1. What do you find most helpful? Give us your feedback on the 2019 SDN Member Survey to help further the SDN mission (and win prizes!)
    Dismiss Notice
  2. Dismiss Notice

MD/PhD worth it if you don't plan on going straight into Basic Research?

Discussion in 'Physician Scientists' started by DeadCactus, Feb 19, 2007.

  1. DeadCactus

    DeadCactus SDN Lifetime Donor
    Lifetime Donor Verified Account 10+ Year Member

    Joined:
    Oct 28, 2006
    Messages:
    2,558
    Likes Received:
    636
    Status:
    Resident [Any Field]
    Is the MD/PhD worth it if you don't intend to begin doing basic research right out of med school or residency, but know you want to get into it maybe 5 years down the road?

    For example, if you want to do pure clinical medicine the first few years out of school for whatever reason, but know that eventually you would like to settle into an academic role and do part basic research part clinical medicine.

    Would the MD/PhD still be the route to go or would you be better off getting a PhD on it's own once you are ready to settle down?
     
  2. physicsnerd42

    physicsnerd42 Member
    10+ Year Member

    Joined:
    Feb 26, 2006
    Messages:
    896
    Likes Received:
    91
    Status:
    Resident [Any Field]
    If you want to do clinical work for a while after residency why not just do a MD? There are many excellent researchers who are MD-only and I feel like if you don't use the research skills you acquired with your PhD for 10+ years, your PhD would be of minimal use. But that's just my feeling.
     
  3. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Staff Member Administrator Physician PhD Faculty Lifetime Donor Verified Expert Verified Account 10+ Year Member

    Joined:
    Oct 12, 2004
    Messages:
    18,899
    Likes Received:
    4,127
    Status:
    Fellow [Any Field], Attending Physician
    I think if you're not sure that you want to do research, you shouldn't get a PhD until you are sure. Attrition for grad school is very high, and it's a lot of hard work for someone who only "might" want to get the degree. Maybe you could consider doing an MD/MS until you figure out what you ultimately want to do.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  4. Circumflex

    Circumflex Junior Member
    10+ Year Member

    Joined:
    Mar 6, 2006
    Messages:
    307
    Likes Received:
    1
    Status:
    Attending Physician
    I totally agree with the other posts - do the MD. If you want to do basic research later, you can - without getting a PhD.
     
  5. greg12345

    greg12345 New Member
    2+ Year Member

    Joined:
    Apr 2, 2006
    Messages:
    123
    Likes Received:
    1
    Most MD/PhDs will not start doing basic science research immediately out of med school/residency because most MD/PhDs will do a fellowship. For example, if you wanted to be a research oncologist, you would do a 3 year residency in internal medicine (which is essentially all clinical time and no lab time) followed by a 3-4 year heme/onc fellowship during which 18mo is devoted to clinical care (most of it front loaded at the beginning of the fellowship) and the rest is hard core lab time. Hence, you will be seeing/taking care of patients exclusively for ~3.5-4.5 (Depending on if you fast track) years before you start hard core research.

    As a person in the final year of my MSTP training, I would strongly recommend that you examine very closely what you want to do in life. An MD/PhD is definitely not something you want to undertake on a whim. Obviously I'm a little biased but I think the PhD will help a lot further on down the road if you want to be a hard core basic scientist...as a fellow you will already know your way around a lab, but more importantly you will know how to think like a scientist, write grants, etc...which will give you an advantage over straight MDs who might be starting their first REAL research project as a fellow.
     
  6. OP
    OP
    DeadCactus

    DeadCactus SDN Lifetime Donor
    Lifetime Donor Verified Account 10+ Year Member

    Joined:
    Oct 28, 2006
    Messages:
    2,558
    Likes Received:
    636
    Status:
    Resident [Any Field]
    I guess my dilemma is that the areas of clinical medicine that interest me most are not conducive to the fields of research that interest me (well as far as I can tell what will interest me before even being in Med School).

    Research wise, I want to do Biomedical Engineering. I love engineering. I want to learn as much as I can and to stay invovled with the field and eventually to contribute to it's advancement via my own research.

