Should I do PhD-to-MD?

[Hatsya]

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I'm not sure if anyone will see this, or if this is the appropriate forum, but maybe someone can help me out? I applied MD/PhD a few years ago, and despite strong academics (3.9+ GPA, 39 MCAT), I think my lack of extra-curricular, applying to mostly top tier schools, and probably some less than stellar interviews meant I wasn't accepted. When winter rolled around without acceptances, I applied to grad school, thinking maybe I would just do research instead. As it turned out I didn't get into any program I wanted, I decided that med school was much too political and/or (insert appropriate lazy excuse here to save severely my bruised ego) for me. If they didn't want me, then maybe pure academia would be better. Surely in academia I could make a difference and have a good career, just by being smart (well, mostly good at standardized tests, but that's something, right?).

I'm in my third year of my PhD in biochemistry now, and I'm realizing that I kinda really want to go to med school. Academia's not really what I hoped it would be, with a lot more grant grubbing and making flashy presentations than discovering new things. Contrary to what I might have expected as a timid college student without a lot of leadership experience, my favorite parts of my PhD have actually been the parts where I'm interacting with/teaching/leading people, through TAing, chairing the community service committee, or the volunteer teaching. It makes me wonder if maybe I was right the first time, and I should do medicine.

I wish I could say I was one hundred percent certain this is the path for me, but I'm not sure. I like smaller towns (I've realized after living in one of the largest cities in the US to do my PhD), and a lot of academic centers are in large cities. I'm not sure if I want to devote the rest of my life and all potential free time to medicine, which seems to be the cost of going into the field. My father is a physician, and I barely knew him at all growing up. If I want to have a family, how will I juggle that all between two careers (scientist and physician)? And I hear about the soul-numbing bureaucracy that comes with medicine (endless forms!) and the patients that hardly seem to realize that you are indeed trying to help them. And, maybe I would be happy as just a professor who mostly teaches and has a small lab at some smaller university.

On the other side, the human body absolutely fascinates me. I end up going through some of my old anatomy and physiology books, just to try and figure how everything works and try to remember it all. My favorite classes are those I've taken at med schools through various programs. Through the volunteer teaching program I'm with, I teach kids a little about anatomy, physiology, and biochemistry, and it's just so rewarding to help translate these higher order concepts to a sixth grade curriculum and really help them understand how their bodies work. As lame and hackneyed as it sounds, I really do like helping people, but I don't feel like that when I'm trying to write a grant by contorting my research project into something that sounds more marketable rather than honestly stating the flaws and benefits of it. I think if I don't go to med school, I'll probably regret it.

Anyway, my sister's MSTP. After hearing this big long diatribe, her advice is to get a Master's, retake the MCAT, and apply MSTP this summer rather than finish my PhD and go MD afterward. I'm three years in, but it seems like even with that, it might financially make more sense. If I apply this summer and graduate with a Master's, I would have a year not really doing much, but her advice was to go work in a research lab at the school I want to go to. I'm hesitant to stop at a Master's in my program, since they really don't like giving them. I really don't like the idea of burning any bridges with my current advisor or program, since they've been really nice to me. I've talked to my PI a little about it, and he seems understanding, but I feel his way of dealing with it is just to never talk about it again after I mentioned it, haha.

So, I'm wondering if anyone still sees this thread, whether they would have any advice. Keep to the PhD and go MD afterward? Get a Master's and reapply MSTP? Or just go sit in some corner and deeply consider what I want to do with my life?

 

[Neuronix]

I like smaller towns (I've realized after living in one of the largest cities in the US to do my PhD), and a lot of academic centers are in large cities.

Smaller towns and smaller cities that have suburbs within commuting distance tend not to be competitive as long as they aren't on the coasts. You're going to have to deal with this issue regardless of whether you use a PhD or MD/PhD. For MDs it depends on the specialty--for primary care it doesn't matter as much, but for specialty medicine you'll probably end up in a small city anyway if that's what you're looking for.

I'm not sure if I want to devote the rest of my life and all potential free time to medicine, which seems to be the cost of going into the field.

