Ph.D after residency--dumb idea?

[WorkaholicsAnon]

I have a little less than a year left of IM residency. I want to have a translational research-based career, and despite past research experience and a first-author paper on original research, I feel a bit underprepared as far as labwork goes, and am a bit burned out by the clinical world nowadays anyway, so I was considering going for a Ph.D after finishing residency training. It is a big pay cut (about 50% less than the resident's salary i'm currently living on), but i'd be able to defer my loans with in-school deferment and I'd get student benefits. I dont have kids to support at the moment. And i'm thinking i might be able to moonlight occasionally for extra cash.

Any thoughts on why doing this might not be such a great idea? (besides the money)
Am I completely out of my mind?
Anyone have experience doing so,or know anyone who did this? Any regrets?

 

[howelljolly]

You really dont need to go for a PhD. Take advantage of the MD and board eligability you already have.

Off the top of my head...

If I were in your position, the first thing I'd consider is a research fellowship (for MDs)... with 80% research, 20% clinical. Google it... you'd have to know what you're looking for. There are plenty of them, and some lead to a Masters degree as well. To me, it would be more of a natural progression toward the goal, rather than dropping medicine, and going for a PhD, and then getting back into the clinical side for translational research. Heres an example: http://dgim.ucsf.edu/education/clinresearch.html. If you have a particular clinical interest, you could look for something more specific, such as.. http://www.aan.com/go/foundation/research


The other thing I might do, go for a M.S. in clinical investigation, part time, while you work.

I really dont know jack, but I suspect that the first option will be an easier transition, since they specifically train clinicians to do research.

Here are some websites that might help
http://sciencecareers.sciencemag.or...s_issues/articles/2007_08_17/caredit_a0700117

http://www.cc.nih.gov/researchers/training.shtml

 

[Gyric]

Yes, it is a dumb idea.

 

[gbwillner]

I have a little less than a year left of IM residency. I want to have a translational research-based career, and despite past research experience and a first-author paper on original research, I feel a bit underprepared as far as labwork goes, and am a bit burned out by the clinical world nowadays anyway, so I was considering going for a Ph.D after finishing residency training. It is a big pay cut (about 50% less than the resident's salary i'm currently living on), but i'd be able to defer my loans with in-school deferment and I'd get student benefits. I dont have kids to support at the moment. And i'm thinking i might be able to moonlight occasionally for extra cash.

Any thoughts on why doing this might not be such a great idea? (besides the money)
Am I completely out of my mind?
Anyone have experience doing so,or know anyone who did this? Any regrets?

Consider your options. There are programs out there that will let you do an accelerated program and pay you a fellowship salary to do research... You could get a PhD and not be paid a post-doc salary if that's your goal.

 

[mercaptovizadeh]

I have a little less than a year left of IM residency. I want to have a translational research-based career, and despite past research experience and a first-author paper on original research, I feel a bit underprepared as far as labwork goes, and am a bit burned out by the clinical world nowadays anyway, so I was considering going for a Ph.D after finishing residency training. It is a big pay cut (about 50% less than the resident's salary i'm currently living on), but i'd be able to defer my loans with in-school deferment and I'd get student benefits. I dont have kids to support at the moment. And i'm thinking i might be able to moonlight occasionally for extra cash.

Any thoughts on why doing this might not be such a great idea? (besides the money)
Am I completely out of my mind?
Anyone have experience doing so,or know anyone who did this? Any regrets?

I wouldn't do this. Perhaps you can do a fellowship in the field that interests you and start research through that. For something like translational research, you may not even need a PhD equivalent of experience. Perhaps a master's type 2 year (as opposed to 4-5 years) research experience would suffice.

At the point where you are right now, I would never consider doing a PhD. Sometimes it's hard to just push ahead as it is in an integrated MD/PhD program. When you're dealing with frustrations year in year out knowing that you could be doing something more useful like treating patients for 5+ times the income, it will be hard to motivate yourself unless you're personally obsessed and passionate about the particular project you're working on.

