MD-PhD Questions

[deleted936268]

Hello everyone, I just have a couple of general questions I was hoping I could ask about pursuing an MD-PhD.

1. First off, and just generally, what type of people are the right fit for an MD-PhD? What should I be looking forward to doing as a part of the job? More research or more clinical?

2. I have heard of an 80/20 split of research to clinical work. How common / is it easily doable for an MD-PhD to instead for instance do like a 60/ 40 or even 50 / 50?

3. As an MD-PhD, what can I expect my day to day to be like? Is it mostly just doing research?

4. I know that money shouldn't be the reason that I pursue a career, and it isn't. But at the end of the day, its important to factor in the salary of a job lol. So how much do average MD-PhD's make? I've read that its largely based on the amount of clinical work done. If so, whats the most clinical work that can be done and how much are those people making? What's the minimum, median, and max that MD-PhD's are making?

5. How important is the MD-PhD program I attend in finding a job? Is it all about the prestige, or is it similar to an MD, where you are on par with your peers no matter your medical school?

6. What are the underlying differences between a MD-PhD and an MD other than just one does research while the other does clinical.

Thanks for any help! I'll be available for pms as well throughout the day. And sorry in advance if I'm making a mistake or anything with my post.

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[LizzyM]

1. First off, and just generally, what type of people are the right fit for an MD-PhD? What should I be looking forward to doing as a part of the job? More research or more clinical?

The point is to train physicians who are scientists and who do research but with the knowledge of a clinician as well. 60 years ago, the strategy was to take scientists and send them to medical school but now we do both at the same time.

2. I have heard of an 80/20 split of research to clinical work. How common / is it easily doable for an MD-PhD to instead for instance do like a 60/ 40 or even 50 / 50?

That is considered success as far as the training pipeline is concerned and the concern of the people operating the pipeline is to keep the money flowing to the program. What happens in reality will depend on the graduates' willingness to do research (rather than just patient care) and their ability to get grants to fund their lifestyle as a physician-scientist.

3. As an MD-PhD, what can I expect my day to day to be like? Is it mostly just doing research?

If you are successful as a physician-scientist, you will be writing grants, supervising and mentoring trainees, managing research team employees, writing papers, giving invited talks, applying for more grants. You might actually be doing work at the bench or you may be directing others who do it on your behalf. Now, some of the time, you might be doing clinical work: seeing patients in clinic or in the hospital/procedure room, supervising trainees (fellows, residents, medical students) who are caring for patients, keeping up with medical record documentation, attending lectures and keeping up with continuing medical education. This might be 20% of your time which could translate into a half day per week in clinic and 4-6 weeks "on service" where you supervise trainees who care for patients in the hospital.

4. I know that money shouldn't be the reason that I pursue a career, and it isn't. But at the end of the day, its important to factor in the salary of a job lol. So how much do average MD-PhD's make? I've read that its largely based on the amount of clinical work done. If so, whats the most clinical work that can be done and how much are those people making? What's the minimum, median, and max that MD-PhD's are making?

Clinical pays better than research. Some specialties pay better than others. You'll make more than a PhD who is just doing lab work but less than an MD who just does clinical work. So, compared with just earning the PhD, you'll be making more but compared with just earning the MD, you'll be making less.

On the other hand, but not to completely make up for the lower wages, many MD/PhD programs cover tuition and provide a stipend. Like the military, you have to really want to do it and if you do it solely to graduate without debt, you will be very unhappy in the end.

5. How important is the MD-PhD program I attend in finding a job? Is it all about the prestige, or is it similar to an MD, where you are on par with your peers no matter your medical school?

Almost all MD/PhD folks go on to residencies. It is very unlikely that a MD/PhD would not match into a residency. That's your first job. From there, your specialty and subspecialty are going to take you places such as Pharma or Academic medicine.

6. What are the underlying differences between a MD-PhD and an MD other than just one does research while the other does clinical.

Some MD only folks do some research, even some bench research, often after having done a research fellowship after residency. It would be very rare for such a person to have enough grant money to be 80% research but not unheard of. MD/PhD folks are better positioned to do more research than MD-alone people but how much they do will depend on their funding. They can also decide that research is not a good fit and choose to do 100% clinical despite having the PhD. Both pathways can lead to administrative positions such as Chairman of a department or Dean of the medical school. That becomes an administrative role in terms of recruiting talent, encouraging submission of grants for funding, negotiating for space, fund raising, and a million other things that are neither medicine nor research.