You're going to work hard in medicine or research. The only difference is that at this point you might be able to settle into a research or some other PhD career with a PhD sooner than if you go to medicine to earn an MD (given that you'll need to do residency, possibly fellowship, etc). The total lifetime incomes may not be that disparate since PhD jobs don't pay as well, but if you do the MD it might be 10+ years before you see the big MD bucks. It's not just about money either. The training is long and grueling, and you have to commit yourself to it.

And, maybe I would be happy as just a professor who mostly teaches and has a small lab at some smaller university.

Well talk to your father and shadow some physicians and see what you think. We can't decide this for you.

Anyway, my sister's MSTP. After hearing this big long diatribe, her advice is to get a Master's, retake the MCAT, and apply MSTP this summer rather than finish my PhD and go MD afterward. I'm three years in, but it seems like even with that, it might financially make more sense. If I apply this summer and graduate with a Master's, I would have a year not really doing much, but her advice was to go work in a research lab at the school I want to go to. I'm hesitant to stop at a Master's in my program, since they really don't like giving them. I really don't like the idea of burning any bridges with my current advisor or program, since they've been really nice to me. I've talked to my PI a little about it, and he seems understanding, but I feel his way of dealing with it is just to never talk about it again after I mentioned it, haha.

That's reasonable. You need to make sure your graduate program is on board with this. See my advice here (starting with #5) http://forums.studentdoctor.net/threads/do-i-stay-or-go-ph-d-to-md.1087623/

It seems more reasonable to me to finish your PhD at this point since you're already 3 years in and you don't think your program would be very happy if you dropped the PhD. I wouldn't worry about the finances. Money is important of course, but you're talking about re-starting your PhD after already doing several years of a PhD program. I think that's a little crazy. Just take on the debt and figure it out later if you really want to go to medical school. That's what everyone else does. You'll still pay it off.

 

[Maebea]

So, I'm wondering if anyone still sees this thread, whether they would have any advice. Keep to the PhD and go MD afterward? Get a Master's and reapply MSTP? Or just go sit in some corner and deeply consider what I want to do with my life?

I recommend you figure out what you want to do with your life. Withdrawing 3 years into a PhD program is a big red flag; I would not be surprised if you received no acceptances from MD-PhD programs. It does not sound like you want the physician's life, so I question whether the MD is right for you. It seems that you are driven by a love of biology and helping others. While the pay is not much, you would probably find greater personal rewards as a teacher at a small college or even a high school.

 

[Hatsya]

Thanks so much for the replies and linking me to that helpful thread!

With family in medicine, I hear a lot of iffy things about the future of doctor's salary, and since I was fortunate enough to graduate from undergrad debt free, I'm a little hesitant about taking on so much debt. I suppose most med students do it though, and they turn out alright. I suppose this course of action would also allow more time for reflection, so I can make sure that I still feel I need an MD to make a complete career. I shadowed a little bit before, but it was always in the specter of that I was going to go to medical school rather than for it to help me make the decision. Maybe with other career options open to me now, I can think a little more clearly about my experiences. I'll try and contact a few doctors to see if I can shadow.

I do like teaching, but I've yet to do it as my sole career which probably will change my perspective on it slightly. I think there's something comforting about having a least a few things that you're working on in life, so that if something goes terribly wrong in one aspect (e.g. sixth graders running around and refusing to listen), at least you have something else to work on. Someone in my lab actually taught high school for a couple of years as she liked teaching as well, but the vibe I got from her experience was "never again", haha. She taught at a more urban high school, so maybe it would be different somewhere else though.

 

[QofQuimica]

Whether or not you want to be a PhD biochemist is a completely separate question from whether to go to med school, so you should take them separately.

Regarding whether to complete the PhD versus leave with an MS, that's a toss-up. Are you ready to get out of school already and enter the work force, or are you happy in grad school? Can you get a job in your field/area with an MS? Might actually be easier to get a job as an MS than with a PhD, especially if you're planning to be a research tech type as opposed to trying to be a PI running your own lab. Maybe you should try applying for some jobs and see what turns up.

