PhD or MD?

[MD_or_PhD]

Hi everyone,

Posted this on the MD forum but since I'm still technically "pre-med" thought I'd post here.

Currently at a crossroads in my life, and want to ask SDN for some wisdom. I currently hold three acceptances to MD schools in the US. However, I've been seriously graduate school—getting a PhD (probably in mol bio) and becoming a professor. I've actually been debating the two for a long time, but now the time has come to actually make a decision...

I was never in it for the money, so we can ignore discussions stemming from that. I genuinely love academia, so even if I become a physician I'd stay within that environment. And I definitely want to do research, and in fact this dilemma comes from my not knowing whether I like the bench or the clinic more. Unfortunately I didn't apply MD/PhD because of my MCAT, a 510 (127/129/127/127 [GPA was 3.72, sGPA 3.68]), which I didn't think was competitive enough. Also, I think I can get into a higher ranked PhD program than I can for medical school (of course, this is an assumption and might not be true).

I know I'm in an MD forum so many will probably say MD, which is fine, but I was wondering if any of you have struggled with a decision like this or know anyone else who has. Thanks!

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[Kingsmen2018]

You have MD acceptances in hand. You can go into academic medicine with that MD. I say with tons of bias that your crazy if you don't go MD

 

[PhilzCoffeeAddict]

If you go the ohD route. You'd get paid to go to school. Something to definitely consider.

 

[Goro]

Hi everyone,

Posted this on the MD forum but since I'm still technically "pre-med" thought I'd post here.

Currently at a crossroads in my life, and want to ask SDN for some wisdom. I currently hold three acceptances to MD schools in the US. However, I've been seriously graduate school—getting a PhD (probably in mol bio) and becoming a professor. I've actually been debating the two for a long time, but now the time has come to actually make a decision...

I was never in it for the money, so we can ignore discussions stemming from that. I genuinely love academia, so even if I become a physician I'd stay within that environment. And I definitely want to do research, and in fact this dilemma comes from my not knowing whether I like the bench or the clinic more. Unfortunately I didn't apply MD/PhD because of my MCAT, a 510 (127/129/127/127 [GPA was 3.72, sGPA 3.68]), which I didn't think was competitive enough. Also, I think I can get into a higher ranked PhD program than I can for medical school (of course, this is an assumption and might not be true).

I know I'm in an MD forum so many will probably say MD, which is fine, but I was wondering if any of you have struggled with a decision like this or know anyone else who has. Thanks!

What does your heart tell you? Medicine is a calling, like being a fireman or a priest.

 

[CazadorFalconry]

I can’t offer insight on the MD route yet, but grad school is great! It is a very stimulating and self-driven environment, with opportunities for personal growth. The stipend and tuition waivers are excellent. While I have enjoyed my 7 years of grad school and my research (and don’t regret any of it), I felt the calling to medicine and now will be going to med school. I second the advice to go with your heart/gut. Academia is difficult but most in it wouldn’t want any other career. You have to go with the route that you’ll be most satisfied in and try not to think about whether the other path would have been greener.

 

[Apothecary Aquinas]

Some schools allow you to apply to their MD/PhD program even after matriculation into their regular MD program while you're in your M1/M2 years. In fact, some schools only do it this way. Keep in mind that a lot of schools will have plenty of research opportunities for you as you complete your MD (allowing you to participate in clinical and bench research if you felt so inclined) as well and that a lot of MDs are involved in research as their primary job function while doing clinical work only minimally. An MD will not by any means stop you from being involved heavily in academia. There are also plenty of research fellowships you can participate in after medical school if you choose.

Explore the research opportunities each school might be able to offer you and that may help you choose. Keep in mind also that during summers you can apply to research programs outside of your institution also.

 

[MD_or_PhD]

You have MD acceptances in hand. You can go into academic medicine with that MD. I say with tons of bias that your crazy if you don't go MD

I know, I mean I feel crazy even thinking about foregoing the MD route—it's something I've worked towards for a very long time. I guess I'm just getting cold feet. But more than that, I really do like the academic/professor lifestyle, and I'm worried I'll be missing some of that if I go "just" MD; I feel like I might get burned out along the road and forego academia, which is something at this point I want to follow through with

If you go the ohD route. You'd get paid to go to school. Something to definitely consider.

