PhD then MD

[Trashino]

I've interviewed at several MSTPs and a PhD program, and am considering (due to quality of life and flexibility) to go the PhD route.

I've read on recent posts that there is funding available to obtain an MD following the PhD program. I'd like to know what you guys think some of the drawbacks and benefits would be of doing a PhD and then MD rather than the 2-4-2 setup that many MSTPs have.

Thanks!

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[Stroganoff]

These are my impressions, although I'm no expert on this topic:

1. Lack of funding. MSTPs provide full tuition, etc. and a stipend.
2. Often with a combined MD/PhD degree some of your medical classes will count as electives for your PhD. Saves a lot of time.
3. MSTPs try to limit you to 7-8 years. Sometimes PhD students get stuck in a lab or whatever and end up spending 6+ years on a PhD!

I hear that PhD programs are easier to get into (by far) than MSTPs, and having a PhD when applying to med school might be a big help too.

It's a huge time and money issue. I'll be 24-25 when I finish my BS, so I'm going for MD/PhD...I would need a lot of convincing to go the PhD->MD route.

 

[Neuronix]

Originally posted by Trashino
I've read on recent posts that there is funding available to obtain an MD following the PhD program.

Funding for things like this (MD after PhD, MD years before joining MD/PhD program) is always rumored and very rare. We have a PhD graduate in my class, who has a very impressive publication list, but even she says she took the "expensive route" by doing the MD after the PhD. I can't imagine that there is much money around to do this. So, don't count on it being there.

I think Dallenoff has pretty much summarized it nicely. I just have a few things to add. Your PhD work often counts as electives for your MD work as well. For example, the fourth year at most med school is entirely elective and research based. At schools like Baylor, Penn, and Duke, the fourth (at Duke the third, but it's the same idea) year of med school is tossed out. This makes it more like a typical 2 - 5 - 1 arrangement. From this I think MD/PhD students get the same quality of education as any other grad student. But, that's another issue I can delve into if anyone wants.

I think MD/PhD students have it better, at least in their training. The grad students are busy striking (!) here. I have no hard facts on attrition rates, but most grad students I talk to agree that the attrition rate for grad school is something like 50%. At least if you leave a MD/PhD program, you can fallback to the MD program and you had the first two years of med school for free (at MSTPs). I like that safety net.

It's very difficult, if not impossible, to switch from a PhD program to a MD or MD/PhD program. So if you do go to a PhD program, make sure you are sure about this! Also, a PhD may help you when applying for an MD program later, but it's not going to make up for anything if your application is otherwise weak.

Good luck!

 

[Treg]

As someone who is currently doing this (finishing PhD and applying to med school), I have to throw in my 0.02.

"Funding for things like this (MD after PhD, MD years before joining MD/PhD program) is always rumored and very rare."

I have to agree that there is no specific funding for people to attend med school after the PhD. However, I think that if you have an excellent MCAT and GPA that the PhD would give you an edge at schools like WashU that have merit scholarships for entering applicants. Also, there is an NIH loan repayment program that will pay back up to $35K/yr + taxes for people who commit to >50% clinical research post-residency. The success rate is high (nearly 70%) and I think would be higher for the MD/PhD applicant vs. MD only or PhD only. I talked to a prof who has sat on this funding committee and he said that someone in my position would be a good candidate. Thus, you could effectively erase your med school debt pretty quickly. Here is the link:

http://www.lrp.nih.gov/about/lrp-clinical.htm

"I think MD/PhD students have it better, at least in their training. The grad students are busy striking (!) here. I have no hard facts on attrition rates, but most grad students I talk to agree that the attrition rate for grad school is something like 50%."

I think that if you do your grad training at a good school (and I know that UPenn is a great school so I don't know what is going on there), the attrition rates would be <5%. Since they fund you completely, they invest in you, and it is in the program's best interest to get everyone out with at least a masters. I only know of 2 people in my dept of 50+ grad students that have left without a degree over the past 4 years.

"It's very difficult, if not impossible, to switch from a PhD program to a MD or MD/PhD program. So if you do go to a PhD program, make sure you are sure about this!"

This completely depends on the school. You should research where you are going for grad school to find out. That being said, you must get into med school just like any other applicant. The grad school link will not be an advantage or a disadvantage, usually.

"Also, a PhD may help you when applying for an MD program later, but it's not going to make up for anything if your application is otherwise weak."

I agree. But if you do really outstanding grad work, you will get awards, publications, and awesome, personal reference letters. This will definitely help your application.

I chose to do the PhD independently because I wasn't sure about if I needed the MD to do the type of research i was drawn to. I am glad that I went this route since I was able to focus my career interests and have a child during grad school (very flexible schedule). I will be done in <5 years (could have been 4 if not for the baby ). Ultimately, you have to decide which is best for you. Good luck, and PM me if you have any questions.

Treg

Good luck!

