Medical Research w/o a Phd....

Yes! Of course! In fact some schools encourage it by having theses (Yale? Duke?)

My cousin at CHOP, she does clinical stuff and research... Medicine and research are rather intertwined.

-RA

 

Clinical research, yes, no pro blem.

Basic science research, there are a lot of advantages to doing a PhD. None the lesss, it is POSSIBLE to do it with only a MD.

There are probably a lot of other threads that go into detail discussing pro's and Cons of doing MD PhD for a research career. (check the Pre-MSTP section, or do a search, also ask Vader or look at his MD PhD site, don't have the link).

In any case, you will probably need to do some post doc equivalent work if you have only MD (three to 4 yrs research after MD).
The PhD will provide a better training, will allow you n ot to need to worry about grants when you're in training (you're initial years), will get you better reputation when you're writing grants. Also, MD PhD is becoming increasingly common, for MDs doing Basic research.

Sonya

 

i am going through the same process of deciding whether the ph.d is necessary. the fact that i took a couple years out of school before applying, (24 years old/M1), doing an mstp (7-8 years, at northwestern avg is 8), and residency (3-7)..i'd be an old croney by the time i finished. the biggest deterrent for me was simply based off the length and the fact that i don't want to be 40 when i'm done "training".
the other factor that was in consideration was that i have interest in several different surgical subspecialties. i think in these fields, there is even less return for the ph.d component.

i am still involved in research, and in fact, i am doing more than the mstp's in my class right now. i'm working part time in a lab while going to school, i did a fellowship the summer before school started, and i have 2 years of research (with publications and abstracts) before i started medical school. although my experience and training won't be as significant as somebody who has gone through the ph.d, i hope that the lab experiences that i am getting now, (and ones that i will pursue later), will be sufficient in giving me the capabilities and confidence to direct research.

there are numerous opportunities to pursue research, even if you aren't an mstp. there are NIH summer fellowships, university sponsored fellowships, the howard hughes fellowship for medical students, howard hughes fellowship - Cloiver, and, even probably more significantly, post-resident research fellowships.
the reason why i feel that post-resident research fellowships are more significant, is because at that point of your career, you know what specialty you are, and your research interests are probably more mature than when you are younger.
you could end up doing a ph.d in a field that may be quite unrelated to the specialty or research pursuits you may have later. most of the time though, by the time residents are finished with their training, they are so sick of working their butts off that they don't even want to deal with doing a post-resident fellowship.

it sounds like i'm dissing the mstp. i think the mstp is a great program, but it doesnt really fit for me. if you know you want to do basic science, understand the length of time involved, and like the idea of having medical school paid for, then by all means, go for it.

(i do have an opinion about how much money you are "saving").
each year that you are doing your ph.d, is time that you are "working", so if you calculate 3-4 years of an avg physicians salary, that'd be more than the cost of medical school.

anyways, i've ranted long enough. good luck!


nuclearrabbit

 

Here's my experience. I'm a MD-PhD grad and worked with both MDs and MD-PhDs. There are two routes to go with research: 1) clinical research; 2) basic science research.

If you want to do the clinical research, e.g. drug trials, case reports, describe clinical findings, then a PhD is not needed. Many MD's do research. In fact, almost all academic physicians do research.

On the other hand, if you decide to do basic science research, then I recommend that you pursue the MD-PhD program for formal training. It'll make you a better physician scientist. You CAN do basic science research as a MD, but you'll need to do a post-doc which takes 2-4 years. You usually Post-Doc in a research laboratory. If doing basic science research requires additional years after medical school, then you should just do the PhD and get the credentials and formal course work too. In addition, you'll also have the chance to get a full-ride scholarship via the MSTP.

 

Its only an extra 4 years, plus you need a postdoc for the MD only route which reduces it to 2 years extra instead of 4 years... so in the end you get both degrees for an extra 2 years vs the MD+postdoc route.

If you are interested in surgical research, you dont need a PhD and you dont need a postdoc.

If you are talking about during the school year then its possible for an MD to be doing more than an MD/PhD student, because most MD/PhD students dont do research during the school year. But theres no way you are going to outgain them in research experience while spending only 4 years at the school, even if you spend every semester working in a lab.

At any rate, its very difficult to do meaningful research during med school years (besides the summers). Of course, its possible, but pretty rare.

Yes, you can do research, but I seriously doubt you will be running your own lab without getting a postdoc. At any rate, you didnt even need those 2 years of research experience to simply do research. Many MD grads have NO previous research experience before med school but yet become researchers after they graduate.

