MD PhD

Discussion in 'Medical Students - MD' started by Firebird, Apr 27, 2004.

  1. Firebird

    Firebird 1K Member
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    I've been accepted at a small Medical School and have I have a strong chance of being accepted as an MD/PhD candidate at that institution. Some people are telling me to go for it, others are saying I shouldn't waste my time in attaining the PhD.

    I don't plan to do only research for a living, as I plan to see patients. But I would like to be involved in some research, and eventually work my way into becoming a program director at a research institution or even as a hospital administrator. I could also see myself working with the University as Dean or something like that.

    Does anyone have any suggestions or thoughts about this???
     
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  2. Seaglass

    Seaglass Quantum Member
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    IMHO a Ph.D. is a wate of time when you are getting an MD, even if you are planning on doing bench research, with the exception being if you are planning on making research only your career as you can avoid all the debt that comes with the MD. You can do clinical research and bench research with an MD only. I don't know but you might have a leg up on funding with a Ph.D. after your name but I doubt it since it seems like funding chases publications and not your degree.

    So unless you have your heart set on being a Ph.D. I'd say skip it.

    C
     
  3. pud129

    pud129 Member
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    I'd agree with what the previous poster said. This is especially true for clinical research. Most of the clinical researchers that I know have only an MD. Several of them are gurus in their field. I think becoming a research director comes through grants, publications, and maybe spending a year in a research fellowship after your clinical residency/fellowship. One big benefit of PhD is no tuition, but then you are losing out on 3 years salary.... Unless you wanna do hardcore bench research, go MD. Just my opinion though
     
  4. peehdee

    peehdee don't have one
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    firebird,

    here's my thoughts on the topic.

    1) the PhD is an academic degree and hence it is for those who like to do things for the sake of doing it, hence the name 'academic'. i think if you plan on being an investigator at any level, its really worth getting the doctorate. i means its only 3 years and plus you get your MED school paid for plus your grad school with stipend. you'd be silly not to take it. a traditional PhD (the real one) takes over 5 years to complete. the MD/PhD program is an easy way of getting a doctorate degree. as a medical student you are in NO WAY prepared to be an investigator. graduate school opens your mind to the 'how's and 'why' of things that we learn. its like going into a fine restaurant and have something really outstanding, whereas medical school is like going to a buffet and getting a small (very small) sample of the different things that are known out there. the other thing to consider is what type of research you wanna do. clinical usually implies giving a drug to a group of people and saying, did the drug work or not? how many people had headaches or improved. it doesn't alway require a doctoral level education to be able to perform such an experiment. but if you're gonna do basic or bench, definately you need a doctorate because the molecular basis of disease and the huge amount of 'stuff' that has been gathered on that topic is just 'huge'. and a few courses in medical school will not prepare you for those who went to graduate school. so you should consider that.

    2) if you don't plan on doing research at any level, then i would agree with the others that you don't need a PhD (except for the free tuition). you're better off doing an MBA. i think that's prolly more prestigious than a PhD if you plan on doing management-related stuff.


    by the way, i have a PhD in biochem (which took a lil over 5 years), did 2 years of a post-doc training, then decided to go back to med school.. if i could do it again, i'd definately go the MD/PhD path (shorter time, and FREE)

    cheers
     
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  5. KyGrlDr2B

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    Firebird,

    I would say that you don't really need the phd, just like the others have said. The people that I know of who are md/phd plan to do research and not see patients. Also, most deans are md's (at least the ones I know of) that happened to get involved in academic medicine. Remember, you don't have to have a phd to be involved in academics. You will probably also want to talk to people who are md/phd and find out what their reasons were for doing it and see if it matches yours. Good luck. :)
     
  6. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    Just a quick sanity check:

    I intend on using my MD/PhD for academic teaching of Molecular Biology at the College or Professional level. Is the MD/PhD a good "thing" for someone headed in this direction? Also, I'm still very fascinated in the basic sciences and bench work along with clinical interaction; from the SDN community's perspective, does this justify the MD/PhD route?

