MSTP vs. NYU MD-only (Full COA)

[account12345]

Hi everyone, I am really struggling to finalize my decision and would love to hear any last minute input. I’ve narrowed down my choices to an MSTP program and a fully funded MD spot at NYU. I would prefer not to specify which MSTP program, but it is at one of the schools being targeted by the Trump administration (so think Columbia, Cornell, Harvard, Northwestern, Penn). I think I would be equally happy at either medical school, so my thought process boils down to: 1. The current state of research in the US and 2. Whether or not an MD-PhD program is the best/only way to achieve my goals.

For number 1, it is honestly a really scary time to be going into academic research. Although the MSTP institution seems committed to funding/supporting all the students in the program, people have also been honest with me in that no one knows what will happen in the future. It seems like the funding situation could get better or even worse fairly quickly, which makes me very scared about committing to an 8 year program right now. I am specifically worried about increasing difficulty/competition to find a lab that has the funding to recruit new graduate students and the possibility of unexpectedly losing funding partway through the PhD. Depending on the financial situation, is it possible that institutional support for the MSTP could be withdrawn? I hope that I am wrong and the situation starts to get better, but how much of a risk would I be taking to attend the MSTP program vs. getting my MD from NYU with no reliance on federal funding?

Second, I know that MD-PhD programs are not the only way to become a physician scientist, but how much of a disadvantage would it be to not have a PhD? The 3 year curriculum at NYU is fairly unique in that I could complete a full research year during medical school and still graduate in 4 years. Would this research year and prior research experience be enough to be competitive for research track residencies? It also seems possible to do a PhD as part of residency or to do extended postdoc-type research during residency/fellowship with only an MD. I see some definite benefits with this pathway in that my research would be very closely tied to my clinical interests and timed better than PhD research completed 2 years before even starting residency. I have no idea what area of medicine I want to go into yet, but it is important to me to have a strong connection between my research and clinical work, so the timing of research training after medical school might be a better fit for me? However, this is a much less structured path and although there are many successful MD-only physician-scientists, I’m worried that I would be at a disadvantage compared to MD-PhDs. Will I be closing any doors by not having the PhD degree?

So it basically comes down to zero risk + increased flexibility at NYU, but with the downside of a potentially much more difficult path to becoming a physician-scientist.

Thank you for reading and I would appreciate any insights you may have!

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[captain_kirk]

Normally, I would say you'd be crazy to choose an MD over an MD/PhD, but a fully funded MD changes the calculus—even without considering the scorched-earth "Trump variable."

Keep in mind: an MD from NYU was enough for Jonas Salk (whom I’d argue is the greatest biomedical scientist of the 20th century). I suggest you take a look at the departments related to your field of interest at Harvard, Stanford, Duke, etc. Check out the degrees of their faculty. Does it look like there's a barrier keeping MDs from reaching the highest levels? I don't think so. And if you decide later that you want a PhD after earning your NYU MD, you can still pursue one without debt, even as a faculty member. That's what David Curiel (the first person to show that an mRNA vaccine could work) at WashU did while he was still a professor at UAB (David T. Curiel, MD, PhD).

 

[Mr.Smile12]

Fully funded MD means you can get out in 4 (or 5) years. MSTP locks you in for 8-10 years at a grad student salary.

I agree even without the current administration's disdain for scientific research, this isn't a difficult choice.

 

[caffeineallergy]

I would recommend looking very closely at the environment right now at NYU before making your decision as a lot of what people mentioned regarding the NYU MSTP offers being rescinded centered around a lack of institutional funding for both the MD and MD/PhD. In an environment like that, will you be able to or have support to do additional research? Along with that, look at the institution that you are considering for MD/PhD. During my second looks, schools told me about certain donations the schools had received recently or other signs of institutional funding ie hiring faculty, involvement of high level people within the hospital system/medical school at the second looks. which demonstrated that if all things fail, the school itself cares about the md/phd program enough that it would make sure those students were supported.

Additionally, to your second point, I think it really depends on how you envision your own research direction going. The reality is that science now vs science of the past is very different. I have had interviewers and mentors discuss the difficulty of getting their foot in the door of research as MDs, but they also were able to get there. I think ultimately, you won't be closing doors, but it's a difference of how you get there and the time you would have put into getting a PhD will be allocated and spent in other parts of your career to become an MD-only physician-scientist.

 

[ophthoaspirant]

Fully funded MD means you can get out in 4 (or 5) years. MSTP locks you in for 8-10 years at a grad student salary.

I agree even without the current administration's disdain for scientific research, this isn't a difficult choice.

Valid point but you have to consider 2 additional factors:

1. How competitive is the residency you want to target (I understand it is hard to pin that down when you have not even matriculated). Some competitive specialty academic residencies will value 3-4 years worth of PhD research compared to just 1 research year.
2. Only a minority percentage of MD-PhD students take longer than 8 years. If funding constraints remain, programs may encourage and support students to complete their PhD quicker in which case the MD-PhD may take only 7 years.....remains to be seen.

I would also lean towards the fully funded MD but it is not a slam dunk decision in my eyes.