Yes, there are plenty of opportunities for a summer or year of medical research. I just think these dont substitute or eclipse a full blown PhD degree. But i agree they are helpful.

thats not necessarily true. Many MSTP programs let you do clinical rotations before picking a PhD thesis. At any rate, research interests change constantly.. its not as if after residency all of a sudden you know what your research is going to be for the rest of your life. The fact that your interests change constantly is just part of the status quo. Your research interests are just as likely to change post-residency as they are during med school, so either way theres no "temporal" advantage of a post-residency fellowship over a Ph.D.

good point, but if you want to do the same research activities as an MD/PhD, you will need a postdoc, which takes 2 years usually. So its not a 3-4 year advantage, its a 2 year advantage because postdocs dont get paid fat salaries like full blown doctors (its similar to a resident's salary)

 

just adding a couple of points:

While MSTPs take 3-4 extra yrs to finish their training(b/c of PhD part), the national data indicates that the avg age of newly appointed professors at academic institutions are the same for MD-PhDs and MDs. This means that MDPhDs move up the ladder faster, or that getting MD degree 3-4 yrs earlier does not mean you'll become a professor faster.

So many people I've met are so concerned about staying extra 3-4 yrs in med school. Well, after attending med school for a while, I've noticed that:

At my school (Top10 USNews Research), more than 30% of students do NOT graduate in 4 yrs, but rather take 1 yr off for research.(My friends at Stanford, Yale, and Hopkins said the %s are similar) Some do HHMI, some AOA Fellowship, and various other programs(or some go overseas for community service). Also, I've met a ton of graduates who took 1-2 yrs off after graduation to do research to enter a competitive residency field(even fields such as surgical specialties (ENT, plastics, ortho, neurosurg, urology), Emergency Med, not to mention the traditional research programs such as ophtho, derm, rad, rad onc, etc)
All of a sudden the extra yrs don't seem that much(now it's more like 1-2 yrs extra), plus you have a PhD in your CV. Doing a fellowship and getting a PhD is very different - w/ a PhD you get much more complete training w/ lectures, grant writing practice, etc. So the extra yr or two pays a bigger dividend IMO.

Also, my last point is that w/ MD degree alone, you will be able to pursue research, no problem. Like ophtho said, almost all academic physicians do research of some sort. BUT the quality and scale of research is very important to me. In my 30 yr career, I wanna do top-notch, frontier-of-our-knowledge research that will move the field. To achieve this, it takes 50% brain and 50% good funding (most successful labs have at least 1M/yr, some like Bert Vogelstein's get 5M/yr). More $ will mean more discoveries. IMHO it is so much easier to get NIH grants & move up the ladder as a MDPhD. (look at NIH grant approval records for MDPhDs vs MDs)

 

a few more points:

You absolutely do not have to do PhD in the field you will be entering after graduation - no way! the foundation you learn during PhD (critical thinking abilities, grant writing, coming up w/ experiments, data analysis, generating hypothesis) can be applied to any field, especially these days when there is so much overlap and collaboration among different fields.

MDPhD does not mean you HAVE TO run a basic science lab. In fact, that's the biggest appeal of a MSTP IMO, b/c the degree offers so much flexibility and freedom. Wanna enter the industry? Bigname companies will fight to have you in their company as a VP. Wanna do private practice? Sure, people will love you b/c they love additional degrees. Wanna do clinical duties only? No problem, in fact, I think MDPhDs make outstanding clinicians b/c they have a good understanding of molecular pathogenesis of disease processes and mechanisms of drugs, and their inquisitive minds will always drive them to think about improving upon existing treatments, eg. a better surgical technique. Bottom line: You get to do whatever you wanna do.

Finally - I don't buy the "you could be making $ earlier so the full ride isn't a good deal" argument. Do you know how many yrs it takes to become an assoc. prof or full prof.? Lecturers, Asst. profs definitely do not make 150-200k. By the time you are able to pay off the debt, how much will have you spent on interest? Also, think about the diminished quality of life by deducting $1000 every month from your paycheck for 7-10 yrs after residency, when you are trying to raise children, buy & maintain a house, start thinking about college tuition for your children, etc. I'll definitely take $ right now rather than the 'potential' income that is not guaranteed 10 yrs from now.

 

i was talking to an md at hopkins who was trained at havrad and is doing excellent research about this. ither are countless examples of "only" md's that have done some amazing research, naming a huge list wouldn't take longer (varmus,kendel .......). but it seems like those people are just the type of people that would have gone the mstp route had it been emphasized then. their md training was enough of a base, but powerful intellects, motivations and focus were more important perhaps. it takes one heck of a drive to hack it in science. the lady did say - she feels like even after 30 years of research, she still feel like she missed the 4 years of formal phd training - which in retrospect is a short time. anywy - i'm looking forward to academic med no matter how i get there (hopefully a free ride!)

-jot

 

It's clear that MDs can do outstanding basic science research too. I know many. However, most have had formal research training in the form of a post-doc of some sort. The point is why not just get a PhD for the work? It'll help you in the long run if you're truly interested in academics.