Question about MSTP vs MD fellowship research

[Akblik]

I originally applied everywhere MD/PhD, but ultimately, my decision has come down to MSTP @ Yale versus a free MD @ Wash U.

Longterm, I'd like to be an academic, but I dont want to have the 80/20 split of MD/PhDs. I want to be involved in research, but have significant clinical time as well. Ultimately, I dont know what the balance is, but I can see myself more clinical than research, but not necessarily much more so. Most importantly, I want to be in a university setting, that at least I am sure about. Furthermore, I am more interested in understanding disease progression, or treatment, than I am in establishing the efficacy of a given drug/regimen. I am struggling to decide if MSTP is the right fit for me, because if it is, I'd rather do it at Yale than Wash U because of the molecular neuroscience (and I like the med school better).

I have read everything I could find on this site, intransit, etc, so hopefully I can make my question pretty narrow about this.

A) What are the advantages, disadvantages, and nature of the research done if you do the following plan: MD+ MA, and then more research during Fellowship. Would that land me in an academic setting, and if so, what kinds of questions would I be pursuing?

B) Do MD/PhDs who are on a residency--clinical track (like my time split) do PostDocs to get their own lab?

C) If you dont have your own lab as an MD, what kind of research questions/opportunities are afforded to you?

Ultimately, my main hesitation is this. Clearly in 4 extra years, I will develop an extra and unique skill set---give my goals, will it be needed/helpful/necessary, and could I develop a more refined (smaller) skill set in less times elsewhere?

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[dl2dp2]

i'm midway in my MSTP. these questions you are asking have no clean answers. You need to think about these two programs in a completely different way and perhaps that'll help you make the decision.

Would you rather live in New Haven or St. Louis? Which campus atmosphere did you like better? What does your gut tell you?

There are philosophical questions and then there are practical questions. practical questions concerning the longterm future have answers that completely depend on the individual whom you are asking. philosophical questions, on the other hand, have answers that are probably not applicable to you if you ask someone else.

hope this post, in a very vague way, helps. i also wrote a "no-bull****", "fair-and-balanced", "alternative" review of MD, MDPHD, PHD programs and it has built up a small notoriety underground. if you are interested i can send you the link.

 

[solitude]

hope this post, in a very vague way, helps. i also wrote a "no-bull****", "fair-and-balanced", "alternative" review of MD, MDPHD, PHD programs and it has built up a small notoriety underground. if you are interested i can send you the link.

Hey, can you post the link or PM it to me? Thanks!

 

[Gut Shot]

I did my PhD and MD sequentially, so I'll weigh in here with a thought or two.

sluox is right in that there are no clear answers. From the tone of your post, however, it seems fairly clear that your standing on research is similar to what mine has evolved into: I enjoy it, it's great, but I don't want it to dominate my life, I don't want to run a lab, and I find clinical work a lot more satisfying.

With that in mind, I'm developing my clinical skills (in pathology), and if I'm ever involved in any meaningful research again it will be as a collaborator with said clinical skills. You can bring a lot to the table with "only" an MD, provided that you have enthusiasm for experimental medicine.

Assuming that your goals stay relatively stable over the next few years, I'd advocate the MD at Wash U (my brother went to med school there and had a great time doing some research as an M4). A combined program sounds like overkill, and there is always a need for clinically oriented individuals to contribute to research projects.

Someday you might find yourself so mired in developing your clinical acumen, which is an enormous undertaking, that research feels like a distant dream. And that's fine.

 

[e_phn]

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[SeventhSon]

have oyu considered the possibility of attending washU, doing summer research for 2 years, and then transferring into the MD/PhD program? That would give you 2 more years to think about it. The success rate for current MD students at WashU applying into MD/PhD is like 85%, and to the sound of it you would be a shoo-in as a current MD applicant, especially since the school is already picking up the tab on your MD years.

And if you are wary of going to washU for 8 years because you like new haven better, then i think yale should be the choice out of your gut feeling regardless.

