PhD instead of MD?

[vmc303]

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Did anyone consider getting a PhD -- either in clinical psychology, neuroscience, or neuropsychology -- rather than an MD? If so, what persuaded you to pursue the MD instead?

I applied to MD programs this year and thus far haven't gotten in anywhere (though I'm on a few waitlists). My grades and scores were excellent; I believe the problem with my application was that while it was clear I was very interested in brain research, there was little to indicate I had any real interest in becoming a physician per se. And indeed, when asked why I didn't just go for a PhD rather than an MD during interviews, I didn't have a great answer.

So now I'm wondering whether I really should apply again next year, or possibly look at applying to masters or doctoral programs in some neuroscience or psychology field. A big part of my initial reason for applying to med school instead was that I thought I could wind up doing virtually the same sort of work in the end, but with more options and a higher income. However, considering that academic/research psychiatrists or neurologists make even less than their clinical counterparts, I'm not sure how true the income part is; when you factor in the added debt from med school vs. the (assumed) free cost of a PhD program, this seems even less certain. The way I'm starting to look at things, I could get a PhD in about the same time it would take me to get through med school and residency, and spend most of those 8-9 years doing work that is more directly related to what my interests are, rather than spending a good deal of time in med school and residency doing stuff that's only tangentially related.

Any thoughts?

 

[golfpropsychguy]

Psychiatry and Psychology are two different things. If you are so sure of getting the PhD why didnt you just apply to those programs first? It seems that your pretty set on going that route. If I were you I would just go after what I really want and enjoy it.

Did anyone consider getting a PhD -- either in clinical psychology, neuroscience, or neuropsychology -- rather than an MD? If so, what persuaded you to pursue the MD instead?

I applied to MD programs this year and thus far haven't gotten in anywhere (though I'm on a few waitlists). My grades and scores were excellent; I believe the problem with my application was that while it was clear I was very interested in brain research, there was little to indicate I had any real interest in becoming a physician per se. And indeed, when asked why I didn't just go for a PhD rather than an MD during interviews, I didn't have a great answer.

So now I'm wondering whether I really should apply again next year, or possibly look at applying to masters or doctoral programs in some neuroscience or psychology field. A big part of my initial reason for applying to med school instead was that I thought I could wind up doing virtually the same sort of work in the end, but with more options and a higher income. However, considering that academic/research psychiatrists or neurologists make even less than their clinical counterparts, I'm not sure how true the income part is; when you factor in the added debt from med school vs. the (assumed) free cost of a PhD program, this seems even less certain. The way I'm starting to look at things, I could get a PhD in about the same time it would take me to get through med school and residency, and spend most of those 8-9 years doing work that is more directly related to what my interests are, rather than spending a good deal of time in med school and residency doing stuff that's only tangentially related.

Any thoughts?

 

[Therapist4Chnge]

Psychiatry and Psychology are two different things. If you are so sure of getting the PhD why didnt you just apply to those programs first? It seems that your pretty set on going that route. If I were you I would just go after what I really want and enjoy it.

Agreed.

They really are two different animals, with two different paths. I'm on the clinical side, and I had a similar dilemma. Sometimes people forget that a psychiatrist is a physician first. Since my career goals weren't in line with that, I chose clinical instead. I decided on getting a strong basis in the hard sciences, and taking that through the clinical route. Both are long and grueling roads, and you can't do either half-heartedly. Best of luck deciding.

-t

ps. Clinical programs look for different things than med school, so you may need to take another year or two to get prepped for a good run at interviews, etc. You need to have solid: GREs, recommendation letters, and research experience. Acceptance rates for quality fully-funded PhD programs is 2%-6%....so it will be competitive.

 

[PsychMD2100]

Scroll Down to "The Usual Showdown" String Listed Below. This was just visited about a week ago.

 

[billypilgrim37]

In your particular case, I'll disagree that the MD or phd routes for you are actually two different animals. It doesn't sound like you want to be a physician or a psychologist--you sound like you want to be a neuroscientist, and that's a third thing, and a very cool thing at that.