    Thanks in advance,

    -Tom
     
  7. Seaglass

    Seaglass Quantum Member
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    Tom I'd say that if you're looking to get into the undergrad university racket then the Ph.D. would definitely be helpful. To the previous Ph.D. poster, most of the MD's I know that do bench work did a lot of on the job training and learned as they went. MD research does not equal drug trials for all.

    C
     
  8. nutmegs

    nutmegs ASA Member
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    I went through a similar situation- all I can offer you is my experience, this is a decision you need to make on your own.

    I got accepted to several NIH funded MD/PhD programs. I'd done research in the same lab for 3 summers/winter breaks, loved it, really found the stuff cool, and saw myself being a clinician 3.5 days/week, researcher 1.5. My ideal setup would be to "medically" supervise a lab- no hands on myself per se, but team up with a full time PhD and advise grad and MD/PhD students, help write grants/papers, and just help coordinate basic science with the clinical stuff to keep it relevant.

    I also fell in love with the MD-only school I'd applied to as a backup. After talking with the MD/PhD students at the schools I interviewed at, they seemed sooooo apathetic about school, "yeah, we're going to be doing this forever, oh well" and I realized I needed enthusiasm. At this point, I realized I
    a) wanted to have time to do community outreach/public health stuff.
    b) wanted to have a family in reasonable time.
    c) didn't want to be stuck in a 7 year committment (and I'm not the type to back out of things).
    d) didn't HAVE to do an MD/PhD program to get what I wanted. There will be opportunities during/after residency to take time to do research, if I want.

    So I sucked it up and gave away the full scholarship. (Eeeeee...). Sometimes I think about it, but I don't regret the decision I made in the least. I love my school, I love my class, I love what I'm doing, and I love having free time and a low stress level.

    If you see yourself doing clinical medicine primarily, I can't help but say you should think long and hard about if you want to have your first two years' classmates as your attendings...
     
  9. jwolfe

    jwolfe Junior Member
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    Greetings-

    In some ways I agree and in others I disagree with what has been stated above.
    While an MD can do research you will still need the appropriate training - this does not come in medical school or residency.
    You will need to do a post-doc if you are interested in basic research or some other post-grad training for other types of research.
    I am a 4th year who has spent significant time in the lab. While it is increasingly difficult to be a clinician-scientist, it is possible. I have worked with both MD (doing epidemiology and maintaining clinic) and MD/PhD (basic science and maintaining clinic).
    Bottom line: the PhD is not a waste of your time, but is not absolutely necessary (sorry to hedge). However, you will need additional training to do research.
    I would look into doing your MD and possibly applying for an HHMI-NIH fellowship after your second or third year. This will get you a year of research and help you decide if it is for you. It will also demonstrate your interest/dedication should you decide to pursue a post-doc.
    Just my $0.02!!
     
  10. peehdee

    peehdee don't have one
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    cg1155,

    i wasn't implying that MDs who do research do only drug trials but i can tell you that doing basic/bench work requires a lot more training than people assume. i think the view has always been, "well if you're good enough to be a medical student then you must be good enough to be a researcher", i.e. research/graduate school is 'easy' and that having an MD gives one the right to look down on the PhD. i'm not saying you personally feel this way, but i think that idea permeates in med students. "if you didn't get into med school, you went to grad school" is obsurd. no med school graduate will ever have the amount of training in science that a graduate student will have. likewise, no graduate student will ever have the training that a med student has. and you are correct, it is possible to learn as you go on in research. so would u then allow a PhD graduate to 'learn as they go' in patient care? i mean there is no reason why a PhD graduate can not learn how to insert a catheter, just like an MD graduate can learn how to run an NMR machine. the fact is an MD degree makes it easier to get into clinical research, but i'm almost certain that if you wanted to do a basic science research you're much better off with a PhD.

    anyway... i should go study..LOL :)

    cheers
     
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  11. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    If this makes any sense, I don't see myself as being the perfect scientist or the perfect clinician, I see myself as a mediator of sorts. Is there a spot for this mental framework? Or is it mostly md/PHD and not many MD/phd? Thank you all for your input. This is a good thread even if it is out of its forum context. :luck: :) Think Big Picture kinda Doctor that has the ability to understand the details and the general direction things should head.
     
