you do, but you're talking about essentially having two specialties which are both very time intensive to learn. talk to your pi.

 

[Neuronix]

which is in itself useless, just like any other PhD degree

lol wut?

Anyways, cort what you're proposing is pretty much unheard of. What you will find is that surgeons have little time to do research. It is a very long, grueling training pathway followed by demanding clinical practice. It boils down to the fact that surgery has very few touchy feely people in it. The touchy feely people tend not to pick surgery or leave the residency because they realize things like their kids have no idea who they are or that the staff are constantly yelling at them. This may sound melodramatic, but it's reality.

The type of research you're proposing would not require a PhD at all. Surveying patients about their attitudes or life events surrounding surgeries is not something you need a PhD for. What you are describing is non-bench clinical research, which is not the type MD/PhD programs are geared to produce. Even for psychiatrists, the goal of your typical MD/PhD program is to produce someone who looks at models of psychiatric disease or uses some techniques that assess disease from an objective standpoint, such as high tech techniques to look at body metabolites (blood analysis, NMR/MRI, etc).

My advice is to think about things frankly. Do you wantto be mostly a surgeon or physician or do you want to be mostly a psychologist? Let that guide your decision. You really could accomplish what you've posted here, but I don't think many MD/PhD programs are going to like that proposal. There are many 5 year options that are more geared towards producing clinical researchers, and this seems more suitable. By taking one year out for research you can get the Psychology courses and research you want, while still training to be a surgeon. Look into HHMI medical student fellowships, other year out fellowships available at most research-oriented medical schools, and also the two medical schools with fixed 5 year programs (Pitt and Cleveland Clinic come to mind).

 

[smq123]

Ok I am having a major "mid college crisis". Heres the deal I came to Rutgers all geared up to be a psych/bio major. Well semester #1 I dropped the whole bio deal & picked up on Psych. I currently am 2nd yr & now have a departmental honors psych & most of my days are spent working in my research lab looking at eating disorders.Over the last 2 years I have come to the realization that I have a profound interest in both psychology & medicine.

For instance my senior thesis is looking at bariatric surgery patients and the psychological aspects of pre/postop time periods. I want to be that surgeon & be able to conduct psych research behind it.

So...if most of your days are spent looking at eating disorders, then I take it that very few of your days are spent actually shadowing physicians?

I'm asking because I get the impression that you're not really aware of what physicians spend most of their time doing. Particularly bariatric surgeons.

I know that bariatric surgery may just have been an example, and not something that you're particularly interested in. But, using it as an example - bariatric surgery is, out of all the surgical fields (besides possibly Vascular, CT, and transplant) one of the most time-consuming fields. Their patients are "poor protoplasms" (to use the horrible, but expressive, surgical slang) - their immense obesity prevents them from being good wound healers. Their wounds can go south VERY quicky, and require your immediate intervention. Necrotizing fasciitis, cellulitis, MRSA wound infections, fistulas, etc. - these are very common with post-op bariatric patients, and will require you, as the surgeon, to come in and take care of it.

You need a hospital willing to support their many needs. 24/7 complete radiological support (they may need a stat barium swallow on a Saturday morning to see if they have a small bowel obstruction, for instance), etc. This is ignoring that this population is, besides the vasculopaths, one of the LEAST compliant patient populations imaginable.

Finally, there is just no time for a bariatric surgeon to do both these surgeries AND the kind of psych research that you're looking at. Bariatric surgery is a very financially draining specialty - the amount of care that the patients need requires a lot of money from the hospital. As such, the hospital is looking at the surgeon to help do as many cases, and recoup some of that money. That doesn't really translate to a lot of downtime.

And, as Neuronix pointed out, most surgeons don't really care all that much about these psych issues. That's why most surgical teams have a social worker or a psychologist on staff - so that they can let other people handle these things.

I think you need to look harder into the physician aspect of this. I get the impression that the idea of being a physician appeals to you, but you don't have that much exposure to the reality of what being a physician means.

 

[GliaGirl]

Consider a career in neuropsychology. You can specialize in neuropsych after getting a Clinical Psych graduate degree. These are the people who work in hospitals doing research on psych disorders and also working to see if patients are somatizing.

http://en.wikipedia.org/wiki/Neuropsychology

 

[cort888]

Hi Guys,
Thanks for all your help-- Here are the answers to a few things most of you didnt know when I posted this.
1. I have alot of physican shadowing under my belt- i worked in an ER for 3 yrs as a volunteer, I spent winter break @ Columbia childrens hospital shadowing a peds general surgeon & I also spent an entire semester shadowing a surgical oncologist so I am very aware of the time demands.
2. I was wondering what you guys thought of MD & then postdoc in clinical psych after med school before residency.
3. The type of psych research im interested in doing isnt just simple psychosocial surveys. For instance my senior thesis is using an Implicit assoications test to measure the stimas of bariatric patients pre op & through a 1 yr post op perioid to see if they change over time. This type of psycholgical test has never been used in this method & is very high tec.
4. I was interested in hearing about the 5 yr MD program where you take a year off to do research-- can you tell me more about that?