As an MD student who is more interested in a research career, and will be perfectly content with a day or two of clinic in between my research days, I'm thrilled I took the route I did. But I think I could have gone to clinical grad school and have been happy and had similar research interests. I think from a funding perspective I will be in a better situation than I would be otherwise, as I do think the MD carries certain advantages in grant reviews, but there may well be others who disagree with that statement.

The focus of the graduate programs might serve you better; I was still interested in patient care and access issues, so the MD route made more sense for me.

 

[vmc303]

In your particular case, I'll disagree that the MD or phd routes for you are actually two different animals. It doesn't sound like you want to be a physician or a psychologist--you sound like you want to be a neuroscientist, and that's a third thing, and a very cool thing at that.

As an MD student who is more interested in a research career, and will be perfectly content with a day or two of clinic in between my research days, I'm thrilled I took the route I did. But I think I could have gone to clinical grad school and have been happy and had similar research interests. I think from a funding perspective I will be in a better situation than I would be otherwise, as I do think the MD carries certain advantages in grant reviews, but there may well be others who disagree with that statement.

The focus of the graduate programs might serve you better; I was still interested in patient care and access issues, so the MD route made more sense for me.

You're exactly correct. If I went the PhD route, I'd likely wind up doing neuroscience or behavioral neuroscience. Part of my rationale for opting for an MD instead was that I figured that in the end, I'd largely be doing the same kind of work anyway. With an MD, however, I'd have more options, could stand to make more money, and would have an easier time getting into schools (I was a humanities major and don't have the necessary background to apply straight to PhD programs).

Now I see the "getting into schools" part isn't such a straight shot after all. I'm also realizing that if I wound up as an MD doing neuro/psych research, I likely wouldn't be making any more than a PhD anyway. I'm interested in science and research, and only interested in being a physician insofar as working with patients might shed light on different research questions.

The thought of slogging through 4 years of med school and spending 90% of my time studying stuff I have little interest in, just to get to the same point I'd be at if I got a masters and then a PhD, is becoming less and less attractive as the "benefits" of such a path are appearing less substantial. Maybe I'm wrong and there are major benefits to getting an MD and winding up almost entirely in research, but to go that route just to "preserve my options" is striking me as a little wrongheaded, especially considering the debt I'd incur in med school.

 

[littlepurplepil]

Have you considered MSTP (medical scientist training program - NIH funded dual-degree program) or MD-PhD joint programs? You would strike off the debt concern (most MD-PhD programs fund your med school yrs as well as your PhD yrs, and MSTP programs are all fully funded for med school & PhD time) and would get the "best of both worlds" as far as degrees go, possibly in a bit shorter of a time than doing a PhD alone. After completing a program you would not necessarily have to do a residency, you could easily go straight to research (though without residency it would be hard to get to have a lot of independent/unsupervised clinical time). Granted to get accepted into an MSTP or Md-PhD joint program is more difficult than a straight MD, but if you have a strong research slant and can provide some answers to the "why do you want to be a physician" question that sound more convincing than "I want the big bucks 😀 " 😉 you'd probably have a good shot. People tend to complete both degrees within 8 years (2 preclinical MD years, 4 PhD years, and 2 final clinical MD years).

Just something else to consider when weighing the pros & cons of med school vs grad school 🙂

 

[vmc303]

Have you considered MSTP (medical scientist training program - NIH funded dual-degree program) or MD-PhD joint programs? You would strike off the debt concern (most MD-PhD programs fund your med school yrs as well as your PhD yrs, and MSTP programs are all fully funded for med school & PhD time) and would get the "best of both worlds" as far as degrees go, possibly in a bit shorter of a time than doing a PhD alone. After completing a program you would not necessarily have to do a residency, you could easily go straight to research (though without residency it would be hard to get to have a lot of independent/unsupervised clinical time). Granted to get accepted into an MSTP or Md-PhD joint program is more difficult than a straight MD, but if you have a strong research slant and can provide some answers to the "why do you want to be a physician" question that sound more convincing than "I want the big bucks 😀 " 😉 you'd probably have a good shot. People tend to complete both degrees within 8 years (2 preclinical MD years, 4 PhD years, and 2 final clinical MD years).

Just something else to consider when weighing the pros & cons of med school vs grad school 🙂

I considered it. It's got its draws, but the thought of spending upwards of 12 years in training (med school + PhD + residency) is pretty daunting. I'm already in my mid-20's; I don't want to be nearly 40 before I'm actually out and "working"!

