MD/PhD without residency?

[rain41]

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I'm an undergrad considering doing an MD/PhD, but my main focus is research, I 'm not sure I'd want to practice medicine. My main reason for considering an MD/PhD is that I want to be able to do research with human subjects. I'm not talking clinical drug trials or anything, but more along the lines of neuroscience research (like cognitive/behavioral fMRI studies, and studies with patients with brain lesions). Does anyone know if doing something like that would be possible without being a board certified MD?

What other benefits would an MD/PhD without doing residency bring to research?

Thanks for your help!

 

[entropy2]

if you can write grants and get nih funding , you can open your own lab and become faculty at a university....

 

[dl2dp2]

PhD students are often really bitter.

MD/PhD students at least have a backup plan.

Frankly, if you want to do human subject research and have money, I'd recommend an MD. Lots of psychologists do fMRI research. How hard do you think it could be? You don't need a PhD for that sort of stuff. PhD = academic sweatshop, level 1. I would know, cause I'm doing it right now.

 

[Vader]

It sounds like you are most interested in research and not very interested in practicing medicine.

The PhD route is most appropriate if you want to do human neuroimaging research. You do not need an MD for this and an MD will give you no training in doing functional imaging studies, whereas a PhD will give you extensive training.

However, if you also would like to practice clinical medicine, then the MD/PhD route makes much more sense.

To sluox: there is quite a bit of bad (or at the very least over-interpreted) functional imaging research published. It is important to know the strengths and limitations of such research if you plan on conducting it. An MD does not give one any such background.

 

[neoserenity333]

Lots of psychologists do fMRI research. How hard do you think it could be? You don't need a PhD for that sort of stuff. PhD = academic sweatshop, level 1. I would know, cause I'm doing it right now.

hey now, i'm a psych major 😡 haha
what kind of psychologists are you talking about? the ones that I know (i.e. my professors) who do research all have PhDs.

 

[Vader]

if you can write grants and get nih funding , you can open your own lab and become faculty at a university....

That is becoming a bigger and bigger "if" these days with the current NIH budget.

 

[Habari]

there is quite a bit of bad (or at the very least over-interpreted) functional imaging research published

amen.
sing it, brother.

 

[dl2dp2]

To sluox: there is quite a bit of bad (or at the very least over-interpreted) functional imaging research published. It is important to know the strengths and limitations of such research if you plan on conducting it. An MD does not give one any such background.

I completely agree with you. Your advice is the standard official line from the MSTPs. I'm just trying to give an alternative twist to this. There is quite a bit of bad fMRI research published, ergo, there's funding for a lot of bad research, ergo, you could be poorly trained and still be funded, ergo, you don't need a PhD.

A PhD in psychology is a whole different animal compared to a PhD in basic biological science. If the above poster wants to do a PhD in psychology then be my guest. But frankly whatever you need to pick up from a PhD in psychology in order to do research in neuroimaging could be easily picked up by doing a residency in neurology/psychiatry by doing a year or two of elective research. There is a reason why most MSTPs do not support a PhD in psychology. Why not do a PhD in anthropology, or history, or write a thesis on "the post-colonial meta-critical exegesis of adiabetic power struggle between Armenia-Hispanic diaspora and the mass media"? Because any of the above does not teach you how to do scientific research. It's not necessary to have a PhD in the biological sciences to do research in history and anthropology and literary criticism or even economics. You could totally pull it off with just an MD. Franz Fanon, for instance was an MD. Freud was an MD. Seymour Ketty was an MD. Many great public health researchers were just MDs. You don't need a PhD to do psychology, it's as simple as that.

 

[Dr.Dr.]

I'm an undergrad considering doing an MD/PhD, but my main focus is research, I 'm not sure I'd want to practice medicine. My main reason for considering an MD/PhD is that I want to be able to do research with human subjects. I'm not talking clinical drug trials or anything, but more along the lines of neuroscience research (like cognitive/behavioral fMRI studies, and studies with patients with brain lesions). Does anyone know if doing something like that would be possible without being a board certified MD?

What other benefits would an MD/PhD without doing residency bring to research?

Thanks for your help!

Just a note, you still need to do an internship to be licenced to practice medicine on people. Otherwise the MD won't get you anywhere a PhD won't get you.

