md vs. md/phd

[munnabhai]

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I know this question has been addressed on SDN quite often but I wanted some specific input from you people.

To those of you who are strongly interested in both research and medicine:
Why are you choosing to go the M.D. route rather than the M.D./Ph.D. route? (Please be more detailed than just saying "time".)

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I am asking this because my statistics are far from stellar and I am undecided about whether to apply to medical school this year as an M.D. or an M.D./Ph.D applicant. If I do decide to pursue M.D. I will apply to reserach intensive medical schools with the intention of pursuing further research there. However one of my professors told me that the Ph.D training was necessary to engage in real research (he was really excited when I asked him for a LOR and kept insisting that I apply to the M.D./Ph.D program at his institution.)

I don't mind a biased answer and I wanted to ask you guys before I ask the people of the M.D./Ph.D forum about their opinions.

Thanks everyone.

 

[AnEyeLikeMars]

Why are you choosing to go the M.D. route rather than the M.D./Ph.D. route? (Please be more detailed than just saying "time".)

I'm considering a career in research/academic medicine. I decided to do MD rather MD/PhD because I'm not completely set on academic medicine and I'm not interested in basic research (if I did academics I'd do a clinical track or clinical research). So, the PhD is not something I need for my career goals.

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I think it really depends on the type of research you want to do. If you think PhD training is going to give you the training you need for your goals, go for it. You'd be hard pressed to find a PhD who'd say you could do research without one, but there are plenty of MDs that do research (generally they do research intensive residencies and/or fellowships). Also keep in mind you can always get a PhD later (it doesn't have to be through a combined program).

 

[emaj1n]

I know this question has been addressed on SDN quite often but I wanted some specific input from you people.

To those of you who are strongly interested in both research and medicine:
Why are you choosing to go the M.D. route rather than the M.D./Ph.D. route? (Please be more detailed than just saying "time".)

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I am asking this because my statistics are far from stellar and I am undecided about whether to apply to medical school this year as an M.D. or an M.D./Ph.D applicant. If I do decide to pursue M.D. I will apply to reserach intensive medical schools with the intention of pursuing further research there. However one of my professors told me that the Ph.D training was necessary to engage in real research (he was really excited when I asked him for a LOR and kept insisting that I apply to the M.D./Ph.D program at his institution.)

I don't mind a biased answer and I wanted to ask you guys before I ask the people of the M.D./Ph.D forum about their opinions.

Thanks everyone.

If you are interestest in clinical research, you won't need a PhD.

 

[spursss]

If you are interestest in clinical research, you won't need a PhD.

Yes, but the PhD will allow you to get the more competitive clinical trials.

 

[etf]

although i'm interested in pursuing an md/phd, i figure that if my stats weren't good enough to get me into an md-only program, i'm toast applying to mstps. so my plan is to apply after i'm already in med school, and have proven (or not) that i can handle the rigors of the combined curriculum.

 

[crimsonkid85]

after talking to many many many people on the interview trail, both current med stuents, professors, and applicants, i think that people who chose to do the MD over an MD/PhD are not as sure that they do want to pursue academic medicine.

personally i think it really just boils down to what medicine means to you. does medicine mean helping people one by one through their sickness? or does it mean helping to advance the field, one step at a time? I think the physician scientists (or people who know that they want to pursue an MD/PhD) really hope to help an entire patient population, and that is what motivates their research. It's no better and no worse as what a (for example) private practice physician who helps patients one by one does. But it IS different.

I was debating between NP/HST versus MSTP for a long time, and in the end, I found that the students who chose HST simply weren't sure that they want to take an extra four years to pursue that PhD. Of course, the HST program has additional research benefits over the traditional MD programs such as NP, but that's another discussion.

 

[epigastric]

Since no one has mentioned this alternate route yet, I will: if you want to do clinical medical research rather than see patients, another option is to get your MD/MPH with the MPH in epidemiology.

Several researchers with no interest in molecular research but plenty of work in pure clinical translation of research have advised this course of action to me recently. As the last one suggested, "get your MPH in epidemiology with your MD and you can head almost any clinical trial you want." He was a bit biased, mind you, but it's something to keep in mind.

I'm sure that the full PhD is better in certain situations. However, the MD/MPH is a one way to do an end-run around the extra few years of school, and most combined programs let you finish both degrees in the regular four years.

Having said that, plenty of doctors find they manage research with no additional degrees whatsoever. But look into the MD/MPH as well as an MD/PhD while you're researching options.

 

[FemalesCANTDriv]

the way i see it, i didnt want to do md/phd ultimately cuz if i wanted to to basic research the rest of my life... i would just do straight phd...

as for you, you should probably look into applying to schools that emphasize research since u have a strong interest in it (that is what i did in applying).

 

[crimsonkid85]

i think one thing bears repeating:

An MD/PhD doesn't mean that you will be doing ONLY basic science research for the rest of your life. The amount of research you want to incoporate into your career is entirely up to you.

One example: an MD/PhD who sees lung patients with a particular disorder mostly manifest in adults sees a child patient for the first time with very similar symptoms. However, there are additional symptoms which make diagnosis challenging. He takes her blood and sequences her genome, finding that she has a heretofore undocumented HUGE chromosome deletion. Now his lab is trying to characterize the genes that have been deleted (some of which have unknown function). Not only will this research be highlighted in NEJM (for its novel clinical discovery), but also will be published in Nature (for basic science contributions).

You'll never be able to do this project with only an PhD because you'll never encounter the patient. You COULD conceivably do this kind of project with an MD, but most MD's don't have labs already in place to handle this kind of project. You COULD do a collaboration, but that's just...yeah.

 

[sexyman]

This is what i think of when I see MD vs. MD/Phd

One I probably wont get into vs. One I definitely wont get into

 

[Critical Mass]

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

Absolutely not. There is no such thing as a career choice that requires MD/PhD. It may help you to do some things, but it's not a de facto necessity for anything.

FWIW, most mudphud programs look seriously at numbers, so if your app isn't stellar, you're still screwed.

Bottom line: good docs who do good research get good grants. The initials don't matter. In fact, I've heard that the newer mudphuds aren't doing research at any greater rate than traditional MD's. I'm of the view that they really shouldn't fund mudphud programs anymore. There is no way an incoming medical student can realisticly decide that mudphud is right for him or herself.

 

[bubbachuck]

I am asking this because my statistics are far from stellar and I am undecided about whether to apply to medical school this year as an M.D. or an M.D./Ph.D applicant. If I do decide to pursue M.D. I will apply to reserach intensive medical schools with the intention of pursuing further research there. However one of my professors told me that the Ph.D training was necessary to engage in real research (he was really excited when I asked him for a LOR and kept insisting that I apply to the M.D./Ph.D program at his institution.)

i think it's a misconception that you have to be "stellar" to get into an MD/PhD program. if you look at the numbers, they should only be slightly higher. for one thing MD/PhD progs look for different things than MD. for example, research becomes very important (up from below MCAT and GPA). i would say it pulls even with MCAT/GPA and maybe above. volunteering becomes less important since the assumption is that you've been doing a lot of research. these are general cases of course. it's possible that an accepted MD/PhD would not have gotten into an MD program because of what each program looks for.

