PhD to MD to Army

[sp4k]

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Hi All,

I'm currently a 4th year PhD candidate in Pharmacology conducting research on the neuroscience of traumatic brain injury (TBI), and scheduled to graduate next year.

Upon graduation I was going to apply for the 71B position in the Army and hopefully continue my research in the TBI field. Recently; however, I talked to several people familiar with the military or TBI field in general and they recommended that if I want to join the Army I might as well get the MD. Their reasoning is that TBI in the military revolves around clinical work, rather than basic science, and MD is a requirement to do clinical work. Personally, I find it appealing as medicine has always been of interest to me, in fact I was going to go to med school before switching to grad school. Additionally, I'm getting a little tired of basic science and would like to participate in a research that has a direct impact on patients. My university has a medical school, I collaborate with many physicians, and have gone through a similar curriculum (at least in terms of coursework) so I don't think getting accepted is going to be an issue.

My question; therefore, is how does the transition look like in the Army, or military in general? I would like to apply for the HPSP scholarship, but does that limit what type of residency I can choose (I really want to continue my TBI research, but I understand that needs of the military have the priority)? Is neurology residency even available in the military? Are MD/PhD's encouraged to conduct research or rather forced to practice medicine?

I apologize if any of these are dumb questions, but I don't know anything about the military side of medicine.

Thanks for all the help.

 

[j4pac]

I wouldn't go into the military if your goal of going to med school is to become a clinical researcher.

 

[deleted480308]

7yrs is a damn big "might as well"...

Also, the military isn't the kind of place that you can ensure a job description containing your research interest

 

[Gastrapathy]

If you were going to pick a research interest that you could be reasonably assured of getting to do in the .mil its TBI research and neuro residency. That said, you may find that you do it all on your own time with zero support.

Civilian MD and a VA job might be wiser.

Don't be sure about walking into med school. We can be funny that way.

 

[jabreal00]

I agree with the other posts. Some clinicians do do research but it's not guaranteed coming out of residency that you'll be assigned to a location where research can be done. There are a lot of variables to being able to do research. One is location. Two is a fairly accomodating supervisors who give you enough time to wade through the administrative process of the IRB and other administrative entities needed to get approval for research. Forget it if you get to a base that's not one of the big medical center. Remember as an active duty physician regardless of one's specialty, the military looks at you as there to provide pre and post readiness to active duty troops first, their dependents second and retirees/dependents third. Plus there's more churn with active duty due to base reassignments and deployments so less continuity for ongoing research.

Most of the researchers at Walter Reed in the TBI/neurology/psychiatry are civilians with the revolving periphery of active duty residents, fellows and staff.

 

[j4pac]

I agree with the other posts. Some clinicians do do research but it's not guaranteed coming out of residency that you'll be assigned to a location where research can be done. There are a lot of variables to being able to do research. One is location. Two is a fairly accomodating supervisors who give you enough time to wade through the administrative process of the IRB and other administrative entities needed to get approval for research. Forget it if you get to a base that's not one of the big medical center. Remember as an active duty physician regardless of one's specialty, the military looks at you as there to provide pre and post readiness to active duty troops first, their dependents second and retirees/dependents third. Plus there's more churn with active duty due to base reassignments and deployments so less continuity for ongoing research.

Most of the researchers at Walter Reed in the TBI/neurology/psychiatry are civilians with the revolving periphery of active duty residents, fellows and staff.

This is VERY true. To oversee an enterprise like the National Intrepid Center of Excellence...you need continuity. You don't get continuity with active duty servicemembers. The civilians run the show...and they are very good. It sounds like the OP would be a great fit and an asset to the military....I just think that he will be more of an asset TO the military than IN the military.

BTW...OP...you should look into PM&R. I loved Neurology going into med school...but I felt that PM&R was a much better fit for me. PM&R also has a HUGE emphasis on TBI and are typically the docs that oversee the acute TBI cases on the wards. If you want more information about the speciality, let me know.

 

[sp4k]

Thank you everyone for your advice.

I do know that anything can happen in the military, even if I joined as a 71B (Biochemist), there's absolutely no guarantee I'll do research (any type of research). But I'm on the crossroads here...

First of all, I understand how difficult medical school is. I've done 2 years of a MedPrep program before grad school, took practice MCATs, shadowed, etc. The reason I changed my mind was because I figured I was more interested in the science, and at the time thought getting PhD was a better idea (despite of what my undergrad advisor thought). I know exactly what I would be signing on for, and I'm okay with it.

In terms of options after PhD, they are quite limited. I REALLY do not want to go to industry or business. In fact, I'm a fellow in an NIH funded industry-training program, and the more I learn about industry the more I hate it. I also don't really want to do a post-doc, simply because there's nothing of interest in my area (not much interesting and promising TBI research) and I can't really move too far for the next 2-3 years (my fiancee just got her PhD and started a job). Additionally, as I said in the original post I've always been interested in medicine. That's why I'm considering getting an MD.

What I got so far out of what all of you posted is that while pursuing an MD might not be a bad idea, military most likely is a bad idea.

 

[HighPriest]

Getting an MD in association with your PhD is a very reasonable way to go. Depending upon your post-doc position, I've known guys who took longer to get an academic job that it took for me to actually complete med school and a residency - so I hear you there. But if you go into the military, you'll be billeted as whatever type of doc you end up being. You'll be a military officer first, a doc second, and somewhere way, way down on the list a PhD. You -might- end up someplace where you can do some fairly half-@$$ed research or you might end up not really having the chance to do any research at all. The military, currently, does not care about research. At all. It's something they offer in small, poor quality servings to pacify people and to augment ACGME. Frankly, if we didn't have ACGME, they probably wouldn't offer any sort of research at all.