However, many of the MD/PhD's I have talked to that do not practice any clinical medicine (all did residencies), still feel that the MD training inspired their work and and introduced them to problems in human disease that they would not have seen without the broad training in medicine.

Also, if you don't want to do a residency because of the lifestyle, I've heard that the internship is worse than residency.

 

[rain41]

if you can write grants and get nih funding , you can open your own lab and become faculty at a university....

But a PhD can do that too though ....

A PhD in psychology is a whole different animal compared to a PhD in basic biological science. If the above poster wants to do a PhD in psychology then be my guest. But frankly whatever you need to pick up from a PhD in psychology in order to do research in neuroimaging could be easily picked up by doing a residency in neurology/psychiatry by doing a year or two of elective research.

My plan would be to do a PhD in neuroscience, specializing in cognitive. My major as an undergrad is neurobiology, so I'd like to stay with the biological aspect of the brain and it's functions. I'm not considering doing ONLY an MD, I will get a PhD either way, I just want to know what added benefit doing an MD with a PhD is, without doing residency. www.intransit.us says that 90% of MD/PhDs go on to residency, meaning 10% do not. What benefit is their MD/Phd serving them?

Also, if you don't want to do a residency because of the lifestyle, I've heard that the internship is worse than residency.

By internship, do you mean the 2 clincal years of med school? Yeah ... I realize that ... but I feel if the benefit is enough, I can handle 2 years. I really don't know if after ~8ish years of MD/Phd I'd want to go through 3-5 years of residency, if I only want to do research though.

Thanks for all of your responses, you've given me a lot to think about.

 

[1Path]

What benefit is their MD/Phd serving them?

The one MD/PhD I know that didn't do a residency did a 3 year post doc and now works in Big Pharma making a TON of money.

 

[solitude]

I know a few MD/PhD's who did not complete residencies and do research 100%. Even these PI's that did not complete residencies believe that the MD portion of their training has informed their research, although they wouldn't necessarily do the combined degree again.

 

[Vader]

Bottom line: if you know AHEAD OF TIME that you are interested in research and do not want to do clinical medicine, do a Ph.D. and forget about medical school. The additional 4 years is not really worth it and you will likely only be miserable (especially during 3rd & 4th year clerkships).

It is a different matter if you are not entirely sure on how precisely you would like to divide your time, but have an interest in both clinical medicine and research.

 

[Dr.Dr.]

But a PhD can do that too though ....


My plan would be to do a PhD in neuroscience, specializing in cognitive. My major as an undergrad is neurobiology, so I'd like to stay with the biological aspect of the brain and it's functions. I'm not considering doing ONLY an MD, I will get a PhD either way, I just want to know what added benefit doing an MD with a PhD is, without doing residency. www.intransit.us says that 90% of MD/PhDs go on to residency, meaning 10% do not. What benefit is their MD/Phd serving them?


By internship, do you mean the 2 clincal years of med school? Yeah ... I realize that ... but I feel if the benefit is enough, I can handle 2 years. I really don't know if after ~8ish years of MD/Phd I'd want to go through 3-5 years of residency, if I only want to do research though.

Thanks for all of your responses, you've given me a lot to think about.

The internship is a final year after all of med school is finished and the MD is awarded. It is necessary for medical licensure to see patients, though does not grant you the rights to conduct specialty work as would be done in a residency and tested for in USMLE step III (correct me if I'm wrong here SDN gurus). For most docs, the internship works out to be the first year of a multi-year resedency.

 

[Gfunk6]

Bottom line: if you know AHEAD OF TIME that you are interested in research and do not want to do clinical medicine, do a Ph.D. and forget about medical school.

Excellent point. I would add that all of the people I know who completed an MSTP and went on to do 100% research did so b/c their work was taking off. Several 1st tier publications, patent(s) produced, a once-in-a-lifetime offer from
academics or pharma, or an idea that was funded by venture capitalists.

Nobody I know PLANNED not to use the MD, but it simply evloved that way. If you really know that you don't want to see patients then I agree with Vader -- stick with a straight PhD.