    Clinically I want to do things like Emergency Medicine. That's no too bad; plenty of room in Emergency Medicine for the development of Biomedical Devices to aid in treatment and diagnosis. The problem is the areas that really interest me are the more "field medicine" areas: Wilderness Medicine, International Medicine, Tactical Medicine, Dive Medicine.

    My assumption:
    It doesn't seem to me that ones Clinical and Research areas HAVE to line up; but it does seem like the areas that interest me would involve a lot of time spent traveling or away, which would get in the way of running a lab.

    Which is why I made this post. I was looking at the idea of doing the PhD/MD, taking a few years to practice the areas of Clinical Medicine that are particularly fascinating to me and then (contently) settling into a nice academic career putting the MD/PhD to work in the way it was intended.

    So I guess my post is really asking two questions:
    In this light, would it be worth it?
    If not, are there any other options to reconcile my two rather opposite interests?
     
  7. Circumflex

    Circumflex Junior Member
    10+ Year Member

    Joined:
    Mar 6, 2006
    Messages:
    307
    Likes Received:
    1
    Status:
    Attending Physician

    From what you said, no it is not worth it for you to do the PhD. You will find that to do something well, you need to focus. Yes, it is possible to do basic research that is not related to your clinical field, but it is difficult. To do basic research, you have to write grants and get grant money. To do this, you need preliminary data and a track record of publication in a specific area. Many physician-scientists are able to use their fellowship or initial faculty appointment to gain this data, but it would be difficult to do wilderness medicine for a few years and come back to the lab and be good at it.

    Regardless, to do the MD/PhD, they want to know how you plan to combine medicine and research into a career. My advice is to go the straight MD route. There is nothing to stop you from getting involved in research later through collaboration or you could take some time off to get formal training (not a PhD), if that is what you really want.
     
  8. greg12345

    greg12345 New Member
    2+ Year Member

    Joined:
    Apr 2, 2006
    Messages:
    123
    Likes Received:
    1
    Yeah, I agree with what Circumflex said. Just a question - what stage are you in? I'm guessing that you are still an undergrad. How do you know for sure what type of medicine will interest you? While you think you may know 100% for sure what you want to do in the future now, things change...8 years is a long time and many of us came in with preconceived notions of what type of physician we would want to be but a lot of changed our minds (sometimes pretty drastically) once we got into our clinical rotations and saw what things were like in different fields.
     
  9. OP
    OP
    DeadCactus

    DeadCactus SDN Lifetime Donor
    Lifetime Donor Verified Account 10+ Year Member

    Joined:
    Oct 28, 2006
    Messages:
    2,558
    Likes Received:
    636
    Status:
    Resident [Any Field]
    Your guess is correct and you are absolutely right, there is no way of knowing for sure what I will want to do almost almost a decade from now. I am probably giving the impression of a person dead-set on one specific career path, but that is not the case. I would not be going into medicine if the vast majority of the specialties did not hold some fundamental interest to me.

    Never the less, the MD/PhD choice will always be one made on rather limited information. I doubt I will be much surer of what specialty I want when i am applying to programs, and I don't think the first to years will be terribly helpful either. The choice of MD/PhD or not has to be made before the exposure of the last two years of Medical School and so I would argue that all MD/PhD applicants are making a significant career choice with limited information.

    The point being that at some point the choice has to be made and in all likelihood it will be made with limited exposure. The best anyone can really do is take the information available and come up with a 10 year plan and see what happens. If the plan needs changing a few years out, so be it.

    I say I want to be an EP and do suchandsuch fellowship because at this point I feel it matches best with my personal interests and my desires for my professional and personal life. I need something to work with while making plans for where to apply and what I need to do to build a better application and such; so I set my sites on a target I feel comfortable putting a certain level of commitment.

    I talk to much...
     
