MD/PhD?

[Microglia]

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I'm not exactly sure why everyone on this thread is making it seem as if MDs can do "all the research they want". They are not giving out funding like candy these days for anyone with any combo of degrees, and the stats I threw out there that everyone is ignoring clearly show that MD/PhDs are much more competitive at obtaining grants.

Of course you've all seen a lot of MD researchers - you're all med students. I'll grant you that med schools are big hubs for biomedical research, but that's not all there is. PhDs still make up the vast majority of biomedical research and the rest is split almost 50/50 between MDs and MD/PhDs. If trends continue as they are going, MD/PhDs will surpass MDs in terms of funding by the time I graduate in 7-8 years, though they comprise 3% of graduating physicians.

Usually what field MD/PhDs decide to obtain their PhD in is at least related to what they want to do in the future, but if it's not, it doesn't matter. The point is that they are experienced in working in research for an extended, continuous period of time, must construct clear research aims, defend a thesis, write publications and grant proposals, and observe how their mentors run labs and go about their various responsibilities.

I'm sorry, but you cannot seriously put that on the same level as a MD student doing research during a summer or as an elective. Even if an MD student does a significant amount of research in med school, who's to say that it will be related to what they want to do? My boyfriend (MD student) is required to do research as part of his curriculum at a top 20 research institution, and there are almost no opportunities in bench research. Researchers don't want an MD student for 3 months - it takes that long to train them.

I actually completely missed your post about funding somehow. That is a great point. Though very few MD/PhD's graduate every year, they do very well in funding relative to their MD counterparts.

To OP: I don't think anyone is saying that an MD can't do research. I think most people believe it's just very hard to get your foot in the door, and instead of collaborating with a PhD to begin, you'll likely have to do a fellowship (essentially a post-doc) in their lab, and likely another fellowship in another lab before you can get those grants. Because these 'fellowships' last 1-2 years (like post-docs), the time it takes is usually 3-4 years to get enough background that a grant committee will hear their ideas out and start funding them.

The only thing I want to clarify: Once an MD has gotten an R01 and is running a lab as well as working in the clinic, they are a physician scientist. At that point, there is no difference between that MD and an MD/PhD, and no academic faculty will think of them any differently. However, that MD had to take debt and do the equivalent of a PhD after getting their MD to get to that point. There's just no point to doing the MD-only path to research if you:

1. Know you want to do mostly research before going to medical school.

2. Are competitive for MD/PhD as an applicant.

If you find out later that you're interested in research or don't have the research experience necessary to apply, you can certainly go the MD route. It is harder, takes the same amount of time, and costs a huge amount more in terms of money, however. Be sure to factor that in.

 

[goodkarma]

I actually completely missed your post about funding somehow. That is a great point. Though very few MD/PhD's graduate every year, they do very well in funding relative to their MD counterparts.

To OP: I don't think anyone is saying that an MD can't do research. I think most people believe it's just very hard to get your foot in the door, and instead of collaborating with a PhD to begin, you'll likely have to do a fellowship (essentially a post-doc) in their lab, and likely another fellowship in another lab before you can get those grants. Because these 'fellowships' last 1-2 years (like post-docs), the time it takes is usually 3-4 years to get enough background that a grant committee will hear their ideas out and start funding them.

The only thing I want to clarify: Once an MD has gotten an R01 and is running a lab as well as working in the clinic, they are a physician scientist. At that point, there is no difference between that MD and an MD/PhD, and no academic faculty will think of them any differently. However, that MD had to take debt and do the equivalent of a PhD after getting their MD to get to that point. There's just no point to doing the MD-only path to research if you:

1. Know you want to do mostly research before going to medical school.

2. Are competitive for MD/PhD as an applicant.

If you find out later that you're interested in research or don't have the research experience necessary to apply, you can certainly go the MD route. It is harder, takes the same amount of time, and costs a huge amount more in terms of money, however. Be sure to factor that in.

👍

 

[Josh7]

It isn't about respect. Its all about the proposal and what work you have done previously. A PhD is a leg up because you will have pre established work and you will have experience writing grant proposals. You will also more likely have more hands on work but the guy writing the proposals is usually more of a lab manager anyways. Many PIs do nothing but write and divvy out experiments to lab personnel.

