My eternal struggle: MD or PhD? Advice needed

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Lost In Transcription

reports of my assimilation are greatly exaggerated
7+ Year Member
Joined
Apr 2, 2016
Messages
2,514
Reaction score
2,301
Hey pre-allo. Some of my friends here know about my struggle, but I think I need a bigger pool of advice.

For about 4 years I have been conflicted about going to medical school or not. To keep it short, I decided I did NOT want to do an MD/PhD because it is so long, and for little payoff in my mind for what I want to do. And I want to get to my work and career rather than stay in school for a long time.

I want to become a field epidemiologist- my dream is to become a CDC EIS officer and then work for the CDC or state health department doing outbreak investigations and ecological microbiology research. Most people in the positions I want are MDs, and I can easily see how being a physician would be useful for the field. But most of what you would learn in med school also seems irrelevant.

I struggle to apply to medical school because I dislike the amount of time spent on politics and beauracracy. It is training for a profession- it won't help me be a better scientist. And the training to be a physician seems dragged out and full of BS to deal with...

I struggle to apply to a PhD program, even with an epi focus, because I don't want to be trapped at the bench. I want to study population/ecological microbiology want to be in the field. I want to meet the people. And I want it to be OKAY to do community work. A lot of people I know imply I will be a ****ty PhD student and scientist because I do community service (instead of just being in lab). I want a career where I can do community work AND research without being dismissed or shuttled into some instructor/advisor position at a university. I love that medicine is so personal and centered on patients and communities, unlike a lot of science (or scientists, at least). I don't want to stop volunteering or caring because "I need to focus more on my research" beyond the 50-60 hrs/week I already do. Sometimes I worry i won't be able to get into a PhD program I want to anyway because my extensive community work will come up in my application.

I am also worried about getting into a research heavy medical school, which I feel is what I would need to do. I only have a LizzyM of about 70-72, but I am a solid A applicant by the WedgeDawg rating system (due to a lot of CV things that I don't want to disclose due to anonymity). So...which one will be more important? Can I even get into Emory if my MCAT if I'm only? I have an app capable of making up for my LizzyM...but is stats a lower bar that will hold me back since I am not URM? And yes, I know you can do research at state schools where I have a good shot at getting in, but the research I am super excited about it at Emory first and foremost, UCLA and Hopkins. Overall, I do still have deeper reasons for wanting to become a physician, but I know that doing public health could fulfill some of those reasons.

TLDR:
I genuinely am torn between the two fields, although I know I have a much better background in science and feel more socially comfortable in science than medicine. I am afraid of getting put into a box at the bench though when I want to be in the field and interacting with the community. Since many field epis have an MD is this the best route of training for me to go?

Any advice or ideas? It's a bit rambly I apologize. Also, I left out a lot of details simultaneously. I thought about posting in the public health forums but it doesn't get much traffic.

Members don't see this ad.
 
  • Like
Reactions: 1 user
Hey! I'm getting my MPH in epi right now and have similar interests. I have a couple professors and have met others who were in the EIS program or are what you would call "field epidemiologists". This is very different from the other area you mentioned in your post "population/ecological microbiology". If you want to do applied epi, i.e. field epi, then you DO NOT need a PhD. A PhD in epi, or any other field, is about inventing new methodologies and understanding all the inner workings of the field. This is totally overkill in most situations. What most people don't tell you is that you do need to know the biology , and often the institutional structures, surrounding a disease in order to be a good epidemiologist. This is where the MD comes in.
FWIW the dean of my public health school / head of my department went to a SUNY for medical school and only did his MPH after residency. He stresses to me the power of an MD/MPH all the time vs just having one or the other.

Dont' stress about where you go to medical school if you want to do public health work. It does matter somewhat where you go to public health school. However, public health school admissions are a breeze, especially if you're already in medical school or residency. You should have no trouble getting into a big epi school like michigan, harvard, hopkins, pitt, or UNC. Most MD schools will let you leave to take the MPH year elsewhere.

