MDPhD in Basic Sciences leading to Clinical Research | My Three Mentors and I

[KaiSH]

Hope all of you are well!

Quick self-intro: I'm a first-time applicant for MDPhD. My stats are a little odd (3.4/521) and I applied to around 30 schools this cycle, no T20 obviously. Almost all of my time spent in research has been clinical- dealing with mostly retrospective studies and having a decent amount of exposure to the specialty I work in. When applying to programs this cycle I've been mostly looking into programs that have a PhDs along the lines of Clinical Investigation, Biostatician, ect.

What this post is really about: The three doctors I work with most closely are all MDPhDs, and split their time 40/60 between practice and research. I've seen after reading recent threads (mostly Lucca's comments), that MDPhD programs are looking for students who pursue research in the basic sciences (the bench stuff). The three doctors I mentioned earlier don't pursue research in their respective PhD fields, spend most of their time orchestrating multiple clinical studies, and have been my biggest source of inspiration.

What does this mean for me? If I want to pursue a career focusing on clinical research, is MDPhD the wrong track? Is an MD better for someone who wants to practice, but focuses on clinical research? Or is the basic science research sort of a proving grounds before an MDPhD can go into clinical research. If I need to reapply for MDPhD next cycle, should I engage more with basic research (Physics major btw)?

I think I'm confusing myself, so I'll stop. Thanks for reading this.

Kisses,

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[KaiSH]

To MDPhD applicants who have clinical research dreams, here's the NIH's FOA from May 2019.

Believe in yourself, I think. I'll let you all know how this cycle pans out for me 🙂

 

[kepler16b]

Why do you want to do an MD/PhD?

 

[KaiSH]

Because I want a career in clinical research and academic medicine. I don't enjoy research in the basic sciences, which as far as I know is the vast majority of MDPhDs. There are newer PhD Programs that focus on a broader curriculum of skills applicable to a clinical researcher (Biostatistics+HealthSystems+Comp+whatever field you want), and although I don't find many (any) current MSTP student studying that at the places I applied, I hope its due to the recency of that as a dedicated field.
If I want to pursue a career like my mentor, practicing but mostly focusing on collaborative, interdisciplinary research, I would like to have the PhD behind my name. The other two pathways I can think of is focusing on research after an MD, or doing an MDPhD in a trad field then redirecting my time. The first seems alright, the later seems like a waste. Question is what research do I want to participate in specifically, and have protected time for? Idk, but I hope I'll have the flexibilty in my PhD curriculum to take the necessary courses once I find a solid mentor/lab. Plus I highkey feel that putting good time and effort in a lab will catch me up to the relevant lit.

My bad if this comes off much, just my thoughts. Why are you pursuing a dual degree?

 

[kepler16b]

Because I want a career in clinical research and academic medicine. I don't enjoy research in the basic sciences, which as far as I know is the vast majority of MDPhDs. I would like to have the PhD behind my name.

To answer your original question: you should do the research that you want to do. You should not pursue basic science research simply in the pursuit of a PhD if your true interest is in clinical research. Asking this question seems to be putting the cart before the horse somewhat- putting obtaining an MD/PhD as the goal rather than seeking the appropriate training for the career you want to have. If you can find an MD/PhD program where you can do the research you described, then you should definitely go do that. If your only option is to do a PhD in a basic science topic, but you are not interested in pursuing basic science research, then maybe you should reconsider.

 

[DoctorWhere]

Sounds like you have a minimum of three people in your life who are more qualified to give you advice about MD/PhD and your goals than me.

 

[KaiSH]

Thank you guys for the responses. That definitely makes sense Kepler, I think I just posted this online because I haven't seen more than one or two threads about this and wanted validation lmao. But my mentors are supportive of the goal, and I'm looking forward to seeing how it pans out.

Best,

 

[Lucca]

Well, to explain my comments, I did not mean to imply there are not MSTPs which support non-basic science PhDs. There certainly are. Chicago, Penn, Yale, HMS come to mind. And even at ones that "dont" theres always a couple of trailblazers here and there.

Computational science / statistics are routes with growing popularity here.

I think in this day and age it is rly hard to pre-envision a career and then train for it. Everything, every single field, and medicine moves too fast. The field you end up in might not exist today. So decide what kind of training you want.

I will say, that I think if what you mean by "clinical research" is clinical trials, prospective and retrospective studies and such, I'm not sure theres too much benefit to doing a PhD. You can get the training you need through the MD route, or in residency, or even as a young faculty member if youre in a supportive department. Academic departments LOVE clinical research and relative to basic science the competition is not as stiff and it is a smaller capital investment in general than supporting basic science.

If you want to do some innovative health services research you may want to get some additional training in economics, for example.

The answer is always "it depends". You have to figure out for yourself what you want out of your training and life. Being a perpetual trainee until 40 has its advantages, but it also has very significant disadvantages. If *I* were interested in purely clinical research, I'd try to get my school or residency to pay for an MS in Epi or Stats or an MPH and get through my clinical training as quickly as possible. But I've also never been immersed in non-basic science fields so dont know what the norms and expectations are for people to actually get a job.

 

[Tangerine123]

I just stumbled upon this thread even though it's 2 months old.

Here are my 2 cents.

I believe this is why MD/PhD ptograms aren't directly a fit towards prople that wish to continue research in a clinical setting. The PhD part makes more sense when combined with the residency so you can move clinical trials forward. Usually students aren't sure what specialty they want to follow after medical school. Your PhD focused on Melanoma but you liked your Critical Care elective and want to do gas/CC? Tough luck. The way you deal with patients is also legaly limited and your desicion making isn't of much impact.

Sure, you can do research without the PhD, but getting protected time for research isn't really feasable all the time.

Currently I have 3 years of funded 100% research time in the middle of my residency that will lead to a PhD. Recruiting patients, doing follow-ups, data analysis and writing are a full time job. It would be -really- demanding if you had to do all of this without protected time, while having clinical duties. This protected time is also used for workshops, courses, seminars, lectures, etc at your discretion.

So if you want to focus on clinical research I would ditch the combined MD/PhD, just try and do some research on the side and learn useful skills (data analysis), and then look for a Residency/PhD program in the future.