 

[ducaliner2]

I was not a premed in college and applied to PhD programs only. However after completing my PhD, I entered med school (do a search for my previous posts), so I can give you advice on my route. I generally agree with most replies. PM me if you have any specific questions.

Re: funding
HMS/HST offers MSTP funding for PhD students in med school for years 3,4 only. Yale doesn't offer anything like that. So it depends on the programs you will be attending; ask around.

Re: Advantages to PhD first then MD
There's a belief held by top med school faculty (usu PhDs) that the PhD part in MDPhD is glossed over compared to the strait PhD programs. True or not, it is a bias that I've heard expressed by many professors (mainly PhDs). One even said that my route was the "better" one. I don't know the answer myself. With a science PhD your logical reasoning training will be excellent, and that will earn kudos from your peers and research-oriented med school faculty. While this may seem to give you an inherent advantage over your peers in med school, success in med school depends on something else: the ability to filter TONS of material and master a huge set of simplified medical concepts and terminology. (Science=narrow & deep. Medicine: Vast but shallow. Two different types of thought processes). Thus said, in an MDPhD 2-(4+)-2 program, splitting up med school with a totally different thought process in the middle can be jarring. Many MDPhDs have told me they felt lost in their 3rd MD year after the PhD esp after forgetting everything they learned in yrs 1&2! While it is true that you have a more flexible schedule in grad school (=more vacations), beware that if you want to do good science in a rigorous PhD program, it will be all-encompassing and will take over your life for YEARS (see below).

Re: Disadvantages to PhD first then MD
This route will most likely will be WAY more expensive. Due to many factors, this route can simply take a painful number of years to complete (unless you are a star like Treg). In the biosciences it took an AVERAGE of 8 years in one study of the 90's. Don't believe me? Check it out for yourself: Freeman R, Weinstein E, Marincola E, Rosenbaum J, Solomon F. Science. 2001 Dec 14;294(5550):2293-4. According to the senior author, it is supposedly taking longer now. The reason for why MDPhD's are pushed out faster is because of MSTP departments put pressure on faculty members to graduate them more quickly (for recruitment reasons as well as NIH MSTP training grant renewal pressure). The same pressure isn't applied to faculty members regarding strait PhD program students (there is no directive by NIH to push out PhDs faster into the field of translational medicine).

Re: having a PhD during the application process.
First rule is: there are no absolutes to "getting in". Thus any of this advice might not even apply to you. But it might give some encouragement. Being a little older (but not too old!) with some accomplishments during your PhD will make you an attractive candidate for med school. In my opinion it while it can make up for a borderline GPA/MCAT, it can't make up for a mediocre GPA and bombed MCAT.

Re: To the original poster.
My opinion (which again may not apply to you), is that if you get into a reputable MDPhD program, go for it. If you don't, there are many other routes... and every one of them can be very fulfilling and successful. Your decision should be based on what is important to you now and in the near future given your choices. If your choice is a so-so MDPHD program vs a killer PhD program and you really want to do top research in a hard core science environment, and want to have an extra vacation or two every year, the chioce is obvious: PhD it is. But if medicine is your primary thing, and you wish to have "good science training", then go for the MDPhD program. Know what I mean?

Good luck in your decision Trashino. And esp. good luck to everyone who is attempting the PhD->MD transition!!!

Ducaliner2


Link to the article I mentioned: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=11743184&dopt=Abstract

 

[Neuronix]

Originally posted by Treg
As someone who is currently doing this (finishing PhD and applying to med school), I have to throw in my 0.02.

However, I think that if you have an excellent MCAT and GPA that the PhD would give you an edge at schools like WashU that have merit scholarships for entering applicants.

These are very rare and very difficult to come by. Estimates are that the top 1% of matriculants come by full scholarships like this. From my experience as a student interviewer, I don't think that your PhD will be that big a help on your application. In any case, I would highly discourage you from factoring scholarships into your decision. They are increasingly rare and are only for the best of applicants. It does help however if you are a URM, as the rates of scholarships is much higher for URMs. If you can get one, good for you, but chances are you will not.

As for the NIH Clinical Research Loan Repayment Program, that's only for clinical research, not basic science. This could conflict with what you want to do at the time you get to that point. Even so, it maxes at $35,000/yr for two years. This means that if you have $200,000 worth of debt (not at all unusual for a private school MD grad), you will still end up with $130,000 of debt. A help, yes. I also wouldn't factor this too much into your decision because by the time you get to that position that money may not be there. Then again, programs like this could be expanded. It's hard to say.

I think that if you do your grad training at a good school (and I know that UPenn is a great school so I don't know what is going on there), the attrition rates would be <5%. Since they fund you completely, they invest in you, and it is in the program's best interest to get everyone out with at least a masters. I only know of 2 people in my dept of 50+ grad students that have left without a degree over the past 4 years.

This is true. Alot of grad students do leave with a masters. I was talking about attrition from the PhD program. Still, a masters is going to help you much less than a PhD in the long run with for lots of things including medical school.