Edit:
Also, just be aware that so many premeds glorify epi for some reason in their heads. The reality, unless you are something like an EIS officer, is you are staring at a screen for 6+ hours a day trying to figure out how to debug your SAS code, or applying for grants, or otherwise all the pitiful BS that goes along with the "publish or perish" climate of science. So if you don't have direct experience in this field right now, then take a summer research internship or something and see if it's everything you dreamed of.
 
  • Like
Reactions: 3 users
Also, just be aware that so many premeds glorify epi for some reason in their heads.

I was just watching contagion. Kate Winslets character made it seem really cool to me...
 
  • Like
Reactions: 1 user
Members don't see this ad :)
I would second getting the MPH in your instance. I doubt very much those jobs are difficult to get after an MD/MPH, and they in all likelihood dont care about where you got your MD or MPH. If you want to get super fancy you can apply to residency programs that provide you with the MPH. The alternative would be go to public health school by itself based on your stats you could get into a good MPH school as well.
 
If you want to be in the field and not stuck inside, do the MD. A combined MPH is a great idea. Being licensed to treat is why we put up with BS in medical school, and the value of that license cannot be overstated. It's a tough road, but it's supposed to be.

As a PhD, you have to constantly worry about money to do what you love. Whether it's retaining some autonomy and winning your own grants, or forgoing autonomy and reporting to a boss, dollars = pipettes. It's really that simple.
 
  • Like
Reactions: 8 users
Hey! I'm getting my MPH in epi right now and have similar interests. I have a couple professors and have met others who were in the EIS program or are what you would call "field epidemiologists". This is very different from the other area you mentioned in your post "population/ecological microbiology". If you want to do applied epi, i.e. field epi, then you DO NOT need a PhD. A PhD in epi, or any other field, is about inventing new methodologies and understanding all the inner workings of the field. This is totally overkill in most situations. What most people don't tell you is that you do need to know the biology , and often the institutional structures, surrounding a disease in order to be a good epidemiologist. This is where the MD comes in.
FWIW the dean of my public health school / head of my department went to a SUNY for medical school and only did his MPH after residency. He stresses to me the power of an MD/MPH all the time vs just having one or the other.

Dont' stress about where you go to medical school if you want to do public health work. It does matter somewhat where you go to public health school. However, public health school admissions are a breeze, especially if you're already in medical school or residency. You should have no trouble getting into a big epi school like michigan, harvard, hopkins, pitt, or UNC. Most MD schools will let you leave to take the MPH year elsewhere.

Edit:
Also, just be aware that so many premeds glorify epi for some reason in their heads. The reality, unless you are something like an EIS officer, is you are staring at a screen for 6+ hours a day trying to figure out how to debug your SAS code, or applying for grants, or otherwise all the pitiful BS that goes along with the "publish or perish" climate of science. So if you don't have direct experience in this field right now, then take a summer research internship or something and see if it's everything you dreamed of.
Thanks for the advice.

And I do have experience with it now, and other ID applications (hospital work etc).

One thing I worry about is payong back med school loans when i won't be a hospitalist...
 
Thanks for the advice.

And I do have experience with it now, and other ID applications (hospital work etc).

One thing I worry about is payong back med school loans when i won't be a hospitalist...
Well if you do it quick enough you would be part of NPSLF. Also MPHs arent funded and take 2 years, so think of it as spending some extra time to get a a degree to make sure you are invaluable to the CDC. I wanna say MD epidemiologists make 100K+
 
  • Like
Reactions: 1 user
Thanks for the advice.

And I do have experience with it now, and other ID applications (hospital work etc).

One thing I worry about is payong back med school loans when i won't be a hospitalist...
Damn... I though it was good lol
 
Well if you do it quick enough you would be part of NPSLF. Also MPHs arent funded and take 2 years, so think of it as spending some extra time to get a a degree to make sure you are invaluable to the CDC. I wanna say MD epidemiologists make 100K+
The amount of time to do an MD Mph makes me wonder why I wouldn't just apply MD and then MSTP internally though.
 
The amount of time to do an MD Mph makes me wonder why I wouldn't just apply MD and then MSTP internally though.
The MPH is one year added on to MD degree's and you pay tuition. Getting an MPH via a FM, IM residency is free.
 
Members don't see this ad :)
A couple thoughts:

- Wouldn't recommend getting an epi PhD unless you truly love it. The funding climate is brutal.