And hospitals are doing a crap ton of research. I'm on mobile so I can't see your status. Are you pre med or med student? Id suspect you're at a small college either way. Look at the med school rankings for different schools by NIH dollars. I may be mistaken, but I believe these numbers are independent of the undergrad or graduate colleges (although my COM funds several grad students and PhDs doing nothing but research as well).

As an MD with limited experience you will likely have to start clinical and begin tying in basic sciences as you go along. But there is nothing stopping you from collaborating and growing your experience to the point of having your own animal lab running genetic and protein experiments along side your clinic work. These researchers tend to be pretty successful. As I said, translational is hot right now and a PhD can't do the clinic part in many cases. So who does the NIH want to fund? The MD who knows how to run a western or a PhD and MD both and pay both salaries?

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I'm at a huge public research university actually 😳

I just don't really understand academic medicine very well, it seems. Thanks for the info though, I'm definitely leaning towards MD/PhD...

 

[NickNaylor]

I'm at a huge public research university actually 😳

I just don't really understand academic medicine very well, it seems. Thanks for the info though, I'm definitely leaning towards MD/PhD...

It all ultimately depends on your ability to secure grant funding as Spect mentioned. Getting grants is a competitive process. While you're correct in that MDs can certainly do research, I've heard from multiple MDs and MD/PhDs that completing PhD training is a huge boon to getting funding. You can have a great idea as a MD but if you have no substantive research experience or don't know how to write a grant (something you become familiar with over the course of PhD training and a post-doc), the chances of you getting funded is very small. When it's you (as a MD) with MAYBE a year of dedicated research time along with some projects here and there versus a PhD that has done many, many years of research, whose project do you think will be awarded a grant?

(sent from my phone)

 

[qwe7791]

Here's another question: If I want to become a practicing surgeon and later retire to be an academic physician, would I need a MD/PhD then?

 

[OCDOCDOCD]

Here's another question: If I want to become a practicing surgeon and later retire to be an academic physician, would I need a MD/PhD then?

MD/PhDs do sometimes become surgeons, but it's rare. Reason being it doesn't mesh as well with translational research as other fields, and because the time till you have a career is insane if you try to become a surgeon on top of MD/PhD (remember that the PhD portion has no set endpoint; the average is 4-6 years on top of the 4 years of med school, but it can take even longer than that if you're unlucky).

If you want to retire as an academic physician, you don't need an MD/PhD. Just get the MD; the debt issue won't matter because you'll be making more than enough as a surgeon to offset the cost. You can do clinical research as a surgeon and collaborate with PhDs if you want to move into translational research. Over the course of a career you'll have gained enough experience to know what you're doing in research. However, if by "academic physician" you just mean a physician that teaches, then you don't even need to do that.

 

[qwe7791]

MD/PhDs do sometimes become surgeons, but it's rare. Reason being it doesn't mesh as well with translational research as other fields, and because the time till you have a career is insane if you try to become a surgeon on top of MD/PhD (remember that the PhD portion has no set endpoint; the average is 4-6 years on top of the 4 years of med school, but it can take even longer than that if you're unlucky).

If you want to retire as an academic physician, you don't need an MD/PhD. Just get the MD; the debt issue won't matter because you'll be making more than enough as a surgeon to offset the cost. You can do clinical research as a surgeon and collaborate with PhDs if you want to move into translational research. Over the course of a career you'll have gained enough experience to know what you're doing in research. However, if by "academic physician" you just mean a physician that teaches, then you don't even need to do that.

What's the difference between translational and clinical research?

 

[Microglia]

What's the difference between translational and clinical research?

Clinical research usually refers to research directly on patients, such as clinical trials. Translational research is more bench oriented, and typically refers to discovering therapeutic targets or potential therapeutics for disease.

 

[OCDOCDOCD]

What's the difference between translational and clinical research?

Basic = Investigating phenomena that don't have any immediately obvious application for the "real world"; the vast majority of scientific research falls into this category. Ex: Finding out that a particular subpopulation of neurons in a certain brain region play a large role in a disease when overactive.

Translational = Taking findings from basic research and finding a way to apply it in a useful way. Ex: Testing ways to inhibit those neurons and see if it actually does reduce the symptoms of the disease in animal models.