 

[RxnMan]

...Any thoughts on why doing this might not be such a great idea? (besides the money)
Am I completely out of my mind?
Anyone have experience doing so,or know anyone who did this? Any regrets?

This would be a terrible move. You have a MD + completed residency. You could qualify for a research fellowship. These can help you accomplish the goals you stated, but are much, much better than the PhD route at this stage of your career.

Take a look at the places Howell Jolly pointed out. Research fellowships for IM are common, and many allow for you to get a MS or MPH. Some, like this one, are clinical with a large research component. You can even extend it to a PhD, but you wouldn't be a regular PhD student. You'd be a clinical fellow or junior faculty, so you'd get paid better, have more respect, you could use your clinical training in relation to your project, and you'd have more control over your project.

Research fellowship: + research time, training, career improvement, fellow salary.
Clinical fellowship: + research time, training, career improvement, fellow salary, speciality board eligible, - clinical time.
PhD student post-residency: ---money, time, productivity, abuse, career stagnantion

 

[howelljolly]

Hey, he cant have that fellowship.... that one's mine!

 

[RxnMan]

Hey, he cant have that fellowship.... that one's mine!

I wasn't suggesting he *take* one of those you pointed out, just that he should look at the ones you suggested.

...or...

Are you saying you want the CU one? 'cause then I might have to take this to the Thunderdome...

 

[howelljolly]

I wasn't suggesting he *take* one of those you pointed out, just that he should look at the ones you suggested.

...or...

Are you saying you want the CU one? 'cause then I might have to take this to the Thunderdome...

yeah I want the colorado fellowship

 

[dendro]

I have a little less than a year left of IM residency. I want to have a translational research-based career, and despite past research experience and a first-author paper on original research, I feel a bit underprepared as far as labwork goes, and am a bit burned out by the clinical world nowadays anyway, so I was considering going for a Ph.D after finishing residency training.

If you really really want the PhD, maybe I would go for it, but if you want to conduct translational research, I would go for a research fellowship.

The type of laboratory techniques you would do as a PhD could be completely different from the types of techniques you would conduct in translational research, especially if the PhD is very basic. Sometimes, many MD/PhD students end up conducting research that is very different from their thesis work.

I would go with a research fellowship track, since you could still see patients every now and then and not loose extra training time (like you would being out 5+ years with a PhD), but then you would still achieve the same goal.

The NIH has some great research fellowships that you could look into. The research conducted there by fellows is pretty translational and there are close ties between your topic research and the diseases patients present with.

 

[WorkaholicsAnon]

Hey, he cant have that fellowship.... that one's mine!

Scuse me, i'm a she!!

But thanks for all the input so far! I do see the points that all of you are making. career stagnation is exactly the right term--I think that is mostly the thing that has been making me hesistate about the ph.D route. I'm not so interested in going for a masters, but if it is possible to get a ph.D doing a "post-doc" type work as a research fellow, that would really be the ideal situation.

btw dont worry howell-jolly, I have no desire to be in colorado!

 

[Vader]

Check out two examples along the lines you are interested in:

UCLA STAR Program
http://www.star.med.ucla.edu/

UCSD Physician-Scientist Training Program
http://pstp.ucsd.edu/

I'm sure there are a bunch of other programs like this, both formal and informal.

 

[JDWflash44]

There are certainly people that have done this and it has not led to career stagnation. Dr Iannotti, chairman of orthopedic surgery at the Cleveland Clinic, did this and has ascended to one of the most respected orthopods in the country. The hard part is finding a clinical dept that is will to take you as a clinician for 30% of your time and give you 70% of protected time to do your PhD. So you get paid for 30% of your time as a clinician and 70% of your time as a researcher. Don't let other people discourage you, if you really want to do it then go for it, but you have to find the right institution with the right support system for it to work. Good luck

 

[RxnMan]

There are certainly people that have done this and it has not led to career stagnation. Dr Iannotti, chairman of orthopedic surgery at the Cleveland Clinic, did this and has ascended to one of the most respected orthopods in the country. The hard part is finding a clinical dept that is will to take you as a clinician for 30% of your time and give you 70% of protected time to do your PhD. So you get paid for 30% of your time as a clinician and 70% of your time as a researcher. Don't let other people discourage you, if you really want to do it then go for it, but you have to find the right institution with the right support system for it to work. Good luck

Take a look at the links provided in the thread. All of these programs provide exactly what you're saying Iannotti did. He just arranged his own research fellowship. Any graduate of residency can do this; we're saying that this person should not go back as a 100% PhD student.