"It's very difficult, if not impossible, to switch from a PhD program to a MD or MD/PhD program. So if you do go to a PhD program, make sure you are sure about this!"

This completely depends on the school.

Believe me when I say that this applies to almost all schools. Many will not consider PhD students at all, a few will consider them but with a significant disadvantage. Though once one graduates, they are fair game to apply to MD programs. I have met several PhD students around the country who tried to switch into MD/PhD programs at their school or applied to other schools and have not been successful even though they were excellent applicants.

I agree. But if you do really outstanding grad work, you will get awards, publications, and awesome, personal reference letters. This will definitely help your application.

Sure, but a certain level of performance is going to be expected of you since you graduated with a PhD. The same will apply if you do awesome research at the undergrad level, and I'm not convinced that the PhD graduate is going to have much advantage over the undergrad who was successful and did alot of research. Again, this comes from going through the application process and then being a student interviewer for the MD program.

One question I have for you Treg, since you graduated so quickly, is whether or not Canadian PhD programs have lower graduation times than American PhD programs? This is definately true for European programs.

I would also like to respond to a couple of ducaliner2's statements, as he posted while I was writing this response.

Originally posted by ducaliner2
Re: Advantages to PhD first then MD
There's a belief held by top med school faculty (usu PhDs) that the PhD part in MDPhD is glossed over compared to the strait PhD programs.

This bias does certainly exist. I will try to address why I think it is silly below.

Re: Disadvantages to PhD first then MD
This route will most likely will be WAY more expensive. Due to many factors, this route can simply take a painful number of years to complete (unless you are a star like Treg). In the biosciences it took an AVERAGE of 8 years in one study of the 90's. Don't believe me? Check it out for yourself: Freeman R, Weinstein E, Marincola E, Rosenbaum J, Solomon F. Science. 2001 Dec 14;294(5550):2293-4. According to the senior author, it is supposedly taking longer now. The reason for why MDPhD's are pushed out faster is because of MSTP departments put pressure on faculty members to graduate them more quickly (for recruitment reasons as well as NIH MSTP training grant renewal pressure). The same pressure isn't applied to faculty members regarding strait PhD program students (there is no directive by NIH to push out PhDs faster into the field of translational medicine).

Part of getting through a PhD program seems to be being a star, and the other part seems to be luck. I have seen people put in tons of hours and struggle with bad projects only to be held in grad school for a long time. This wouldn't happen in a MD/PhD program, because if you struggled in a bad project you would be moved off that project.

Despite what I just said, I don't believe that MD/PhDs are "pushed out" or given "cushy projects" or somehow unfairly helped in other ways. First, why would the MSTP department have so much sway on departments that they could tell the department to graduate a student? Of course there is many to be gained via the MSTP grant, however the NIH will get on you if you start graduating students who are not ready for the real world.

The fact is that most MD/PhD students take about the same amount of time to graduate and there are good reasons for time difference. What good reasons? First, there's usually no teaching requirements on MD/PhDs. You can argue with this is important or not, but I don't think teaching undergrads (scut, and alot of what this Penn strike is about) helps you with research. Second, there's often diminished graduate school coursework required due to medical school coursework. Third, most MD/PhD students enter with 2 or 3 laboratory rotations completed by the time they enter grad school. This means they can get their project rolling right away. Also, MD/PhD students on average have more laboratory experience than PhD students when they enter the program. Even so, at schools like Penn MD/PhDs average ~5 years to get their PhD, which is a reasonable time for PhDs. There aren't so many getting screwed because there's better oversight. If there's a bad mentor or project, things tend to get fixed for MD/PhD students for MSTP grant purposes or just because the student can or does leave with a perfectly useful MD degree. The fact that PhD students are often left in the lurch and that they can take forever to graduate I think is an indictment of graduate school education in general as opposed to saying that PhD is a more quality degree.

So for those reasons I think the bias comes down to one of those "us or them" group mentalities. It also comes from lack of understanding of what the dual-degree actually entails.

 

[Treg]

As for the NIH Clinical Research Loan Repayment Program, that's only for clinical research, not basic science.

From my own experience, you had better want a career in very translational/clinical research if you are coming from a PhD to medicine. Otherwise, the adcoms will wonder why you are applying. This is definitely something to consider-thanks for pointing it out Neuronix

This is true. Alot of grad students do leave with a masters. I was talking about attrition from the PhD program. Still, a masters is going to help you much less than a PhD in the long run with for lots of things including medical school.

Again, I totally agree. In my experience, people who drop down to a masters do so for the following reasons-bad "hands" at the bench, realize they hate lab work, realize they want a different career, are a generally unmotivated person who went to grad school for the wrong reasons, etc. I also don't think these are the type of people that would consider MSTP (but I could be wrong).

One question I have for you Treg, since you graduated so quickly, is whether or not Canadian PhD programs have lower graduation times than American PhD programs?