 

[LM02]

A PhD in psychology is a whole different animal compared to a PhD in basic biological science. If the above poster wants to do a PhD in psychology then be my guest. But frankly whatever you need to pick up from a PhD in psychology in order to do research in neuroimaging could be easily picked up by doing a residency in neurology/psychiatry by doing a year or two of elective research. There is a reason why most MSTPs do not support a PhD in psychology. Why not do a PhD in anthropology, or history, or write a thesis on "the post-colonial meta-critical exegesis of adiabetic power struggle between Armenia-Hispanic diaspora and the mass media"? Because any of the above does not teach you how to do scientific research. It's not necessary to have a PhD in the biological sciences to do research in history and anthropology and literary criticism or even economics. You could totally pull it off with just an MD. Franz Fanon, for instance was an MD. Freud was an MD. Seymour Ketty was an MD. Many great public health researchers were just MDs. You don't need a PhD to do psychology, it's as simple as that.

This is so completely uninformed, I would strongly recommend that the original poster ignore it altogether. A PhD in psychology is a research-based degree. We are strongly schooled in the scientific method & multivariate statistics, required to conduct our own empirical research for the master's thesis and dissertation, and biologically-based models are strongly emphasized. In my graduate department, there were sub-programs in behavioral neuroscience and behavioral genetics. Faculty in these programs were considered tops in their fields, and regularly presented research side-by-side MDs. In fact, there were a handful of MD/PhD students in my department. In addition, faculty in these programs also regularly collaborated with sub-specialties that are considered "softer science" such as clinical and social psych.

I have a PhD psychology, and am currently PI on my second NIMH-funded grant. I am also receiving funding from the NIH clinical research loan repayment program. I'm 30. If what i learned in graduate school was the equivalent of completing humanities degree (as this person seems to believe), I doubt that I would have a successfully funded independent research program this early in my career (and during this administration).

You've gotten great advice and feedback otherwise, so I won't bother repeating what you've already heard. You can do the kind of research you are proposing with a PhD only. However, if you have specific reasons for wanting to jointly pursue an MD, go for it. 👍

 

[tr]

I'm not considering doing ONLY an MD, I will get a PhD either way, I just want to know what added benefit doing an MD with a PhD is, without doing residency.

None. Zero. It's a waste of 3.5 years if you don't do the postgraduate training.

I would agree that in theory the degree you require for what you want to do is a PhD. Unfortunately, I cannot agree with Vader and Gfunk6 in advising you to do a straight PhD, because that is a road to despair. When I look at brilliant postdocs with multiple Cell papers who are in their tenth postdoc year because they cannot get a faculty job anywhere, I cannot in good conscience advise anyone to just get a PhD.

The problem is that no-one will tell you this because biological bench science requires a constant supply of graduate students and postdocs to do the enormous amount of manual labor involved. However, very few of those grad students and postdocs will ever actually get faculty jobs. Academia is a tournament scheme (just like crack peddling, apparently, for those of you who have read Freakonomics).

Maybe things are different in neuroimaging. I would find some neuroimaging postdocs and talk to them before you make any decisions.

 

[mercaptovizadeh]

None. Zero. It's a waste of 3.5 years if you don't do the postgraduate training.

I would agree that in theory the degree you require for what you want to do is a PhD. Unfortunately, I cannot agree with Vader and Gfunk6 in advising you to do a straight PhD, because that is a road to despair. When I look at brilliant postdocs with multiple Cell papers who are in their tenth postdoc year because they cannot get a faculty job anywhere, I cannot in good conscience advise anyone to just get a PhD.

The problem is that no-one will tell you this because biological bench science requires a constant supply of graduate students and postdocs to do the enormous amount of manual labor involved. However, very few of those grad students and postdocs will ever actually get faculty jobs. Academia is a tournament scheme (just like crack peddling, apparently, for those of you who have read Freakonomics).

Maybe things are different in neuroimaging. I would find some neuroimaging postdocs and talk to them before you make any decisions.

I agree, MD/PhD is the way to go, even if you don't care to work with patients. Reason is there is a lot more money in biomedical research, there are some things that only an MD can do (and grants that he may apply to), the MD/PhD program (if it is coherent, unlike Harvard's) will push to help you finish your PhD faster (no 7 or 8 years PhDs!), and you can always fall back on clinical medicine.

I strongly suggest you do a residency if you get into an MSTP.