  12. skiz knot

    skiz knot Legendary Dr. X
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    All the posters out there who think that you will get an MD/PhD in 7 years may be mistaken. Spending 3 years in a lab doesn't get you a PhD. You have to have work. They don't want to tell you this, but you are more likely to spend 4 years (or more) pursuing your PhD, and that is with your advisor being a little more lenient because you are also going for an MD. The PhD's in my department generally have the opinion (biased, I'm sure) that MD/PhD's aren't always prepared to commit to full time research. They are "let out" early so they can continue with medical rotations.
    I don't want to hear a bunch of responses saying that they know someone or a bunch of people who finished their PhD in 3 yrs, because I know that it happens, but you should be prepared to spend significantly more time pursuing the PhD portion of the degree.
     
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  13. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    This is a good point. Does anyone have any statistics on the distribution of time in years spent doing an MD/PhD dual program?
     
  14. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    You know what I just noticed? There is a Pre-MD/PhD forum but no MD(DO)/PhD forum ... hmmm... lack of interest?
     
  15. Neuronix

    Neuronix Total nerd
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    Uhhh... I think I need to set some things straight.

    The PhD helps you to do basic science research. If you have experience in basic science research and you feel you want to make it a very significant part of your career (well greater than 50% of your professional time), than the PhD will help you obtain the training, connections, positions, and funding you need. If you decide to do this as an MD, you will owe alot of debt and you will still have to dedicate a significant amount of time to getting the research training you need.

    The MD/PhD program is not an "easy way" to get a doctorate degree. Maybe at some schools this is the case, but not at the more regulated MSTPs. There's many reasons for this, but frankly the average time for a PhD here is about 4 - 5 years. The medical school portion at many places (including here) are shortened by a year (much of fourth year is electives), hence the 7 - 8 year graduation time.

    Why is it then that a MD/PhD "appears" shorter? Ignoring that MD/PhDs on average have more research experience and higher qualifications coming in than PhD students, MD/PhD students don't have some of the useless requirements. Teaching requirements are often times waived. I don't know how you feel about this, but at everywhere I've been where it's required, it's just been free work for the department. Coursework requirements are usually cut down, since we're getting tons of life science relevant information from medical school. Many students also take graduate courses while in medical school, so they have to spend less time doing it during graduate school. Rotations are done over summers before entering the PhD portion. This way, you get right into a lab and a project when you start. Sure, we get advising that keeps us from floundering in a bad lab. Our people look our for us, such that we don't get PIs who keep us around forever, or don't have the funding for us, or won't give us a decent project. Grad students often get screwed this way, and it's something that needs to get fixed about graduate education. Since there's so much being invested in us, the stakes become higher, and so there's incentive to fix issues that should be fixed anyway. I could go on, but there's always going to be some unfounded bias that MD/PhD is not a "real" PhD. It's the post-doc/fellowship that counts for careers anyways, and we do seem to be getting jobs and funding... So....

    Things are changing now that MD/PhD is becoming more common. While in the past, a PhD has not been an important degree to have for academic positions, it's becoming increasinly valuable. One wonders how important it will be in the future as more and more MD/PhDs come on the market...

    Tom, as a MD/PhD you will most likely be teaching medical students or grad students, not undergrads. This means you will probably teaching one small aspect of the cirriculum and/or doing clinical training for students. As teaching is downplayed and research is being increasingly valued, your training will be used to bring in funding for the University. TAs and unproductive researchers will increasingly be the teachers. As it is now, I don't know any MD/PhDs who spend time teaching undergrads, only PhDs.