 

[howelljolly]

Take a look at the links provided in the thread. All of these programs provide exactly what you're saying Iannotti did. He just arranged his own research fellowship. Any graduate of residency can do this; we're saying that this person should not go back as a 100% PhD student.

Yup.

80% research - 20% clinical means more research, and is a fairly standard arrangement. Usually the clinical responsability is just as a fellow in the continuity clinic of your specialty service, one day per week. Its a nice predictable schedule, and you usually get to teach/supervise the residents who are rotating in your service.

 

[WorkaholicsAnon]

There are certainly people that have done this and it has not led to career stagnation. Dr Iannotti, chairman of orthopedic surgery at the Cleveland Clinic, did this and has ascended to one of the most respected orthopods in the country. The hard part is finding a clinical dept that is will to take you as a clinician for 30% of your time and give you 70% of protected time to do your PhD. So you get paid for 30% of your time as a clinician and 70% of your time as a researcher. Don't let other people discourage you, if you really want to do it then go for it, but you have to find the right institution with the right support system for it to work. Good luck

See, i think the issue with me is that I want to take a bit of a break from the clinical world after residency in the sense of having a set up that is relatively time-flexible (i.e. mostly research + moonlighting here and there). If i wanted something more rigid within a clinical department, I could go for a clinical fellowship, since that usually involves protected research time, especially during 2nd year in most of them.

What if I went for a ph.d program and then tried to moonlight occasionally for extra money? Do you guys thing that would work?

 

[Vader]

See, i think the issue with me is that I want to take a bit of a break from the clinical world after residency in the sense of having a set up that is relatively time-flexible (i.e. mostly research + moonlighting here and there). If i wanted something more rigid within a clinical department, I could go for a clinical fellowship, since that usually involves protected research time, especially during 2nd year in most of them.

What if I went for a ph.d program and then tried to moonlight occasionally for extra money? Do you guys thing that would work?

It would help if you explain what you mean by "a bit of a break". To me, the reasons you are interested in research are not particularly clear.

A Ph.D. in the biological sciences in a stand-alone program will take you 5-7 years to complete. Some Ph.D. programs restrict outside employment such that you may not be technically allowed to moonlight. If you are allowed or do so unofficially, it is also important to think about how much money you would like to make to live to your standard of living. You could probably fairly easily make the equivalent of a clinical fellow by moonlighting not too frequently (i.e. a few times a month). But remember, moonlighting is not exactly "taking a break from the clinical world". Moreover, you would be off the clinical track, so should you decide to specialize, this would require a clinical fellowship and its attendant commitments.

 

[howelljolly]

Yup, what Vader says...

and

1. a PhD is no joke. My MD/PhD friends actually have more brutal schedules when they are doing the PhD thing. There are deadlines, experiments running around the clock, papers to write, cell lines to rescue, schedules, lecturing, theres even scutwork - in the form of "write this abstract" or "draft a grant proposal for me". I cant give you details, because I dont have a PhD, but I promise you, my friends had longer working hours and less flexible schedules when they were doing their PhD work. You really will not be able to make your own schedule.... and then after thats all done, you'll be expected to do a post-doc or two...

Theres flexibility in rigid clinical schedules... thats why EM, Path, and Radio are considered lifestyle specialties

2. What sort of moonlighting could you do? You could the the doc-in-the-box thing once in a while, but you wouldn't get paid much for it, and you may not find it worthwhile, and it might stress you out even more.

What sort of research are you interested in?

Of course you could go for a clinical fellowship with protected research time, but we're all assuming that thats not something you want.

What are your thoughts on a research fellowship, with or without a PhD?