If you get an MD, you'll have the chance to do research during school (just be careful not to let it hamper your grades), you'll definitely do research during residency, and assuming that you do well in medical school you'll be very competitive to most research-oriented residency programs. When you're finished, you'll be more competitive to academic programs. I've had people talk to me about academic spots, and I have an M.S., so I imagine you'll be fine. (I have no interest in academics). I agree that going a military route if your real love is research would be a mistake.

 

[HighPriest]

You will not get any more useful information out of a recruiter than you will from this board. Many of us on the board are Army physicians, although it never does hurt to get more opinions.

 

[DeadCactus]

I'm going to throw in the obvious statement that no matter how much you love neurology research, you may find that clinically you despise the practice and end up doing an entirely different field. Don't make your decisions based on following such a narrowly pre-determined path. Medicine is a bad decision if you can't imagine at least a handful of situations across a few specialties that would make you happy.

 

[sp4k]

I'm going to throw in the obvious statement that no matter how much you love neurology research, you may find that clinically you despise the practice and end up doing an entirely different field. Don't make your decisions based on following such a narrowly pre-determined path. Medicine is a bad decision if you can't imagine at least a handful of situations across a few specialties that would make you happy.

I absolutely agree, that's why I'm doing my best trying to find a neurologist whom I could shadow. I'm a neuroscientist by training, and while I absolutely love the nervous system, I do realize that it is an entirely different experience working with this patient base.

I also do see myself in other specialties. I love surgery (have lots of experience with various rodent surgery procedures), was always interested in pathology, and my interest in pharmacology could translate into anesthesiology. Anyway, what I'm trying to say is that even though I come with a PhD and love for research, I also have an open mind.

Again, thank you all for your time and advice. For now, I'm confident I want to pursue medicine, whether it's in the military or not.

 

[Shikima]

I absolutely agree, that's why I'm doing my best trying to find a neurologist whom I could shadow. I'm a neuroscientist by training, and while I absolutely love the nervous system, I do realize that it is an entirely different experience working with this patient base.

I also do see myself in other specialties. I love surgery (have lots of experience with various rodent surgery procedures), was always interested in pathology, and my interest in pharmacology could translate into anesthesiology. Anyway, what I'm trying to say is that even though I come with a PhD and love for research, I also have an open mind.

Again, thank you all for your time and advice. For now, I'm confident I want to pursue medicine, whether it's in the military or not.

Maybe it is, down the road, as a reservist?

 

[BlackFrancis33]

Sp4k, I would encourage you to consider neurology. In my experience, neurology moreso than other specialties attracts people with a pre-determined interest in the neurosciences. I agree with most of what was said above. The focus is to train clinical neurologists to take care of patients first and foremost. Still, there is a need for folks who can go bench to bedside and back. There are absolutely no guarantees as to where you will be stationed etc. You have to be OK with being a clinician first, and hoping you are in a place with resources and time to work on research (=stationed in Bethesda, not Fort Benning). If you have questions about military neurology you can PM me.

 

[DrMetal]

Hi All,

I'm currently a 4th year PhD candidate in Pharmacology conducting research on the neuroscience of traumatic brain injury (TBI), and scheduled to graduate next year.

Upon graduation I was going to apply for the 71B position in the Army and hopefully continue my research in the TBI field. Recently; however, I talked to several people familiar with the military or TBI field in general and they recommended that if I want to join the Army I might as well get the MD. Their reasoning is that TBI in the military revolves around clinical work, rather than basic science, and MD is a requirement to do clinical work. Personally, I find it appealing as medicine has always been of interest to me, in fact I was going to go to med school before switching to grad school. Additionally, I'm getting a little tired of basic science and would like to participate in a research that has a direct impact on patients. My university has a medical school, I collaborate with many physicians, and have gone through a similar curriculum (at least in terms of coursework) so I don't think getting accepted is going to be an issue.

My question; therefore, is how does the transition look like in the Army, or military in general? I would like to apply for the HPSP scholarship, but does that limit what type of residency I can choose (I really want to continue my TBI research, but I understand that needs of the military have the priority)? Is neurology residency even available in the military? Are MD/PhD's encouraged to conduct research or rather forced to practice medicine?

I apologize if any of these are dumb questions, but I don't know anything about the military side of medicine.

Thanks for all the help.

First, you need to ask youself what you wanna do: research or clinical? If you want to do something clinical, then yes you have to go to medical school.

If research is your main passion, don't go to medical school. Get yourself a good postdoc and forge ahead.

BTW: the military is not a "great place" for TBI research, and those who are doing the research are mostly civilians (not active duty military members). If you're looking for great places doing basic science research in TBI, look to NIH, look the HHMI institues, etc. You'd rather be there, and you might have opportunities to collaborate with the DOD or VA (without having to be an employee of the DOD/VA).

 

[Kilgoretrout 65]

The good news is that you could apply for advanced service credit and get 3 years of promotion and pay credit for your PhD after med school, if they approve it(has to be related to new specialty- neurology would work). By and large, with some heroic exceptions, the military is a lousy place to do research. Of course nowadays, the USA is a lousy place to do research with NIH grants funded at 3.9% of the applicants and most congressman being anti-science.