 

[etf]

it's possible that an accepted MD/PhD would not have gotten into an MD program because of what each program looks for.

i don't know, i think that if you're good enough for the combined degree program, the school must think that you can handle the md program AND something else. since md's aren't exactly cake to get, that's saying a lot.

 

[HreComesTheSun]

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I am asking this because my statistics are far from stellar

no, not a necessity, but you should have research experience. you can always do this after med school, during a fellowship or something...

don't worry, i know plenty of mud/phuds who don't have stellar stats, but they do have to be solid

You'd be hard pressed to find a PhD who'd say you could do research without one

i'm a PhD and i think you can absolutely do research without one

Yes, but the PhD will allow you to get the more competitive clinical trials.

no it won't...this is where the MD comes in handy

another option is to get your MD/MPH with the MPH in epidemiology.

OP, don't consider this unless you are interested in statistics and population studies...it's useful, but you won't get any hard science benchwork experience here

 

[crimsonkid85]

i agree that MD/PhD programs look more closely at research than MD programs. Of course, don't forget that for most MD/PhD programs you will still have MD interviewers, so you can't entirely forget things like volunteering, etc.

In my own experience, I expected the weakest part of my application to be shadowing. I didn't even know that shadowing was expected until 6 months before applying. My pre-med committee told me flat out: you need shadowing experiences! So I shadowed here and there, (hard-core during the week of spring break) for ~50 hours. Nobody gave me a hard time about it....I was genuinely surprised.

 

[Sinfekl]

In fact, I've heard that the newer mudphuds aren't doing research at any greater rate than traditional MD's...There is no way an incoming medical student can realisticly decide that mudphud is right for him or herself.

I'm pretty sure the first part pretty much can't be true. Any stats, please? Or are youjust counting the fact that MD-PhD's still go into residency before they transition into academic medicine? Also, it says nothing of the quality/depth of the research. Funding numbers are still higher for MD-PhD's than for MDs or PhDs alone.

As for the second part, speak for yourself. I did it. And worst comes to worst, I've traded 4 years for no debt. And its grad school, the more time spent in school and not in the real world the better.

 

[Karina 07]

after talking to many many many people on the interview trail, both current med stuents, professors, and applicants, i think that people who chose to do the MD over an MD/PhD are not as sure that they do want to pursue academic medicine.

Having just come from a regular master's program in a subject where a lot of people continue on to a Ph.D., I can tell you that I have frequently heard "man, it's another four years!" and "man, I don't know that it will be useful to me, whether I want to..." when the person just didn't have the grades.

Not saying that's terrible or anything, just making a snarky observation that sometimes you can't trust what people say! (At least in the people I've known.)

 

[Critical Mass]

I'm pretty sure the first part pretty much can't be true. Any stats, please? Or are youjust counting the fact that MD-PhD's still go into residency before they transition into academic medicine? Also, it says nothing of the quality/depth of the research. Funding numbers are still higher for MD-PhD's than for MDs or PhDs alone.

As for the second part, speak for yourself. I did it. And worst comes to worst, I've traded 4 years for no debt. And its grad school, the more time spent in school and not in the real world the better.

I went to an md/phd conference where a lecturer said it. Since it takes 10-20 years to track a mudphud and the programs didn't really take off until the NIH started increasing the number of funded schools a few years ago, we won't really know if they are working or not until millions of our tax dollars have already been pumped into it.

Funding numbers are higher yes, but since the compensation for going into academic medicine is less than private practice, there is every reason for a mudphud grad to have his cake and eat it too.

As for the program at my school, 4 out of 5 of those who have matriculated as mudphuds have told me privately that they are just going to take the money and run. Since the school only really looks at numbers for admissions, they pay the top MCAT kids for mudphud, they do well in school, and then aspire to become clinicians only for better pay.

Your second paragraph proves my point. The school prefers to invest in people who would never call the program a possible trade for no debt. That shouldn't be in your vocabulary because there is no possible career path for you outside of research.

I don't have any problem with schools covering tuition plus stipend during the PhD years just like grad school, but the overall mudphud package that they provide draws too many people who are just in it for the money. And when I see that the MCAT averages for mudphud acceptees is significantly higher than the general pool of acceptees at a given school, it tells me that schools are promoting it as a form of elitism rather than reserach interest.

 

[anxietypeaker]

i think one thing bears repeating:

An MD/PhD doesn't mean that you will be doing ONLY basic science research for the rest of your life. The amount of research you want to incoporate into your career is entirely up to you.

One example: an MD/PhD who sees lung patients with a particular disorder mostly manifest in adults sees a child patient for the first time with very similar symptoms. However, there are additional symptoms which make diagnosis challenging. He takes her blood and sequences her genome, finding that she has a heretofore undocumented HUGE chromosome deletion. Now his lab is trying to characterize the genes that have been deleted (some of which have unknown function). Not only will this research be highlighted in NEJM (for its novel clinical discovery), but also will be published in Nature (for basic science contributions).

You'll never be able to do this project with only an PhD because you'll never encounter the patient. You COULD conceivably do this kind of project with an MD, but most MD's don't have labs already in place to handle this kind of project. You COULD do a collaboration, but that's just...yeah.

This is the most ridiculous thing ive heard. Firstly, YOU do NOT have power over what amount of research you want. Now way in hell. The typical route is after completing your residency, fellowship, and postdoc (most do a clinical fellowship, otherwise a bit harder to get some of the more competitive faculty positions), you get a faculty position. They contract for these people stipulate that no more than 50% of time goes to research (so you CAN do MORE clniical work if you want, but NOT more research). Moreover, you CANNOT do both well. Being a great basic researcher and a great clinician is nearly impossible. This is according to even the NIH, who funds the darn MSTPs. Hence, nearly all of them pick one aspect (research vs. medicine). Granted, over years, as long as ur research pans out, the contract can change and you can get to near 100% research or something like 90% research and 10% clinical, but it takes time. And the latter option will pretty much bar you from being known as a great clinincian. All this said, you should pursue the md-phd cuz you think that the extra ~7 years (4 years for PhD +3 years for postdoc) invested will combine with your medical degree to allow you to do stellar research. Whether its self-selection or a causality, these individuals DO indeed become fairly successful in industry/academic reserach. As for collaborations, you will do collaborations if your a researcher. Darn impossible to do it without. People who do do research know this pretty much hands down. As for the MSTP attracting money grabbers/elitism, thats not quite true. At least when it counts. The VAST majority go into a resaerch career eventually according to the NIH studies (u can find the study online somewhere).

