Should I apply for MD/PhD? When is best to get PhD as a doctor?

[chocolatelove]

Hello, I'm a junior applying this cycle and I've been juggling with the idea of applying to an MD/PhD program. I was in a neuroscience lab for two years without any publications of my own, and currently I am working as a clinical research assistant with a manuscript (about symptom prevalence among a clinical population) coming along where I am first author. This summer I will be starting independent research in neuroscience at my school's medical school.

As you can see, I lack a committed experience in independent bench/basic research. However, becoming an MD/PhD is a very attractive option for me. One of my career goals is to become a medical professor and I hear having an MD/PhD would make me a competitive candidate for academic positions. Also, if I really enjoy doing independent research this summer, I would regret not applying for MSTP programs.

So, do you think I should apply to MD/PhD programs this year, or build up my portfolio more in the coming years and apply to transfer into a program during med school? Are there programs that would appreciate my experience in clinical research (and the publication)? And what are some options to pursue a PhD after getting an MD and how feasible are they?

Thank you so much!

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[Mansamusa]

For the feasibility of doing a PhD after med school. So let's say you go $250K in debt for med school--> about a $2K/month loan payment (didn't actually check this, but I'm assuming based on my stuff). A generous PhD stipend is $35K--> 2.9K/month BEFORE taxes.

Of course, it is more feasible if you have parental support for med school.

I would say wait to apply until you feel comfortable with your research porfolio. Many MD PhD students take gap years before applying. And you can be a med school professor with just a MD (I even know plenty of MD PhD program directors who only have a MD and do research exclusively). Only do the PhD if you want to be doing research

 

[JustAPhD]

If not an MD/PhD then I'd suggest the PhD before the MD. As Mansamusa said, this way you won't have to pay med school loans during your PhD stipend years.

 

[chocolatelove]

I have no parental financial support for med school unfortunately :/

Thanks for the info though! I am planning on going straight to medical school because of family / personal reasons. What would you say of transferring into an MD/PhD program as a second year or third year?

 

[chocolatelove]

I'm afraid that may be 5-6 years after graduating from college, from what I hear? Considering I'm more sure about MD than PhD, it might be better for me to matriculate into med school first.

 

[Chemistry>Physics]

For the feasibility of doing a PhD after med school. So let's say you go $250K in debt for med school--> about a $2K/month loan payment (didn't actually check this, but I'm assuming based on my stuff). A generous PhD stipend is $35K--> 2.9K/month BEFORE taxes.

Of course, it is more feasible if you have parental support for med school.

I would say wait to apply until you feel comfortable with your research porfolio. Many MD PhD students take gap years before applying. And you can be a med school professor with just a MD (I even know plenty of MD PhD program directors who only have a MD and do research exclusively). Only do the PhD if you want to be doing research

Wait a second....

MD/PhD programs pay for med school ... No 250K debt for at least MSTP programs.

I would say do it. Shadow heavily, work with academics and MD/PhDs more. You're a junior which is getting later in the game but you should seriously consider it. If you're wondering about it further and you're willing to expend a year to get a full grasp on what you want to do in life, go for one of those "pre-doctoral" 1 year or 1 1/2 year programs. I know for a fact the NIH has them and I think it would be a great way to spend a full year engulfed in research where you would come out with an idea of what you want to do.


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[minor.groove]

Don't waste your time. Double degrees are near worthless to most who get them. Want to do research as a physician... just do a research fellowship and involve yourself in research as a resident and/or attending. Don't want to be a clinician or do research which would benefit from having clinical privileges? Get a Ph.D. (or actually don't... but that's a different story altogether).

If you are set on doing it, a traditional MD/PhD program is probably the best way to do it (note not all MD/PhD programs are MSTP) but most offer a stipend and tuition remittance for the whole time you are in the program... Doing them separate... PhD after MD is probably a bit of a pain, really you would probably need to do it after atleast PGY-1 (someone who has actually gone this route could comment). Debt wise I'm not sure if makes much of a difference. You could either defer payment (probably not a great idea if you go anywhere but a cheap school) during grad school, otherwise do income adjusted payments (that would count for 4 or more like 6 years of your 10 toward forgiveness... maybe anyways, think about it as I write this you are not considered an employee of the university as a grad student a lot of the time..., so figure that question and if you did, then between grad school and residency you would probably hit the forgiveness requirement for government employee).

