Thinking about doing PhD instead of MD-PhD...

[clarkalim]

I'm a pre-med student with my sights set on the MD-PhD. Rather, they were set on that until a few days ago.

I'm starting to think that I'd prefer to do bench research (in addition to teaching at the university level), since my ultimate goal is to push back the boundaries of the unknown, and find answers to unanswered questions. I feel like I would be wasting my time by being a physician, because I'd be treating patients with what is already out there and not devoting 100% of my time to research. I'm not too sure about this, though. I'm especially worried about the money aspect of things, because I want to be comfortable. I've been reading all these horror stories about the rich MD-PhD who makes 10x the salary of the poor researcher who has a PhD...I don't want to be them.

I used to want to do my PhD in Genetics, but now I'm considering Metabolic Biology because I've always been more nutrition oriented. I'm actually taking a genetics class right now. I used to think I LOVED genetics, but as I get deeper and deeper into it, even though it's interesting, I'm not so sure that I'd want to earn my PhD in it.

If I am interested in research surrounding how our diets and certain nutrients influence cancer, the immune system (especially autoimmune disorders), and genetic diseases, would aiming for a PhD in Nutrition and Metabolic Biology be a good idea? Or would getting a PhD in this be weak? Would I do better by earning my PhD in something else?

This is the only program I've been able to find that is EXACTLY what I'd like to study:

http://www.columbia.edu/cu/gsas/departments/nutrition/bulletin.html

Let me know what you think.

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[clarkalim]

Also, I'm wondering if I should just do the MD-PhD since

-It takes about the same amount of time to get as a biomedical PhD
-And, I have an interest in the coursework of the MD, just no interest in going through residency and becoming a practicing physician.
-And, the money thing helps with the MSTP being funded, but that's not my top concern.

 

[tortuga87]

Well, the decision is up to you, but if you have no interest in being a physician, ppl will tell you not to become an MD/PhD. I would just make sure you really don't like to treat patients because there are perks to adding some clinical work. You may also grow to like clinical care. Maybe try it out some more if you already havent?

Some things I can think of that you may want to consider

Pros to MD/PhD:

If you are aiming to be a professor, there is a higher chance you will become an long-term postdoc or have to go into industry instead with just a PhD. But maybe you are amazing and can beat the odds. You can try a 7 year post-doc, but you might as well have done MD/PhD anyways, time-wise at least.

You can go into an MD/PhD with the goal of pushing back the unknown and seeing patients as a way to gain insight to your research. You will have a broader knowledge base (e.g., be able to draw connections between diseases), ask questions that may ultimately have a more direct impact on the clinic, and can work more closely with your MD colleagues in collecting data (it's harder for a PhD to work with MDs than MD/PhDs). Sounds like your research interests are very translational anyways

Breaking out of monotony. Just being nice to see patients once a week than having to research all the time.

More pay


Cons:

More training time (a little, statistically that is)

Work harder

I have heard that biomedical PhDs don't have it as bad as basic biology PhDs. But I don't have any data to back that up. Perhaps someone else might

 

[clarkalim]

Well, the decision is up to you, but if you have no interest in being a physician, ppl will tell you not to become an MD/PhD. I would just make sure you really don't like to treat patients because there are perks to adding some clinical work. You may also grow to like clinical care. Maybe try it out some more if you already havent?

Some things I can think of that you may want to consider

Pros to MD/PhD:

If you are aiming to be a professor, there is a higher chance you will become an long-term postdoc or have to go into industry instead with just a PhD. But maybe you are amazing and can beat the odds. You can try a 7 year post-doc, but you might as well have done MD/PhD anyways, time-wise at least.

You can go into an MD/PhD with the goal of pushing back the unknown and seeing patients as a way to gain insight to your research. You will have a broader knowledge base (e.g., be able to draw connections between diseases), ask questions that may ultimately have a more direct impact on the clinic, and can work more closely with your MD colleagues in collecting data (it's harder for a PhD to work with MDs than MD/PhDs). Sounds like your research interests are very translational anyways

Breaking out of monotony. Just being nice to see patients once a week than having to research all the time.

More pay


Cons:

More training time (a little, statistically that is)

Work harder

I have heard that biomedical PhDs don't have it as bad as basic biology PhDs. But I don't have any data to back that up. Perhaps someone else might

Great advice!

Well, I'm doing the SMDEP program at UWash this summer, so maybe that will also help me to decide whether I want to do MD-PhD or not.

I'd just REEEEEALY rather focus 100% of my time on research and teaching. Like, 75% research, 25% teaching. If I had to add practice in there, it would be like 34% research 33% teaching 33% clinical. That would suck.

I don't know...it probably WOULD be an advantage to have the knowledge that an MD has under my belt. But, if I'm not going to do a residency, is it really worth it? Just to get that extra knowledge? And that extra degree? Or should I just solely focus on PhD?

 

[PfNO22]

Great advice!
I'd just REEEEEALY rather focus 100% of my time on research and teaching. Like, 75% research, 25% teaching. If I had to add practice in there, it would be like 34% research 33% teaching 33% clinical. That would suck.