Note: the situation that you described is also ridiculous. Sequence a persons genome just like that??? its takes time and MONEY. No WAY in hell youd be allowed to do that as a junior faculty, youd even be hard pressed as a sr faculty. Then to say that your discovery will be in NEJM and Nature.........dont hold your breath. Anyone whos done research (not just lab work or grunt work in a research setting) knows luck is hugely involved too. Doing 10% time to clinical work will not get you near that patient once the deletion is discovered (meaning no nejm article, lol...itd be funny if they allowed you to publish that you "discovered" the patient...you gotta do post work up for something like that and youd step back cuz your not the "great" clinican, your a great researcher). Money wise, the above post was correct. You can make much more money without the mdphd and just the md going clinical, even with the debt. Realize that during your 50/50 split, your publishing will most likeley be in a different category from most basic researchers. It will be in basic journals that are more geared toward phys-scientists. And these journals DO NOT have the huge impact factor (ie its like a measure of "prestige") that nature does. NOT even half...probably more like 7/30s of it, TOPS.

Personally, i agree with the poster that the VAST majority dont know if mdphd is for them coming straight out from undergrad. HOwever, apparently, these individuals are publishing fairly consistently and well (quality) according to the NIH. All in all....apply md-phd if you feel that

1) you need the structured time/schedule for research studies. While the PhD is not that structured, it is much more so than doing research on the side with a pure md
2) you think the md and phd will allow you to do much better research than just with one

TAKE EVERYTHING U READ ON SDN WITH A GRAIN OF SALT. IVE ARGUED A FEW THINGS AGAINST WHAT PEOPLE HAVE CLAIMED. IT TAKES TIME BUT INVESTIGATE IT URSELF FIRST. SDN IS THOUGH A GREAT PLACE TO START

 

[Sinfekl]

That shouldn't be in your vocabulary because there is no possible career path for you outside of research.

Come on, you're being a little self-righteous now, don't you think? Eight years is a long time, people change preferences and thats to be expected. That's like saying we shouldn't fund PhD's because so many of them are gonna go into industry. I've signed no contract, the NIH has given me funding and I'll do with it what I want to. Odds are I'll end up in research because that's what I like, but hey, eight years ago I thought girls had cooties and wrestling was real, who knows what I'll be doing in another eight.

I still contend that it seems unlikely that most MD-PhD's end up on the clinical side. My experiences run exactly counter to yours, most of the MD-PhD's I know are excited to get into research, and some are even skipping residencies. It's simple: you take people who have enjoyed research in the past, its likely they'll enjoy it in the future. It seems to me that even those who take the "quick" money of clinical medicine are likely to return to research careers once they buy their Benz. So take anecdotes for what they are, and as you said, we'll have some good data in 8-10 years.

 

[Critical Mass]

Come on, you're being a little self-righteous now, don't you think? Eight years is a long time, people change preferences and thats to be expected. That's like saying we shouldn't fund PhD's because so many of them are gonna go into industry. I've signed no contract, the NIH has given me funding and I'll do with it what I want to. Odds are I'll end up in research because that's what I like, but hey, eight years ago I thought girls had cooties and wrestling was real, who knows what I'll be doing in another eight.

Again, my original statement was that "there is no way an incoming medical student can realisticly decide that mudphud is right for him or herself," and now you've come full circle to prove my point by noting that a change in preference is expected over 8 years.

It's normal for traditional med students to change their minds about specialty once they actually learn about salary and lifestyle considerations, but MD/PhD is designed for people who have already dedicated their lives to research. If somebody switches from ped's to gas, that's fine because you're gambling with your own money. When somebody takes a family med scholarship and then doesn't do primary care, then they have to pay the money back. With MD/PhD, however, people can just cut and run with a quarter of a million in taxpayer subsidy. That's not cool to me.

When you were interviewed, I doubt that you told the program "I'm signing no contract, once the NIH gives me funding, I'll do with it what I want to."

 

[diosa428]

I know that you said that you didn't want to hear the "it takes more time" argument, but that's really what did it for me. I started medical school at 23. I will finish at 27. Then, I have at least 3 years of residency, possibly more, and then possibly fellowship. So, we're looking at 30+ when I finish training and start collecting a paycheck and working (more) normal hours. A PhD takes at least 4 years (and I stress at least, because most of the PhD students I know took longer than that). So if I went the MD/PhD route, I would be finishing school at the same time I'd be finishing residency if I went straight MD.

Meanwhile, I know that all the money they offer you looks great. But let's say you're going to be $200k in debt when you finish med school (and that's at the higher end of things). So you pay that off over 20 years and it skyrockets to $400k total b/c of interest. Ok. But you will be 4 years ahead in your career. Let's say the average attending makes $200k (which obviously depends upon your specialty, but go with it). So rather than spending those 4 years working on a PhD, you're working on an attending's salary for $200k/year, which adds up to $800k. Even after taxes, you're bringing in more than enough to cover your debt. So the money argument really doesn't fly, at least in my mind, unless you really WANT that PhD.

You can do research in med school. You can take a year off in med school and do research in one of the research-based programs (Doris Duke, HHMI, NIH), and have more of an option of whether you want to do basic science or clinical research. You can enter a reseach-intensive residency program. And you can do research as an MD. Yes, having a PhD may help you get some grants, but you can still get grants as an MD.

So, my decision not to go MD/PhD was based on these thoughts. I think that, if you REALLY WANT a PhD, then go for it. I'm sure it would be helpful in the future if you really want to conduct your own lab. But there are plenty of MDs at my school that have their own labs and are doing fantastically well.

 

[HreComesTheSun]

This is the most ridiculous thing ive heard. Firstly, YOU do NOT have power over what amount of research you want. Now way in hell. The typical route is after completing your residency, fellowship, and postdoc (most do a clinical fellowship, otherwise a bit harder to get some of the more competitive faculty positions), you get a faculty position. They contract for these people stipulate that no more than 50% of time goes to research (so you CAN do MORE clniical work if you want, but NOT more research). Moreover, you CANNOT do both well. Being a great basic researcher and a great clinician is nearly impossible. This is according to even the NIH, who funds the darn MSTPs. Hence, nearly all of them pick one aspect (research vs. medicine). Granted, over years, as long as ur research pans out, the contract can change and you can get to near 100% research or something like 90% research and 10% clinical, but it takes time. And the latter option will pretty much bar you from being known as a great clinincian. All this said, you should pursue the md-phd cuz you think that the extra ~7 years (4 years for PhD +3 years for postdoc) invested will combine with your medical degree to allow you to do stellar research. Whether its self-selection or a causality, these individuals DO indeed become fairly successful in industry/academic reserach.

Note: the situation that you described is also ridiculous. Sequence a persons genome just like that??? its takes time and MONEY. No WAY in hell youd be allowed to do that as a junior faculty, youd even be hard pressed as a sr faculty. Then to say that your discovery will be in NEJM and Nature.........dont hold your breath. Anyone whos done research (not just lab work or grunt work in a research setting) knows luck is hugely involved too. Doing 10% time to clinical work will not get you near that patient once the deletion is discovered (meaning no nejm article, lol...itd be funny if they allowed you to publish that you "discovered" the patient...you gotta do post work up for something like that and youd step back cuz your not the "great" clinican, your a great researcher). Money wise, the above post was correct. You can make much more money without the mdphd and just the md going clinical, even with the debt.