 

[eteshoe]

I'm afraid that may be 5-6 years after graduating from college, from what I hear? Considering I'm more sure about MD than PhD, it might be better for me to matriculate into med school first.

There are some advantages to doing a PhD before the MD (e.g. avoiding step score creep) but it is an "inefficient" path. Not impossible but not for everyone. Also the bolded concerns me. The difficulty of the PhD doesn't come from the course work but from the open-ended nature of the degree. Do not pursue a PhD if you aren't sure you'd need it (ask yourself why you'd need a PhD). You can easily take a research yr during med school or go for a masters if you want the research experience. There are also research heavy residencies/fellowships that can yield a PhD upon completion.

Wait a second....

MD/PhD programs pay for med school ... No 250K debt for at least MSTP programs.

I would say do it. Shadow heavily, work with academics and MD/PhDs more. You're a junior which is getting later in the game but you should seriously consider it. If you're wondering about it further and you're willing to expend a year to get a full grasp on what you want to do in life, go for one of those "pre-doctoral" 1 year or 1 1/2 year programs. I know for a fact the NIH has them and I think it would be a great way to spend a full year engulfed in research where you would come out with an idea of what you want to do.


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Even though many MD/PhD programs are funded, the common sense consensus is that getting med school paid for is not worth the pain of doing a PhD if your heart is not into research. That's a hell of a lot of sacrifice for a career path that would lead to such good compensation (i.e. more yrs as an attending) if the graduate portion was avoided. I do agree with you that the OP (@chocolatelove) needs to really shadow some physician scientists (MD/PhDs and MD-only) to see if the lifestyle appeals to them.

For the bolded, I assume you mean postbacc fellowships like the NIH-IRTA or something

Don't waste your time. Double degrees are near worthless to most who get them. Want to do research as a physician... just do a research fellowship and involve yourself in research as a resident and/or attending. Don't want to be a clinician or do research which would benefit from having clinical privileges? Get a Ph.D. (or actually don't... but that's a different story altogether).

If you are set on doing it, a traditional MD/PhD program is probably the best way to do it (note not all MD/PhD programs are MSTP) but most offer a stipend and tuition remittance for the whole time you are in the program... Doing them separate... PhD after MD is probably a bit of a pain, really you would probably need to do it after atleast PGY-1 (someone who has actually gone this route could comment). Debt wise I'm not sure if makes much of a difference. You could either defer payment (probably not a great idea if you go anywhere but a cheap school) during grad school, otherwise do income adjusted payments (that would count for 4 or more like 6 years of your 10 toward forgiveness... maybe anyways, think about it as I write this you are not considered an employee of the university as a grad student a lot of the time..., so figure that question and if you did, then between grad school and residency you would probably hit the forgiveness requirement for government employee).

I would agree that a lot of combo degrees aren't absolutely necessary (like JD/MD or MD/MBA) but the MD/PhD can be useful if one has some particular career paths in mind. I agree with most of the rest of your first paragraph. If one is doing the separate degree path, the PhD would have to come much further down the line than PGY-1 (typically end of residency or during fellowship) since one's competitiveness decreases quite drastically once they're yrs out of med school.

Overall, @chocolatelove you will most likely need to take a gap year(s) if you are considering this path just so you have some sustained research and can really evaluate if you want to do the dual degree program.

P.S. I was 4 yrs out of UG by the time I started the MD/PhD and it didn't affect me at all really. Though it may be a different issue for females (just my opinion) if they also want families - just because this does tend to be a ~15 yr training path.

 

[URHere]

You are really asking two questions here.

1) If you should get the PhD: As a general rule, a PhD will be of no use to you unless you want a predominantly research career. If you want to teach at a medical school, you can do that with an MD alone. If you want to be a dean or department head, you can also do that without the PhD. The question that is harder to address is whether a PhD is right for those who do want to be heavily involved with research. It is true that you could just graduate from an MD program and then pick up more practical research training as part of a research-heavy residency (PSTP programs or similar)...but this isn't the right choice for everyone. Overall, the PhD gives you more direct basic science training, more mentored time when you are encouraged to take risks, and is a more gentle and natural way to learn to think like a scientist. Of the MD-only researchers I know, many ended up limiting themselves to safer projects out of necessity (you only have so many years to secure each grant), and quite a few regret not having formal PhD training. That being said, they're still successful. Only you can decide what is worth it to you.