    If you're okay with this set up, go for it! As for your next post about being the mediator, that's the idea of translational research. I like that idea as well. As for statistics, I don't have any handy right now, but the average for MD/PhD programs is between 7.5 and 8 years. It tends to vary between those two numbers at every program I know.

    I plan on doing a, and I know plenty of researchers who do that. In fact, one of the things that is lacking right now is a basic science component of community outreach and public health. As for b, I also plan on doing that. The question I have for you is, when do you plan on having a family with your MD? Assuming you are 22 when you start...

    26y.o. Graduate medical school
    Graduate Residency and/or Fellowship... 31y.o.

    If you decide to go into academics these ages could be prolonged and when you're an assistant professor that pressure does not go down as you'll be fighting to get tenure and/or keep your job. I'm in my OB/GYN block and we're told that fertility is already impaired at the age of 30. So, this is something you have to face no matter what. I definately plan on having a family... Maybe when I'm in grad school or residency. I'd probably do that if I went the MD route.

    As for c, that's your decision. I'm very happy with the fact that the MSTP lets me back out if I want to without negative consequences. There are arguments against d, but I still think that's perfectly reasonable as long as you aren't staring down $200k+ in debt.

    I'm not pushing anyone to do the MD/PhD program. If you think you want to dedicate a good amount of your time (well greater than 50%) in basic science research or industry, it's a good way to go IMO. If not, the MD/PhD was not created for you and it's probably not the right way to go.

    You got it. A very small percentage of SDNers continue to post after beginning medical school. This isn't different for MD/PhDs, there's just fewer of us to begin with. Feel free to post there though. There are a couple regulars and even more irregulars :)
     
  16. nutmegs

    nutmegs ASA Member
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    a- I meant during school. there is no way I'd have the time to put into the things I'm currently involved with if I was taking graduate classes on top of my med courses.
    b- plenty of people do it. just because it's hard to do, doesn't mean delaying a career by another 3-5 years by getting a PhD would make it any easier. arguably, it's easier for a male (ie, you) to do it during grad/residency than a female (ie, me). one of the almost-finished MD/PhD students says that his kids consider school to be his job. I personally don't want that.

    in the end, it's still a personal decision. just wanted to share some of my thoughts on it.
     
  17. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    WOW!!!

    Thanks for the information. Even though karma is against my personal ideology in the forum, you got some of my positive stuff!

    Thanks again for your time and help. :luck: :)
     
  18. ears

    ears Senior Member
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    I'm nearly at the end of my MD/PhD, and sometimes people ask me about whether I think they should do an MD/PhD.

    I always say, "No."

    I figure, if the person is going to be influenced by what I say, then they really shouldn't do it; these programs are too tough to go into with doubts. On the other hand, if they do it anyway, it might be the right thing for them. :)
     
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  19. SaltySqueegee

    SaltySqueegee El Rey de Salsa
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    The only concern I had before deciding to add a PhD to the mix was the personality fit for me and my future advisor(s). I had to be able to see them as my friends first and then I would feel comfortable having them influential in a very personal part of my life (thesis and dissertation).
     
  20. Firebird

    Firebird 1K Member
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    Anyone who doesn't ask for advice from an experienced person before making a major decision (eg, MD/PhD) is foolish in my opinion. Just because someone wants your advice doesn't mean they won't be committed to the program. It's always good to ask about something before you leap into it. And just because they're asking your opinion, doesn't mean they're going to be easily influenced.
     
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  21. MacGyver

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    Some of the straight MDs here are painting an overly rosy picture of MD-only researchers.

    1) for clinical research, MD is better

    2) for basic science research, MD/PhD is unquestionably better

    For #2, there are reams of NIH data. They show that MD/PhDs outperform MDs across the board in publication rates, chair positions, % who enter academic medicine, NIH funding, # of citations, etc.

    Those who said above that PhD makes no difference for basic science research is a fool. MD/PhDs outperform MDs across the board in terms of basic science research parameters.
     
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