- Getting an unfunded MPH prior to medical school is expensive and inefficient compared to a funded year out during medical school, residency, or as a fellow.
 
  • Like
Reactions: 7 users
Agreed on timing. Best to do it during residency (more likely fellowship). You'll get more out of it and it'll be cheaper.


And MSTP in epi would tack on at minimum 3 years, but probably at least 4. MD/MPH or MPH during residency is just one year.
 
Have you ever heard of a DrPH? It's basically very applied public health doctorate program and you are trained to do more field work than PhD I believe.
 
Another Epi grad student here. Most of our Epi PhD students aren't really doing a bunch of stuff in a lab at a bench, though some certainly do. There are plenty of opportunities to do stuff heavy on the field work. Either way though you will be spending a good chunk of time staring at your SAS code wondering why it's not workng. So make sure you're into that. Several have gone on to do EIS fellowships.

Another option very similar is the CSTE fellowship which is modeled after the EIS fellowship, but you can do it with a masters or doctorate. So you can have the type of position you're looking for without a doctorate.

Getting the PhD doesn't tie you into trying to be an academic researcher who relies on grant funding. There are lots of industry jobs and health department jobs where you'll be doing interesting stuff. Note here that you might be more supervisory overseeing others who do the actual field work. It depends.

Then of course, yes, you can do the MPH in along with an MD in a total of 4-5 years, though it's probably better to do it during fellowship where you have better odds of it being paid for you.

Lastly, it might not hurt to pause before deciding and get a little more hands on experience before you make a decision. Something like this might be an option

https://www.cdc.gov/phap/about/index.html
 
Last edited:
Hope you like writing grants, being stuck in post-doc, and constantly finding funding for your lab while getting paid chump change.

I'm being a bit pessimistic, but hopefully you've been exposed to the ugly side of research before you jump.
 
If you're struggling to decide then medicine is probably not for you. It requires an immense amount of passion and motivation. No matter how brilliant an individual thinks he is, it is a humbling experience.
 
  • Like
Reactions: 1 users
I
Hope you like writing grants, being stuck in post-doc, and constantly finding funding for your lab while getting paid chump change.

I'm being a bit pessimistic, but hopefully you've been exposed to the ugly side of research before you jump.
Don't necessarily want a lab. I would be very satisfied working for a government state health department. Shrug.

And yeah, been in bench research for five years so I know the get go.
 
  • Like
Reactions: 1 users
I

Don't necessarily want a lab. I would be very satisfied working for a government state health department. Shrug.

And yeah, been in bench research for five years so I know the get go.
If that is your end goal, getting an MPH should be sufficient. The degree doesnt have a great ROI, but it will get you to that position. The MD opens many more doors.
 
Hey pre-allo. Some of my friends here know about my struggle, but I think I need a bigger pool of advice.

For about 4 years I have been conflicted about going to medical school or not. To keep it short, I decided I did NOT want to do an MD/PhD because it is so long, and for little payoff in my mind for what I want to do. And I want to get to my work and career rather than stay in school for a long time.

I want to become a field epidemiologist- my dream is to become a CDC EIS officer and then work for the CDC or state health department doing outbreak investigations and ecological microbiology research. Most people in the positions I want are MDs, and I can easily see how being a physician would be useful for the field. But most of what you would learn in med school also seems irrelevant.

I struggle to apply to medical school because I dislike the amount of time spent on politics and beauracracy. It is training for a profession- it won't help me be a better scientist. And the training to be a physician seems dragged out and full of BS to deal with...

I struggle to apply to a PhD program, even with an epi focus, because I don't want to be trapped at the bench. I want to study population/ecological microbiology want to be in the field. I want to meet the people. And I want it to be OKAY to do community work. A lot of people I know imply I will be a ****ty PhD student and scientist because I do community service (instead of just being in lab). I want a career where I can do community work AND research without being dismissed or shuttled into some instructor/advisor position at a university. I love that medicine is so personal and centered on patients and communities, unlike a lot of science (or scientists, at least). I don't want to stop volunteering or caring because "I need to focus more on my research" beyond the 50-60 hrs/week I already do. Sometimes I worry i won't be able to get into a PhD program I want to anyway because my extensive community work will come up in my application.

