MD vs. MD/PhD

[dani6706]

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My main goal is to get my MD, but I love research also and am starting to think I want to get my PhD program. My application isn't too competitive, but I'm scared if I don't go for my PhD now I will never have the chance.. I'm not sure which program to apply for.

 

[vc7777]

My main goal is to get my MD, but I love research also and am starting to think I want to get my PhD program. My application isn't too competitive, but I'm scared if I don't go for my PhD now I will never have the chance.. I'm not sure which program to apply for.

If you love research there are also other options, such as informal or formal 5 year MD/MS programs (like Cleveland Clinic or Pitt's clinical or medical science training programs).

Please check out the forum:
Physician Scientist [ MD, MD/PhD, MD/MS, DO/PhD, DDS/PhD ]

 

[loljkttyl]

I'm a graduating medical student and here is my honest take on this subject. When I was applying for med schools, I also considered the MD/PhD track b/c I loved research. Also, it sounded cool...you know like having two degrees...it was like two for the price of one. But in retrospect, with graduation just a couple of weeks away, I don't know what in the world I was thinking. In retrospect, I would only do MD/PhD if you are 100% sure that's what you want. It's a HUGE time commitment b/c essentially you are going to med school x 2. They often tell you it will take 3 extra yrs but realistically it often goes to 4 EXTRA YRS. That's a long time!!! And you don't realize it until you actually go through it. A lot of my friends who are MD/PhD's at my school and other schools have told me they feel like they are being left back while all their peers are graduating. Even though you get free tuition and a stipend as an MD/PhD student, you have to take into account that your former classmates will be earning their $200,000-300,000 salary several yrs before you. But regardless of the money issue (b/c one could argue MD/PhD's don't have to pay back any loans), there is just a huge PSYCHOLOGICAL toll of spending an extra four years in school during the prime years of your life. Besides, you can still do research if you only have an MD; all three of the PI's I have worked with in the past were MD's only. Plus, you can always do the MD route and take a year off in b/w 3rd and 4th to do research in your future specialty via Doris Duke fellowships, etc. Most of the MD/PhD's candidates I know are forced or at least heavily encouraged to do basic science research instead of clinical research related to their future specialty...so you might be devoting an extra 3-4 yrs of your life which may have little to do with your future specialty. Is this worth it? Depends on the individual person. I have a LOT of respect for MD/PhD's for the huge sacrifices and time commitments they have to make, and I'm sure many of them will play a role in the scientific/medical discoveries of the future. However, the bottom line is that you should not do the MD/PhD route unless you are 100% sure and only after you have seriously weighed the costs and benefits. Like maybe if you want to be the future surgeon general or a future department chair at a top notch academic institution, then get your MD/PhD. If you are on the younger side and are going straight from college to med school, maybe you can at least consider. But if you have already taken off some yrs at any point during your education, it probably is not worth it. On a side note, doing MD/PhD can also limit your future specialty choices. For instance, many MD/PhD's who once aspired to go into interventional cards or neurosurgery or some other super long residency program have now ruled out those specialties/fellowships b/c they realize they will be super old by the time they finish their educational training! Just some food for thought...

 

[jdh71]

Besides, you can still do research if you only have an MD; all three of the PI's I have worked with in the past were MD's only..

While this is basically true, you will need to pick up some formal research training along the way somewhere, which will likely mean you will need to find a fellowship where you can learn from mentors. There is no real formal training in research in medical school.

I was a guy who thought about doing a PhD, was talked out of it and into medical school, and I was also talked out of a MSTP by the same arguments presented above, but I loved to do research. I naively thought that being able to do it with simply an MD wouldn't be that big of a deal, but it is, because while it takes you an extra 3-5 years to get the PhD you are closely working with a mentor and learning the game. There is nothing in medical school that prepares you to play the "physician scientist game" outside of working with other physician scientists and finding one who has the time and energy to mentor you.

And the truth of the matter about eventually doing clinical research is that you will likley have to "make your bones" in the wet lab first, before you can move onto big clinical research projects. It's a game, and you have to play.

How bad do you want to do research? How bad do you want to be published? How bad do you want make a name for yourself? Be the cheif of a division, department, or dean of a SOM?

Think about it.

 

[crixx]

It's a HUGE time commitment b/c essentially you are going to med school x 2. They often tell you it will take 3 extra yrs but realistically it often goes to 4 EXTRA YRS. That's a long time!!! And you don't realize it until you actually go through it.

If you're thinking about an MD/PhD, this is certainly not the attitude you should have. I also debated between applying for MD/PhD vs MD and ultimately chose MD because I don't think I'm completely devoted to research. My PI is an MD/PhD (rather, an MD, then PhD later on) but he does the research because he loves it. It's kind of like a hobby for him. He would make more money if he spent the time in the clinics instead of the lab, but it's just something he loves.