2) When you should get the PhD: A combined program is easiest and has the benefit of paying for medical school. If you do 2 years of medical school and then transfer, you'll still have two years of medical school debt. If you do 4 years and then decide to do research during fellowship, you'll face the situation I described above. If I were you, I'd take an extra year to figure out what you want to do with your life before you start applying to programs. That's exactly what I did, and it's how I ultimately chose between MD and MD/PhD. For me, it was 100% worth it.

As a side note, PhDs are very unique things. They are emotionally damaging in a way that you really can't understand until you've been there, but they are also truly transformative for people who complete them. If you do it right, a PhD will entirely change the way you think. Even if I don't end up back in research, I won't regret that experience.

 

[minor.groove]

I would agree that a lot of combo degrees aren't absolutely necessary (like JD/MD or MD/MBA) but the MD/PhD can be useful if one has some particular career paths in mind. I agree with most of the rest of your first paragraph. If one is doing the separate degree path, the PhD would have to come much further down the line than PGY-1 (typically end of residency or during fellowship) since one's competitiveness decreases quite drastically once they're yrs out of med school.

It's funny, of the common combined degrees (MD/JD, MD/MBA, MD/PhD and MD/MPH) I would say the only one that adds definitive value (if it is a career path you hope to pursue) is the JD, as it is the only of those that provides a degree that opens a field that you cannot practice without the dual degree (granted their aspects of law/policy that don't require a JD, such as patent law, there are many that do).

I should have clarified, I would say the only practical ways to combine the PhD and MD is to do the PhD first or as a combined degrees, as doing one after you would essentially HAVE to do atleast PGY-1 first (and probably need to complete your residency in reality... and then probably work to maintain your clinical skills while completing a PhD).

Having interacted with numerous MD (basic and clinical science) researchers, MD/PhD's (students and researchers) and done the grad school thing myself, I honestly believe that with rare exception your time would be better spent getting one degree or the other. If you are not 100% for research at the the time of starting the PhD I would say it's useless and these research skills can be developed in more productive ways later (research fellowships or just slowly integrating more research into your career starting in med school, through residency and clinical fellowships and then pursing employment at a University affiliated hospital). PhD's are a long, un(der) appreciate journey that often don't really pay the dividends in the end (finically or career wise- as in, if you are good at research you can get a job at any research institute in the country with just an MD, if you are not good at research/are not particularly successful at it an added PhD isn't going to get you that job anyways). Get your MD, get a job, involve research if you want or your career allows... skip the PhD.

 

[eteshoe]

It's funny, of the common combined degrees (MD/JD, MD/MBA, MD/PhD and MD/MPH) I would say the only one that adds definitive value (if it is a career path you hope to pursue) is the JD, as it is the only of those that provides a degree that opens a field that you cannot practice without the dual degree (granted their aspects of law/policy that don't require a JD, such as patent law, there are many that do).

I should have clarified, I would say the only practical ways to combine the PhD and MD is to do the PhD first or as a combined degrees, as doing one after you would essentially HAVE to do atleast PGY-1 first (and probably need to complete your residency in reality... and then probably work to maintain your clinical skills while completing a PhD).

Having interacted with numerous MD (basic and clinical science) researchers, MD/PhD's (students and researchers) and done the grad school thing myself, I honestly believe that with rare exception your time would be better spent getting one degree or the other. If you are not 100% for research at the the time of starting the PhD I would say it's useless and these research skills can be developed in more productive ways later (research fellowships or just slowly integrating more research into your career starting in med school, through residency and clinical fellowships and then pursing employment at a University affiliated hospital). PhD's are a long, un(der) appreciate journey that often don't really pay the dividends in the end (finically or career wise- as in, if you are good at research you can get a job at any research institute in the country with just an MD, if you are not good at research/are not particularly successful at it an added PhD isn't going to get you that job anyways). Get your MD, get a job, involve research if you want or your career allows... skip the PhD.

Valid points but as I've heard before "the MD/PhD is for the most indecisive sort of people" (can't remember the name of the guy but he was some MD/PhD PI up at Harvard that gave a talk I went to yrs ago). Gotta say I agree with the statement (some people just are gluttons for pain lol). Though I don't regret the path at all (so far) - it really isn't for everyone.

