MD then post-doc or PhD?

[threecoins]

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I am an MD, currently in the second year of my oncology fellowship at a top institution. I just started in the lab and I have serious aspirations to becomes a physician-scientist.

My understanding is that to have my own lab and to compete at the RO1 level I need several more years of lab training , my question is: should I consider doing a PhD ( I found that the average length of a PhD at Cold Spring Harbor is 4.5 years and I know that this is short) versus doing a post-doc in the lab.

The pros of doing a PhD is getting a PhD degree and some structured training, the advantage of doing a post-doc is that I may have a slightly higher salary than a PhD stipend which may be beefed up if I can see patients once a week or so but I feel that it would be less structured and less formal than a PhD.


I would appreciate any thoughts?

 

[gutonc]

I am an MD, currently in the second year of my oncology fellowship at a top institution. I just started in the lab and I have serious aspirations to becomes a physician-scientist.

My understanding is that to have my own lab and to compete at the RO1 level I need several more years of lab training , my question is: should I consider doing a PhD ( I found that the average length of a PhD at Cold Spring Harbor is 4.5 years and I know that this is short) versus doing a post-doc in the lab.

The pros of doing a PhD is getting a PhD degree and some structured training, the advantage of doing a post-doc is that I may have a slightly higher salary than a PhD stipend which may be beefed up if I can see patients once a week or so but I feel that it would be less structured and less formal than a PhD.

I would appreciate any thoughts?

There are essentially no "pros" of doing a PhD at this point in your training, unless you can spin your fellowship into it (which is possible). Just land yourself in a good lab (you've done this already, right?) and get a few good papers and a couple of grants out of it. Make sure your work has clinical/translational options and then, when the time comes (which will be 2-3 years after your fellowship is technically complete and which you'll spend as an "instructor" or similar non-tenure track faculty) apply for faculty jobs.

The current funding situation is pretty bleak so if I were you (and I say this as somebody who did a PhD and a research fellowship), I would pursue what you want to do but keep an eye on how things will play out a couple of years down the road.

TL;DR - Don't do a PhD. Finish your fellowship and see what happens.

 

[threecoins]

Thanks Gutonc , this is excellent advice. I did choose a good lab but I am still trying to figure out exactly how to frame what I need from my mentor and when to approach him with a concrete. I am currently paired with a very experienced senior post-doc who is teaching me basic lab techniques. What would be an average salary for an "instructor" or similar non-tenure track faculty in my position?

I am planning to apply for YIA but I am not likely to get funding in time to factor it into my first job after fellowship.

 

[gutonc]

Thanks Gutonc , this is excellent advice. I did choose a good lab but I am still trying to figure out exactly how to frame what I need from my mentor and when to approach him with a concrete. I am currently paired with a very experienced senior post-doc who is teaching me basic lab techniques. What would be an average salary for an "instructor" or similar non-tenure track faculty in my position?

$70-100K.

I am planning to apply for YIA but I am not likely to get funding in time to factor it into my first job after fellowship.

You're going to need something. If not a career dev grant (think YIA but also AACR and more importantly K99/R00 or similar) then a few great first author papers...like a couple of JCO and a Cell or something. You're probably going to have to spend a few years as a post-doc of sorts. The person/department most likely to hire you to do this is where you already are. Your first "real" job after fellowship is either going to be in PP or it's going to come a few years after fellowship ends. Just be prepared for that.

 

[threecoins]

So there is a bit of a mystery in my mind as how the salary range is determined...let's say you have one clinic day a week and you share calls for the weekend with the other attendings , how much money is that worth for the division? where does the risk come from. I suspect that people who get this kind of instructor/post-doc job may have applied to grants which but probably have NOT heard back from the committee by the time they are negotiating their job offer. Does the lab bear any part of the cost of hiring me? and if so where does this money come from ? Any insights into the "math"?

You mentioned that it is most likely to get that kind of position at the institution that I am training , do you mean for the "post-doc of sorts " job or for the faculty-level job? if I want to expand my options even for the sake of "negotiating" what can I do to make such job possible at other institutions around?

 

[dl2dp2]

So there is a bit of a mystery in my mind as how the salary range is determined...let's say you have one clinic day a week and you share calls for the weekend with the other attendings , how much money is that worth for the division? where does the risk come from. I suspect that people who get this kind of instructor/post-doc job may have applied to grants which but probably have NOT heard back from the committee by the time they are negotiating their job offer. Does the lab bear any part of the cost of hiring me? and if so where does this money come from ? Any insights into the "math"?

You mentioned that it is most likely to get that kind of position at the institution that I am training , do you mean for the "post-doc of sorts " job or for the faculty-level job? if I want to expand my options even for the sake of "negotiating" what can I do to make such job possible at other institutions around?

