TPF,
Sounds like you have put in a lot of time thinking about the MD/PhD. Many of the insights and concerns are very valid ones. In fact, I thought about the same ones before I started my MD/PhD. I am currently finishing the 3rd yr rotations and am applying to go into Radiology. My PhD was in molecular and cell biology. My plan is to be a clinician first and foremost, but I also plan on doing some research.
-Anyone know how well MD/PhDs match to radiology? Any MD/PhDs in radiology residencies right now? If so, do you think your PhD training has given you any edge over the MD only radiology residents either in the applying to residencies and actual residency performance?-
At my school which graduates 3-4 MDPhDs a year many have went into radiology and been successful getting residencies (mayo, emory, miami, vanderbilt). Speaking with them about interviewing most found that programs were fighting to get them. I think one of the most important things that you gain from doing a PhD is maturity. Doing seminars, interacting with collaborators, going to conferences, completing a project...all of these experiences give you professional maturity that I have found to be head and shoulders above your 3rd yr colleagues. The experiences teach you how to have tact and interact with intelligent individuals in a professional manner.
-Do you know if the PhD of most of those students where radiology related?-
I would venture to say that the majority are not. I don't see hardly any MD/PhDs pursuing a phd in engineering or physics which is what the prototypical radiology research has focused on. Instead, you have the opportunity to study the biology of disease and take this knowledge to apply the techniques of radiology to approach disease states in novel ways. I think that is the future of radiology imaging research in particular molecular imaging.
I think a big problem with an MD/PhD program is that you have that big 3-4 yr discontinuity between the first two years and the clinical rotations of the 3rd and 4th year of medical school. That can really hinder how well clinical rotations go for an MD/PhD student. Also, by the time you finish your clinical rotations, the field you did your PhD in may have progressed so far that you'll be left behind. Balancing the two very well strikes me as difficult if not impossible. Anyone have thoughts on this?
The discontinuity is not as much of a problem as you may think. Success in 3rd and 4th yr depends more on your personality, work ethic, ability to interact professionally with your team members. It also helps if you're good at taking the standardized tests. Don't misinterpret. My first rotation was internal medicine and I felt like I was way behind the other 3rd years. I mean, I had forgotten antibiotics, hypertensives, etc. I had to review a lot of basic concepts as I went through the first 3 months and it really took me three months to feel that I was up to speed. But, the fact is all 3rd years have to adjust to the clinics. You're not as far behind as you think, and if you work hard and jump into it you catch up quickly. To your advantage, I found that I was refreshed and gungho to start the clinics. I was tired of being in the lab and the excitement of starting in the clinics sustained me through the hard first 3 months. I jumped into it, studied hard and made junior AOA.
Don't worry about your phd topic. You will be out of date within 6 months of leaving the lab, but the reality is you'll probably never research your topic again. Getting a PhD is about learning how to approach a problem scientifically. It is training to do research. It's not training to know everything in the world about 1 or 2 proteins. It's the process not the results that matter.
On paper, that what it is supposed to so but in practice most MD/PhDs I know choose one or the other. Either they do mostly bench science or just clinical.
Doing the MD/pHD opens doors for you. If you know for sure that you just want to do bench work, get a phd. If you don't, then getting a MD/phd is totally worth it. In today's grant environment, you have to have a disease based research goal. The MD training gives you unique perspectives that PhDs can never get. Plus, I felt more comfortable knowing that the if I didn't like the pressure of grants having a MDPhD would give me the backup of doing clinical practice. Plus, there are more grants you are eligible for and promotion as well as hiring into faculty positions appears to be much easier with the dual degree.
One other note, having a PhD legitimizes your ability to do research. You can do that going through the MD route followed by research training after or during residency, but I feel that the MDPhD is the most efficient way.
hope this helps. good luck.
B