The bottom line- do it if you can't see yourself in a career without the intense research. You've got to enjoy the entire process and not worry about how long it's going to take.

 

[JmanDO]

And once you've made up your mind, don't let others sway you. Be confident and enjoy the ride!

 

[tremulousNeedle]

My schools accepts ~200 MD students + 4 MD/PhD student per year. At the completion of my first year there were 3 students who transferred to the MD/PhD program, making the total 7 for our year. As long as there is funding available programs will try to work with the students to get them involved. Obviously this is school and economy dependent, but if you are accepted to an MD only program, that might not be the end of the road.

 

[loljkttyl]

Sort of the opposite of the above post but... Another loophole that I've heard of people doing (that sort of irks me) is that people can drop out of MD/PhD programs and not be required to pay back the free tuition and/or stipend. If this is you, you can sort of view this as a free two-year full tuition scholarship...a pretty sweet deal for the person switching out of MD/PhD but sucks for whoever is giving out the money 🙂 Of course, I've heard that some schools make you pay part of it back, but many just let you keep the money.

 

[heyyouyouyou]

just be aware that if you apply to an MD and MD/PhD program at a school, and if you are not accepted for an MD/PhD interview, the school will then look at your application to see if you should be invited for an MD interview.

some schools say that they are independent of each other, and both committees look at your application at the same time. That is a bunch of hoopla!

I was actually accidently CC'ed on an email that said something like this

"here's another MD/PhD reject, do you want to invite him/her for an MD interview?"

so, if you apply to the programs late, and your MD/PhD application is not viewed until late in the cycle, you are putting your MD-chances at a disadvantage.

 

[SweetRain]

Before you say that you love research, how do you know this? Is it just from doing undergrad research while taking classes?

I once considered MD/PhD program, but I'm really glad I changed my mind. I have been doing research at school for two years, a full time summer research and took a grad course to see if I like it. Obviously I didn't.

If you're doing research at your institution, make sure you have a project that is completely independent of any other post docs or grad students. I have my own project where it's just me and my PI and I realized how stressful that can be. It makes a world of difference. Also try full time summer research where you are in lab ALL DAY until your work is done.

If you still love it, go for it.

 

[URHere]

Before you get too involved in the MD vs MD/PhD debate, you need to consider a couple of things:

1) Do you really see yourself with a research-predominant career? MD/PhD programs are really designed for those who plan to run their own basic science labs and split their time about 80:20 between research and clinical medicine. If your dream is a bit different (working primarily as a clinician and publishing clinical research in between), then you would probably be wasting your time with a PhD. PhD programs are phenomenal if you need to specialized basic science experience, but they aren't the right choice for everyone.

2) Do you have a realistic shot at admissions? If you want to gain admission to an MD/PhD program, your research record needs to be excellent. This usually means at least two years of responsibility-bearing lab experience. Most students have carried out their own projects, written up, and presented their own data. If you haven't done that then you probably need more experience under your belt before you apply.

Also, although research background is most important, high MCAT scores are expected of MD/PhD graduates. A safe number is something above a 35. Lower number will cause you some heartache.

At the completion of my first year there were 3 students who transferred to the MD/PhD program, making the total 7 for our year.

This is not uncommon among schools but it really depends on a school's funding status. If you decide to apply MD-only, you can always email the MD/PhD program directors to see if internal applications are common for the school's MD/PhD program.

Sort of the opposite of the above post but... Another loophole that I've heard of people doing (that sort of irks me) is that people can drop out of MD/PhD programs and not be required to pay back the free tuition and/or stipend.

Schools try really, really hard to keep these people out of MD/PhD programs, and I think that those who do creep through with no intention of earning a PhD are somewhat of a rarity.

As for paying money back though, there are a few rules. If you are a student in a program with federal support (MSTP), you cannot be required to pay back federal money (the government would consider this an undue pressure for someone to stay in the program). If schools use private money to pay tuition and stipends, however, they make their own rules about repayment.

just be aware that if you apply to an MD and MD/PhD program at a school, and if you are not accepted for an MD/PhD interview, the school will then look at your application to see if you should be invited for an MD interview.

Many, but not all schools automatically consider MD/PhD applicants for the MD program. It is not uncommon for secondaries to have a check box asking: "If you are not accepted to the MD/PhD program, would you like to be considered for MD admission?". Also note that some schools (usually top schools) allow no cross consideration at all.

PS - there is also an MD/PhD forum that you can visit for more information.