These are answers that are very very hard to provide online because we can't evaluate you without a complete evaluation of your background, research, previous experience, mentorship relationship, etc... There are also very field specific considerations in terms of what kind of work you are going into, and what your career goals are. This is especially problematic in relation to salary negotiations because intrinsically there is also a component of geography embedded.

It sounds like you don't have a clear sense of how to proceed in order to establish a research career. If you are in a clinical oncology fellowship, the person I would suggest you talk to is your fellowship program director, as well as your laboratory head if he's an MD/PhD or MD. Suffice it is to say, unlikely in clinical medicine, in research there is no one path that leads to success and independence. Your salary and other component of the package (lab space, funding, etc.) is largely dependent on (1) external support (2) your ability to pitch a sound narrative of your research plan and your capacity to execute that plan. You can't get sufficient mentorship from an online forum for these questions.

 

[gutonc]

So there is a bit of a mystery in my mind as how the salary range is determined...let's say you have one clinic day a week and you share calls for the weekend with the other attendings , how much money is that worth for the division? where does the risk come from. I suspect that people who get this kind of instructor/post-doc job may have applied to grants which but probably have NOT heard back from the committee by the time they are negotiating their job offer. Does the lab bear any part of the cost of hiring me? and if so where does this money come from ? Any insights into the "math"?

Salary range is determined by what they want to pay you. It's generally something that's institution-wide and your clinical output (your "RVU Monkey-ness") has very little to do with it. It's also virtually non-negotiable, at least in terms of a $ amount...you may be able to get less clinical time but you won't get more cash. The lab may pay part of your salary, as may you out of smaller grants. That's how you buy back research time. Every institution will be different, but suffice it to say that the bigger the name, the less you're going to get paid. As an example, a friend of mine who is in her final year of a research fellowship at Man's Greatest Hospital is appointed as an instructor and makes less than I did as a senior fellow (she easily doubles her salary by moonlighting once a week...that's how bad it is).

You mentioned that it is most likely to get that kind of position at the institution that I am training , do you mean for the "post-doc of sorts " job or for the faculty-level job? if I want to expand my options even for the sake of "negotiating" what can I do to make such job possible at other institutions around?

You want the "super-fellow" job at your current institution because it will allow you to continue your current research and hopefully get the pubs and K/YIA/CDA funding that will make somebody pay attention to you and offer you a faculty job. Where you get that one is up to you and the job market at the time. A good pub record and a submitted K app (or a rejected one with a borderline funding score) may be enough to get an Asst Prof offer somewhere. But as sluox points out, this is where great (not good...I had good...it didn't work) mentorship comes in.

 

[gutonc]

I got the following PM and got permission to reply to it in-thread because I think it's a good question.

So I'm in my app cycle right now, and have gotten interviews at Pretty good institutes. One of the things I'm looking at is the quality of potential Mentors. you mentioned "Great (not good) mentorship" in your recent post. Could you clarify on what you mean? Do you mean your PI having lots of connections? Thanks for the info.

By "great" mentorship, I mean that you need both a clinical and research mentor (they can be the same person, but I think it's better to have 2 different people...just my opinion) who have experience as physician scientists and know exactly what it takes to create a successful career as a physician scientist. I had two great mentors, one research and one clinical. Unfortunately, neither of them were physician scientists and, as a result, weren't really able to provide me with the appropriate mentorship in the "soft" side of things, simply because they didn't know how to do it. So, while their clinical and research mentorship, on its own, was excellent, the physician-scientist mentorship was lacking, hence the overall "good" rating.

Now, this is not to say that you can't do your research in a lab with a PhD mentor, but you need to seek out somebody else to be a career mentor as well.

 

[threecoins]

Thanks Gutonc. I was actually about to ask you the same question. My mentor is a physician scientist but is a pathologist so it is not exactly the same as having an oncologist, however I tried to establish a " team" of mentors, in fact the most active person in that team is a clinical researcher who is constantly sending my ideas, grant proposals, answering my questions by email and in person on almost daily basis. While he may not be facile with the details of what happens in the lab he knows all about grantsmanship and how to get funded.

There is one point that is still confusing to me, if the salary for the post-doc of sorts/Instructor position is largely non-negotiable, how would obtaining a training grant/YIA as a fellow matter , or is that mainly for the next step of getting a " Real job "?

 

[sakata8242]

Absolutely do not go for a Phd+post doc at your stage.
There has to be resources at your institution for people wanting to do research fellowships (e.g.. T32 training grants) under the mentorship of a faculty adviser.

 

[Jimsy]

Is it advised to finish paying off medical school debt first before starting the pursuit of a research career as an MD? I imagine it must be financially harder to go straight into fellowship right after residency..