Again, I dont have a PhD, but I really think that if you were to get one, that would be the most inflexible 6 years of your life.

 

[WorkaholicsAnon]

It would help if you explain what you mean by "a bit of a break". To me, the reasons you are interested in research are not particularly clear.

A Ph.D. in the biological sciences in a stand-alone program will take you 5-7 years to complete. Some Ph.D. programs restrict outside employment such that you may not be technically allowed to moonlight. If you are allowed or do so unofficially, it is also important to think about how much money you would like to make to live to your standard of living. You could probably fairly easily make the equivalent of a clinical fellow by moonlighting not too frequently (i.e. a few times a month). But remember, moonlighting is not exactly "taking a break from the clinical world". Moreover, you would be off the clinical track, so should you decide to specialize, this would require a clinical fellowship and its attendant commitments.

The reasons I want to do research are a little bit beside the point, but since you ask. . .I've always wanted a research career. I have a scientific background from undergrad, did a lot of research during college as well as a year-long research fellowship at the NIH, and am passionate about research. I want to be an innovator that this is what I will find most rewarding from a career. However, I do find clinical work rewarding most of the time, and dont want to give it up completely. I may end up wanting to do a clinical fellowship in the future, I am not sure in which specialty though yet, and like you mentioned, there are the "attendant committments" that go along with that, and that is what i feel like taking a break from. I've been in school + training nonstop since kindergarten, and I just want to be (somewhat) in charge of my time for a little while before committing myself to another 3 years of clinical fellowship at this point. I feel like moonlighting is just a "whenever I feel like it" thing, so in my mind I see it as taking a break from the day-in, day-out clinical grind. That is what I meant.

I do know that the timeline for getting a Ph.D. is an undefined period, but it does allow for more time flexibility (i.e. I am in charge of my time, except for whatever coursework I would need to take), while possibly helping advance my primary interest in a research career and giving me more experience in the research world, since at this point I dont feel very confident about my ability to conduct research independently. I am not in a hurry to rush to the top of the totem pole just yet.

Are you saying that it might be difficult to get back into the clinical world if I go off into Ph.D land for a while? If I take the internal medicine boards in the August after I finish residency, how would it be difficult?

 

[themudphud]

The reasons I want to do research are a little bit beside the point, but since you ask. . .I've always wanted a research career. I have a scientific background from undergrad, did a lot of research during college as well as a year-long research fellowship at the NIH, and am passionate about research. I want to be an innovator that this is what I will find most rewarding from a career.

So actually I think the reason you want to do the research has a lot to do with whether it is a good idea or not. And if you want an academic career, then I would totally do it! But I would time it to overlap with research you do during your fellowship. Don't do the PhD now if you are planning on doing a fellowship afterwards. Here's why, when you do the PhD, you will build up a ton of momentum with regards to your research--a ton I tell you. When you drop that research to do a clinical fellowship, you will lose most if not all of the momentum. At the point when I finished my PhD, I could've spent another year in the lab and cranked out a few more high quality papers--I had a ton of momentum. But I had to go back to the wards and, yes, I keep doing some stuff on the side, but I have lost a lot of the momentum I had before.

Now take my buddy who had a couple years of research built into the end of his clinical fellowship but took those two years and ultimately added another two-three and got a PhD. Now my buddy is looking for a faculty job and will take a ton of research momentum to that faculty post--will hit the ground running. Sometimes I think this may actually be a better/more efficient route than doing the MSTP, since I feel like I'll have to do a few years of research postdoc after I finish residency/fellowship despite having done a PhD already.

I think if you time it right--it is absolutely a great thing to do since it sounds like you want an academic career.

 

[howelljolly]

The reasons I want to do research are a little bit beside the point, but since you ask. . .
Are you saying that it might be difficult to get back into the clinical world if I go off into Ph.D land for a while? If I take the internal medicine boards in the August after I finish residency, how would it be difficult?

We're not trying to be nosey or anything. Knowing why you want to do research will help come up with the best way for you.

You won't have a problem getting back into the clinical world after years of research or a PhD... clinical medicine doesnt move that fast. The reverse isnt true though. Research, and academic medicine moves very fast.