Personally, i agree with the poster that the VAST majority dont know if mdphd is for them coming straight out from undergrad. HOwever, apparently, these individuals are publishing fairly consistently and well (quality) according to the NIH. All in all....apply md-phd if you feel that

1) you need the structured time/schedule for research studies. While the PhD is not that structured, it is much more so than doing research on the side with a pure md
2) you think the md and phd will allow you to do much better research than just with one

i think the poster was referring to time for research during a career, not just training. and it is absolutely possible to devote your career to research if you are an MD, many do it

i know PI's who do both clinic and research well, including mine...being outstanding in both, well that's another story

ok, i have to agree with you here, sequence a person's genome like that, i don't know where that came from

what's more important than structure is self-motivation, whether you are in a PhD program or not

 

[anxietypeaker]

i think the poster was referring to time for research during a career, not just training. and it is absolutely possible to devote your career to research if you are an MD, many do it

i know PI's who do both clinic and research well, including mine...being outstanding in both, well that's another story

ok, i have to agree with you here, sequence a person's genome like that, i don't know where that came from

what's more important than structure is self-motivation, whether you are in a PhD program or not

Note: i meant NEARLY impossible to do both great. Also, im not talking just good research/clinical. Im talking REALLY great. While most fall short of this, i think aiming for it is a good thing. You should know though what be prolly neccessary to reach that goal. Im highly confidant that faculty members will agree if you ask them about it.

 

[1Path]

So, we're looking at 30+ when I finish training and start collecting a paycheck ........

Are you aware that residents AND fellows get paychecks too?😕

As a person who has done research since before many of you started elementary school, it's hilarious reading thorugh some of these posts. Epidemiologists don't do benchwork, you can't be good at both clinical work and research, and on and on.🙄

OP, talk to some people IN MD/PhD programs, folks WITH MD/PhD, as well as those who have MD's only and do research. In other words, talk to some folks who have been in the system long enough to know what they're talking about.

@ Karina 07, you are so right about how people makes up excuses when they don't have the stats. I'm just hoiping I won't have to be one of them one day too!

 

[HreComesTheSun]

Note: i meant NEARLY impossible to do both great. Also, im not talking just good research/clinical. Im talking REALLY great. While most fall short of this, i think aiming for it is a good thing. You should know though what be prolly neccessary to reach that goal. Im highly confidant that faculty members will agree if you ask them about it.

i'm not exactly sure what you're trying to say here, but i think i agree with you . i would say my PI is an excellent physician and a good scientist (we did just get a $3mil grant though, wahoo!)...and i do plan on aiming for being great at both 😉 but yeah, for sure there are docs who are great at research who have poor clinical skills and vice versa

 

[jdh71]

I know this question has been addressed on SDN quite often but I wanted some specific input from you people.

To those of you who are strongly interested in both research and medicine:
Why are you choosing to go the M.D. route rather than the M.D./Ph.D. route? (Please be more detailed than just saying "time".)

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I am asking this because my statistics are far from stellar and I am undecided about whether to apply to medical school this year as an M.D. or an M.D./Ph.D applicant. If I do decide to pursue M.D. I will apply to reserach intensive medical schools with the intention of pursuing further research there. However one of my professors told me that the Ph.D training was necessary to engage in real research (he was really excited when I asked him for a LOR and kept insisting that I apply to the M.D./Ph.D program at his institution.)

I don't mind a biased answer and I wanted to ask you guys before I ask the people of the M.D./Ph.D forum about their opinions.

Thanks everyone.

My two cents, and I have not read the whole thread . . . you really don't have a ton of time to do research as an MD student. You can make some time, but if you are really interested in research in medicine, the time you spend doing your PhD is almost purely your own research time, at your own pace (within reason of course, no one is going to let you kick around campus for 10 years without finishing, publishing, and defending your research). The PhD helps in many competitive fields and does the publications - seriously - research, even though a bit silly for clinical practice, is a highly valued aspect of your CV and competitive specialties look at this quite closely. Research heavy residency programs want applicants who can take on a project without needing to be told everything - brings in the money 🙂 Helps with program "ranking". Most school will pay your tuition if you do md/phd - and I struggled with this before admission and I went md, but now kind of wish I had not. One thing I'm really begining to realize is that a few extra years really is not much in the grand scheme of things (Finally, you get to start your third year as a Doctor! HA!)

 

[anxietypeaker]

i'm not exactly sure what you're trying to say here, but i think i agree with you . i would say my PI is an excellent physician and a good scientist (we did just get a $3mil grant though, wahoo!)...and i do plan on aiming for being great at both 😉 but yeah, for sure there are docs who are great at research who have poor clinical skills and vice versa

i THINK that were in agreement...but ur a suns fan unfortunately.

 

[HreComesTheSun]

i THINK that were in agreement...but ur a suns fan unfortunately.

 

[Karina 07]

Again, my original statement was that "there is no way an incoming medical student can realisticly decide that mudphud is right for him or herself," and now you've come full circle to prove my point by noting that a change in preference is expected over 8 years.

It's normal for traditional med students to change their minds about specialty once they actually learn about salary and lifestyle considerations, but MD/PhD is designed for people who have already dedicated their lives to research. If somebody switches from ped's to gas, that's fine because you're gambling with your own money. When somebody takes a family med scholarship and then doesn't do primary care, then they have to pay the money back. With MD/PhD, however, people can just cut and run with a quarter of a million in taxpayer subsidy. That's not cool to me.

When you were interviewed, I doubt that you told the program "I'm signing no contract, once the NIH gives me funding, I'll do with it what I want to."

Oh, that's silly. There are a ton, a TON of scholarships everywhere through undergrad university, master's/doctoral programs (for non-medical students) -- nobody's saying these people have to pay it back in some way.

They're just taking a gamble.

They just want to support X, Y or Z, and think it's as good a way as any.

They change their mind, they can put their funding elsewhere.

But its THEIR decision to do that. Someone who applies for and wins a huge scholarship paid for by gov't money has to make sure they don't become a housewife, don't decide to run a small variety shop, etc., and has to MAKE something of themselves? Is morally REQUIRED to?

That's a strong statement, and it would apply to far, far more people than just MD/Ph.D.s.

Look, unless the gov't makes them swear that they'll do something, it's the gov't's fault for being an idiot about it, not a student's fault for applying.

 

[crazy_cavalier]

My advice is that you apply to the regular MD program.

If there's any shred of doubt, always go with the regular plain ol' MD route.

You mentioned your credentials are not jaw-dropping stellar. Keep in mind the MD/PhD applicant pool is far more competitive than the regular MD applicant pool... and that says a lot!

So, the thing about applying MD/PhD is this: First, your app goes through the MD/PhD admissions process. For some schools the committee that administers this is different from the MD adcom. Anyway, you have to wait for them to make a decision on your MD/PhD status (e.g. grant an interview? accept after an interview? reject? waitlist?)... Supposing you get rejected from the MD/PhD program, your file will then get passed on to the regular MD admisisons process. The danger with applying MD/PhD is this - by the time you get tossed into the regular MD pile, you'll be at the bottom of the stack and you'll face the same sort of thing that happens when you apply very late in the process. Poor communication/coordination between the programs augments this disadvantage.