Clinical = Testing new treatments, drugs, etc. Ex: Taking one of the substances found in the translational studies above and testing it in humans.

 

[Gut Shot]

Here's another question: If I want to become a practicing surgeon and later retire to be an academic physician, would I need a MD/PhD then?

To be a well rounded academic physician you need to generate revenue from clinical work, generate revenue from research grants, publish articles and chapters, teach students and residents, and serve on committees.

People typically do not "retire" into this setting for a number of reasons. If you spend your early career as a practicing surgeon you will have little or no record of academic productivity, which is generally necessary to secure a faculty appointment. Simply put, no one will give you laboratory space and start-up funds if you have no idea WTF you are doing.

Having said that, I have seen emeritus physicians occasionally remain active with teaching duties, depending on their specialty and particular talents.

 

[qwe7791]

I know I will probably practice surgery until I'm 50 because it'll eventually take its toll. What are my options after I retire? I don't want to sit around and do nothing, but I don't want to do something that is too demanding..

 

[red doctober]

I know I will probably practice surgery until I'm 50 because it'll eventually take its toll. What are my options after I retire? I don't want to sit around and do nothing, but I don't want to do something that is too demanding..

I hear golf is relaxing...

 

[notbobtrustme]

I know I will probably practice surgery until I'm 50 because it'll eventually take its toll. What are my options after I retire? I don't want to sit around and do nothing, but I don't want to do something that is too demanding..

consulting, teaching, administration, etc etc.

 

[plumazul]

What's the difference between translational and clinical research?

Clinical research is usually concerned with sifting through all the known treatments for a given condition and methodically coming to a consensus on standard of care. Translational research seeks to bring breakthroughs(or perhaps recently rediscovered science examined in a new light) in basic science to the clinical setting. The insight that an MD/PhD can bring to this process is powerful. This is what I want to spend the rest of my life doing. 🙂

 

[TriagePreMed]

I'm not exactly sure why everyone on this thread is making it seem as if MDs can do "all the research they want". They are not giving out funding like candy these days for anyone with any combo of degrees, and the stats I threw out there that everyone is ignoring clearly show that MD/PhDs are much more competitive at obtaining grants.

Of course you've all seen a lot of MD researchers - you're all med students. I'll grant you that med schools are big hubs for biomedical research, but that's not all there is. PhDs still make up the vast majority of biomedical research and the rest is split almost 50/50 between MDs and MD/PhDs. If trends continue as they are going, MD/PhDs will surpass MDs in terms of funding by the time I graduate in 7-8 years, though they comprise 3% of graduating physicians.

Usually what field MD/PhDs decide to obtain their PhD in is at least related to what they want to do in the future, but if it's not, it doesn't matter. The point is that they are experienced in working in research for an extended, continuous period of time, must construct clear research aims, defend a thesis, write publications and grant proposals, and observe how their mentors run labs and go about their various responsibilities.

I'm sorry, but you cannot seriously put that on the same level as a MD student doing research during a summer or as an elective. Even if an MD student does a significant amount of research in med school, who's to say that it will be related to what they want to do? My boyfriend (MD student) is required to do research as part of his curriculum at a top 20 research institution, and there are almost no opportunities in bench research. Researchers don't want an MD student for 3 months - it takes that long to train them.

It is pretty obvious that this forum is filled with naive pre-meds. I agree with you when it comes to being a bench researcher MD/PhD and PhD > MD alone. No matter how smart a med student is, becoming proficient in a field and learning all the relevant biomedical research techniques necessary is hard. Yes, there are a lot of MD-only researchers, but many of them come from the old days, have foreign degrees or had a long transition. At one of the labs at my place of work there is an MD that has been doing a post-doc for 3+ years to become proficient enough and have the credibility behind their name to become a bench researcher and obtain grants. The grand majority of people wouldn't be willing to transition from residency/fellowship to a post-doc position paying 40k a year.

 

[flyers]

OP - you'll get more detailed/personal responses from the physician scientist forum: http://forums.studentdoctor.net/forumdisplay.php?f=32

There's a lot of helpful stuff there, including a wide array of posters (many current MD/PhD students, residents, fellows and some program directors).

 

[civic4982]

I know I will probably practice surgery until I'm 50 because it'll eventually take its toll. What are my options after I retire? I don't want to sit around and do nothing, but I don't want to do something that is too demanding..