Thanks,
Cortney

 

[Neuronix]

2. I was wondering what you guys thought of MD & then postdoc in clinical psych after med school before residency.

That's always an option. Just keep in mind you'll be buried in loans and it'll be difficult to afford it. If you get involved with extended periods of research as a fellow you'll make more money and have more foregiveness on your loans. As I commented in the other thread in the Psychology forum, I don't see why you're looking for separate CLINICAL experience when you're trying to do Psychology RESEARCH. Why not Social Psychology or any of the other research branches?

You can look into the NIH Loan Repayment Program though. It might cover you. That's a multi-year commitment, which you may be okay with then.

This type of psycholgical test has never been used in this method & is very high tec.

I hate to sound like a jerk, but I loled.

4. I was interested in hearing about the 5 yr MD program where you take a year off to do research-- can you tell me more about that?

Sure, look into these options for any medical school:
http://www.hhmi.org/grants/individuals/medfellows.html
http://www.ddcf.org/mrp-crf

There are other programs as well.

Specific schools:
http://www.icre.pitt.edu/cstp-m/index.aspx
http://www.clevelandclinic.org/cclcm/

Note that both of those school programs come with full scholarships (not stipend though like MD/PhD programs). I think there's some other programs as well. Some other research medical schools are also very generous with scholarship money like Mayo.

 

[strangeglove]

Why aren't you interested in psychiatry? Psychiatrists do all of what you're talking about, except for the surgery (and this isn't really as exciting as they make it out to be on TV, especially at 5 am when you will be coming into work every day). In fact, psychiatrists are the one's who have to evaluate the psychological capacity for all people who get bariatric surgery, in addition to everyone who get's a liver transplant. And they do plenty of research on the psychological aspects of these surgeries. And a PhD in psychology would be extremely useful in this field. Also, if you're really interested in the medical side of things, there's the sub-specialty of psychosomatic medicine (AKA consultation-liaison psychiatry), who are the psychiatrists who get called when medical or surgical patients in the hospital have psychiatric problems (like becoming depressed because they developed necrotizing fasciitis after getting bariatric surgery, or becoming delirious because they have an infection). In addition, there's a whole field called behavioral medicine, which deals with the psychological aspects of medical illnesses and treatments. It's mostly the purview of clinical psychologists, but a lot of psychiatrists are involved with this, too. You probably have concerns that psychiatrists aren't real doctors and that they are basically like the clinical psychologists you work with in your research lab. This is quite far from the truth. We (I'm a psychiatrist) are doctors first, and are called upon all the time to address medical, surgical, dermatologic, whatever problems in our patients (of course, we refer or consult the appropriate specialists when indicated). Is this your concern?

 

[cort888]

Interesting--- No thats not really my concern. I respect what you guys do, but I don't want to be a treating psychologist/psychiatrist. I want to be able to practice surgery/ER medicine (maybe something else im sure my interests will change) but I have no interest in looking at biochemical factors of disease, genetics etc... I love the clinical aspect of medicine esp the hands on fields where you are using your hands and not only your mind to "do the job". But I also love learning about why people do things they want to do, what influences decision & cognitive processes. So I much rather be a hands on doctor but instead of looking at the genetics behind diseases (post op complications etc..) I rather look at them from a psychological standpt. Just like my research now looking at the unconscious aspects that may play a role in failures of post op bariatric patients. I feel that if i went to grad school & got the PhD along side or did a post doc in psych that would better prepare me to do psychological research. I dont think what I learn now as an undergrad although im getting alot of experiance is enough to carry me throughout my future. Y I think clinical is a good way for me to go is the grad programs offer the courses needs to apply psych to medicine (IE eating disorders class, play therapy etc..) all things I will need to know more in depth about if I plan to apply it to the clinical aspect of medicine. I think the clinical practicum part will help me see treatment plans/techniques CBT etc.. and how to apply that. So in the future I will be able to investiate if CBT helpful as a followup addon in postop patients undergoing w.e type of surgery.

My thinking may be wrong... I dont know-- Any thoughts.

