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No Residency?
Started by Marquis_Phoenix
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QofQuimica
Seriously, dude, I think you're overreacting....
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I don't see why it would. On the other hand, I also don't see why you'd go through all the trouble of getting an MD and then not get a license to use it. Why not just do a PhD if you don't want to do residency?
No. You will meet all sorts of PIs on the interview trail (if I recall correctly, you're gearing up to apply right now) that have MD/PhDs and did not complete a residency that are uber-successful. When you ask them if they regret the MD/PhD, they almost invariably say that they would do the same thing again. Medical school is obviously not sufficient to practice medicine, but it is no meager amount of medical knowledge and I think it can only enhance your understanding of research.
Now with that said, if you are 100% positive that you don't want to do a residency, I think you may want to seriously reconsider the MD/PhD. But more likely you're 21ish, and there is simply no way at this point in your life that you can know for sure. From talking with fellow applicants, it seems that most of us are pretty sure we want to be physician-scientists, but really we just have no idea what we want to do with our lives. Maybe science, maybe medicine, probably some undefined mixture of the two--but where to fall along that spectrum? The MD/PhD kicks the can down the road and prepares you for so many eventualities that it's really a beautiful stall technique. I would NOT recommend giving this schpiel in an interview (unless the interviewer brings it up), but I think it is a much, much more common applicant ideology than people acknowledge.
Now with that said, if you are 100% positive that you don't want to do a residency, I think you may want to seriously reconsider the MD/PhD. But more likely you're 21ish, and there is simply no way at this point in your life that you can know for sure. From talking with fellow applicants, it seems that most of us are pretty sure we want to be physician-scientists, but really we just have no idea what we want to do with our lives. Maybe science, maybe medicine, probably some undefined mixture of the two--but where to fall along that spectrum? The MD/PhD kicks the can down the road and prepares you for so many eventualities that it's really a beautiful stall technique. I would NOT recommend giving this schpiel in an interview (unless the interviewer brings it up), but I think it is a much, much more common applicant ideology than people acknowledge.
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Nice job on the candid answer, Solitude 👍. I think at age 21/22/23, it's surprising how high the bar is for expecting MD/PhD applicants to know precisely what they want. Inevitably, by the age of 30, many things change - both professionally and personally. MD/PhD training opens all biomedical doors at the cost of tacking on an extra 3-5 years.
That being said, I respectfully disagree with solitude. I think if you don't want to practice, don't do MD/PhD. There are more and more PhD programs that are getting smarter in how they train their future scientists, with some programs allowing their PhD candidates to take gross anatomy alongside MD students, and building programs to address the medical knowledge aspects of translational science. This might substitute for something like 0.5-1 year of MD training. Arguably, the clerkship years are a waste to someone not interested in practice. Then you're left with the enormous volumes of knowledge from an MD training, to which I say - go read a lot of medical textbooks and you're at least halfway there. Looked at in the opposite direction, go and ask a series of MDs and MD/PhDs if residency is worth it. You will find that they truly 'learned medicine' in their residency, and that's where all that knowledge stuck. On the flip side (and in accordance with solitude), if there's still a sliver of doubt that you might want to practice, then MD/PhD keeps that door open.
I know 100% that my end-goal is entrepreneurship - to start-up my own company based on a technology I develop, - whether biomedical devices, or biotechnology, or if I'm not feeling too confident about my chances, later switching to venture capital and getting involved in biomedical entrepreneurship as an investor or a CEO.
If either one doesn't look too bright, then just settle for practicing. So that financial independence in the start-up phase - having the MD to fall back upon, as well as while being on the PhD route - not having to worry about getting tenure or the politics, and being able to have independence with what you want to research.
Just not sure how fitting MD/PhD would be for that although I see numerous precedents. Perhaps it could help with research, finding new problems, open some doors in terms of knowing people doing interesting biomedical research/clinical trials?
If either one doesn't look too bright, then just settle for practicing. So that financial independence in the start-up phase - having the MD to fall back upon, as well as while being on the PhD route - not having to worry about getting tenure or the politics, and being able to have independence with what you want to research.
Just not sure how fitting MD/PhD would be for that although I see numerous precedents. Perhaps it could help with research, finding new problems, open some doors in terms of knowing people doing interesting biomedical research/clinical trials?
Hmmmm... Those are very specific goals. I don't think there is any sort of training program that can prepare a successful entrepreneur; that takes a good idea, capital, and ... luck. Going back to your original question, however, if you do not do a residency, you cannot practice and therefore, you can not use medicine as a 'back up' plan. (Others will probably tell you that you should not go into medicine at all if it is not your number 1 passion, but I realize that there are all sorts of different reasons why people choose the field.) What would you do if you decided NOT to do an MD/PhD?? It sounds like a PhD in BME and perhaps and MBA would help get you on the track where you want to be.
The bioengineering program at UTSW is a great example of this. Memorial Sloan-Kettering is also starting up some sort of "Disease-focused PhD" program. There are bound to be other similar programs.
I've asked MD/PhDs what they thought on this subject. All of them have said that the MD should be followed by a residency. Some have regretted their choice to not do a residency - you close doors, both in career options and finances. As a MD + license, you're more valuable to institutions and pharma.
I agree with many of the posters here that if you don't want to do a residency, then you probably shouldn't pursue the MD as well. When doing your PhD you can take med school courses that would get you a lot of the knowledge. Just as an example, one of my professors did his PhD in BME from Hopkins and he said he had to take most of the same courses as the M1 and M2 students do during his first couple years (not sure if this is still the case there). obviously you won't have the clinical experience if you do this, but there are still ways in which you can get it. Theres a program at Rice, for example, for starting phd students in BME that gives them clinical rotations through different hospital departments the summer before they start.
Also, with a biomedical company, you're likely going to have to have physicians or surgeons, as the case may be, to consult for you anyway (depending on what kind of device/technology, etc). even if you do an md/phd and don't do the residency, you will have some working knowledge with your MD training, but without the residency won't know the ins and outs of the field, and will likely need someone/a team to consult. and frankly, in terms of a business perspective, if your going to start up a company, MD + PhD + residency + possible fellowship has a huge opportunity cost.
I think it would also be hard to get a company started up from your invention/technology without some business background and training. given your specific goals, you might have seen it before, but I think this is a program you should strongly consider: http://www.biot.cam.ac.uk/mbe/
I was really attracted to it, but eventually decided not to pursue it. but it would be great to do before/after a phd.
just my two cents.
MD/PhD = Yes