Getting a bit ahead of ourselves are we?

Might I enlighten you on another option for academics that may be to your liking:

"Clinical Track Faculty"

Google it... I think your mind will be blown. No bench research needed 😉

Good luck. 👍

 

[civic4982]

Something else to consider is your area of interest in bench research.

What if your medical school, residency, or fellowship don't offer the specific field of research that you have most interest in? You'll be looking to do a post-doctorate style academic position with part time clinical work anyways after you've finished up fellowship.

I think this can very easily be a wash when considering PhD years of an addition 3 (or more) years versus spending those three years writing papers with a mentor that's doing the EXACT work you're interest is in.

Now if you land yourself in an MD/PhD program at the school that has your favorite scientist whose articles have become posters on your walls and whom you quote in custom made t-shirts that you wear to school everyday then PERFECT. If not there's always the option of continuing to learn from the best in your field and area of interest in other ways.

Remember that often it needs to be both the right time and the right place for magic to happen!

 

[NickNaylor]

Something else to consider is your area of interest in bench research.

What if your medical school, residency, or fellowship don't offer the specific field of research that you have most interest in? You'll be looking to do a post-doctorate style academic position with part time clinical work anyways after you've finished up fellowship.

I think this can very easily be a wash when considering PhD years of an addition 3 (or more) years versus spending those three years writing papers with a mentor that's doing the EXACT work you're interest is in.

Now if you land yourself in an MD/PhD program at the school that has your favorite scientist whose articles have become posters on your walls and whom you quote in custom made t-shirts that you wear to school everyday then PERFECT. If not there's always the option of continuing to learn from the best in your field and area of interest in other ways.

Remember that often it needs to be both the right time and the right place for magic to happen!

I don't have anything to add, but just want to say that you're a brave soul for doing geriatrics (referring to your title). You couldn't pay me enough to work exclusively with that population.

 

[Mako555]

Glad to know that my desire to teach at the undergrad level is a "waste of time."

teaching undergrads is not a waste of time for anyone. lots of MD's do it. but they are hardly ever listed as faculty of the undergrad bio department, because they do their research at the med school. that's all we were discussing. faculty listings.

The DNP field experience argument about encroaching on OUR turf is more valid than this.

i'm not familiar with that argument, but you are quite wrong. an MD with 10+ years of experience and publications will be on even footing with a similarly experienced PhD when it comes to writing/getting grants. i repeat, there is nothing they teach you in a PhD program that you would not know after 10+ years in the field. the people who review grants know this. i am curious about why you would think otherwise. please share.

 

[SpecterGT260]

teaching undergrads is not a waste of time for anyone. lots of MD's do it. but they are hardly ever listed as faculty of the undergrad bio department, because they do their research at the med school. that's all we were discussing. faculty listings.




i'm not familiar with that argument, but you are quite wrong. an MD with 10+ years of experience and publications will be on even footing with a similarly experienced PhD when it comes to writing/getting grants. i repeat, there is nothing they teach you in a PhD program that you would not know after 10+ years in the field. the people who review grants know this. i am curious about why you would think otherwise. please share.

How are you defining "the field"?

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[Mako555]

so getting your foot in the door is harder for an MD, obviously. but once you get a grant, and then get a few more, and publish a dozen or more papers, you are at no disadvantage compared to a PhD. that's what i'm saying by "in the field for 10 years." I had a half hour discussion about this with one of my old PI's who is an MD at a top 5 med school and that is what he told me. We had this talk when I was deciding on MD vs MD/PhD. I chose MD.

 

[SpecterGT260]

so getting your foot in the door is harder for an MD, obviously. but once you get a grant, and then get a few more, and publish a dozen or more papers, you are at no disadvantage compared to a PhD. that's what i'm saying by "in the field for 10 years." I had a half hour discussion about this with one of my old PI's who is an MD at a top 5 med school and that is what he told me. We had this talk when I was deciding on MD vs MD/PhD. I chose MD.

I am not entirely sure what your point is.... yes, someone who has actively been doing research in an area for 10 years will not be at a disadvantage to a PhD.

But that isn't really a point. That is how PhDs do what they do as well - they put in time. However grad school is directed under a PI who doesn't let you waste time, energy, and resources out of ignorance.