Regarding the second issue, IMO, no, you should not go to medical school. You are not committed to a career in medicine, and you have no solid reason for going. (Really, the only solid reason to go to med school is that you want to practice medicine.) While a certain amount of dabbling in grad school for a few years while you try to find yourself is common and expected (hence the high attrition rate), med school is not for dabblers. Do not start down this road until and unless you are ready to commit to becoming a practicing physician. If you want to explore medicine as a possible career, then as someone else already suggested, some time spent shadowing and talking to physicians about their jobs would be a reasonable next step for you. I think you already know in your heart of hearts though that this is not the right career for you. And if, in spite of my warning and your own gut feelings telling you not to do it, you decide to go to med school for the wrong reasons anyway (i.e., out of ego, or for any other reason not related to wanting to practice medicine), you will definitely regret it.

 

[wholeheartedly]

@Hatsya you might want to check out careers in something like clinical chemistry (note: this is not medicinal chemistry). You can do a 2 year fellowship then work as a clinical laboratory director in a hospital lab (not research but diagnostic) be involved in academics without dealing with grant grubbing, teach, do medically related projects and research if you wanted, generally smaller scale than basic science stuff. You'll get to learn a ton more medical physiology. There are also fellowships for toxicology, molecular genetics, etc). You could also have options to work in industry with this as well.

Several of my PhD friends have gone this route after deciding traditional basic science type academics wasn't for them and are quite happy with their choice. We have a fellowship program here and I think something like this might be a good option for you, given what you've described as your interests and it would be the most time efficient route as well.

Check out these links.

https://www.aacc.org/~/media/files/sycl/mccuddentranscript.pdf?la=en

http://www.comacc.org/training/Pages/default.aspx

Just browse around some of the training programs, the Amercian Assoc. for Clinical Chemistry site.

 

[Erufaelonion]

Based on the book you wrote, you have a number of conflicting values. Of the alternatives you listed, going to medical school definitely is not the answer. Allow me to reiterate: do not get an MD. Practicing medicine does not appear to be one of your varied and respectable interests.

You should take some time to consider what you really want in life and identify the preferences you value most. You do not need a PhD, MD, or MD-PhD to be happy. Teaching, volunteering, fascination with anatomy/physiology, all that good stuff, can be accomplished without degrees.

Figure-out what you want. Then figure-out what you can do to get what you want. And remember that you cannot have the best of all worlds.

 

[Naruhodo]

@wholeheartedly The route your suggest is actually what I did (not clinical chemistry but a post-doctoral training program of a similar ilk). I agree there are lots of wonderful things about it, including better job prospects, more clinically relevant work (for those who always wanted that), less concern over obtaining funding, (in my experience) more professionalism, etc.

However, you are not a clinician. You may be working in close proximity to medical providers, learning lots about various medical conditions, have the opportunity to meet patients through your work, are involved in patient care (and the stakes are high that you do your job properly), but at the end of the day you are not the person caring directly for patients.

For me, rather than taking the place of wanting to become a physician this experience has reinforced my desire to pursue medical school. I am so much happier in my work now than when I was doing basic science, and that has made me feel capable and ambitious and wanting to be able to do more for patients. Being in a cozy lab director position where I don't have to wrangle with difficult issues surrounded disability and disease on a daily basis just doesn't feel like enough of a challenge anymore.

The most telling thing to me was how quickly my mentors got behind it when I told them my plans to apply to medical school. I'd felt a little guilty about having taken this coveted training spot and not following the straight and narrow path to becoming a lab director, but they told me that they understood the limitations of being restricted to the lab side and they fully supported my application. Several of them are foreign MDs who I think would have continued to practice medicine in the US if that were more feasible without repeating residency.

Anyway, if anyone is interested in getting the low-down on postdoctoral clinical laboratory fellowship feel free to PM me. It really is pretty interesting work for anyone fascinated by science/medicine and who craves helping patients. One mentor who kindly proofread my personal statement actually told me I needed to be less positive about my fellowship in order to sound hungrier for medical school. 😀 Honestly though that is a "problem" I am glad to have.