 

[crimsonkid85]

My advice is that you apply to the regular MD program.

If there's any shred of doubt, always go with the regular plain ol' MD route.

You mentioned your credentials are not jaw-dropping stellar. Keep in mind the MD/PhD applicant pool is far more competitive than the regular MD applicant pool... and that says a lot!

So, the thing about applying MD/PhD is this: First, your app goes through the MD/PhD admissions process. For some schools the committee that administers this is different from the MD adcom. Anyway, you have to wait for them to make a decision on your MD/PhD status (e.g. grant an interview? accept after an interview? reject? waitlist?)... Supposing you get rejected from the MD/PhD program, your file will then get passed on to the regular MD admisisons process. The danger with applying MD/PhD is this - by the time you get tossed into the regular MD pile, you'll be at the bottom of the stack and you'll face the same sort of thing that happens when you apply very late in the process. Poor communication/coordination between the programs augments this disadvantage.

i would like to add that in some instances, you WON'T be considered for MD admissions if you apply MD/PhD. For example, UPenn won't consider you for MD if you are rejected MD/PhD. Hopkins will only consider you for MD if you are an absolutely AMAZING MD candidate that just hasn't done quite enough research. There are many other instances. Beware!

oh, and wrt to the timing thing. i think that if you're truly passionate about medicine, you'll do it for the rest of your life. I've seen physicians in their 80s and some in their 90s still going strong. 🙂 They're amazing, and they still talk about medicine with the same kind of passion I've seen in younger physicians. If this is the case -- and this is what one doctor told me when I was trying to decide between MD vs MD/PhD -- what's an extra 4 years in the grand scheme of things? nothing. 🙂

 

[Sinfekl]

When you were interviewed, I doubt that you told the program "I'm signing no contract, once the NIH gives me funding, I'll do with it what I want to."

No, but I did say, hey, I really like research, and I want to dedicate my life to research (and I meant every single word), but I don't know what role clinic and research will eventually play in my life because thats a long ways away. I didn't really come full circle, perhaps you misunderstood the second paragraph of my post, where I said that identifying people who have a passion for research is simply the best you can do and that these people are very likely to continue with research in their career. However, there is no gaurantee, but that doesn't necessarily undermine the whole program.

Your main point thay I disagree with is that most MD-PhDs "take the money and run," so to speak, at which point it is a waste of taxpayer dollars. I'm simply saying that, to me, this seems unlikely. Neither of us have stats, but I'd like to think the burden of proof is on you, seeing as how some very intelligent people hand-pick not only students they think will make good students, but those that have demonstrated a past commitment to research and that they think will continue with research in the future.

 

[Gut Shot]

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

Absolutely not. The majority of academic faculty will be MD only.

I'm PhD -> MD and have many friends who did combined programs. It's a tough call. While a minority of MD/PhD's really thrive, the rest just suffer and more than a few regret it. Unfortunately it's not easy to know ahead of time which camp you'll fall into. As a 33 year old PGY-2, my advice would be to go MD only unless you're really, really, really, really sure you want the PhD.

If you want to pursue a career in research, having "only" an MD will not, by itself, hold you back. At the end of the day it all comes down to your drive to become a successful scientist. It's not just about spending four or five years to get three extra letters after your name, it's about your entire career.

I myself am not so hot on research these days. NIH funding is stagnant, and competition for dollars has skyrocketed. It's vicious.

 

[CCLCMer]

I know this question has been addressed on SDN quite often but I wanted some specific input from you people.

To those of you who are strongly interested in both research and medicine:
Why are you choosing to go the M.D. route rather than the M.D./Ph.D. route? (Please be more detailed than just saying "time".)

Also if a person is intends to persue a possible career in academic medicine, is an M.D./Ph.D a sort of de facto necessity?

I am asking this because my statistics are far from stellar and I am undecided about whether to apply to medical school this year as an M.D. or an M.D./Ph.D applicant. If I do decide to pursue M.D. I will apply to reserach intensive medical schools with the intention of pursuing further research there. However one of my professors told me that the Ph.D training was necessary to engage in real research (he was really excited when I asked him for a LOR and kept insisting that I apply to the M.D./Ph.D program at his institution.)

I don't mind a biased answer and I wanted to ask you guys before I ask the people of the M.D./Ph.D forum about their opinions.

Thanks everyone.

I'm in a five year program that is an MD with qualifications in biomedical research. You can also get an optional MS if you want. I think it is a good choice for people who want to do clinical research or who want to do research but don't want to get an entire PhD for whatever reason. You said you don't want to hear time as a reason, but time does matter to a lot of people. At some point, most of us want to get out of school and have "normal" lives, whatever that even means. It is definitely not necessary to have a PhD if you want to do research. My PI this summer is an MD who does clinical research, and there are lots of other people here with MDs and not PhDs who do research. Oh, and I agree with the people who said that if your stats are not stellar, you should not apply to MD/PhD programs, because they tend to want higher stats.

 

[ut2010]

I have a Ph.D. and want to do research as a physician but a Ph.D. is not necessary for many areas of research. If you do want to have some extensive research training, NIH has a program available for physicians interested in doing research. Another idea is to talk with physicians involved with research and learn about their training, they may even be willing to train you in their lab.

 

[diosa428]

Are you aware that residents AND fellows get paychecks too?😕

Are you aware that those paychecks are for $40k a year, which qualifies most residents/fellows for a deferral on their loans based on the fact that they are essentially too poor to pay them back? My point is that, when I am in my 30s, I would like to start a family, and would therefore prefer to be out of residency, so that I can work more normal hours and make enough money to support that family. Doing an MD/PhD program would inevitably delay that for 4 more years.

 

[crimsonkid85]

Are you aware that those paychecks are for $40k a year, which qualifies most residents/fellows for a deferral on their loans based on the fact that they are essentially too poor to pay them back? My point is that, when I am in my 30s, I would like to start a family, and would therefore prefer to be out of residency, so that I can work more normal hours and make enough money to support that family. Doing an MD/PhD program would inevitably delay that for 4 more years.

i would argue that the training you receive during a PhD is not equivalent to that gained in a 'research intensive' residency or fellowship. it really is what you want to do.

also, i have a friend who is starting her md/phd, and she is married and thinking of having a child. (her husband is also an md/phd). it's totally do-able. it's simply where your priorities lie.

 

[diosa428]

also, i have a friend who is starting her md/phd, and she is married and thinking of having a child. (her husband is also an md/phd). it's totally do-able. it's simply where your priorities lie.

I'm certainly not saying it can't be done, I'm just giving my perspective, based on my situation, which is what the OP asked. I realize that many people are married and do manage to have babies during medical school, and I would imagine having a child while you're doing the PhD portion of your degree could be even less stressful. But for those of us not entering medical school married, and perhaps feeling that marriage isn't something we're prepared to do in the near future, popping out a kid during year 3 isn't really an option. So if I'm planning on not having a kid until I'm in my 30s, I'd much rather be an attending than an intern.