Haha definitely not a shorter time for Canadian schools. I would say for my dept it is 5-6 years avg. I had a very strong undergrad research background, so I came into my current lab 2 weeks after graduating in May from undergrad to start the PhD. I didn't rotate so this put me at an advantage as well. That being said, I spent 3 years on a project that produced tons of data-all negative. My committee said that I have enough for a thesis but I need 3 first authored papers. Lucky for me my stuff has been going great and I will have all of them from my last year or so of work. I am also very proactive about my training and have pushed all of my requirements (i.e. telling my cmte. that I need things done by I certain time). I think a lot of people take longer because they get sidetracked at the bench and let some of the administrative stuff slide.

To address the following issue:

There's a belief held by top med school faculty (usu PhDs) that the PhD part in MDPhD is glossed over compared to the strait PhD programs.

I have heard this many times as well. I have seen particularly with residents that are trying to get a PhD that a lot of the actual bench work ends up getting handled by techs. Also, since as Neuronix said MSTP students are taken off of bad projects, etc. it prevents them from having to take the time to really think about the hypotheses being tested and troubleshoot/design new experiments, etc. themselves. Also, I have heard that there are no strict publication requirements for MSTP students, while for most PhD students there are "unspoken" rules like the one I referred to in my case.

I just want to be clear that I am in no means trying to say that one is any better or worse than the other. I am trying to convey my experience as a "pure" PhD student entering med school.


Treg

 

[Neuronix]

Originally posted by Treg
I have heard this many times as well. I have seen particularly with residents that are trying to get a PhD that a lot of the actual bench work ends up getting handled by techs. Also, since as Neuronix said MSTP students are taken off of bad projects, etc. it prevents them from having to take the time to really think about the hypotheses being tested and troubleshoot/design new experiments, etc. themselves. Also, I have heard that there are no strict publication requirements for MSTP students, while for most PhD students there are "unspoken" rules like the one I referred to in my case.

Prevents them from having to take time? If a project is going nowhere and doesn't have much prospect of proceeding, you should be changed off of it. That's sound advice for grad students as well from what I've seen. We've all seen grad students who were kept around by their PIs for long periods of time, or been forced to teach alot for various reasons, etc... Maybe this doesn't happen at "good" PhD programs, but I guess I haven't seen a good program yet. Still, opinions about this vary, and I've met some (few) who feel like PhD students should be forced to flounder around for awhile. I think that's a waste of everyone's time.

I've definately seen and heard the stories of people who have had to leave PhD programs because they got screwed. For example, they got scooped, their PI screwed them and will either never let them graduate or does things that are completely inappropriate, their project is going nowhere, etc. Sure, I don't have a PhD, but I've worked in three different grad schools now with lots of grad students and I've just observed that alot of grad school comes down to luck, your PI, and other things our your control. The measure of a good program is what the program will do if bad things happen. That's why I like MSTP.

I've never seen a department that exempts MD/PhD students from publication requirements. It would be bad for the student also to graduate from a program without publications, so I don't think I've ever seen a MD/PhD student without at least one first-authored paper.

Residents who do PhD work or do research work while in residency are a different bunch. I'll agree that I've not seen anything real promising on that front because the clinical pressure on them is still too high for them to do enough basic science.

I don't mean to be attacking or anything like that. We have two different perspectives and we come from two different places. I do think overall that I have a more negative view of graduate school, but that's one of the reasons I didn't go. I've just seen too many bad things happen to grad students.

 

[pathdr2b]

Originally posted by Neuronix
I've never seen a department that exempts MD/PhD students from publication requirements. It would be bad for the student also to graduate from a program without publications, so I don't think I've ever seen a MD/PhD student without at least one first-authored paper.

I've seen plenty that didn't have one 1st author publication. This is one reason why some in professional circles feel that the ciombined program is very diluted.

To address the OP's original question, I was also working on a PhD. I have now decided after having a perfect GPA in school and for a variety of reasons, to do just the opposite. Get the PhD AFTER medical school. Maybe I'll start a PhD after MD thread.

Originally posted by Neuronix
Residents who do PhD work or do research work while in residency are a different bunch. I'll agree that I've not seen anything real promising on that front because the clinical pressure on them is still too high for them to do enough basic science

Doing this is rare but as with everything else, I think it depends on your research background. In general, it's quite "reasonable" for Pathology residents to complete research requirements for the PhD because at least 1 year of reseacrh is required for most programs anyway.

Originally posted by Neuronix
I do think overall that I have a more negative view of graduate school, but that's one of the reasons I didn't go. I've just seen too many bad things happen to grad students.

No doubt, there's a TON od BS in graduate school!

 

[Fixed Gear]

Originally posted by Neuronix

Part of getting through a PhD program seems to be being a star, and the other part seems to be luck. I have seen people put in tons of hours and struggle with bad projects only to be held in grad school for a long time. This wouldn't happen in a MD/PhD program, because if you struggled in a bad project you would be moved off that project.