  10. Circumflex

    Circumflex Junior Member
    10+ Year Member

    Joined:
    Mar 6, 2006
    Messages:
    307
    Likes Received:
    1
    Status:
    Attending Physician
     
  11. greg12345

    greg12345 New Member
    2+ Year Member

    Joined:
    Apr 2, 2006
    Messages:
    123
    Likes Received:
    1
    Yes, the decision to pursue MD/PhD training will always be made with limited information. When I decided to do MD/PhD I had no idea what I was getting myself into, I thought I did but I really didn't. It is a lot of blood, sweat, and tears and there were many times at all stages of my training where I wondered if I would have been better off with just straight MD training. Now that I am more or less done I can say it was totally worth it and I would definitely do it over again if I had the choice. The 2 most critical issues you have to identify within yourself are:

    1) Do you love basic science research? - most important
    2) Do you love medicine? - not as important, but still important

    If you can wholeheartedly answer yes and are willing to work long and hard then you should do the MD/PhD. Coming out with a dual degree gives you almost unlimited flexibility when it comes time for you to decide what you want your career path to be - whether it is an academic clinician doing basic science research, pure basic scientist, pure academic clinician, industry, or private practice. And if you want to pursue basic science or translational research, you will be uniquely trained to do so.
     
  12. nayan

    2+ Year Member

    Joined:
    Nov 20, 2006
    Messages:
    17
    Likes Received:
    0
    Status:
    Resident [Any Field]
    this question is not relevant to the above one. i finished my internal medicine residency. i wanted to do some translational cancer research and pursue a fellowship later if i decide to. My question is after doing my phd in cancer research, could i stop at that point and look for jobs in academic medicine?
    doing research in cancer helps me in getting heam-onc fellowship?
    Please help me , i am little confused.
    thanks
     
  13. sample simple

    Joined:
    Feb 27, 2007
    Messages:
    5
    Likes Received:
    0
    Right now I am entering a PhD graduate program in biochem and molecular biology...I have a growing idea that I might want to be an MD instead however. If I were to switch career paths, I would want to be pure nonacademic MD practicing medicine (not doing research)...at the current time I love research, but not really medical/clinical oriented research, more basic cellular stuff...

    I was wondering if it would make sense to try and transfer into an MD/PhD degree...My question is basically with the MD/PhD degree, if after you finish it you decide you dont want anything to do with research, can you still have success as a practicing physician (either private practice or at a hospital). Alternatively, can you also decide you want to focus on 100% basic science and leave the medical compenent behind?

    I've found a lot of information suggestion you can balance both research and see patients but not much suggesting that you can focus on 100% one or the other after you get the dual degree...especially regarding private practice...

    any input would be greatly appreciated...thanks
     
  14. gbwillner

    gbwillner Pastafarian
    Moderator Emeritus Verified Expert 10+ Year Member

    Joined:
    Jan 30, 2006
    Messages:
    2,158
    Likes Received:
    282
    Status:
    Attending Physician
    Probably not. You will have to do a post doc, unless by "academc medicine" you mean being an attending in an academic center. During your post doc you will apply for grants, and after a few years the institution will give you a start-up package to start your own lab.

    That's my understanding of how things work, anyway.
     
  15. gbwillner

    gbwillner Pastafarian
    Moderator Emeritus Verified Expert 10+ Year Member

    Joined:
    Jan 30, 2006
    Messages:
    2,158
    Likes Received:
    282
    Status:
    Attending Physician
    You should really sit down and think about this. Starting a PhD and quitting is a waste of your time. Doing a PhD and nonacademic medicine is 95% of the time ALSO a waste of time.

    Yes you can, and in fact many do. However, not only is this a complete waste of your time, you will never get admitted to an MD/PhD program with this mindset.

    Those people are plentiful but don't get a lot of attention, as the goal of the program IS using both degrees. I'm telling you that unless you REALLY REALLY REALLY want to be a physician-scientist, DO NOT do an MD/PhD. You will be kicking yourself every day during the PhD especially, until you quit.
     
  16. sample simple

    Joined:
    Feb 27, 2007
    Messages:
    5
    Likes Received:
    0
    I'm saying I want to do either 1 or the other, and not both...right now I want to go for the PhD and research path...I am thinking ahead that in my 3-4th year I may *MAY* want to stop and get an MD...I was thinking by transfering immediately into a dual degree I wouldn't be risking wasting those first 2-3 years of PhD time should I switch to a medical career...

    Also, don't the dual degrees pay you a stipend and tuition waiver whereas pure MD programs you have to pay tons of money to go to school?
     
