Not sure about career anymore...

[Doye]

Hey everyone. I'm back because I feel I need some advice from people with more experience than me.

I'm doing research right now and everything is going well. I still really enjoy research, my project is moving along at a reasonable pace, my PI and the people I work with are great, MCAT studying is boring AF but it is going as well. However, I've become quite disillusioned by the purpose of academic work. I realize things can have an impact in the long term but I really don't like how sterile and unemotive the lab environment is most of the time. Is that just my lab? I mean we all get along and crack jokes but it is really hard to feel like people in academia actually care about other people. During the semester I can usually remedy this by volunteering but over the summer as I work full time I have no opportunity to do anything service oriented and I started thinking "What if my entire career is like this?" considering an ideal basic science appointment would minimize clinical time.

My question is this: Even if I am just as excited about science as ever, I'm good at it and want to use it to help people, if I want a more service related job like Medecins sans Frontiers for a year or serving in a more rural community, etc. then does that necessarily make the MD/PhD not worthwhile? I still want to do research but the thought of being a PI and not having the opportunity to perform more of the service related aspects of medicine kind of grates on me at this point.

It's not that I feel that academics don't care about people but I feel bad when I think about how much time I spend working on a highly complex, protracted problem when there are so many people suffering who just need someone to be able to provide them with care.

What do you guys think? Is this just a pre-career misconception? Can I have a PI job and still have a very service oriented career? If I can, is the MD/PHD overkill for that type of career?

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[Nanorust]

I don't have any grand advice, but I get what you're saying. I was wondering about the same things this time last year (the summer after my sophomore year, too). I was researching abroad which left me without the same opportunities to interact with people, especially since my mastery of the language was weak.

The thing that helped me was my PI allowing me to shorten my hours (read: come in about one day a week) for a few weeks the next semester to focus on a service opportunity. I decided that while I had missed the interpersonal interaction in a research-only enviornment, I missed the research in a service-only enviornment more. I was only missing whatever I wasn't doing at the time. I say look around during your next break from research and see if this is a "grass is greener" problem.

I know that doesn't answer all of your questions, but it's all I've got. Any advice from older folks?

 

[dl2dp2]

Can I have a PI job and still have a very service oriented career?

No. Do not have the delusion that you can be a PI and randomly take off a year. How would your funding agency react to this?

If I can, is the MD/PHD overkill for that type of career?

Yes. You don't need a PhD to deliver medical care.

 

[Neuronix]

You're not in the clinic. Being a clinician is not as idealistically noble as pre-meds and junior medical students think it is. You need to spend a few months as a third year to get the idealism knocked out of you.

It's not that I feel that academics don't care about people but I feel bad when I think about how much time I spend working on a highly complex, protracted problem when there are so many people suffering who just need someone to be able to provide them with care.

You'll come to realize that you can't fix the world's healthcare maldistribution. It's a government and distribution of resources problem that is above all our heads. This is why Paul Farmer is so good at it. He's a great fundraiser. You're not going to be successful at that part-time.

But hey, if that's what you want, I would say that MD/PhD isn't for you. This is a pathway to train the next generation of physician-scientists. This pathway is meant to train specialist physicians at academic medical centers with a significant amount of research.

We all provide service somewhere. Every doc provides uncompensated medical care as a part of their job. I get what I think is a reasonable amount of service by contributing to SDN and mentoring both in the real world and on this site. As someone who has done global health work in the past, I think you do more benefit to underserved patients in the third world by sending $2000 to fund a project at a clinic in the third world than spending $2000 in travel to go there yourself for a week or two. That's just my take. You'll find your own.

 

[Doye]

You're not in the clinic. Being a clinician is not as idealistically noble as pre-meds and junior medical students think it is. You need to spend a few months as a third year to get the idealism knocked out of you.



You'll come to realize that you can't fix the world's healthcare maldistribution. It's a government and distribution of resources problem that is above all our heads. This is why Paul Farmer is so good at it. He's a great fundraiser. You're not going to be successful at that part-time.

But hey, if that's what you want, I would say that MD/PhD isn't for you. This is a pathway to train the next generation of physician-scientists. This pathway is meant to train specialist physicians at academic medical centers with a significant amount of research.

We all provide service somewhere. Every doc provides uncompensated medical care as a part of their job. I get what I think is a reasonable amount of service by contributing to SDN and mentoring both in the real world and on this site. As someone who has done global health work in the past, I think you do more benefit to underserved patients in the third world by sending $2000 to fund a project at a clinic in the third world than spending $2000 in travel to go there yourself for a week or two. That's just my take. You'll find your own.

You are probably right and so is @Nanorust . Maybe I'm just experiencing fatigue since I barely did any community service last semester and now since my projects are actually working and I'm spending a lot of time in the lab because of it. I don't really feel like I'm going to save the world or anything but I just don't feel like any real human connection in the lab with anyone and that is kind of depressing for me, personally.

I think it also doesn't help that my exposure to fellow premeds makes me feel like everyone wants to go into academia and research and no one will ever go out to rural Montana or something and make sure the people in our own country at least don't have to drive to a different city to get taken care of. I'm going to give it more time. This is my second summer working full time, if I still have these sorts of feelings after next semester then I should do some serious rethinking.

 

[Neuronix]

I think it also doesn't help that my exposure to fellow premeds makes me feel like everyone wants to go into academia and research and no one will ever go out to rural Montana or something and make sure the people in our own country at least don't have to drive to a different city to get taken care of. I'm going to give it more time. This is my second summer working full time, if I still have these sorts of feelings after next semester then I should do some serious rethinking.

That is an interesting perspective. You must be in one of the big name places in Bawston. Where I went to undergrad, the people who were going to med school almost all went into primary care. Don't worry, physicians can be enticed to go where they need to go. You focus on what interests you. The world will sort itself out.

 

[Fencer]

Several of my fellows have taken rural jobs for neurologists of large catchment areas. In general, their guarantee salaries are in the 75% or higher percentile. In contrast, those who want to stay in less underserved areas (i.e.: high metropolitan areas) often start their careers in the 25-50% percentiles. The bottom of the percentiles (0-25%) is reserved for academic neurologists.

Think about it from this standpoint. The average professional life-span of clinician-scientists is about 30-35 years after completion of all training. Do you want to love what you do almost every day of those 30-35 years?

 

[Neuronix]

Do you want to love what you do almost every day of those 30-35 years?

You're assuming that all academics love what they do. My first day of residency, the attending said "this is the worst job ever and do not do academics."

 

[Fencer]

you are assuming that I am assuming... I feel sorry for your attending. Part of what you have to do by your fellowship is to have figured out what you enjoy the most ... Hopefully, this is something that you find out as you do electives rotating with some private practitioners and/o research electives to prepare you for your K-award application. Not everyone is cut for academic careers of 80/20 and even fewer for 50/50.

 

[Neuronix]

You're right Fencer. I just have a hard time believing in someone loving their academic career for 30-35 years because I've seen a lot of miserable failures and a lot of people struggling to make it. When you apply MD/PhD you only see the success stories. But Fencer is right. Maybe some people do love their entire careers.

 

[Fencer]

There are stages in everyone of us. Few of us are able to do the same thing during the 30-35 years. You can change careers mid-way and re-invent yourself. I currently have small amounts of funding for basic research, clinical research and health care outcomes research. The variety of research approaches is what keeps me, personally, happy. The clinical and administrative activities also contribute to my satisfaction on my career. I enjoy, particularly the career mentoring of other clinician-scientists. Beside mentoring MD/PhD students, I also mentor PGY5 clinical fellows and junior faculty in the KL2 program.