No, no, no, no, no, no, no.

It's upsetting reading a lot of these posts becuse people are going by rumor and heresay.

There is no double standard that exists between a straight PhD and MD/PhD concering research projects. Yes, there are people who can take 7+ years, but there are also MSTPs that have been at a school for over 10 years (and not yet done with their PhD work)(I reference Harvard here). It is SCHOOL specific. A lousy graduate department, regardless of a student's affiliiation, be it PhD or MST, may have students stuck on crappy projects. A GOOD/GREAT program wil have students on good projects and remove them from crappy ones.

While Ducliner2 is able to quote a journal article (albeit from 2001, and things change very fast in the sciences) showing long times to graduation, I think times are getting shorter. Cold Spring Harbor Labs offers a guaranteed 4 year PhD. There is pressure on institutions by applicants/students to speed up the process- take qualifying exams early, TA early, and grind out work so move forward, publish and graduate.

People seem to think that MSTs get a 'gold card' to do an awesome project that will take three years. That, my friends, is a pipe dream. Here at my school, MSTs end up on crappy projects, change labs, and can take over five years to finish their PhD with no publications.

My rant is over.
xFGx

 

[Neuronix]

Originally posted by Fixed Gear
It's upsetting reading a lot of these posts becuse people are going by rumor and heresay.

It's not rumor and heresay. I've worked in three different labs at three different institutions and I've seen it this way at every one. You can argue that it's different at different programs, and that I might buy. As for the last sentence, all I can say is that I'm glad I'm not at your school.

 

[Habari]

It's not rumor and heresay. I've worked in three different labs at three different institutions and I've seen it this way at every one. You can argue that it's different at different programs, and that I might buy. As for the last sentence, all I can say is that I'm glad I'm not at your school.

there definately is a lot of rumor and heresey above [not all of it].

as for his last sentance - it most certainly is true at every school - from washU to penn to harvard to ohsu. you are quite mistaken if you believe otherwise. it's naive to think that every mdphd that has a ****ty project is goign to be moved off immediately. sometimes the reality isn't apparent from the outset - people don't set out on crap projects. i checked the publication record of various recent graduates of almost every school i was seriously considering. while most people had done rather well - there was always 1 or 2 that didn't publish well or without first author papers at all. there are very few departments [i don't know of any] that do have 'publication' requirements explicitly.

 

[pathdr2b]

Originally posted by Habari
it's naive to think that every mdphd that has a ****ty project is goign to be moved off immediately. sometimes the reality isn't apparent from the outset - people don't set out on crap projects.

Definitely aggree with this statement. However, sometimes it's not about a crappy project as much as you can have a "great" project but a crappy advisor.

What I know for sure after earning an MS at a research institution and watching/working in the research game for over 10 years is that it appears the single best "way" to get a PhD is AFTER the MD. From what I've seen, most programs are EXTREMELY reluctant to screw an MD around. As a matter of fact I've never met one that took longer than 3 years to complete the PhD requirements. Then there's the automatic "respect" that MD's get no matter the school they attended once they walk through the door.

Just a little somehting to think about..............................

 

[Treg]

there are very few departments [i don't know of any] that do have 'publication' requirements explicitly.

In my dept we have an unspoken rule of 3 first authored pubs to get a PhD. I know that on the books you must have one first-authored accepted before you can defend your thesis. I am really shocked that people finish PhD without pubs or with no first authored papers. With the market as competitive as it is, you would suffer to get funding for PDF, faculty position, etc.

In terms of this whole discussion regarding crappy projects, here is my perspective. Your project should be based on a hypothesis that gives you an answer that is publishable whether or not you were "correct." That way, if you produce solid data, you are ok either way. I mean, it may be the difference between JCI vs. Transplantation, but a pub is a pub is a pub. If you are struggling because of your model, not your hypothesis, then you need to work at it/find an alternative strategy until it works. This is what it means to be worthy of a PhD, and if you don't learn how to do this in grad school then you will struggle with it at some point later on when the stakes are higher. So, if an MD/PhD student is taken off of a 'crappy' project for a reason that could be solved with troubleshooting, which takes time (perhaps up to a 1 yr+), then they are getting the short end of the stick.

Trust me, I *know* what it is like to have a project that is not working. It goes something like this-3 years, 8 sets of injections, 600+ Tg mice with no protein expression. 3 sets of transplant experiments with ambiguous/negative data. At this point my PI has lost interest in the project and is providing very little input. I design an alternative strategy and he lets me run with it (it is fairly inexpensive) although he isn't really into it and as long as I am busy he is happy. 6 months later, tons of positive data, a new model is established, a rapid pub is getting prepared, a grant based solely on my project is written (mostly by me) and submitted. My next two papers will be submitted in the next 6 months. I have learned so much about science and myself through this process, and I feel now that I got my $$ worth for the PhD (lets hope my cmte agrees ).