True. Most PhD programs I've looked at cover tuition (though student fees are still a thing).

What does your heart tell you? Medicine is a calling, like being a fireman or a priest.

I get what you're asking, and 2 months ago I would've said it was my "calling," but now that I've been considering this PhD option, that's been thrown up in the air. And on perhaps a more practical level, not all physicians are such because they "felt a calling." There are many other reasons one might want to become a physician, and the reasons for a PhD are now competing with the former for me right now...

 

[MD_or_PhD]

I did both. My preference is research over medicine, but my fear was not being able to get an academic job with just the PhD - it’s a tough market even if you are very good, and even then there is often little ability to control what part of the country you end up in. Basically you go where the jobs are. I too had an interest in medicine, so I figured I’d do the MD, work a few days clinically to pay the bills then do research the rest of the time.

Caveat, this probably only really works if you get into a specialty that is conducive to such arrangements - things like Pathology, derm, PMR, certain IM subspecialties. Anything with heavy call and anything where your income is dependent on keeping hospital OR time makes it very difficult to do both research and medicine without working 80+ hours per week for life. Note, some will say “oh just do the MD then do research afterwards.” I disagree with that approach if research is the primary goal. An MD teaches you medicine, and while there’s nothing wrong with MDs doing research in their spare time and they might even be highly published, it’s very uncommon that an MD really understands good research, much less able to run a basic science lab. PhDs are researchers, MDs are doctors, and that’s that. The whole point of the MD/PhD is to do both so you can “speak both languages” and be in a position to understand clinical context, and apply your scientific mindset to solve problems to create higher impact than either discipline could alone.

So aside from the MD/PhD program, you could always do a PhD during or after residency. In some ways that’s nice because you will be able to tailor your research to your specialty. Outside of that, you will have to ask yourself this question:

Would I rather do something I love that doesn’t pay as well and with less job security (but you ideally get to start working a lot sooner), or do something I like with a big debt load, but great pay and security prospects, with the possibility of doing additional research training down the road. If the later, welcome to the 18 years of school club.

Thank you for such a thought out response! I appreciate it.

The bolded is the issue: I'm having a hard time deciding which I would be more happy/successful/etc, as a researcher or doctor. And having answered in the latter for my entire life—though currently feeling myself shifting to the former—it's a little hard to admit the change in my passions. So in your opinion, the specialties I'm interested in (surgery, probably ophtho, but I do like gas and heme/onc) aren't conducive to a heavy research lifestyle?

 

[wysdoc]

Thank you for such a thought out response! I appreciate it.

The bolded is the issue: I'm having a hard time deciding which I would be more happy/successful/etc, as a researcher or doctor. And having answered in the latter for my entire life—though currently feeling myself shifting to the former—it's a little hard to admit the change in my passions. So in your opinion, the specialties I'm interested in (surgery, probably ophtho, but I do like gas and heme/onc) aren't conducive to a heavy research lifestyle?

I know a Heme/Onc MD PhD who does mostly research and very little clinic. It's what he enjoys.

 

[LoGo]

Thank you for such a thought out response! I appreciate it.

The bolded is the issue: I'm having a hard time deciding which I would be more happy/successful/etc, as a researcher or doctor. And having answered in the latter for my entire life—though currently feeling myself shifting to the former—it's a little hard to admit the change in my passions. So in your opinion, the specialties I'm interested in (surgery, probably ophtho, but I do like gas and heme/onc) aren't conducive to a heavy research lifestyle?

Yes, interest can certainly change - that’s what keeps things interesting!

Anesthesia is conducive to research as it’s mostly shift work. Same for EM. I meant the OR is more a problem if you’re a surgeon - you get dedicated OR days and if you decide not to use it because you want to do research that day, there’s no alternative OR day for you - use it or lose it, unlike anesthesia where you are probably on a rotating schedule.

Heme/Onc is fine as well, as are many of the internal medicine specialties. They do not have huge amounts of on-duty time commitments for the most part, and usually a bit more flexible schedules.

Ophtho is the one surgical specialty that would probably work just fine because they are mostly clinic based, and you would not even necessarily need hospital OR time for your procedures. Though not a surgical specialty, derm is very much along the same lines as ophtho in terms of clinic/procedures balance, so something to consider.