 

[Critical Mass]

No, but I did say, hey, I really like research, and I want to dedicate my life to research (and I meant every single word), but I don't know what role clinic and research will eventually play in my life because thats a long ways away. I didn't really come full circle, perhaps you misunderstood the second paragraph of my post, where I said that identifying people who have a passion for research is simply the best you can do and that these people are very likely to continue with research in their career. However, there is no gaurantee, but that doesn't necessarily undermine the whole program.

Your main point thay I disagree with is that most MD-PhDs "take the money and run," so to speak, at which point it is a waste of taxpayer dollars. I'm simply saying that, to me, this seems unlikely. Neither of us have stats, but I'd like to think the burden of proof is on you, seeing as how some very intelligent people hand-pick not only students they think will make good students, but those that have demonstrated a past commitment to research and that they think will continue with research in the future.

The first time that I applied for mudphud was 2001. At the time, there were less than 3 spots available at the non-NIH MSTP's which back then were all but maybe 20 programs. Nowadays, the NIH has become more generous while privately-funded mudphud programs have increased slots to compete, and kids currently go through college eyeballing the programs in response to a steeply rising medical education pricetag (at least in my region).

Back in 01, a 30 on the MCAT was typical for a mudphud matriculant at the school which I currently attend. This year, they weren't even interviewing people under 32. Furthermore, the majority that they let in are in fact only doing it for the money.

As for research experience, that it is indeed secondary to numbers at many programs. I have an M.S. and worked on NIH-funded projects from 1999 through 2004 at the bench, had multiple publications and LOR's from science faculty at multiple research universities, and several other meeting appearances/posters. I am also a med tech and worked as a patient care tech for a while, so it was clear that I had given the career choice a lot of thought. However, my MCAT was only a 32R, so it was clear that I wasn't going to get much oos love from MSTP's despite my commitment to research and research background.

So I realized that the mudphud concept is as far as actually admitting research-minded individuals is concerned.

I am fine with the burden of proof, but all that I can offer right now is heresay from program directors and MD/PhD colleagues. At one of my MD/PhD interviews in 2005, the program director suggested that the NIH may consider cutting back on MSTP funding in the future. The thing is that I believe them based on everyone I've talked to.

Karina--I am saying that the government is being an idiot by paying out money for MD/PhD programs since the financial investment appears to be a pretty bad gamble on the students graduating. That is money that could be better spent elsewhere in the US healthcare system. Instead they should subsidize people to go into underserved areas and hold matriculants responsible for paying the cash back if they don't.

 

[1Path]

Are you aware that those paychecks are for $40k a year, which qualifies most residents/fellows for a deferral on their loans based on the fact that they are essentially too poor to pay them back?.

Are you aware that 40K is more than many, many Americans make in the US? If you spend wisely and not plan to have a basketball team by age 35 or marry a bimbo who doesn't want to work because she married a doctor, YOUR 40K combined with another income should be more than enough to live on. You'll simply have to continue to drive that new BMW your parents got you when you were accepted to med school.🙄

My point is that, when I am in my 30s, I would like to start a family, and would therefore prefer to be out of residency, so that I can work more normal hours and make enough money to support that family. Doing an MD/PhD program would inevitably delay that for 4 more years.

Like I said before, if you're a dude marry a woman who wants to contribute to the families bottom line, and if your a woman, don't plan to have too many kids and you'll be just fine no matter how old you are when you get to residency. MD/PhD doesn't delay a thing. YOU do.👍

 

[hawkeey]

Are you aware that 40K is more than many, many Americans make in the US? If you spend wisely and not plan to have a basketball team by age 35 or marry a bimbo who doesn't want to work because she married a doctor, YOUR 40K combined with another income should be more than enough to live on. You'll simply have to continue to drive that new BMW your parents got you when you were accepted to med school.🙄
Like I said before, if you're a dude marry a woman who wants to contribute to the families bottom line, and if your a woman, don't plan to have too many kids and you'll be just fine no matter how old you are when you get to residency. MD/PhD doesn't delay a thing. YOU do.👍

Among my first year MSTP classmates there are already three children. MD/PhD will not stop you from having a family if that is what you want. You're going to be poor for a while, but you will be just fine in the end. You get some extra money from not having to pay as much tax.

Anyone who does MD/PhD for the money is an idiot. In the time that it takes someone to do an MD/PhD, someone else could get their MD and make all of their money back. Search the forums, there are pretty detailed analysis out there. The saying goes like "train for twice as long to get half the pay". MD/PhDs typically work in academic medical centers. The real money is in the private sector. The reason MD/PhD programs need to be funded is because of the significant financial disadvantage to begin with.

It is true that MD-only doctors can do great research, but its difficult because you don't have the disciplined training and experience that a graduate student gets while doing a PhD. The lack of a good scientific backgrounds shows in a lot (not all) MD-only research.

I would not pick MD/PhD versus MD along just for the goal either though, but rather for the path. How much do you like science and research? Are you the kind of person who is satisfied with just memorizing the current best practices, or do you want to know why the best practices are the best? Do you accept the literature as fact or do you challenge and question every sentence?

As for numbers and applications, MD/PhD programs look very closely at things that a MD-only adcom would only spend a few seconds on. Research experience is weighted way more than numbers after you get past the primaries. For many programs, you just need enough in terms in numbers to get past the initial screen.

 

[Neuronix]

I want to make it clear before I start that I'm not saying that everyone should go into a MD/PhD program who's interested in academics. I'm not even sure I made the right decision, let alone to tell everyone they should be doing what I've done. That being said, I feel like there's some misinformation in this thread I'd like to discuss. I don't hold any negative feelings towards Critical Mass or anyone else for voicing your opinions and I'm glad you have done so. I always appreciate Critical Mass's avatars.

FWIW, most mudphud programs look seriously at numbers, so if your app isn't stellar, you're still screwed.

This is true, though at my school the MD/PhD numbers are no higher than the MD numbers. This is true for many top and mid-ter prviate MD/PhD programs. At the state schools MD/PhD stats are higher because there's no state preference in MD/PhD (at least MSTP) admissions.

I would actually agree that the numbers should factor into these decisions less. Unfortunately, it doesn't go away. Residencies don't really care that much (especially competitive ones) if you're MD/PhD if you don't have decent grades and Step I scores to back it up.

In fact, I've heard that the newer mudphuds aren't doing research at any greater rate than traditional MD's.

I don't believe this for one second. Here's data why: http://publications.nigms.nih.gov/reports/mstpstudy/

You're saying "newer" mudphuds, which you're right people don't have data for. I still don't believe this. Even if you take the cynical view that many MD/PhDs are just doing it for the money, the ones that are not will outweigh the MD crowd, who often never had any serious research experience outside of the top-tier MD programs.

The first time that I applied for mudphud was 2001. At the time, there were less than 3 spots available at the non-NIH MSTP's which back then were all but maybe 20 programs.