I am also worried about getting into a research heavy medical school, which I feel is what I would need to do. I only have a LizzyM of about 70-72, but I am a solid A applicant by the WedgeDawg rating system (due to a lot of CV things that I don't want to disclose due to anonymity). So...which one will be more important? Can I even get into Emory if my MCAT if I'm only? I have an app capable of making up for my LizzyM...but is stats a lower bar that will hold me back since I am not URM? And yes, I know you can do research at state schools where I have a good shot at getting in, but the research I am super excited about it at Emory first and foremost, UCLA and Hopkins. Overall, I do still have deeper reasons for wanting to become a physician, but I know that doing public health could fulfill some of those reasons.

TLDR:
I genuinely am torn between the two fields, although I know I have a much better background in science and feel more socially comfortable in science than medicine. I am afraid of getting put into a box at the bench though when I want to be in the field and interacting with the community. Since many field epis have an MD is this the best route of training for me to go?

Any advice or ideas? It's a bit rambly I apologize. Also, I left out a lot of details simultaneously. I thought about posting in the public health forums but it doesn't get much traffic.
You may think you won't pick up a lot from medical training with regard to public health, but actually, I think it's pretty damn useful preparation. The thing about getting in at the CDC is that there's plenty of PhDs out there willing to do the work, so they've kind of got an excess of basic researchers. What they're lacking is physicians willing to take the pay cut to do field work, as there is just so much more money to be made virtually anywhere else in medicine. So keep in mind that getting a public health degree doesn't really guarantee a shot at the CDC, but getting a medical degree is a pretty damn good step toward a job there due to the simple supply and demand aspects of it.
 
  • Like
Reactions: 3 users
If you're struggling to decide then medicine is probably not for you. It requires an immense amount of passion and motivation. No matter how brilliant an individual thinks he is, it is a humbling experience.
I tend to lean to this. I have seen the advice of "if you aren't 100% medicine don't do it", which makes sense to me. It's not really about intellect from my point of view, just opportunities.

I have seen @efle post that that mentality isn't always right though, so I am back to comtemplating med school.
 
You may think you won't pick up a lot from medical training with regard to public health, but actually, I think it's pretty damn useful preparation. The thing about getting in at the CDC is that there's plenty of PhDs out there willing to do the work, so they've kind of got an excess of basic researchers. What they're lacking is physicians willing to take the pay cut to do field work, as there is just so much more money to be made virtually anywhere else in medicine. So keep in mind that getting a public health degree doesn't really guarantee a shot at the CDC, but getting a medical degree is a pretty damn good step toward a job there due to the simple supply and demand aspects of it.
I'm just not looking firward to continuing t deal with the premed mentality and bull**** associated with that in med school. Arg. Haha. Though I DO want to be a physician.
 
I'm just not looking firward to continuing t deal with the premed mentality and bull**** associated with that in med school. Arg. Haha. Though I DO want to be a physician.
Once you're in it's not nearly as bad. I mean, at least it wasn't at my school. Some of the top tier schools are pretty cutthroat though. Going for epidemiology, you could shoot for FM or IM though, and thus wouldn't really have to deal with that crowd or mentality.
 
  • Like
Reactions: 1 user
I'm just not looking firward to continuing t deal with the premed mentality and bull**** associated with that in med school. Arg. Haha. Though I DO want to be a physician.
There is always bull**** to deal with, if it isnt premed stuff, its office politics, or funding, or organizational change, or pay structures, or what ever. Life is one big steaming pile of it. Just have to do something you enjoy enough to deal with it.
 
  • Like
Reactions: 1 users
There is always bull**** to deal with, if it isnt premed stuff, its office politics, or funding, or organizational change, or pay structures, or what ever. Life is one big steaming pile of it. Just have to do something you enjoy enough to deal with it.
True. But I don't know if I would enjoy doing pelvic exams or taking histories enough to do it for years...haha.
 
I'm just not looking firward to continuing t deal with the premed mentality and bull**** associated with that in med school. Arg. Haha. Though I DO want to be a physician.