  17. gbwillner

    gbwillner Pastafarian
    Moderator Emeritus Verified Expert 10+ Year Member

    Joined:
    Jan 30, 2006
    Messages:
    2,158
    Likes Received:
    282
    Status:
    Attending Physician
    Oh my... you also might want to off yourself now, to prevent the future headache your going to have... Ok, I'm KIDDING.

    So you're going to wait 3-4 years, decide that you're wasting your time and quit, and THEN start an MD? OR you could switch now??? Good luck with that- it doesn't work that way. You would have to go through the riggors of the MD application process. It will take at LEAST a year, assuming you have taken the MCAT already. If you are somehow admitted to the MDPHD program, you will have to stop your PHD, and all that work will be lost anyway. THEN you do 2 years of Med school, THEN you start the PhD. No one is going to let you put your work "on ice" for two years. It probably won't be relevant anymore anyway.

    Man, you seriously need to think about your future and what you want it to be!
     
  18. sample simple

    Joined:
    Feb 27, 2007
    Messages:
    5
    Likes Received:
    0
    I just was accepted to PhD programs...so I will start next fall...the first 2 years are course work and rotations so you dont start researching until your 3rd year anyway...

    Options are:
    Do PhD and finish in 6-7 yrs and dont decide to do MD

    Do PhD then decide 3-4yrs in I'd rather be an MD and switch into an MD program and wasted those years in the PhD program

    Do 1 yr of PhD, get some courses out of the way and then transfer into MD/PhD dual program so that I'm in a program preparing me for either route..some of my courses in the 1st year of PhD program might even transfer over

    Right now, like i said, I like basic research but over the past 4 months I've began entertaining and inreasiningly liking the idea of possibly being an MD...I don't feel like I want to pursue it yet but I may decide I want to in a few years...I'm trying to avoid wasting those few yrs
     
  19. gbwillner

    gbwillner Pastafarian
    Moderator Emeritus Verified Expert 10+ Year Member

    Joined:
    Jan 30, 2006
    Messages:
    2,158
    Likes Received:
    282
    Status:
    Attending Physician
    OK. I think it's good that you've though about this. Let's discuss the possibilities more realistically...
    1- how competitive of a candidate are you? How good are your grades? Have you taken the MCAT?
    If not, take the MCAT now before you start the PhD. MD/PhD applications are taken in September, so you really don't have long to decide what you're going to do.

    2- If you really think in 3-4 years you may reconcider the PhD... stop now. Really. the PhD is A LOT of work and VERY difficult. You will probably be contemplating killing yourself just to end the misery at that time, not just wondering if you'd made a mistake. If you have doubts now, it's not too late.

    3- Assuming you're competitive and get an MCAT over 33, congratulations, you have a chance. but there is no "transfer" from PhD into MD/PhD, only the other way around. So realize you WILL be starting over. And unless you are at the same institution (very unlikely), none of your credits will transfer.

    4- You don't really need to wait 3-4 years to decide you don't want to do a PhD. Most people decide just after they fail their quals.

    My advice, given all you've said- is to make sure you have all courses/tests for med school completed, and that you have a realistic chance of acceptance. If you do, then apply ASAP. you should consider that it will look BAD to drop out of a PhD program. Be prepared to defend your decision. Apply for MD/PhD, and start grad school. If you're accepted, drop out of PhD, and wait for the next year to begin. If not, pretend like it never happened.
     
  20. Dr.Watson

    2+ Year Member

    Joined:
    Oct 11, 2006
    Messages:
    236
    Likes Received:
    1
    Status:
    Pre-Medical
    For the most part, transfering into MD/PhD while in a PhD program is rare, very difficult and has to be at the same institution. Transfering from an MD program into MD/PhD is much more the norm and is easily facilitated in the typical structure (2 MD, 3-5 PhD, 2 MD). If you want to go to medical school at all, it's best to start off in medical school. MD admissions are more difficult than PhD admissions, and medical schools (not grad school component) tend to have 'control' over MD/PhD's coursework/direction/integration.

    The best option for pursuing MD/PhD: Take a year off, take the MCAT, do more research (maybe get a masters), and apply for MD/PhD if you want a dual career.