Anyway, my point here is not to brag, but to point out that I had the type of project a lot of people would have bailed from.

Treg

 

[pathdr2b]

Originally posted by Treg
So, if an MD/PhD student is taken off of a 'crappy' project for a reason that could be solved with troubleshooting, which takes time (perhaps up to a 1 yr+), then they are getting the short end of the stick.

Oooh, I hadn't though about this... Good point!

Originally posted by Treg
Anyway, my point here is not to brag, but to point out that I had the type of project a lot of people would have bailed from.

Girl, we all know your're the bomb, so stop trippin' Dr.Treg

 

[Primate]

As for the tired discussion of length of PhD (aka, "thesis envy"), I'll throw my observations into the ring:

One of my classmates finished the PhD in 3.5 years and will do a total of 7. The rest are running about 60/40 at 4.5/5.5+. In other words, about half will take 8 years total and a bit less (but close to that) will take 9 (or more?). 5.5 years is NOT a quick and dirty PhD.

If there were any thoughts toward getting people off crappola projects to get them through quickly just because they're MSTP, I haven't seen it here.

Also, as for competitiveness after finishing, I know several BIG name labs where the PI doesn't care a whit about where you published, but rather how you thought about your project. There are many examples of people who publish well based on the project they picked up, but who can't talk intelligently about what they did. On the other end, there are (unfortunately) many examples of smart/motivated/competent people who get tough but well considered projects but publish poorly for a variety of reasons. From what I've seen, good pubs certainly do not hurt, but the second type of student mentioned above will do very well in hunting down post-doc positions.

It also seems that many good post-docs (really, almost all the good ones) are via word of mouth. Having a well connected PI helps in this regard. Of course, since this is a combined degree forum, most of us will ostensibly do a residency before any thoughts of a post-doc, and that does change the calculus.

Just thoughts/obs.
P

 

[Fixed Gear]

Originally posted by Neuronix
As for the last sentence, all I can say is that I'm glad I'm not at your school.

I wasn't very clear before.

What I meant is that it *can*(and does) happen to MSTs here at WashU as well. MSTs are not immune to lousy projects/advisors/programs/departments. It comes down to the student's presonal choices, whether they choose a doomed project, a lazy PI, or whether they attend a well organized school that keeps track of their students and know what sort of progress they are making.

I still disagree with your original statement that MSTs are more 'guarded' or 'watched over' than are PhDs. That is a matter of the PhD-granting institution's level of organization, not whether a person is getting a PhD or MD/PhD.

 

[Fixed Gear]

Originally posted by pathdr2b

What I know for sure after earning an MS at a research institution and watching/working in the research game for over 10 years is that it appears the single best "way" to get a PhD is AFTER the MD. From what I've seen, most programs are EXTREMELY reluctant to screw an MD around. As a matter of fact I've never met one that took longer than 3 years to complete the PhD requirements. Then there's the automatic "respect" that MD's get no matter the school they attended once they walk through the door.

That has to be the single stupidest statement I have ever read. Period.
If I ran a PhD-granting institution and had an MD applying for a PhD, I would think:
A)Their MD is from Upstairs Hollywood Medical School
or (far more likely)
B) They have no interest in practicing medicine anymore.

The fact is, that there are amazing, incredible sceintists that have an MD, not a MD/PhD (Stu Orkin, Ron DePinho, Stan Korsmeyer......The list goes on). Once you have an MD, you can choose a more research-heavy route.

And your line about respect? Some of the most worthless lab members I have dealt with have an MD. You may personally revere them as gods, but I think that's a huge mistake. Once you're in the lab, it doesn't matter if your highest desgree is a BA, MA, PhD, or MD. What matters is whether you do good science.

 

[pathdr2b]

Originally posted by Fixed Gear
That has to be the single stupidest statement I have ever read. Period.

Letss grow up, stop with the insults and take a deep breath. Try going back and rereading what i wrote as you taken a lot out of context. I based my comments on my own personal observations as a predoctoral fellow at the premiere research institution in the world. Buy it or don't buy, it doesn't change the real world reality of the "power" of the MD degree.

Once you're in the lab, it doesn't matter if your highest desgree is a BA, MA, PhD, or MD. What matters is whether you do good science.

You're naivete is amazing. Get back to us after you've been in the research game 10 years. If degrees didn't matter, I imagine there wouldn' t be so many people working on the MD/PhD combo.

 

[Fixed Gear]

Well, you didn't adress the points I made in my post, but that's your choice. You're not gonna like like this, but I think you're mostly trying to rationalize your decision to drop out of your PhD program. Yeah, you've been less than modest about your grades and the caliber of your institution (NIH?, so actually GW?) but best of luck to you in your endeavor. Especially considering the red flag your app. will have because of your "dropped out of PhD program" status.

