I am one of those people who wants to do research and practive with patients. I have thought about the whole "Why not PhD?" And one of the biggest reasons I have is that I need and want patient contact, but I also want to do research in hopes that it will contribute to finding new cures or treatments.
Heh... I'd be careful with that answer. MDs with PhDs do happen quite a lot, and they do practice with quite a bit of patient contact. In many cases, those physicians end up as the heads of departments/schools/hospitals, so be aware of that. Remember that almost all the people who will teach courses at major medical schools will have PhDs, and research brings in a lot of good money that helps to fund those schools.
So there are a few more questions you might want to answer:
1. Do you see yourself in primary care? Particularly as a PCP in a small clinic/serving underserved communities, where research opportunities might not be available?
2. MD/PhD tends to mean academic medical environments for your life. Do you perhaps not see yourself in those situations?
3. Perhaps you enjoy the patient-facing side of clinical research, and feel that you'd rather be supporting research that way, rather than leading it intellectually, which might be less patient-centric? In which case, do you see your MD training as being sufficient for that task? Distinguish what you like and dislike, and then do some checking to make sure that you understand what those careers entail.
The 'Why not a PhD?' question is a really hard one, especially if you make research a part of your application. Perhaps you actually ought to do a PhD, and the amount of time that it would take is intimidating... Still you should think hard about it. A PhD can open a lot of doors, and it really does put you in a position to be part of the process of driving medicine forward. The things that you learn during a PhD, the methodologies, the mechanisms of dealing with collaborators and systems can enable a lot of positive developments in your future career. If research does excite you, think very seriously about a PhD. It's long, it's tough, but so is an MD path. It can also allow you to not just practice medicine and make a short-term difference in the lives of single patients, but to contribute to a sustained change in the lives of patients worldwide, for generations.
The flip-side, of course, is that people often do research to bulk up their applications. "Hey! Look at me... I've done some research, so I'm a more valuable applicant, so you should choose me!"
The 'Why not a PhD?' question in that situation goads the applicant, asking that they follow up on that promise or admit that they were just doing the research to look better - you're caught on the edge of telling the admissions committee that you did research in your past only to impress them and try and improve your chances. Lots of people do that, and they know it, which is why the question is so hard; it challenges you to incriminate yourself.
Have a long think about what you want your career to be. If you don't see yourself in academia, that's fine. If you can't face the extra time, that's okay too (but be prepared for the follow-up 'But an MD isn't too long?'). If you saw what a research lifestyle was like and it didn't quite appeal to you, that's okay too.
But if you really enjoyed research, and you are passionate about it, the 'Why not a PhD?' question is serious, and you should consider it. If being part of the future of medical development is important to you, suck it up and try for the PhD - the world could do with more people who care deeply about doing it.
Meanwhile, at least you aren't answering the question 'So... you've got a PhD in X, why switch to medicine?'
😀