 

[tbo]

have oyu considered the possibility of attending washU, doing summer research for 2 years, and then transferring into the MD/PhD program? That would give you 2 more years to think about it. The success rate for current MD students at WashU applying into MD/PhD is like 85%, and to the sound of it you would be a shoo-in as a current MD applicant, especially since the school is already picking up the tab on your MD years.

And if you are wary of going to washU for 8 years because you like new haven better, then i think yale should be the choice out of your gut feeling regardless.

I'm going to chime in here as an addendum to SeventhSon's suggestion. A good thought experiment might be to ask yourself, if you got into the MD/PhD at WUStL, would you immediately take it? While the first two posters are more pragmatic, this may get to the heart of whether or not your interests lie firmly in an MD/PhD and all of the attached commitments (overall time, research/clinical distribution of time, research 'doors' being opened with an MD/PhD, funding potential later down the line, etc). If you say I'd totally take WUStL MD/PhD in a heartbeat, go there for the experience - there are a number of stories where people do successfully transition into the program.

 

[dl2dp2]

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[akaz]

Now I am going to chime in. I have been in labs at HMS for a long time in grad school. I have seen awesome MD/PhD's and MD's in research. I have seen lousy MD/PhD's and MD's in research. It depends on the person. Many MD's only get awesome funding too. It depends on their productivity during their post-doc. If you are going to do it, do it for the extra training or because you love it. The MD/PhD isn't essential for everyone. Productivity is what matters.

 

[OwnageMobile]

Sluox, that's a cool site with a good amount of interesting stuff. I liked your cartoon review as well as the Kerouac and traveling notes.

 

[huknows00]

I was in a similar situation with the OP this cycle, and I chose to go with HST MD only. Being on the dark side now, after getting past the initial relief from knowing that I will have a job before I'm thirty, the facts started sinking in. If you're serious about an academic research career, the MD/PhD will put you a step closer to your goals and may be a worthy investment with payoffs years down the road.

I've heard many people comment rather poorly on the quality of MD fellow's research - which is understandable given their relative lack of protected research time. Seeing the grad students in my lab come and go as they wish and really take their time thinking stuff over makes me ask myself whether spending a good part of your twenties totally free from responsiblities except to think and explore what you're curious about is actually such a bad idea afterall...

 

[e_phn]

here's the link.

http://www.columbia.edu/~xsl2101/interests.htm#mdphd

sluox, it's a cool link. thanks.

 

[NoPDM]

I went from PhD to MD and am glad I did it that way. I plan on doing academic research and think that the MD/PhD is a good way to go.

Look into the Clinical Investigator pathway. It's a way to shorten your residency and fellowship and gets you to clinical research even faster.

When thinking about clinical experience vs research, a common way to do the process is to spend one month out of the year on the floors and pepper the remainder of the year with once-weekly clinic. That gets you time in the clinic and protected time the rest of the year doing research.

 

[TheMightyAngus]

I went from PhD to MD and am glad I did it that way. I plan on doing academic research and think that the MD/PhD is a good way to go.

Look into the Clinical Investigator pathway. It's a way to shorten your residency and fellowship and gets you to clinical research even faster.

When thinking about clinical experience vs research, a common way to do the process is to spend one month out of the year on the floors and pepper the remainder of the year with once-weekly clinic. That gets you time in the clinic and protected time the rest of the year doing research.

Are clinical research and laboratory research mutually exclusive? Would a "clinical investigator pathway" be for someone looking to run a lab, or is it primarily for researchers who want to spend most of their time in the clinic? Or is it for both?

 

[NoPDM]

Are clinical research and laboratory research mutually exclusive? Would a "clinical investigator pathway" be for someone looking to run a lab, or is it primarily for researchers who want to spend most of their time in the clinic? Or is it for both?

No, clinical and lab research are not mutually exclusive. However, if trying to combine clinical practice, clinical research, and basic science research, I imagine you'd find one area would fail and likely be eventually dropped. The average person can't be spread so thinly as to do all three well.

The CI path is most suited for an academic clinician who wants to do some degree of research, be it clinical or basic science. The amount of time spent on research is likely greater than 50% for those in the CI path. For those more interested in less that 50% time research, it's harder to get science accomplished. Impossible? Of course not, but just harder.