But, being a board eligible internist, you have so many more options available.... and some of those options will open more doors for you than others.

 

[WorkaholicsAnon]

So actually I think the reason you want to do the research has a lot to do with whether it is a good idea or not. And if you want an academic career, then I would totally do it! But I would time it to overlap with research you do during your fellowship. Don't do the PhD now if you are planning on doing a fellowship afterwards. Here's why, when you do the PhD, you will build up a ton of momentum with regards to your research--a ton I tell you. When you drop that research to do a clinical fellowship, you will lose most if not all of the momentum. At the point when I finished my PhD, I could've spent another year in the lab and cranked out a few more high quality papers--I had a ton of momentum. But I had to go back to the wards and, yes, I keep doing some stuff on the side, but I have lost a lot of the momentum I had before.

Now take my buddy who had a couple years of research built into the end of his clinical fellowship but took those two years and ultimately added another two-three and got a PhD. Now my buddy is looking for a faculty job and will take a ton of research momentum to that faculty post--will hit the ground running. Sometimes I think this may actually be a better/more efficient route than doing the MSTP, since I feel like I'll have to do a few years of research postdoc after I finish residency/fellowship despite having done a PhD already.

I think if you time it right--it is absolutely a great thing to do since it sounds like you want an academic career.

I know what you mean about the momentum--I felt it even at the end of the year I did the research fellowship in med school. In fact this is one of the reasons i want to dive back into research ASAP--I want to finish up some of the unfinished work i left.

What about if I go for a ph.d and if I'm on a roll, not do a clinical fellowship? will I have a niche?

 

[WorkaholicsAnon]

We're not trying to be nosey or anything. Knowing why you want to do research will help come up with the best way for you.

You won't have a problem getting back into the clinical world after years of research or a PhD... clinical medicine doesnt move that fast. The reverse isnt true though. Research, and academic medicine moves very fast.

But, being a board eligible internist, you have so many more options available.... and some of those options will open more doors for you than others.

I didn't mean for my phrase to come across as me thinking of you guys as nosey. The way Vader phrased his/her question about what my reasons were for wanting to do research came across as an implication that I wanted to do research simply to take a break from clinical work, which is inaccurate.

Thanks for the encouragement, though. Which options will open more doors for me? Doing a research fellowship you mean?

 

[Vader]

I didn't mean for my phrase to come across as me thinking of you guys as nosey. The way Vader phrased his/her question about what my reasons were for wanting to do research came across as an implication that I wanted to do research simply to take a break from clinical work, which is inaccurate.

Thanks for the encouragement, though. Which options will open more doors for me? Doing a research fellowship you mean?

Sorry if my question came across as harsh--most of us on this particular forum are interested in helping and it helps to know your reasons for pursuing a particular career trajectory.

It sounds like you are very interested in research, particularly translational research, which is great--we need more folks like you!

What are the reasons you are interested in pursuing a Ph.D.? What advantages would this give you over, say a 2-3 year research fellowship?

Btw, congratulations on almost finishing residency--quite an accomplishment already!

 

[howelljolly]

I didn't mean for my phrase to come across as me thinking of you guys as nosey. The way Vader phrased his/her question about what my reasons were for wanting to do research came across as an implication that I wanted to do research simply to take a break from clinical work, which is inaccurate.

Thanks for the encouragement, though. Which options will open more doors for me? Doing a research fellowship you mean?

Nah, nobody thinks you are skelling out of work.

With an independent PhD, you certainly could create a niche, but you'd be doing it on your own.

Think about why the program you are going into is in place. A PhD program is designed to..... get you a PhD. But a research fellowship is designed to, get you an MS or PhD... train you for a career in academic medicine.... Get you connected with the academic medicine world.... Get you a some clinical experience thats related to what you are researching... give you a faculty position waiting for you when you finish... and get you board eligible for a specialty... All these things really benefit the program itself.

If you train within a academic medicine program, it will be a smoother transition than if you work your way into it later on with an independent PhD. Your niche will have been created around you.