I wouldn't avoid medicine just for that reason. I'm sure it gets better as you move along. I'm not of the mentality personally that one "shouldnt do medicine if they could see themselves doing anything else". In fact, I would be a little wary of the person who thinks they couldnt do anything else. It's a bit of an extreme statement. If you don't want to see patients, don't get the MD. I think thats the bottom line. At the end of the day, if what you want to do involves seeing patients or the knowledge associated with clinical medicine then get the MD. Otherwise, don't.

Not great advice but all I got.

I can understand your dilemma though. I had this exact same problem. I want to keep doing science and see patients and work on research problems related to disease. On the other hand, it irks me that doing science is so competitive while so many people don't have a physician in their area / can't access any of the options available to them. Ultimately, I chose the thing that I saw myself enjoying more.
 
  • Like
Reactions: 1 users
I wouldn't avoid medicine just for that reason. I'm sure it gets better as you move along. I'm not of the mentality personally that one "shouldnt do medicine if they could see themselves doing anything else". In fact, I would be a little wary of the person who thinks they couldnt do anything else. It's a bit of an extreme statement. If you don't want to see patients, don't get the MD. I think thats the bottom line. At the end of the day, if what you want to do involves seeing patients or the knowledge associated with clinical medicine then get the MD. Otherwise, don't.

Not great advice but all I got.

I can understand your dilemma though. I had this exact same problem. I want to keep doing science and see patients and work on research problems related to disease. On the other hand, it irks me that doing science is so competitive while so many people don't have a physician in their area / can't access any of the options available to them. Ultimately, I chose the thing that I saw myself enjoying more.
I agree on all points I suppose, including doing what you want.

I find it difficilt to believe that I will be happy playing good-ol-boys club to move up a ladder and also see patients that I can barely treat because medicine is so far behind science...that sounds awful.

But I know I don't want to stay behind the bench and out of touch with reality.

I guess I will still keep thinking about field science vs medicine.
 
I agree on all points I suppose, including doing what you want.

I find it difficilt to believe that I will be happy playing good-ol-boys club to move up a ladder and also see patients that I can barely treat because medicine is so far behind science...that sounds awful.

But I know I don't want to stay behind the bench and out of touch with reality.

I guess I will still keep thinking about field science vs medicine.

Maybe you are thinking too macro and absolutely. Sure there's some truth in what you say, but at the end of the day what kind of things do you want to work on? What kind of life do you want? Which path gives you what you want?

If you go too broad just about anything doesn't seem like the right choice hehe
 
I wouldn't avoid medicine just for that reason. I'm sure it gets better as you move along. I'm not of the mentality personally that one "shouldnt do medicine if they could see themselves doing anything else". In fact, I would be a little wary of the person who thinks they couldnt do anything else. It's a bit of an extreme statement. If you don't want to see patients, don't get the MD. I think thats the bottom line. At the end of the day, if what you want to do involves seeing patients or the knowledge associated with clinical medicine then get the MD. Otherwise, don't.

Not great advice but all I got.

I can understand your dilemma though. I had this exact same problem. I want to keep doing science and see patients and work on research problems related to disease. On the other hand, it irks me that doing science is so competitive while so many people don't have a physician in their area / can't access any of the options available to them. Ultimately, I chose the thing that I saw myself enjoying more.
Even if you dont want to see patients epidemiology, Rads, Path are fine paths for an MD.
 
But why would or should anyone go into MD when they don't like patients? Like....why. haha
Because they like the mental stimulation of medicine, but hate the general public. Even most proceduralist have limited exposure to patients considering they do procedures all the time and have their midlevels deal with the patients in the clinic.
 
Maybe you are thinking too macro and absolutely. Sure there's some truth in what you say, but at the end of the day what kind of things do you want to work on? What kind of life do you want? Which path gives you what you want?

If you go too broad just about anything doesn't seem like the right choice hehe
I don't know which path does. :( That's why I'm here. I suspect multiple paths will get me there.

@Goro, sorry to bug you. From skimming do you have any advice? I know this isn't your field but you are always a source of wisdom!
 