    In the scenarios you're describing, you'll *mostly likely* have to do the 2 degrees separately and pay for your MD degree unless you're lucky and get a full-ride. Also, dropping out of a PhD program doesn't look good to MD AdComs. PhD courses likely won't transfer. Oh and the either/or idea as far as careers, won't pass muster for the MD/PhD admissions (despite the either/or paths that many MD/PhD graduates pursue). Starting a PhD program now, most likely, will be a waste of time unless you complete the degree and pursue research.
     
  21. Circumflex

    Circumflex Junior Member
    10+ Year Member

    Joined:
    Mar 6, 2006
    Messages:
    307
    Likes Received:
    1
    Status:
    Attending Physician
    Sample Simple, listen to the good advice you've been given. You should talk with and shadow some physicians and see if you like medicine. Medical school sounds like a good idea, but if you do it because you are not sure what you want to do, you will regret it. The same goes for the MD or MD/PhD programs. They are a lot of work.

    Also, MD/PhD programs are very competitive - the admissions committee for MD and MD/PhD will want to know that you know what you are getting into. You need to do some more footwork and soul-searching to figure this out now, not 3-4 years from now.
     
  22. sample simple

    Joined:
    Feb 27, 2007
    Messages:
    5
    Likes Received:
    0
    I've always been all about science and biology...specifically biomedical and cellular stuff...I've taken tons of courses in pathogenesis, gene expression, virology...I just was turned off from the idea of med school because of the premed students in my courses who grade begged for As and then threw all their notes and books out the day classes were over..

    Recently I've had some minor exposure to psychiatry through an MD friend, and I've been researching the life of an MD. I've been admitted to some of the top PhD programs in biochem, molecular and cell biology, and for now that is what I want...I LOVE science and LOVE research but I'm not sure that I want to make science the rest of my career...I'm not sure at all about getting an MD, but sometimes I feel like I might be a lot happier helping people, having more interactions at work, and having an education thats more applicable to life and people...I also recently diagnosed a friends boyfriend who is from Ukraine and it turns out has been living with Marfan's syndrom, and the experience made me appreciate the problem-solving nature of diagnosis...

    It seems whenever I bring up the switch-to-medicine subject everyone around me gets pissed off...I've been involved in research all through undergrad, I work now as a research tech, and I'm starting my PhD next fall...but I just wonder what would happen should I decide that I want to pursue an MD halfway through and if there is anything I can do in the mean time to kind of cover my ass...But as for right now research is my passion and I feel like my mind is built for it...I'm just trying to think 15 years down the line if I will be happier still doing research or having some sort of medical practice.

    PS - Thank you all for your input so far..
     
  23. gbwillner

    gbwillner Pastafarian
    Moderator Emeritus Verified Expert 10+ Year Member

    Joined:
    Jan 30, 2006
    Messages:
    2,158
    Likes Received:
    282
    Status:
    Attending Physician
    It doesn't sound like you know what you want at all. Going to graduate school because it's what you want to do now- but don't want to make it a career- is really, really dumb. You will suffer at the bottom of the totem pole, only to flee before you ever get to do what you want. If you just like the concept of science but don't want to make it a career- stay working as a tech. At least that way you get paid to be a scrub.

    Your comment that you got into competitive PhD programs means nothing when compared to MD programs. Why do you think all those snobby Pre-meds begged for A's? Because without them they have no shot at an MD program.

    There is nothing you can do to "cover your ass". Figure out what you want to do and do it.
     
  24. greg12345

    greg12345 New Member
    2+ Year Member

    Joined:
    Apr 2, 2006
    Messages:
    123
    Likes Received:
    1
    Here's my advice, which admittedly may be suspect, BUT:

    Forget about the PhD program you just got into, cancel, don't go, don't start. FORGET ABOUT IT DUDE. Take a year off & work as a lab tech to pay bills/ continue research, meanwhile expose yourself to as much clinical medicine as possible (volunteering, shadowing, etc.) while preparing to apply for med school and buffing your med school application. It sounds like you are hesistant to pursue both science and clinical medicine in the future, and will likely pick one or the other - in that case you should always get the MD - it allows much more career flexibility (this is assuming you liked what you saw of clinical medicine from your exposure to it). Plenty of MDs do 95% basic science research with minimal clinical time, plus if you hate research, you can always see patients exclusively to make a living. Or you can do both...it is totally up to you and what you want out of your career. Best of both worlds.