I continue to disagree with about 90% of your opinions, but that's what people do, right? Sometimes we agree, sometimes we don't. Although I will say that in my 7+ years in labs, I continue to have the mindset that i do. Maybe after the 10th year, I'll think differently.

xFGx

 

[pathdr2b]

Originally posted by Fixed Gear
I continue to disagree with about 90% of your opinions, but that's what people do, right?

The difference is that most people can disagree without insulting others. Good luck to you too!

PS- GWU DOESN"T have a PhD program in Pathology but I guess the point of your post isn't to be honest it's to disparage and wish ill will toward others. Congratulations, you should feel very proud of yourself, and I'll be sure let you know which medical school I'll be attending next year a soon as I get that acceptance letter.

 

[Primate]

Hopefully stepping away from the vitriol for a moment, I have to say that the response to an MD coming to the bench in every lab in which I've worked over the last decade or so is initially one of raised eyebrows. Many have proven themselves to be excellent, but there are more than enough examples of MDs who are not so good in the lab (for a variety of reasons) that the onus appears to be on them to show that they can perform. There has certainly been no deferrence accorded them based solely on their degree. I've now seen this at several large and well thought of University programs - it may not be representative of all science, but it sure seems this way in the NE.

As for whether a PhD program would somehow back off or tone down their requirements because someone had an MD, I imagine this to be quite unlikely (again, I can only speak to what I've observed). They may get some class credit, as would a combined degree student, but that's about it, I think.

Just my opinion, so take it for what you paid.
P

 

[Fixed Gear]

Primate, I echo all your sentiments.

Pathdr2b, I don't really harbor any ill will, nor was my intention to insult you. A guy (who very well may end up on my Thesis committee) did his PhD at NIH through GWU and he does some really, really cool stuff with transcriptional control in MODY (Mature Onset Diabetes of the Young (I think)). Thus, I think you took my school comment the wrong way.

xFGx

 

[pathdr2b]

Originally posted by Primate
I have to say that the response to an MD coming to the bench in every lab in which I've worked over the last decade or so is initially one of raised eyebrows.

In NO WAY do I disagree with this statement. But I'm talking about [OPPORTUNITY here in a translational research setting. It's very obvious to me why the MD and MD/PhD is so highly valued.

As for whether a PhD program would somehow back off or tone down their requirements because someone had an MD, I imagine this to be quite unlikely (again, I can only speak to what I've observed).

For a pathology resident that wants to pursue a PhD in pathology it makes perfect sense that many of the medical school courses would be applicable to the PhD since many PhD pathology programs require medical school classes. This will obviously decrease the time it takes to complete it. NO WHERE have I EVER suggested some watered down version of a PhD.

You know what, I freakin give up....... To the OP, Good luck in whatever you decide and remember that you are the master of your destiny no matter what degree you decide to pursue!

 

[Trashino]

Thank you to everyone that has commented on my post. Your discussion has been very helpful to me. This whole process (interviewing, posting on SDN) has really shown me how outstanding my colleagues are, so I am sure I will be happy about wherever I end up going

 

[ClassSwitch]

Thoughts from an MSTP who received the PhD last year and is about to start residency in a couple of months:

There are a lot of generalizations and assumptions posted on this thread made by people who are either in or about to delve into various MST programs. Some rumors/stereotypes are indeed based on valid trends, but in my limited experience there are no absolute rules to this game of higher education (and I do mean game).

There is an overall impression amongst academics that it's easier to get a PhD as an MSTP candidate than as a pure graduate student. Whether this is actually true in the personal experiences of PhD candidates depends not only on your institution, as mentioned before, but also on your specific PI, as well as your thesis committee members. I'd argue, in fact, that it's your PI and committee members who are the most important factors in determining the length of your PhD, whether you're an MSTP or straight-PhD candidate. (Let that be a lesson to all MSTPers who want to graduate quickly and are trying to choose a lab and put together a committee: make sure you go with a PI who has a record of getting graduate students out quickly, and committee members who aren't known to be real sticklers!)

That being said, a PhD is a PhD is a PhD, and people who are looking to accept you into their residency programs, or to hire you onto their faculties, are probably not going to automatically dismiss an MSTP simply as having an inferior PhD. So many other factors come into play by the time you get to this level.

Having an MD doesn't guarantee anyone respect outside of the wards/clinics by any stretch of the imagination. As stated in a previous post, the world of science research, as opposed to the world of academic medicine, is based on strength of ideas/data production, not on heirarchy or degree. This was actually a disappointing concept for me to face when I went to the wards after finishing my graduate work. In the world of science, you're on a first-name basis with everyone, and even if you're a piddly little undergrad, if you've got a great idea or you've just done a cool experiment, people for the most part will listen. By contrast, in the wards, everyone is addressed as Dr. So-and-So (at least out here in stuffy New England), and you could be the most brilliant med student in the world, but your superiors will be less inclined to pay heed to your intellectual fancies simply because you're lower on the totem pole. Moreover, from what I've seen, and as stated earlier by other people posting on this thread, the basic science folks tend to view MDs who do research as ... well, to use the phrase often spoken with scorn by a former postdoc in my lab who's now a PI at Rockefeller: "MDs who do research!" There are a lot of straight-PhD folks who think that MDs gloss over important experimental details and don't understand the scientific method very well. (This was less of an issue for some of the grand old researchers from the 50s and 60s who started off as MDs and then made famous scientific discoveries -- think Kornberg -- I asked this of one of my thesis committee members who fit that category, and he commented that it was a depression-era thing.)