I applied in 2002. There were MANY MORE programs than that. Hell, I was accepted at UMaryland and they were taking ~5 incoming students that year. Yes, the MSTP has been expanding, but it hasn't been that dramatic in the past ~5 years. There's something like >100 non-MSTP MD/PhD programs (from: http://www.aamc.org/research/dbr/mdphd/applicantfaq.pdf), 41 of which are currently funded by the NIH. Some of those are new, most are not.

Your second paragraph proves my point. The school prefers to invest in people who would never call the program a possible trade for no debt. That shouldn't be in your vocabulary because there is no possible career path for you outside of research.

That's ridiculous. Everyone knows money is a factor in making the MD/PhD decision. That's why the whole MD/PhD program was formed. Debt is crushing physicians to continue in clinical practice despite whatever else they might be doing. Research doesn't pay nearly as much.

This is the most ridiculous thing ive heard. Firstly, YOU do NOT have power over what amount of research you want. Now way in hell. The typical route is after completing your residency, fellowship, and postdoc (most do a clinical fellowship, otherwise a bit harder to get some of the more competitive faculty positions), you get a faculty position. They contract for these people stipulate that no more than 50% of time goes to research (so you CAN do MORE clniical work if you want, but NOT more research).

I wouldn't say no way in hell. This depends on the position, the department, the location, how hot the guy is, etc etc etc... I've seen people in several specialties get contracts to do mostly research right out of fellowship. I've also seen people turn these down because of location or better pay by doing more clinical work.

With MD/PhD, however, people can just cut and run with a quarter of a million in taxpayer subsidy. That's not cool to me.

When you were interviewed, I doubt that you told the program "I'm signing no contract, once the NIH gives me funding, I'll do with it what I want to."

This was found to be unenforceable years ago and done away with. When MD/PhD was first started they tried to enforce this kind of thing, and it failed miserably for a number of reasons. First, the courts wouldn't uphold it. Second, how long do you require someone to do research? Third, is 100% research the only desirable MD/PhD outcome? The NIGMS has required programs not to require any form of payback. What if someone does change their mind? You want them to be forced to do research forever because the government contributed some money to them?

Otherwise I agree with Karina 07's statement.

BTW, I did tell a program I wasn't going to sign their contract and then didn't go there.

However, my MCAT was only a 32R, so it was clear that I wasn't going to get much oos love from MSTP's despite my commitment to research and research background.

Did you actually apply? That MCAT isn't that bad, especially if paired with a solid GPA. I've seen people in the low 30s get into top MSTPs over and over again, especially with that caliber research.

At one of my MD/PhD interviews in 2005, the program director suggested that the NIH may consider cutting back on MSTP funding in the future. The thing is that I believe them based on everyone I've talked to.

Funding is tight for everything. NIBIB just cut their NRSA kirchstein grants for regular graduate students, let alone just for MD/PhDs. I'm surprised it hasn't been cut simply for the reason that money is so tight now at the NIH.

But for those of us not entering medical school married, and perhaps feeling that marriage isn't something we're prepared to do in the near future, popping out a kid during year 3 isn't really an option. So if I'm planning on not having a kid until I'm in my 30s, I'd much rather be an attending than an intern.

If you're actually doing research or even just in many specialties, just because you're attending doesn't mean your life has gotten any easier. You have to put in the extra training time somewhere if you end up doing basic science research. Also, junior level faculty positions pay fairly poorly, you'll have to work very hard to advance, your job will be unstable, and you're still pretty low on the totem pole. It's one thing to just not be interested in this pathway. Unfortunately, you'll have to balance your family if you do academic medicine and have kids at ANY age. I wouldn't let this deter anyone from the MD/PhD route.

 

[diosa428]

Are you aware that 40K is more than many, many Americans make in the US? If you spend wisely and not plan to have a basketball team by age 35 or marry a bimbo who doesn't want to work because she married a doctor, YOUR 40K combined with another income should be more than enough to live on. You'll simply have to continue to drive that new BMW your parents got you when you were accepted to med school.🙄

Are you aware that most Americans are not $200k in debt? But, hey, if 40k is so much money, feel free to pay back my loans when you're in residency.

 

[TheCybermen]

Funding is tight for everything. NIBIB just cut their NRSA kirchstein grants for regular graduate students, let alone just for MD/PhDs. I'm surprised it hasn't been cut simply for the reason that money is so tight now at the NIH.

The answer is simple: Cut MD/PhD funding and you won't churn out MD/PhD graduates. No one appears to have addressed the very practical issue that money is "so tight now at the NIH" because research is not rewarded. The capitalist returns on research are not there the way they are for clinical practice, end of story. Until that point is reached, research will always yield a smaller earning in the grand scheme of things, and people who are interested in research SHOULD be supported. Assessing that interest will always be a challenge, but:

Has anyone thought of how ridiculous it would sound to offer a 7-8 program for which a prospective applicant would have to pay in full out of pocket and/or through the use of student loans (riddled in scandal, guys)/bank loans? With medical school costing nigh 250K after all's said and done, who in their right mind would want to do anything but eliminate their debt a la cosmetic dermatology??

The suggestion of eliminating MD/PhD and PhD funding is ludicrous. The suggestion of tweaking the programs so as to be more cost-effective is not, nor is the suggestion of figuring out a way to solve the financial problems with American science and medicine on a grander scale. All that said, the system presently in place works to the best of the ability that surrounding professional environment affords it.

 

[Neuronix]

The answer is simple: Cut MD/PhD funding and you won't churn out MD/PhD graduates. No one appears to have addressed the very practical issue that money is "so tight now at the NIH" because research is not rewarded.

Money is so tight right now at the NIH because of President Bush and his personal war. Funding grew rapidly under President Clinton and that growth was halted to the point that the NIH has been losing money after inflation. We need to provide money for tanks and missles somewhere. But beyond the MD/PhD program, many PhD training programs are being cut or eliminited right now, not just the one I mentioned of coruse. We've been fortunate as MD/PhDs don't to have to suffer the MSTP grant being cut, though MSTP is getting much more competitive. If anything that the MSTP grant is still growing slowly, though I don't have any stats on hand. On the flip side, applying for a F30 (MD/PhD funding outside MSTP) or K grants for starting careers is much harder than it was 10 years ago.

All the established big name MSTP guys say these things go in cycles and the funding situation will get better. Will it?

The capitalist returns on research are not there the way they are for clinical practice, end of story. Until that point is reached, research will always yield a smaller earning in the grand scheme of things, and people who are interested in research SHOULD be supported.

Returns on research are not the "way they are for clinical practice" simply because they are not short-term and immediately tangable. Research offers benefits to society in a number of ways and I'm surprised you'd say that research yields "a smaller earning in the grand scheme of things" in real dollars when I think the reality is that research yields a much greater earning in the grand scheme of things for numerous reasons.