 

[OldPsychDoc]

I considered it. It's got its draws, but the thought of spending upwards of 12 years in training (med school + PhD + residency) is pretty daunting. I'm already in my mid-20's; I don't want to be nearly 40 before I'm actually out and "working"!

If you get a PhD and do multiple post-docs before getting a faculty position, you'll be there anyway.

I started an MD/PhD program at age 28, residency at 37, attending faculty job (no longer doing research) at 42. It can be done. It beats slogging away at something you don't like!

 

[MBK2003]

Have you considered MSTP (medical scientist training program - NIH funded dual-degree program) or MD-PhD joint programs? You would strike off the debt concern (most MD-PhD programs fund your med school yrs as well as your PhD yrs, and MSTP programs are all fully funded for med school & PhD time) and would get the "best of both worlds" as far as degrees go, possibly in a bit shorter of a time than doing a PhD alone. After completing a program you would not necessarily have to do a residency, you could easily go straight to research (though without residency it would be hard to get to have a lot of independent/unsupervised clinical time). Granted to get accepted into an MSTP or Md-PhD joint program is more difficult than a straight MD, but if you have a strong research slant and can provide some answers to the "why do you want to be a physician" question that sound more convincing than "I want the big bucks 😀 " 😉 you'd probably have a good shot. People tend to complete both degrees within 8 years (2 preclinical MD years, 4 PhD years, and 2 final clinical MD years).

Just something else to consider when weighing the pros & cons of med school vs grad school 🙂

I also did MD-PhD combined degree and have several co-residents who are MD-PhD and continuing on after graduation with research careers. This is how the timeline actually runs:
MD + PhD = 7-8 yrs
Psychiatry Residency = 4 yrs
Research Fellowship = 2-3 yrs

For my friends with PhD's in neuroscience, it's more like:
PhD = 5-6 yrs
Post-doc #1 = 3 yrs
Post doc #2 = 3 yrs

There's a lot more sharks in the pool trying to catch the very small number of fish (academic positions) when you go the PhD route. As an MD-PhD you have more available job opportunities in academia, but you have to be committed that you are interested in (not just willing to tolerate) seeing patients. We all know the occasional MD-PhD MS3 student who has no interest in clinical care, zero interpersonal skills, and makes you wonder why they just didn't get the PhD instead.

Good luck!
MBK2003

 

[strangeglove]

I also did MD-PhD combined degree and have several co-residents who are MD-PhD and continuing on after graduation with research careers. This is how the timeline actually runs:
MD + PhD = 7-8 yrs
Psychiatry Residency = 4 yrs
Research Fellowship = 2-3 yrs

For my friends with PhD's in neuroscience, it's more like:
PhD = 5-6 yrs
Post-doc #1 = 3 yrs
Post doc #2 = 3 yrs

There's a lot more sharks in the pool trying to catch the very small number of fish (academic positions) when you go the PhD route. As an MD-PhD you have more available job opportunities in academia, but you have to be committed that you are interested in (not just willing to tolerate) seeing patients. We all know the occasional MD-PhD MS3 student who has no interest in clinical care, zero interpersonal skills, and makes you wonder why they just didn't get the PhD instead.

Good luck!
MBK2003

I'm just starting a residency in psych after an MSTP and this looks like the same schedule I've been told I have to look forward to. The thing that bugs me about it is the requirement for fellowship after residency. I think that MD-PhDs, at least those who've published a few good papers during their PhD (as many as one can publish during a research fellowship), should not have to go through this extra step, since you are competing mostly with straight MDs whose only research experience is during fellowship. Of course, there is the unspoken requirement for many tenure track faculty positions that one must arrive with at least a K-level grant. One can argue that the fellowship is the time to write one of these. However, if you have a PhD, which confers significant research ability and hopefully ability in grant writing, one may be able to accomplish this during residency during one's elective time, which can be up to a year at most programs. Remember that most "research fellowships" that people do after residency include significant clinical responsibilities, which is why they pay a good deal more than standard scientific postdocs. So, out of a 2 year fellowship you may actually only spend 1-1.5 years in the lab, which is not much more than your elective time in residency.