Because the like the mental stimulation of medicine, but hate the general public. Even most proceduralist have limited exposure to patients considering they do procedures all the time and have their midlevels deal with the patients in the clinic.
I just always think those people should go into science. Mental stimulation is probably higher there. :p
 
Med school has too many things you don't like. Seems like MPH is the route to go. Otherwise, consider the MD or DO degree to be a means to an end.


I don't know which path does. :( That's why I'm here. I suspect multiple paths will get me there.

@Goro, sorry to bug you. From skimming do you have any advice? I know this isn't your field but you are always a source of wisdom!
 
  • Like
Reactions: 1 user
Med school has too many things you don't like. Seems like MPH is the route to go. Otherwise, consider the MD or DO degree to be a means to an end.
Will schools even accept me though if they know I want to do epi/ID work eventually? :confused:I want to work mostly in the states, but if I don't say that I would be totally happy as an OBGYN would they accept me?

I have a good app and actual good reasons and experiences for a PS, but I don't want to lie.

So IYO PhD isn't a good plan?
 
Pre-med mentality? Virtually everyone at my school is mature and dedicated. Early 20s, top of their class, research, extracurricular, etc. There's a reason why they got accepted in medical school in the first place. The admissions committee is sharp when it comes to admitting the right people. I think you have a misconception of how students behave in MD school.
 
Pre-med mentality? Virtually everyone at my school is mature and dedicated. Early 20s, top of their class, research, extracurricular, etc. There's a reason why they got accepted in medical school in the first place. The admissions committee is sharp when it comes to admitting the right people. I think you have a misconception of how students behave in MD school.
But I don't want to be around self-righteous, poorly motivated people who are in a degree for prestige...

I'm constantly around some of the best 3rd and 4th year students in the country...
 
But I don't want to be around self-righteous, poorly motivated people who are in a degree for prestige...

I'm constantly around some of the best 3rd and 4th year students in the country...
b/c taking the PhD route negates that possibility of "degree" for prestige? Unless you consider a PhD to be less pretigious than an MD, your argument is quite flawed and intrinsically illogical.
 
But I don't want to be around self-righteous, poorly motivated people who are in a degree for prestige...

That might describe a few people who get through. You need to expose yourself to more people.

There are medical students in my class who will be the only doctors I would trust with my loved ones. Seriously.

Most medical students I know are extremely motivated, and eager to learn. The impostors don't make it very far.

On the other hand I've had extensive experience with graduate students and PhDs. It's not a black and white issue. If you want to find a prestige-*****, please show yourself to nearest lab. Every minute it's impact factor, grant money, fellowship, etc. Yes, medical students behave like this too in some respects.

People are people. Find your people.
 
Last edited:
  • Like
Reactions: 1 users
That might describe a few people who get though. You need to expose yourself to more people.

There are medical students in my class who will be the only doctors I would trust with my loved ones. Seriously.

Most medical students I know are extremely motivated, and eager to learn. The impostors don't make it very far.

On the other hand I've had extensive experience with graduate students and PhDs. It's not a black and white issue. If you want to find a prestige-*****, please show yourself to nearest lab. Every minute it's impact factor, grant money, fellowship, etc. Yes, medical students behave like this too in some respects.

People are people. Find your people.
Fair enough point. I definitely filter out the focus on prestige in science though it is there. I find it's easier to in science than in medicine though.

Sometimes I feel I expose myself to too MANY people... :p
 
MD/MPH dual degree- problem solved. If you do decide to apply, make sure you BS your personal statement and don't deliberately be honest about pursuing an MD to become a field epidemiologist (although a masters degree is sufficient). All the best.
 
MD/MPH dual degree- problem solved. If you do decide to apply, make sure you BS your personal statement and don't deliberately be honest about pursuing an MD to become a field epidemiologist (although a masters degree is sufficient). All the best.
Why would med schools not be okay with that outcome anyway?
 
Yes. But just say you have an open mind on everything. You never know when cardiology might bite you in the ass and you find your true love


No to a PHD

Will schools even accept me though if they know I want to do epi/ID work eventually? :confused:I want to work mostly in the states, but if I don't say that I would be totally happy as an OBGYN would they accept me?

I have a good app and actual good reasons and experiences for a PS, but I don't want to lie.

So IYO PhD isn't a good plan?
 
  • Like
Reactions: 1 user
Top