 

[GliaGirl]

How about an MD/MPH? It's not as strictly psychological, but it still deals with the "human" side of medicine versus the purely scientific aspects.

Also, keep in mind that as a doctor you can do research in pretty much whatever you want by collaborating with others. So if you want to go to med school and become a surgeon, there are plenty of psych people who would love to collaborate with you on researching how those surgeries affect the mental health of patients. As an MD, you are perfectly within your rights to do medical research, especially if you include in your education a program that involves a year of research training, or even a post doc or research residency. If you are not looking to do basic scientific research, then congratulations: you don't need to take the time to get a PhD!

 

[smq123]

1. I have alot of physican shadowing under my belt- i worked in an ER for 3 yrs as a volunteer, I spent winter break @ Columbia childrens hospital shadowing a peds general surgeon & I also spent an entire semester shadowing a surgical oncologist so I am very aware of the time demands.

I guess I'm going to sound kind of patronizing, but I somehow doubt that you're really that aware of the time demands. If you were, you'd realize how difficult it is to do the type of research that you're describing AND be a surgeon.

Starting your days at 6 AM, ending them at 6 PM, and then (on occasion) coming in at 3 AM for an emergency, does not leave a lot of time for in-depth research. Unless you plan on never having a family or a personal life. And that's as an attending - as a resident, starting your day at 4:30 AM, and ending at 7 PM, is not all that unusual.

but I have no interest in looking at biochemical factors of disease, genetics etc...

If you honestly have no interest in this part, you are probably not cut out to be a physician.

The biochemical factors and the genetics of disease is what drives medicine. The procedures are important, but the knowledge of disease is what makes us physicians - and not just technicians.

I really like the surgical part of medicine. I like the pace, I like the procedures, I like the types of problems I see. I like to operate, and I like being in the OR. But, like all other physicians, I have to know the biochemical disorders and the genetics of the diseases that I am treating. If I don't, I'm not much better than technician who only knows how to do procedures, and nothing else.

As strangeglove pointed out, television and shadowing makes the "hands on" parts of medicine look really glamorous. But when you're the one doing it (i.e. the one who's been standing up for 9 hours straight in sterile garb, without a pee break), it's not so glamorous anymore.

 

[strangeglove]

Interesting--- No thats not really my concern. I respect what you guys do, but I don't want to be a treating psychologist/psychiatrist. I want to be able to practice surgery/ER medicine (maybe something else im sure my interests will change) but I have no interest in looking at biochemical factors of disease, genetics etc... I love the clinical aspect of medicine esp the hands on fields where you are using your hands and not only your mind to "do the job". But I also love learning about why people do things they want to do, what influences decision & cognitive processes. So I much rather be a hands on doctor but instead of looking at the genetics behind diseases (post op complications etc..) I rather look at them from a psychological standpt. Just like my research now looking at the unconscious aspects that may play a role in failures of post op bariatric patients. I feel that if i went to grad school & got the PhD along side or did a post doc in psych that would better prepare me to do psychological research. I dont think what I learn now as an undergrad although im getting alot of experiance is enough to carry me throughout my future. Y I think clinical is a good way for me to go is the grad programs offer the courses needs to apply psych to medicine (IE eating disorders class, play therapy etc..) all things I will need to know more in depth about if I plan to apply it to the clinical aspect of medicine. I think the clinical practicum part will help me see treatment plans/techniques CBT etc.. and how to apply that. So in the future I will be able to investiate if CBT helpful as a followup addon in postop patients undergoing w.e type of surgery.

My thinking may be wrong... I dont know-- Any thoughts.

Your thinking is not wrong, but maybe informed by limited information. Psychiatrists are by and large not concerned very much with genetics, except for a few who are doing research in the area of psychiatric genetics. As I mentioned in my post, there is a whole field of psychiatry that deals with things exactly like unconscious aspects that may play a role in failures of post op bariatric patients. Sadly for many patients, their surgeons never think about these things (which is why they leave this to the psychiatrists), and you would be perhaps the only surgeon to have an interest in the unconscious. However, it sounds like you are really excited to work with your hands. If that is the most important thing in your life, then by all means become a surgeon, as you will need this love of handiwork to sustain you through a very grueling training and work schedule. However, if it is more important for you to do things like "investiate if CBT helpful as a followup addon in postop patients undergoing w.e type of surgery", then you really should strongly consider consultation liaison (C-L) psychiatry, as C-L psychiatrists have been doing this kind of research for a long time. C-L psychiatrists spend a lot of time talking to and thinking about unconscious processes that affect outcomes in patients after surgery. They don't do the surgeries, but are required to know a good deal about what the surgeries entail (as all physicians are). And they have generally have a lot more time after they see their patients to actually do this research, compared to surgeons.