 

[LizzyM]

@chocolatelove Most medical school faculty have the PhD or the MD. Very few have both even at the top research-focused schools. At this point, your research experience is too light to be considered a strong candidate for a highly competitive PhD program which is what the MD/PhD is.

Can you see yourself doing 80% "bench" and 20% clinical work 20 years from now? If so, it might be worth taking a gap year to build your research resume (or at least to have your senior year on your application with regard to research).

Med school will give you the opportunity to do research. There are residencies with a year of research built in and ditto for fellowships. Some fellowships also include a MS or MPH where you can gain additional skills in study design and data analysis specific to your area of interest at the time you are going to use it (e.g. clinical investigation, health services research, health care quality)

The MD/PhD is nice in that it pays for your tuition along with a small stipend but in essence you are trading 4-6 years of your life in exchange for the $300K (or whatever) you don't have to borrow for medical school. when you think about what you could be doing and what you could be earning if you graduated from medical school and finished residency 4-6 years earlier, you can see that it is a good deal only if you can't see yourself doing anything other than running your lab with a couple of half days per week in clinic (or a month or two per year "on service" supervising residents on the floors and otherwise in your lab full time writing grants and supervising trainees).

 

[alpinism]

Sounds like a MD/MS or MD + year long research fellowship would better suit your interests at this point.

 

[Montisumo]

It's funny, of the common combined degrees (MD/JD, MD/MBA, MD/PhD and MD/MPH) I would say the only one that adds definitive value (if it is a career path you hope to pursue) is the JD, as it is the only of those that provides a degree that opens a field that you cannot practice without the dual degree (granted their aspects of law/policy that don't require a JD, such as patent law, there are many that do).

I should have clarified, I would say the only practical ways to combine the PhD and MD is to do the PhD first or as a combined degrees, as doing one after you would essentially HAVE to do atleast PGY-1 first (and probably need to complete your residency in reality... and then probably work to maintain your clinical skills while completing a PhD).

Having interacted with numerous MD (basic and clinical science) researchers, MD/PhD's (students and researchers) and done the grad school thing myself, I honestly believe that with rare exception your time would be better spent getting one degree or the other. If you are not 100% for research at the the time of starting the PhD I would say it's useless and these research skills can be developed in more productive ways later (research fellowships or just slowly integrating more research into your career starting in med school, through residency and clinical fellowships and then pursing employment at a University affiliated hospital). PhD's are a long, un(der) appreciate journey that often don't really pay the dividends in the end (finically or career wise- as in, if you are good at research you can get a job at any research institute in the country with just an MD, if you are not good at research/are not particularly successful at it an added PhD isn't going to get you that job anyways). Get your MD, get a job, involve research if you want or your career allows... skip the PhD.

I have to disagree here. Ive finished my PhD already and am doing the MD now. In my experience, every single MD who has rotated thru my lab has been absolutely clueless when it comes to research. They just have no idea how to ask the right questions or pursue the right path in research. You may think you know the value of a PhD, but unless you have gone down that road, you really can only speculate. In my opinion, what you gain from a PhD program is far more than 3 letters. You learn how to think first and foremost. I have trained and mentored a dozen MD research fellows including several chief residents and for real, every one of them struggled with research. Now I did it the hard way and I do not recommend doing a PhD before an MD if you can help it. But I can tell you guys, going through a PhD and coming out the other end with several pubs and grants, you will learn what I call "the intangibles". You will learn how to think and answer open ended questions, plan the appropriate steps towards answering these and learn how to do science from the ground up. With just an MD you can learn similar, albeit it will take a steep learning curve (I've seen it over and over again, MDs struggle I their first two years of rrsearch). My advice is to skip the PhD of you are not sure research is for you, you can always come back and do research as an MD. Just be aware that what you will learn as a result of getting the PhD, is far more than these people are making it seem especially since they have not gone through this process. The degree is like a symptom of a much bigger story. That story is a revolution in your mind. The unstructured nature of grad school has eaten up just about every single MD I've come across and I say that with great respect for them, it was just unnerving to see how much they all struggled (all ivy leaguers if that makes a difference). Learning how to succeed when there is noone telling you what to do, or any hint of what you should do is the essence of grad school. Med school is about as structured as you can get. Transitioning between the two is a skill that takes years to learn. But in my experience ce and discussions with dozens of fellows, MD phds faculty etc, you go to grad school to learn how to think. I hope that helps some, msg me if u have specific qs. Sent from my wireless

 

[sss1219]

The 80/20 split discussed above is rigid at many schools, so if you're 'more about the MD than the PhD', this is an important point to keep in mind. Also, correct me if I'm wrong, but MD/PhD programs are tailored towards students who will eventually be running their own labs, however the 80% of your time you spend doing 'research' will predominantly be grant-writing and such - your lackeys will be doing the the actual research for the most part.

