Switching from MD to MD/PhD with debt, not sure if I should do it

[doctorobvious]

I'm a 25 yo second-year medical student. I entered my program as an MD only and was very lucky to get a full tuition scholarship. Right now I've got about $60k in loans, all federal.

My first year I decided to apply to the MD/PhD program. I got accepted, although they won't start giving me a stipend until this fall (my third year). As of now they haven't given me any money.

I've had a pretty hard time deciding whether it would be worth it for me to do the program. I have to decide fairly soon.

I guess finances are a pretty big concern for me. I don't like the idea of having my debt sit there for another 5 years while I'm on an MSTP stipend. I sometimes also don't like the idea of adding another 3-4 years onto an already long training pathway.

However, I am definitely interested in academic medicine and doing research. I don't think that I would want to do 100% clinical medicine at any point in my career. In that respect, getting a PhD might be a good thing because it would at least allow me to stay in academics, apply for grants, go into administration, and work on different projects.

However, I'm not really sure if I need the PhD to do all of the things I want to. There are plenty of MD's who do all of the above.

So I guess I'm just looking for some advice. I've talked to a lot of different people and I've really struggled with this decision. I almost wish I had never applied just because this decision has really made my life miserable for a while, and I had a pretty good deal with my full tuition MD scholarship.

I guess I think grad school would probably be fun, and I would learn a lot. My background is in electrical engineering, and so I would probably do research in biomedical engineering. However, I haven't really done research in about 3 years, and I'm not sure if I'll really enjoy being in a lab if I'm just thinking about going to residency the whole time and wondering how a circuits class that I'm taking is really going to help me in the long run.

However, again I'm a little worried that I have debt from my first two years, and sometimes it doesn't seem like a smart decision to stay in school until I'm 30-31 just because it would be fun (or does it?). I also think it could make things harder just because I would have to switch out of clinical medicine for 4 years to do research and then switch back in to finish up my MD. I know that a lot of people do it though. I'm also not incredibly keen on spending the next 5 years in the city where I am, although it wouldn't be the worst thing in the world.

Also another factor: my school allows us to do the MD training in 3 years, so the total time to MD/PhD would be 1 year less than a traditional program.

Any thoughts on what I should do? Would you do MSTP if you were in my shoes? (ie with debt and with similar goals)

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[achamess]

The question is, will you be able to do what you want in the future without the PhD? As you are probably well aware, there are lots of very successful physician-scientists without a PhD. To be sure, at some point in their career, they put in the time to learn the skills and techniques necessary to do good science, but it need not have been a 4+ year commitment to graduate school. If you think that the protected time and didactic components of a PhD is invaluable and without it you would be unable to realize the future career you envision for yourself, then go for it. 60K + interest is not an unreasonable sum to pay for your future happiness, and one day, if you are unable to do what you'd like to do, you may be kicking yourself for being deterred from making the right decision. I'd suggest, to the best your ability, to think very specifically about what you'd like to do and not in general terms like 'a PhD will open doors...' or something like that.

I hope that helps.

 

[raltima07]

The question is, will you be able to do what you want in the future without the PhD? As you are probably well aware, there are lots of very successful physician-scientists without a PhD. To be sure, at some point in their career, they put in the time to learn the skills and techniques necessary to do good science, but it need not have been a 4+ year commitment to graduate school. If you think that the protected time and didactic components of a PhD is invaluable and without it you would be unable to realize the future career you envision for yourself, then go for it. 60K + interest is not an unreasonable sum to pay for your future happiness, and one day, if you are unable to do what you'd like to do, you may be kicking yourself for being deterred from making the right decision. I'd suggest, to the best your ability, to think very specifically about what you'd like to do and not in general terms like 'a PhD will open doors...' or something like that.

I hope that helps.

Very good points

 

[Neuronix]

if you are unable to do what you'd like to do, you may be kicking yourself for being deterred from making the right decision. I'd suggest, to the best your ability, to think very specifically about what you'd like to do and not in general terms like 'a PhD will open doors...' or something like that.

I will make the counter-argument that there are no PhD specific jobs and that for research positions one can always pursue research during medical school in a year out fashion and then obtain more research experience later in their career. If anything, thinking very specifically about why you are doing your research and focusing your research towards that area becomes much easier once you've actually identified your specialty and spent some time in it.

My position is: if you're this uncertain about doing the PhD, don't do it.

I guess I think grad school would probably be fun

I laughed at this. Maybe this does come down to a certain perspective about how one views graduate school. I did think grad school was fun at times (mostly towards the beginning), but talking to MD/PhDs at the end of grad school is like talking to a group of people with PTSD.

 

[QofQuimica]

I will make the counter-argument that there are no PhD specific jobs and that for research positions one can always pursue research during medical school in a year out fashion and then obtain more research experience later in their career. If anything, thinking very specifically about why you are doing your research and focusing your research towards that area becomes much easier once you've actually identified your specialty and spent some time in it.

My position is: if you're this uncertain about doing the PhD, don't do it.

I agree with this.

OP, in your case, I don't think it makes sense to do the PhD when you don't seem to have a strong need for one. As you pointed out yourself, you already have a good deal. Although, I *do* have to take objection to your concern about being in school until you reach the ancient age of 30, seeing as I was 31 when I started medical school and will be starting my internship at 36.

I laughed at this. Maybe this does come down to a certain perspective about how one views graduate school. I did think grad school was fun at times (mostly towards the beginning), but talking to MD/PhDs at the end of grad school is like talking to a group of people with PTSD.

 

[bd4727]

I would basically echo what others have said with this additional view:

At its essence, the MSTP money is there basically to subsidize people who will take PhD jobs but have gone to medical school as well. I cannot tell for sure what it is you are interested in, but there is a big difference between being an R01 funded PI who does 1month of clinic per year (the people MSTP funding is geared for) and being a clinician at an academic institution where you occasionally teach, do some case studies and maybe even a natural history trial. If yours it the later case, I do not see why you would take all the extra time and lose the 4-5 years of 100k+ income.