    If you don't end up liking clinical medicine or if you don't get into med school, well guess what, if you got into grad school once I bet you could do it again...so you lost a year or two, big deal. Better to do that than to go to grad school for 3-4 years then decide you want to pursue MD training.

    What you should NEVER NEVER NEVER do is decide to pursue an MD/PhD without 100% commitment to a career as a physician scientist or b/c it is paid for, or b/c it sounded good at the time. That would honestly be the biggest mistake you would probably make in your life.
     
  25. Dr.Watson

    2+ Year Member

    Joined:
    Oct 11, 2006
    Messages:
    236
    Likes Received:
    1
    Status:
    Pre-Medical
    If you decide to pursue an MD halfway through, then basically you wasted 3-4 yrs. In fact, you probably hurt your MD chances significantly because you have then get a lot of recent clinical exposure to buff your MD app, take the MCAT, get LORs (from a PI who's pissed you quit and profs from undergrad?), and try not to look like a total flake who can't commit and might drop of the MD halfway through. There's no 'cover your ass' aspect to it. It's lost time.

    We're not getting pissed off at you, but there's a good reason you keep getting this vibe from everyone who propose this plan to: the plan is a bad one that doesn't work. None of us want you to make a HUGE mistake. For MD/PhD applications, we've all had to think an awful lot about this career path, weigh MD or PhD, and explain ourselves seemingly hundreds of times to interviewers on what we want to do with our lives. PhD to MD/PhD is incredibly hard and risky, and if you're doubting your PhD commitment on day 1, transfering PhD to MD/PhD is simply a bad plan that will not result in what you desire.
     
  26. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Staff Member Administrator Physician PhD Faculty Lifetime Donor Verified Expert Verified Account 10+ Year Member

    Joined:
    Oct 12, 2004
    Messages:
    18,899
    Likes Received:
    4,127
    Status:
    Fellow [Any Field], Attending Physician
    sample simple, I am a PhD who is now in medical school. I agree with the previous posters that it sounds like you do not know yet what you want to do, and I agree that even doing a straight PhD program is probably not the best plan for you until you decide for sure whether you'd rather be a scientist or a clinician. Attrition in grad school is very high; only about half of the people I started with graduated. Since you definitely don't want to be a physician scientist, DON'T apply for an MD/PhD. You probably won't be able to transfer into an MD/PhD program from a straight PhD program anyway. (If it were so easy to do this, I wouldn't be doing my degrees separately. ;) ) Here are my suggestions:

    1) Change your PhD program to a MS program. You should be able to finish a thesis MS degree in 2-3 years. This will buy you some time to find out how you feel about a career in research, and give you a degree at the end of your time. If you still want to apply to med school, you can definitely do so with a terminal MS; it may even be an asset to your app.

    2) During these next couple of years, spend more time with physicians and talk to more people in the medical field. The reality of med school (and clinical medicine) is not all fun diagnosing Marfan's syndrome patients. Marfan's is relatively rare. Actually, if you're in a clinic, most of your patients will come to you with hypertension due to obesity/bad lifestyle choices if they're adults, or ENT infections if they're children. In either case, you'll spend part of your time trying to persuade them to comply with their treatments and improve their health habits, and the rest of it wrestling with HMOs and Medicare/Medicaid to get compensated. That's life as a community physician.

    3) You might consider speaking to a career counselor about various options. There are tests they can give you to help you learn more about your aptitude and interests.

    Best of luck to you. :)
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  27. greg12345

    greg12345 New Member
    2+ Year Member

    Joined:
    Apr 2, 2006
    Messages:
    123
    Likes Received:
    1
    I'd argue that clinical medicine can be almost all fun IF you pick the field that is right for you and practice it in the right environnment. I would die in any surgical field and most primary care fields, but multiple IM subspecialty fields are really appealing to me. There are plenty of interesting fields to go into even if you hate interacting with patients (rads, path, gas). The real downer with medicine these days is not the medicine, it is the endless insurance paperwork/reimbursement hassles, etc. or if you are in academic medicine, the politics/adminstrative duties, etc. But seriously, the politics and struggle of getting grants funded as a basic scientist has to be the worst of all.
     

Share This Page