I'm facing the same dilemma as some of the people on this board. I have been accepted to the MSP program at U of IL in Urbana. Although it's not the same program as the more competitive MSTP sponsored by the NIH, it offers phD first followed by the md training in 8 years on average. I have also been accepted by my state's medical school. Although I'm not very satisfied with it, it does offer great clinical training in 3rd and 4th year. Also, if you work hard and stay at the top, you can still get into top residency programs. I like doing research, but the prospect of 8 years for the dual degrees sounds a bit scary. It's hard to vision what I will be doing ten years from now, be it clinical medicine or academic medicine. If you're having doubts about doing the phD because it might drag on longer, is it a sign that you shouldn't go for MD/phD? Another factor is no debt or 100K+ in debt.