 

[dl2dp2]

completely agree with tr and the poster after him.

that was pretty much my original point. (it was not to diss any psychology phd programs. although i maintain my thesis that in order to do neuroimaging you don't need a phd in psychology so long as you have MD. as whether the principle and practice of (much of) academic psychological research is, in fact, scientific, that's a whole different can of worms that we shouldn't get into.)

in this game of life, an MD just gets you THAT much farther than a good old PhD. Maybe it's unfair, but it's the way it is.

 

[Vader]

None. Zero. It's a waste of 3.5 years if you don't do the postgraduate training.

I would agree that in theory the degree you require for what you want to do is a PhD. Unfortunately, I cannot agree with Vader and Gfunk6 in advising you to do a straight PhD, because that is a road to despair. When I look at brilliant postdocs with multiple Cell papers who are in their tenth postdoc year because they cannot get a faculty job anywhere, I cannot in good conscience advise anyone to just get a PhD.

The problem is that no-one will tell you this because biological bench science requires a constant supply of graduate students and postdocs to do the enormous amount of manual labor involved. However, very few of those grad students and postdocs will ever actually get faculty jobs. Academia is a tournament scheme (just like crack peddling, apparently, for those of you who have read Freakonomics).

Maybe things are different in neuroimaging. I would find some neuroimaging postdocs and talk to them before you make any decisions.

I usually agree with your posts, tr, but am a bit confused at your response in this case. Are you saying that doing a PhD in general is a road to despair? Or a PhD specifically in psychology/neuroimaging?

So what are you advising the poster to do? He/she was asking about whether it is possible to conduct research using functional neuroimaging or on patients with brain lesions without an MD. Some of the folks I know who are in this field have MDs, some PhDs, and some both. It is certainly not necessary to have an MD, but that a PhD seems to be the most appropriate route given the poster's current interests. If not MD and not PhD, then what do you suggest?

 

[Vader]

The internship is a final year after all of med school is finished and the MD is awarded. It is necessary for medical licensure to see patients, though does not grant you the rights to conduct specialty work as would be done in a residency and tested for in USMLE step III (correct me if I'm wrong here SDN gurus). For most docs, the internship works out to be the first year of a multi-year resedency.

Actually, one typically takes Step III during internship year (PGY-1). There are specialty boards for individual specialties. The testing never ends, unfortunately. 🙂

 

[Vader]

I completely agree with you. Your advice is the standard official line from the MSTPs. I'm just trying to give an alternative twist to this. There is quite a bit of bad fMRI research published, ergo, there's funding for a lot of bad research, ergo, you could be poorly trained and still be funded, ergo, you don't need a PhD.

A PhD in psychology is a whole different animal compared to a PhD in basic biological science. If the above poster wants to do a PhD in psychology then be my guest. But frankly whatever you need to pick up from a PhD in psychology in order to do research in neuroimaging could be easily picked up by doing a residency in neurology/psychiatry by doing a year or two of elective research. There is a reason why most MSTPs do not support a PhD in psychology. Why not do a PhD in anthropology, or history, or write a thesis on "the post-colonial meta-critical exegesis of adiabetic power struggle between Armenia-Hispanic diaspora and the mass media"? Because any of the above does not teach you how to do scientific research. It's not necessary to have a PhD in the biological sciences to do research in history and anthropology and literary criticism or even economics. You could totally pull it off with just an MD. Franz Fanon, for instance was an MD. Freud was an MD. Seymour Ketty was an MD. Many great public health researchers were just MDs. You don't need a PhD to do psychology, it's as simple as that.

I think you have a very narrow definition of "scientific research". Actually, our program (UCSF) offers a PhD in medical anthropology for MSTP students. UPenn and some other top programs will also allow MD/PhD students to pursue PhDs in other fields. The general trend seems to be a liberaliziation of the areas in which students may obtain PhDs in addition to their MD.

You are clearly implying that psychology, anthropology, literary criticism, economics, etc are somehow less rigorous fields that do not require the expertise garnered through PhD work. Unfortunately, this belief is quite misguided. While you may be correct that a PhD is not strictly required to do work in such fields (and also not in biomedical sciences), it provides a higher level of expertise and experience unmatched by an MD alone.