Medicine is similar which is why I brought up the NP argument (btw, it is that they work in the clinic getting "experience" and after a few years are just as competent as any physician 👎 ). There are a TON of things that medical school just plain doesn't teach you - lab technique, both simple and complex (even things like basic pipetting needs to be taught to many med students), Proper experimental design..... I mean, honestly nothing about research is actually taught in medical school unless you do it as an elective. So yes, you could draw a line of equivalency between them if you allow for a green medical grad to go forth and fumble around for the better half of his career, but that isn't reasonable. Such a situation is akin to someone spending decades with medical texts and performing back alley medicine until they have learned all the ropes Your statement implied that medical school would prepare someone to be an equivalent researcher. This just isn't the case. I'd say I am one of only a handful of students in my class that actually knows how to perform most wet lab experiments. To the average medical student, westerns and elisas are magical pictures with some theory to be learned for the test and otherwise they just appear after you order them in the clinic.

 

[Mako555]

yes, you are absolutely right. i just realized we are looking at this from different viewpoints. my own background has a ton of research experience. so if I want to do research after I get my MD, I will know enough to get started. but you are totally right about medical school not teaching you enough about research. for those with little research experience, an MD will never be enough to do bench research.

the difference is that an MD can do research and that is just dependent on the MD's knowledge and experience, but that logic does not apply in clinical situations because there are rules, obviously. A PhD or a nurse practitioner can never do many things that an MD does.

I just wanted to make sure that students interested in bench research know that they can do it after med school without a PhD. I think I've got that point across by now.

👍

 

[red doctober]

Not to discuss this ad nausem, but MDs getting into non-clinical research have to go through a lot of the same types of training exercises as PhD students, it's just not called a "PhD program" and no degree is conferred. There's an MD fellow in my lab that is at the end of a combined residency/research fellowship and is now moving toward independence, but he had a lot of prior research experience during undergrad and med school, which was probably a requirement for the position. He does do some benchwork, but compared to the post-docs in the lab his projects are much more clinical. Once he's done with that, he's going to work for another PI as a post-doc type of position. My point is that even though MDs can reach a position that is equivalent of that of PhDs, it's not like they're bypassing all the hoops that PhD students have to jump through. They have to go through the same types of training because undergrad + medical school research alone does not adequately prepare one to be a successful basic scientist these days. If you're already in med school or done with it, does that mean you can't get into research? Of course not, but getting into it isn't necessarily going to be any easier than that of an entering graduate student just because you have an MD.

 

[SpecterGT260]

yes, you are absolutely right. i just realized we are looking at this from different viewpoints. my own background has a ton of research experience. so if I want to do research after I get my MD, I will know enough to get started. but you are totally right about medical school not teaching you enough about research. for those with little research experience, an MD will never be enough to do bench research.

the difference is that an MD can do research and that is just dependent on the MD's knowledge and experience, but that logic does not apply in clinical situations because there are rules, obviously. A PhD or a nurse practitioner can never do many things that an MD does.

I just wanted to make sure that students interested in bench research know that they can do it after med school without a PhD. I think I've got that point across by now.

👍

Yeah, that I can agree with. I fully plan to have a wet lab at some point in my career. Somewhere between cell culture and animals, with clinical specimens to round it out. Honestly that is where the money goes nowadays anyways. I have no figures, but it feels like translational is getting funded way over pure basic or pure clinical. My UG lab was under a surgeon (MD only) who had a research scientist with her PhD who worked in the lab. She wrote many of the grants, and she and I did the experiments, all he had to do was collect surgical samples to give to us to culture and show up for lab meeting (sometimes) to throw ideas around I was like "THAT is a sweet gig!".

It is also worth noting that some residency programs have required research years that can be clinical or bench (or both), and there are also research fellowships to do as well. Plenty of ways to get the experience if you don't have it already, but IMO it is best to learn this stuff in UG so that you can be halfway proficient as a med student in the lab if you choose that way.

as far as when to learn lab technique and experiment design: UG > MS > Resident and don't even bother applying to a research fellowship with no prior experience (no idea on the match process, I just feel like that is a no brainer). The further along you go, the less people want to train you and the more they want you for free labor.