I think it’s a pretty common problem you are facing among those interested in MD/PhDs. Many wanted to be a doctor first, then saw the light and found their way to research. In some ways, it’s a good problem to have as you are debating which of two careers you’d like the most. If you do both, you basically just defer the decision until later once you’ve had time to see what medicine is actually like.

 

[Lucca]

Here’s what you should do:

1. Ask yourself: DO I WANT TO SEE PATIENTS AND PRACTICE MEDICINE. If yes, go for the MD.

2. Once in medical school, if you still want to do basic science after year 1, try to transfer into your school’s md/PhD program.

3. Alternatively, prepare to apply for a research year fellowship like the one from HHMI for basic science.

4. Alternatively again, hone in on your clinical interests and keep up with research on the side to do an academic postdoc after/during residency.

There are loads of ways to do science. Only one way to see patients. If you don’t want to see patients, you can still focus in on specialties like rads and path (which tend to have a lot of physician scientists anyway). If you are not interested in clinical medicine period or seeing patients, don’t go to med school.

 

[Microbug]

What is your research experience?

 

[getdown]

You can always go back and do research get a PhD. Once you turn down your MD acceptances you're SOL if you do change your mind to go into medicine. Go the safer and smarter route and do MD then possibly see if you can do PhD between MS2 and 3 years. The MD option opens more doors than a PhD alone especially when it comes to clinical trials. Academic PhD is a long process with low pay and unlikely to get tenure.

 

[minor.groove]

PhD to professor is currently a long shot career path as biomed PhDs are in gross excess of research funding. Even if you get there it is probably 6yrs or so of PhD work and another 4-6 postdoc work, followed by an insecure non-tenure tract position or if you’re lucky assistant professorship.

Tons of research options for MD including basic (bench) science particularly if you go ID, pathology, hem/onc type specialty. Plus you mostly always have the security of falling back on clinical work.

 

[SurfingDoctor]

You could do both. But in the current era and the uncertainty with funding sources, if you want to have a guaranteed salary when you are 50, MD > PhD. I can't speak to industry and I would assume (though maybe incorrectly) that the job opportunities in industry for a PhD are pretty good... but there will always be patients who want to see a doctor.

 

[MareNostrummm]

MD is much more flexible and valuable than the PhD.

 

[aldol16]

The number of tenured professorships available is dwindling by the year because there are many many professors here and they don't want to retire. Academia is a cushy job and nobody wants to get out because they get paid a lot of money to do very little (relatively speaking). So the chances of you coming out of your PhD program/post-doc and getting such a job is going to be pretty low (probably even lower in the future). With that said, there are definitely ways to help stack the deck in your favor - working with a very well-known PI, for example, who has a history of sending recently-graduated grad students into great post-docs, which in turn feeds into assistant professorships. Usually these people will be at the best institutions and it might be difficult to get into their labs. But if you have the scores and the application, this is an option. Just know that the job prospects aren't that great out there because we're graduating too many PhDs. Very few institutions fail their PhD students after quals now and if you just do the math, that's a lot of PhD students graduating for every one PI who won't retire until he or she is 70+ anyway.

Another factor to consider is that you already have MD acceptances. If you turn them down, it is my understanding that you won't get that opportunity again in the future. So think about this choice carefully before you make it. Lots of MDs are involved in basic science research. Now, it may be harder to start your own lab as just an MD due to funding issues but you can certainly be involved in basic research to whatever amount you want. If your research is biomedical, being an MD is probably an asset since biomedical labs want that clinical input - their research is supposed to eventually benefit human health, after all.

 

[hebrewBAMmer]

I did a PhD and am now getting an MD. I strongly considered teaching as well. That's when I decided I'd rather get both degrees and do academic medicine. Trust me, don't do a PhD alone. The market sucks now, and it's very difficult to get a teaching position at a university (Something like only 1 out of 6 are able to do so). Take the MD, run with it, and if you want, do research or go into academic medicine. Don't do what I did.

 

[seren1051]

I've been in a research lab for several years. Some grad students like what they're doing, some hate. But while vast majority of them are eyeing for a professorship, most of them ends up going into industry or land a job outside of academia. Quoting my mentor (MD/PhD), Hahvahd alone produces enough grad students to fill every single available academic positions in US. Exaggeration maybe, but it's tough. I was originally eyeing for a PhD and he passionately advised me against it. Something to think about.