While it may be possible to do "a year or two of elective research" during a psychiatry residency (more realistically less than a year), it would be quite difficult to do that much research during a neurology residency. Neurology programs are 3 years, with 2 years of required rotations and 1 year of electives. At most programs, you cannot typically take a whole year of research electives, so you would be limited in the amount of research you could do. It would be much more likely that one would do an additional 1-2 years of fellowship to be involved with research to a significant extent.

 

[beetlerum]

Wait, he wasn't serious, was he? I can't imagine any intelligent person claiming that an MD could just figure out econ research without a PhD or serious training. Oddly, if he was serious, he seemed to be saying that an MD might need a PhD in biological sciences to learn scientific research but wouldn't need it to do serious research in history or econ. Maybe I'm misunderstanding. Anyway, have more respect for non-medical disciplines!

I think you have a very narrow definition of "scientific research". Actually, our program (UCSF) offers a PhD in medical anthropology for MSTP students. UPenn and some other top programs will also allow MD/PhD students to pursue PhDs in other fields. The general trend seems to be a liberaliziation of the areas in which students may obtain PhDs in addition to their MD.

You are clearly implying that psychology, anthropology, literary criticism, economics, etc are somehow less rigorous fields that do not require the expertise garnered through PhD work. Unfortunately, this belief is quite misguided. While you may be correct that a PhD is not strictly required to do work in such fields (and also not in biomedical sciences), it provides a higher level of expertise and experience unmatched by an MD alone.

While it may be possible to do "a year or two of elective research" during a psychiatry residency (more realistically less than a year), it would be quite difficult to do that much research during a neurology residency. Neurology programs are 3 years, with 2 years of required rotations and 1 year of electives. At most programs, you cannot typically take a whole year of research electives, so you would be limited in the amount of research you could do. It would be much more likely that one would do an additional 1-2 years of fellowship to be involved with research to a significant extent.

 

[tr]

I usually agree with your posts, tr, but am a bit confused at your response in this case. Are you saying that doing a PhD in general is a road to despair? Or a PhD specifically in psychology/neuroimaging?

There may be some disciplines where this is different, but in most of the ones I know, very few PhDs will ever become faculty. The problem is somewhat less severe in the biological sciences than in the humanities because the country needs more researchers than college professors; but the basic tournament arrangement holds. I am suggesting that if there is a chance that neuroimaging is unusual in that the employment prospects for PhDs are reasonable, then I would recommend a PhD in this case.

So what are you advising the poster to do? He/she was asking about whether it is possible to conduct research using functional neuroimaging or on patients with brain lesions without an MD. Some of the folks I know who are in this field have MDs, some PhDs, and some both. It is certainly not necessary to have an MD, but that a PhD seems to be the most appropriate route given the poster's current interests. If not MD and not PhD, then what do you suggest?

I agree with your assessment; I'm just less sanguine than you are about the likelihood of success with a PhD alone. The MD seems to support some halfway options: one can be a neurologist or psychiatrist who uses imaging in one's practice, and collaborate with others to do research part of the time. This is a reasonable, feasible career option for anyone who can get through med school.

The PhD, in contrast, is all or none: either you get a faculty-level job (few PhDs) or you spend years in underpaid postdocs until you finally give up (most PhDs). I know a lot of PhD students who wish they had known then what they know now. Therefore I might suggest an MD/PhD with residency as the most practical option for the OP.

 

[tr]

I completely agree with you. Your advice is the standard official line from the MSTPs. I'm just trying to give an alternative twist to this. There is quite a bit of bad fMRI research published, ergo, there's funding for a lot of bad research, ergo, you could be poorly trained and still be funded, ergo, you don't need a PhD.

Sluox seems to be approaching this from a credential-based perspective. I agree that in the presence of an MD, a PhD is not a crucial credential for conducting research. Unfortunately, there is far more to the PhD than credentialing. You learn an enormous amount about how to conduct (and fund!) good research in those years. I agree, you are sufficiently well credentialed to do crappy, meaningless research with an MD. But your chances of doing good, meaningful research are much higher if you are appropriately trained.

You don't need a PhD to do psychology, it's as simple as that.

That's nonsense. You could have both an MD and a bioscience PhD and never have taken a single class in statistics. How could you hope to conduct psych research without a whole lot of extra support?

 

[LM02]

The PhD, in contrast, is all or none: either you get a faculty-level job (few PhDs) or you spend years in underpaid postdocs until you finally give up (most PhDs). I know a lot of PhD students who wish they had known then what they know now. Therefore I might suggest an MD/PhD with residency as the most practical option for the OP.