 

[eteshoe]

The 80/20 split discussed above is rigid at many schools, so if you're 'more about the MD than the PhD', this is an important point to keep in mind. Also, correct me if I'm wrong, but MD/PhD programs are tailored towards students who will eventually be running their own labs, however the 80% of your time you spend doing 'research' will predominantly be grant-writing and such - your lackeys will be doing the the actual research for the most part.

That's the reality of being a PI in most cases (PhD, MD/PhD, and MD) - unless you choose to be a research tenure track PI (e.g. Research Asst. Prof, etc.). The rule of thumb I've always heard is that PIs are still doing some "hands-on" research in the lab for the first 3-5 yrs after establishing it in order to train their grad students, postdocs, etc.

 

[EventualMD]

You don't need to publish to get into an MD PHD program. Just succeed in your lab and get good letters. Focus on your grades and practice your interviews.

 

[Chemistry>Physics]

You are really asking two questions here.

1) If you should get the PhD: As a general rule, a PhD will be of no use to you unless you want a predominantly research career. If you want to teach at a medical school, you can do that with an MD alone. If you want to be a dean or department head, you can also do that without the PhD. The question that is harder to address is whether a PhD is right for those who do want to be heavily involved with research. It is true that you could just graduate from an MD program and then pick up more practical research training as part of a research-heavy residency (PSTP programs or similar)...but this isn't the right choice for everyone. Overall, the PhD gives you more direct basic science training, more mentored time when you are encouraged to take risks, and is a more gentle and natural way to learn to think like a scientist. Of the MD-only researchers I know, many ended up limiting themselves to safer projects out of necessity (you only have so many years to secure each grant), and quite a few regret not having formal PhD training. That being said, they're still successful. Only you can decide what is worth it to you.

2) When you should get the PhD: A combined program is easiest and has the benefit of paying for medical school. If you do 2 years of medical school and then transfer, you'll still have two years of medical school debt. If you do 4 years and then decide to do research during fellowship, you'll face the situation I described above. If I were you, I'd take an extra year to figure out what you want to do with your life before you start applying to programs. That's exactly what I did, and it's how I ultimately chose between MD and MD/PhD. For me, it was 100% worth it.

As a side note, PhDs are very unique things. They are emotionally damaging in a way that you really can't understand until you've been there, but they are also truly transformative for people who complete them. If you do it right, a PhD will entirely change the way you think. Even if I don't end up back in research, I won't regret that experience.

" they are also truly transformative for people who complete them. If you do it right, a PhD will entirely change the way you think. Even if I don't end up back in research, I won't regret that experience"

Explain more on this


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[URHere]

" they are also truly transformative for people who complete them. If you do it right, a PhD will entirely change the way you think. Even if I don't end up back in research, I won't regret that experience"

Explain more on this

@Montisumo already touched a little bit on this. Unlike high school, college, or medical school, the point of a PhD isn't to specifically learn anything. The point is completely overhaul the way you think. PhDs are challenging because you can know everything about a given topic and still fail at research. You need to learn how to ask the right questions. You need to learn how to be comfortable with inconclusive results and uncertainty, and you need to know how to make decisions based on what is often very abstract thinking. You need to become truly self-motivated. All of this is really, really hard to do, but it is the goal of a PhD.

At the end, you think differently. You respond to stress differently. You are a very different person than you were at the beginning. Although it may not be true for everyone, I found that many of my new skills were useful for clinical medicine. When I got to clerkships, I had no problem with time pressure, presenting in front of large groups, or thinking through the various meanings of uncertain information, and I think a lot of that was because of my PhD training. I was young when I started medical school - I matured a lot during the course of my PhD, and I cringe when I think about what my MS3 year would have been like if I had gone straight through. So, even if I never set foot in a lab again (which I hope isn't the case), I don't regret the PhD.