 

[cort888]

Humm... that does sound interesting. I think if I didnt want to be a surgeon or more "hands on" type of doctor then I would potentially consider this. Do you know if med schools have CL psychiatry as a elective rotation during med school? Also is there a special residency for this or research period?

 

[strangeglove]

Humm... that does sound interesting. I think if I didnt want to be a surgeon or more "hands on" type of doctor then I would potentially consider this. Do you know if med schools have CL psychiatry as a elective rotation during med school? Also is there a special residency for this or research period?

Yes, you can do a C-L elective as a medical student. C-L is also part of all psychiatry residencies (anywhere from 2-4 months in total). You can do up to 1 year research elective as part of most 4-year psychiatry residencies, which can be pretty much anything you want to do, including research on unconscious processes in bariatric surgery patients (by the way, it strikes me that you are interested in both unconscious processes and in cognitive behavior therapy, which would seem to be somewhat of a contradiction, but I'll leave that alone for now). There is a 1-year fellowship for C-L, though some people do C-L without doing the fellowship in places that really need this service but have difficulty finding fellowship trained people. The fellowship tends to be primarily clinical. If you want to learn more about C-L psychiatry, come to the psychiatry forum and seek out Doc Sampson. He's the local expert in C-L and is very active in that forum.

 

[cort888]

Thanks! I am def. going to look more into this speciality and see if im interested in it. Ha im not really into CBT I was just using that as an example. Right now my strongest interests lie in eating & weight disorders in both the clinical & research spectrum. Primarily because thats what my grad student does her research in so that my main exposure. Overtime that might change but as of right now I def. find it to be facinating.

THanks for your help

 

[Clinic Girl]

So...if most of your days are spent looking at eating disorders, then I take it that very few of your days are spent actually shadowing physicians?

I'm asking because I get the impression that you're not really aware of what physicians spend most of their time doing. Particularly bariatric surgeons.

I know that bariatric surgery may just have been an example, and not something that you're particularly interested in. But, using it as an example - bariatric surgery is, out of all the surgical fields (besides possibly Vascular, CT, and transplant) one of the most time-consuming fields. Their patients are "poor protoplasms" (to use the horrible, but expressive, surgical slang) - their immense obesity prevents them from being good wound healers. Their wounds can go south VERY quicky, and require your immediate intervention. Necrotizing fasciitis, cellulitis, MRSA wound infections, fistulas, etc. - these are very common with post-op bariatric patients, and will require you, as the surgeon, to come in and take care of it.

You need a hospital willing to support their many needs. 24/7 complete radiological support (they may need a stat barium swallow on a Saturday morning to see if they have a small bowel obstruction, for instance), etc. This is ignoring that this population is, besides the vasculopaths, one of the LEAST compliant patient populations imaginable.

Finally, there is just no time for a bariatric surgeon to do both these surgeries AND the kind of psych research that you're looking at. Bariatric surgery is a very financially draining specialty - the amount of care that the patients need requires a lot of money from the hospital. As such, the hospital is looking at the surgeon to help do as many cases, and recoup some of that money. That doesn't really translate to a lot of downtime.

And, as Neuronix pointed out, most surgeons don't really care all that much about these psych issues. That's why most surgical teams have a social worker or a psychologist on staff - so that they can let other people handle these things.

I think you need to look harder into the physician aspect of this. I get the impression that the idea of being a physician appeals to you, but you don't have that much exposure to the reality of what being a physician means.

I would agree completely here. I have an MSW and worked in a Surgical ICU and saw not only the GBGBs (gastric bybass gone bad) but the rest of what the surgery teams deal with. And those gastric bypasses can go VERY badly very quickly, as pointed out above.

And it's true, most surgeons don't care much about psych stuff, but do seem to sincerely appreciate the social worker who does handle and smooth things out with patients and families.

I agree that the MD lifestyle is probably not what the OP is looking for, and the first thing I thought when I read it was how loooonnnng the MD process is to be a surgeon, let alone the added "bonus" of doing a PhD. And the psychiatry route - I opted not do to medical school because it makes little to no financial sense for a psychiatrist to do therapy when they can do 4 med reviews in that same time frame and make at least twice as much. And I like doing therapy.

So, OP, if you want to work with people and their feelings, and their issues surrounding their health maladys, get a PhD or a PsyD in health psychology. There are several truly awesome programs that are housed in medical schools that may satisfy a lot of what you think you want from medical school.