 

[jdh71]

2) Do you have a realistic shot at admissions? If you want to gain admission to an MD/PhD program, your research record needs to be excellent. This usually means at least two years of responsibility-bearing lab experience. Most students have carried out their own projects, written up, and presented their own data. If you haven't done that then you probably need more experience under your belt before you apply.

Also, although research background is most important, high MCAT scores are expected of MD/PhD graduates. A safe number is something above a 35. Lower number will cause you some heartache.

I disagree with the above, because I don't think you can make such a blanket statement about all of the medical schools offering MSTPs. I see you are from your location you're likely at OHSU, and let's be honest, a POWERHOUSE for basic science research . . . this may not be terribly widely known, and I would expect strongly that to get into the program at OHSU, and any other big name, your qualifications would be quite germane, but I think for your mid-tier to lower level schools offering a MSTP, this simply isn't the case. You will need to demonstrate a serious interest in research, but having had two years solid basic lab experience will not be a requirement at many places.

 

[docelh]

I never thought of OHSU as a powerhouse of basic science research. They seem more like a clinical research place focused on primary care.

 

[jdh71]

I never thought of OHSU as a powerhouse of basic science research. They seem more like a clinical research place focused on primary care.

Well, you learn something new every day. You are welcome.

 

[docelh]

Well, you learn something new every day. You are welcome.

Well, you are the resident. 😀

 

[Parts Unknown]

My main goal is to get my MD, but I love research also and am starting to think I want to get my PhD program. My application isn't too competitive, but I'm scared if I don't go for my PhD now I will never have the chance.. I'm not sure which program to apply for.

Ugh, research funding these days is FUBAR, and it's not going to get better in the foreseeable future. The pay line for most NIH-funded research areas is around 6-8%, which sucks. The $10 billion increase in funding that Arlen Specter tucked into the stimulus package is mostly being distributed among established, already-funded labs.

Graduate students are cheap, intelligent, highly motivated labor, and as biomedical knowledge has advanced there has been great impetus to utilize more and more of them. The result is that PhDs are a dime a dozen, and if you become a researcher you will be competing with hordes of them for money.

Think of it this way: you're a hungry pit bull in a room with ten other hungry pit bulls and a grizzly bear. A pound of raw meat is dropped onto the floor. That's what it's like getting an R01 grant in this era.

That said, in the coming decades much money will be spent on research, many great advances will be discovered, and many careers will be made. But it's going to be a very hard and uncertain road for any individual who wants to climb in the ring and go for it. Having a realistic appraisal of your chances of success will help avoid future shock and disappointment.

 

[jdh71]

Ugh, research funding these days is FUBAR, and it's not going to get better in the foreseeable future. The pay line for most NIH-funded research areas is around 6-8%, which sucks. The $10 billion increase in funding that Arlen Specter tucked into the stimulus package is mostly being distributed among established, already-funded labs.

Graduate students are cheap, intelligent, highly motivated labor, and as biomedical knowledge has advanced there has been great impetus to utilize more and more of them. The result is that PhDs are a dime a dozen, and if you become a researcher you will be competing with hordes of them for money.

Think of it this way: you're a hungry pit bull in a room with ten other hungry pit bulls and a grizzly bear. A pound of raw meat is dropped onto the floor. That's what it's like getting an R01 grant in this era.

That said, in the coming decades much money will be spent on research, many great advances will be discovered, and many careers will be made. But it's going to be a very hard and uncertain road for any individual who wants to climb in the ring and go for it. Having a realistic appraisal of your chances of success will help avoid future shock and disappointment.

👍

I rubber stamp this post, and this is why you can't just simply "do research" in any big way with an MD outside of of some significant mentoring.

The K08s seem fairly reasonable to obtain, but after that money runs out . . . it will be a blood bath.

I know a guy who's moving to the VA because it basically allows him to "double-dip", VA funds, plus other funds, and as I barely understand it in this situation its completely kosher.

 

[Tiktaalik]

Sort of the opposite of the above post but... Another loophole that I've heard of people doing (that sort of irks me) is that people can drop out of MD/PhD programs and not be required to pay back the free tuition and/or stipend. If this is you, you can sort of view this as a free two-year full tuition scholarship...a pretty sweet deal for the person switching out of MD/PhD but sucks for whoever is giving out the money 🙂 Of course, I've heard that some schools make you pay part of it back, but many just let you keep the money.

Typically schools are wise to this and have safeguards in place. I'm going for a DVM/PhD, which is the vet equivalent of an MD/PhD, and the school has 2 safeguards: 1, your PhD work is inserted between 2nd and 3rd year, so you leave your class and work for 4 years. This essentially holds your DVM hostage, because you can't just get it for free and then run. 2, if you don't defend by the end of your 4th DVM year (8th year overall), then they make you pay back all the tuition benefits you got from being a dual-degree student.