It should be noted, however, that some of the prejudices of straight PhDers against "MDs who do research" might have to do with rumors that it's easier to obtain faculty positions and grants with an MD than without. Nonetheless, the issue gets really complicated because of the nature of faculty appointments and grant requests/reviews. Your average PhD candidate with a very specific interest in protein folding might apply for a very competitive job in the department of molecular biophysics at some institution, and submit a grant to study protein folding which might be very difficult to receive. By contrast, your average MD or MD-PhD with the same interest in protein folding might have to wing it through an internal medicine department or subsection, take on some clinical responsibilities, and get a grant for something a bit more macroscopic and less ambitious. (This is just a hypothetical situation of course -- I'm just trying to point out that there are multiple levels to consider besides what simple rules and generalizations suggest on the surface.)

My last point is a purely philosophical one, about the issue of people being disappointed in the depths to which their peers would sink on the ethical ladder in order to obtain their goals. While it is disheartening to encounter what might be perceived as ethical shadiness in what should be ethical professions, the reality is that this is how life is, and you really shouldn't get too caught up in this because you will drive yourself crazy. If you honestly think physicians are moral gatekeepers of humanity, then you obviously haven't spent much time on the wards. Some of the most heartless and rude people I've met have been physicians, and during the residency interview trail, I met some reeeeeeeal doozies, people I hoped to God I'd never have to work with. Moreover, if you think scientists are moral gatekeeprs of humanity's search for the truth, then you obviously haven't spent much time in science. Many famous scientists are fairly ego-driven people who would stop at very little to publish a sexy story at all expense.

 

[pathdr2b]

Originally posted by ClassSwitch
By contrast, your average MD or MD-PhD with the same interest in protein folding might have to wing it through an internal medicine department or subsection, take on some clinical responsibilities, and get a grant for something a bit more macroscopic and less ambitious.

I've seen A VARATION OF THIS WITH MY OWN EYEBALLS IN PATHOLOGY A THOUSAND TIMES. This is what I meant by "respect" for the MD, in the opportunities you get NOT resepct as if MD's are the "master's of the universe". Anyone that has spent time in a reseacrh setting especially a translational research setting would have known exactly what I was referring to.

Originally posted by Fixed Gear
And your line about respect? Some of the most worthless lab members I have dealt with have an MD. You may personally revere them as gods, but I think that's a huge mistake.

Originally posted by ClassSwitch
Having an MD doesn't guarantee anyone respect outside of the wards/clinics by any stretch of the imagination.

I think the fact that so many of you were so quick to assume I meant respect as in "reverence for" may indicate the need to reexamine your owns views and motivations for pursuing your future/current profession.

I'm going into this with my eyes WIDE OPEN with a specific primarily ALTURISTIC interest in addressing health disparities in cancer morbidity/mortality through my research. If I were interested in money and prestiege, I guess I'd go into business with my fiance' since he makes more than most doctors do especially academic physicians. However, after rereading this and other threads in this forum, I'm really starting to wonder about the folks who may one day be making decisions about whether or not I get tenure or funding or my papers published.

 

[pathdr2b]

I bump for the wishy-washy folks like myself. Of course, my PI telling me that my recent research proposal looks very "dissertation like" doesn't help in my decision making process

 

[Ottercreek]

Ran into this thread...found it very interesting how generalizations really grate on people.

Bottom line is productivity is a good metric by which to judge a group...and it seems to me that anyone in an academic medical setting can identify both MDs and PhDs who excel and are venerated.

The MSTP students here take on the same types of projects as the graduate students, and in my experience, the mentor is the most important factor in the length of training.

 

[zep]

I'm with Ottercreek on this. Many of the combined degree students at our school have done great work, while some have done pretty crappy. Likewise, some of the graduate students have done great work, and some...well, lets say that they should have pulled out with a MS and called it a day.

The point is that the outcome of training depends so much on the PI, the student, and the environment that we can't really make any generalizations about their abilities or potential. I had a PhD prior to med school and I have never looked at the MSTP students and thought to myself "I have a real PhD and you won't". Thats just crap. I would not hesitiate to work with MSTP grads on research projects down the road, and in fact, I hope that I can because we all have a slightly different set skills and mental filters to bring to the table.

 

[pathdr2b]

Bump! Not wishy washy anymore. or am I?