First, research provides products to market for our economy that nobody else in the world has. Almost all the drugs in the world were originally produced here in the USA based on research performed in the USA. The drug companies pick up on the research started in academics and would never fund most of this research themselves. Second, research has cured or treated many diseases and these provide for increased productivity of our workforce. Third, many if not most of our clinical treatments are thanks to research. All of those big Radiology salaries you see... THANKS MRI AND CT! Interventional Cardiology? Thank stents (a result of research on atherschlerosis)! If it wasn't for all the research that has gone on in the last century, medicine would still be as it was last century. Few of the other nations in the world have provided significant medical discoveries, though a few have and a few more are getting there. Medicine in the 19th century, seeing is though it did little and was pretty basic, paid very little and was nowhere near the economic powerhouse it is today. It was only because of a solidification of medicine in sound research and standards that it took off, financially as well as its benefits to society.

Seeing though that research does not provide a short-term financial benefit to the institution that provided the research, it becomes obvious why the government must fund basic science research in order to benefit society.

Has anyone thought of how ridiculous it would sound to offer a 7-8 program for which a prospective applicant would have to pay in full out of pocket and/or through the use of student loans (riddled in scandal, guys)/bank loans? With medical school costing nigh 250K after all's said and done, who in their right mind would want to do anything but eliminate their debt a la cosmetic dermatology??

I don't see why we don't have loan repayment programs though. The only ones offered now are for 2 years at 35k/year each for a total of 70k, which is pretty much nothing. IMO, There should be 4 year repayment plans that will completely pay off the medical debt of the person doing it no matter how big the debt and provide a little extra on the side, just like how it is for MD/PhDs. Then again, would this necessarily produce more MD/PhDs or would it produce "Wow, I'll go do research for 4 years to get rid of all this debt!" My thought is when people are closer to the independence and "big" bucks (i.e. residents/fellows), their incentive to do this kind of thing for the money decreases.

 

[TheCybermen]

Money is so tight right now at the NIH because of President Bush and his personal war. Funding grew rapidly under President Clinton and that growth was halted to the point that the NIH has been losing money after inflation. We need to provide money for tanks and missles somewhere. But beyond the MD/PhD program, many PhD training programs are being cut or eliminited right now, not just the one I mentioned of coruse. We've been fortunate as MD/PhDs don't to have to suffer the MSTP grant being cut, though MSTP is getting much more competitive. If anything that the MSTP grant is still growing slowly, though I don't have any stats on hand. On the flip side, applying for a F30 (MD/PhD funding outside MSTP) or K grants for starting careers is much harder than it was 10 years ago.

All the established big name MSTP guys say these things go in cycles and the funding situation will get better. Will it?



Returns on research are not the "way they are for clinical practice" simply because they are not short-term and immediately tangable. Research offers benefits to society in a number of ways and I'm surprised you'd say that research yields "a smaller earning" in real dollars when I think the reality is that research yields a much greater earning in the grand scheme of things for numerous reasons


First, research provides products to market for our economy that nobody else in the world has. Almost all the drugs in the world were originally produced here in the USA based on research performed in the USA. The drug companies pick up on the research started in academics and would never fund most of this research themselves. Second, research has cured or treated many diseases and these provide for increased productivity of our workforce. Third, many if not most of our clinical treatments are thanks to research. All of those big Radiology salaries you see... THANKS MRI AND CT! Interventional Cardiology? Thank stents (a result of research on atherschlerosis)! If it wasn't for all the research that has gone on in the last century, medicine would still be as it was last century. Few of the other nations in the world have provided significant medical discoveries, though a few have and a few more are getting there. Medicine in the 19th century, seeing is though it did little and was pretty basic, paid very little and was nowhere near the economic powerhouse it is today. It was only because of a solidification of medicine in sound research and standards that it took off, financially as well as its benefits to society.

Seeing though that research does not provide a short-term financial benefit to the institution that provided the research, it becomes obvious why the government must fund basic science research in order to benefit society.



I don't see why we don't have loan repayment programs though. The only ones offered now are for 2 years at 35k/year each for a total of 70k, which is pretty much nothing. IMO, There should be 4 year repayment plans that will completely pay off the medical debt of the person doing it no matter how big the debt and provide a little extra on the side, just like how it is for MD/PhDs. Then again, would this necessarily produce more MD/PhDs or would it produce "Wow, I'll go do research for 4 years to get rid of all this debt!" My thought is when people are closer to the independence and "big" bucks (i.e. residents/fellows), their incentive to do this kind of thing for the money decreases.

neuronix i completely agree with everything you've said -- it is unfortunate that the the flow of capital into the knowledge sector of the economy (i.e. research) has had to take a hit for so-called national defense purposes. it is doubly unfortunate that this has happened despite the fruits of this sector's efforts being so palpable on a daily basis for millions of people. you were probably shocked because of the tone of my post, but the tone was that of devil's advocate: most people (not on this forum, that is) are not concerned with benefits to society as a whole and are more immediately concerned with paying rent or auto insurance. so when taxpayers elect their representatives they want people who'll give them more money in the bank, not a diagnostic test that will churn out a prognosis based on a tumor cell's gene signature. that is essentially the why the climate change debate, to just bring up another peripherally-related topic, is happening.

if people were different, obviously this wouldn't be true -- "short-term" and "immediately tangible" wouldn't be paramount to long-term, global benefits for society (and, by extension, to the individual. but that is an idealization at best, for which reason you are in saying that the government must carry a certain responsibility to distribute these funds as appropriate.

 

[Sinfekl]

Just thought I'd give a thumbs-up to Neuronix for his/her posts, you made some points I was trying to make, but much more effectively and with some actual proof, as well as some things I haven't thought of. 👍 Well done.

 

[Critical Mass]

Did you actually apply? That MCAT isn't that bad, especially if paired with a solid GPA. I've seen people in the low 30s get into top MSTPs over and over again, especially with that caliber research.

Sure did. Rejected multiple times. And I'm sure that Maryland would have told me to get my ass back on the covered wagon I arrived on and trail back to Kansas (me and my little dog Toto) had I even been offered an interview there.

Lemme point something out to be clear. There is a difference between coastal programs/programs at the top 20-30 med schools in the country and where I am.

What you guys are saying is probably true at the better programs. Thumbing through the MSAR, there are plenty of scrub schools out there (like mine) too. My views are based on the interview circuits that I participated in as well as the 20-30 mudphuds I've known over the years.

All I can be is a voice of my region, and I am more than certain that where I am, the scholarship/stipend is the primary reason why people do it; and yes, mudphud adcoms take people with better numbers over people with research experience. Regarding the state school thing, all of the matriculants at my house this year were in-staters (the in-state admits with the highest MCAT scores).

 

[1Path]

Are you aware that most Americans are not $200k in debt? But, hey, if 40k is so much money, feel free to pay back my loans when you're in residency.

Gee dude, how old are you?

The average cost of a decent sized house in a relatively metro area, is going to run you 200K, and FAR more if we're talking about places like DC, NYC, or Boston. So the fact is that yeah, quite a few americans ARE at LEAST 200K in debt, just a different kind of debt.🙄