 

[deleted936268]

Thank you so much for such a detailed response.

A couple other side questions as a follow up:

1. You mentioned that MD-PhD's can legitametly do 100% clinical at some point. What are the cons of this? My main trifle with the idea of an MD-PhD is that there is no fallback plan once you're locked into the career, but I guess this is wrong?

2. I've heard that its much harder to get in as a competitive MD-PhD applicant to a t30 program. Do you know any guides on SDN or anywhere that detail how to become more competitive other than just detailing about research. Something that explains what extracurriculars to get involved in, what items are check in the boxes (like clinical volunteering in this case bc MD-PhD ) and such like that. Could you lend some advice to this area?

Thanks!

 

[LizzyM]

Thank you so much for such a detailed response.

A couple other side questions as a follow up:

1. You mentioned that MD-PhD's can legitametly do 100% clinical at some point. What are the cons of this? My main trifle with the idea of an MD-PhD is that there is no fallback plan once you're locked into the career, but I guess this is wrong?

2. I've heard that its much harder to get in as a competitive MD-PhD applicant to a t30 program. Do you know any guides on SDN or anywhere that detail how to become more competitive other than just detailing about research. Something that explains what extracurriculars to get involved in, what items are check in the boxes (like clinical volunteering in this case bc MD-PhD ) and such like that. Could you lend some advice to this area?

Thanks!

The con is that your alma mater will be deeply disappointed and you'll have wasted the training slot that was provided by not coming out the other end as a physician scientist. You'll also have wasted 3-4 years of your life earning a PhD you are choosing not to use. But if you like knowing that you now have the freedom to just practice medicine, you do have that.

It is not easy to get into a MD/PhD program. The slots are very few and there is competition just as their is competition for PhD slots and for MD slots. One of the tricks is to apply to schools that are doing research that interests you and where you already have some transferrable lab skills. Double points if you already have publications in a related area of research to the work being done at that school. At the same time, you need to check all the same boxes as MD students do: clinical experience, volunteerism/community service, teamwork/leadership, grades/scores, some evidence that you know how to relax and have fun and relate well to others.

 

[deleted936268]

The con is that your alma mater will be deeply disappointed and you'll have wasted the training slot that was provided by not coming out the other end as a physician scientist. You'll also have wasted 3-4 years of your life earning a PhD you are choosing not to use. But if you like knowing that you now have the freedom to just practice medicine, you do have that.

It is not easy to get into a MD/PhD program. The slots are very few and there is competition just as their is competition for PhD slots and for MD slots. One of the tricks is to apply to schools that are doing research that interests you and where you already have some transferrable lab skills. Double points if you already have publications in a related area of research to the work being done at that school. At the same time, you need to check all the same boxes as MD students do: clinical experience, volunteerism/community service, teamwork/leadership, grades/scores, some evidence that you know how to relax and have fun and relate well to others.

Im currently working with my PI on a project and he is on the admissions committee for the program i'd like to apply to. In that case, is it possible for him to pull me in if he senses a strong need for my lab skills?

 

[Fencer]

He will likely be in Conflict-of Interest with your application, and be withdrawn. However, the reviewers will read very carefully her/his LOR. In general, it is positive.

 

[deleted936268]

He will likely be in Conflict-of Interest with your application, and be withdrawn. However, the reviewers will read very carefully her/his LOR. In general, it is positive.

That makes sense, thanks! Also, I've been looking at MTSP programs/scholarships such as Goldwater and was wondering if there is a list of everything for a future MD-PhD applicant to go through to understand what programs make a person more competitive, which ones are prestigious, and which ones are good for experience, etc. Do you know of such a place or is this something everybody just does their own solo research on?

 

[LizzyM]

Im currently working with my PI on a project and he is on the admissions committee for the program i'd like to apply to. In that case, is it possible for him to pull me in if he senses a strong need for my lab skills?

If he's on the admissions committee, he should be able to tell you what the committee looks for in an applicant. He could be a very valuable source of informaiton for you even if he has to recuse himself when your application comes up for review and discussion.

 

[Lucca]

Here is a good place to start to get more information on the md/PhD path:

Physician Scientist Forum Readme & FAQs (updated 3/21/10)

Disclaimer I am just a senior MD/PhD student. I post because there are a lot of MD/PhD questions and not a lot of people who consistently answer them. If you think I am wrong or are more qualified to answer than me, I encourage you to post what you think or to write me your thoughts...

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