Overall, I don't disagree about the tight prospects for a faculty job. They are hard to come by.

However, you are forgetting one area in which a PhD alone could easily garner a high-paying job - big pharma. There are plenty of opportunities to do neuroscience research (although not imaging, per se) in this context, and applying for such jobs is much less involved than going on the academic job market.

 

[dl2dp2]

tr is right.

there are probably things that you don't learn from a MD pathway that are necessary for successful neuroimaging work. it's funny tr mentioned stat, cause many biology people i know are really pretty bad at stat, and even in basic biological research PhD programs you don't learn stat comprehensively.

I'm suspicious of the organizations of most PhD programs in the country at this point, speaking from the perspective of a 3rd year MDPhD student at a top 10 institution. PhD is one of those things where you could really get away with doing very badly. There's no quality assurance. There's nothing that says at the end of it you had to have acquired certain skills, you had to know how to "do science" etc etc. To me, to "do science" is a certain lifestytle that entails getting your research funded and manage a lab like any given PI, not simply making a hypothesis and conducting experiments. It's like to "do medicine" involves actually carrying out the LIFESTYLE of a clinician, may it be managing a practice, funding academic clinical research or otherwise, and not simply making a diagnosis and write a prescription. An MD trains you to "do medicine" and in fact has the LEGAL OBLIGATION to train you to do so. A PhD doesn't train you to "do science". In fact, many PhDs don't know how or can't or don't want to "do science". In my opinion, A PhD gives you two things, a credential for doing strictly academic research as a post-doc/industrial researcher, and time to build up your CV so you could hope for a grant eventually.

The best scholars in humanities and social sciences are, indeed, very well trained...but the PhD programs for these diciplines do not necessarily train you to become an exceptional scholar in these diciplines i.e. is a PhD in English the best way to become a good literary scholar? An argument could be made (and has been, by conservative thinkers such as Allan Bloom,) that it is, in fact, not. There's a difference between what is entailed of PhD programs per se and the level of scholarship coming out of it.

Similar arguments could be made about various different kinds of basic biological research. Is a PhD in biology the best training program for conducting translational research directed to bring lab results to the bedside? No, in fact it is not. (The best program is an MD/PhD.) Most of the PhD only students in the country doing research on topics ranging from cancer genetics to diabetes should, but most don't, in fact, have some training in clinical medicine.

Here i'm making the argument that to do psychopathology research with neuroimaging, the most appropriate background is an MD with a psychiatry residency, not a PhD in experimental psychology. This line of research is enormously clincial in nature and could be rather importantly informed and benefitted by clincial experience and population access.

I tend to believe, and you can take my opinion as it is, that a PhD doesn't train you to DO anything. What it does is to give you protected TIME so that you could determine what you want to do and move yourself along that direction. I pretty much consider the idea that a PhD "teaches you how to do..." to be a little silly at best and very misleading at worst.

 

[beetlerum]

The best scholars in humanities and social sciences are, indeed, very well trained...but the PhD programs for these diciplines do not necessarily train you to become an exceptional scholar in these diciplines i.e. is a PhD in English the best way to become a good literary scholar? An argument could be made (and has been, by conservative thinkers such as Allan Bloom,) that it is, in fact, not. There's a difference between what is entailed of PhD programs per se and the level of scholarship coming out of it.

How do you know? Do you have a PhD in a social science or humanity? Don't minimize the achievements without having any firsthand knowledge. I mean, if you're saying that you don't need top scholar achievement to get a PhD, then granted. You also don't need to be a world-class clinician to become a doctor. The minimum to get the degree is not the level of exceptional achievement. I guess I don't even know what you're getting a. If this is supposed to back the point that MDs could become econ scholars without econ training, it is not very convincing. Just as the true point that you can get an MD without being an exceptional clinician says nothing about whether an econ PhD could start a medical practice.

I think there's plenty of quality control in PhD programs, if a little unpredictable (from individual advisor personalities). There are lousy docs who slip through the cracks too. Your standard for what would constitute acceptable quality in a PHD program is not realistic.

 

[entropy2]

every medical school has a person that runs the mstp... why don't you talk to one of them ?