Have you read this? : http://sciencecareers.sciencemag.or...660/a_typical_path_for_a_physician_scientist/

65% research -- sounds like he really, really loves research
5% clinical
10% teaching -- my old lab head loved teaching, but it took tons of effort every lesson
20% administration -- unavoidable. but depends on what other responsibilites you take on

Being in the class of 2013, you still have lots of time, even if it doesn't feel like it. Allow yourself to change your mind many more times. Do what you feel like doing for now, but keep your options open.

 

[emericana]

I'm a pre-med student with my sights set on the MD-PhD. Rather, they were set on that until a few days ago.

I'm starting to think that I'd prefer to do bench research (in addition to teaching at the university level), since my ultimate goal is to push back the boundaries of the unknown, and find answers to unanswered questions. I feel like I would be wasting my time by being a physician, because I'd be treating patients with what is already out there and not devoting 100% of my time to research. I'm not too sure about this, though. I'm especially worried about the money aspect of things, because I want to be comfortable. I've been reading all these horror stories about the rich MD-PhD who makes 10x the salary of the poor researcher who has a PhD...I don't want to be them.

I used to want to do my PhD in Genetics, but now I'm considering Metabolic Biology because I've always been more nutrition oriented. I'm actually taking a genetics class right now. I used to think I LOVED genetics, but as I get deeper and deeper into it, even though it's interesting, I'm not so sure that I'd want to earn my PhD in it.

If I am interested in research surrounding how our diets and certain nutrients influence cancer, the immune system (especially autoimmune disorders), and genetic diseases, would aiming for a PhD in Nutrition and Metabolic Biology be a good idea? Or would getting a PhD in this be weak? Would I do better by earning my PhD in something else?

This is the only program I've been able to find that is EXACTLY what I'd like to study:

http://www.columbia.edu/cu/gsas/departments/nutrition/bulletin.html

Let me know what you think.

Honestly... make SURE that the PhD is what you want to do before you do it.

When you are in the bubble that is undergrad you think:

1) You will never need to make a lot of money
2) That you can do anything you put your mind to

The real world is relentless. You want to put yourself in a place where you have an advantage over others.

I decided to go into podiatry after working as a research tech post grad. During undergrad I worked 40 hours/week in neuroscience for nearly 3 years while doing classes. I got published in j neuro, did conferences posters the whole deal.

Then I tried living on $30k or whatever they pay you as a research tech. After you get your PhD you get rewarded by $38500 or something similar.

Good luck living on that money if you have a significant other you need to support, something happens to your car, or you have a medical issue. You go broke REALLY REALLY FAST.

Read this article:
http://blog.devicerandom.org/2011/02/18/getting-a-life/

 

[SilverBvllet]

Just food for thought, all MD-PhDs I've ever met apparently do not spend less than 80% of their time on research. You cannot expect to compete with 100% research PhDs if you only put 33% of your time into research.

 

[GellaBella]

also realize that as a PhD scientist you're being trained to run a lab...sure you'll do bench science as a PhD candidate and post doc but ultimately, if you don't want to earn a postdoc salary for the rest of your life ($38k/yr) you'll need to transition to running a lab and spending endless hours writing for grants. many students think getting a PhD = actually doing research but the actual research you will do is limited. If you'd like to write grant proposals and papers endlessly (in combination with teaching)then go for a PhD. Otherwise I think that you would be better served either doing the MD/PhD, MD only, or perhaps a MD/MS to supplement your medical education.

 

[cge0]

...

 

[PfNO22]

also realize that as a PhD scientist you're being trained to run a lab...sure you'll do bench science as a PhD candidate and post doc but ultimately, if you don't want to earn a postdoc salary for the rest of your life ($38k/yr) you'll need to transition to running a lab and spending endless hours writing for grants.

I really thought that MD/PhDs also run labs and write grants endlessly... I think this is just a part of research that MD does not exempt you from.

 

[whiteshadodw]

I really thought that MD/PhDs also run labs and write grants endlessly... I think this is just a part of research that MD does not exempt you from.

you know, on a side note, MD/PhDs also have special grants available to them that PhDs do not have. i know post-docs who have been 'post-docs' for 9-10+ years and most of them tell me to just do an MD or MD/PhD. the amount of work you're expected to do as a post-doc and the reimbursement for your time is really not that great.

 

[emericana]

you know, on a side note, MD/PhDs also have special grants available to them that PhDs do not have. i know post-docs who have been 'post-docs' for 9-10+ years and most of them tell me to just do an MD or MD/PhD. the amount of work you're expected to do as a post-doc and the reimbursement for your time is really not that great.

It is a shame that this is the case but it is true. There are a few fields that doing a PhD could be worth it, such as computer science (google regularly hires phd cs ppl at 80-90k) but biomedical sciences is not one of them. Many people get brainwashed in undergrad because their professors are PhDs. This nearly happened to me until I took time off to be in the real world. It is crappy this is the way it works but it is. To make money as a PhD you need to get into biotech or pharma. The real money is always made by starting your own business so as a phd you would have to open your own biotech company up. Patent law is another option but I hear that currently there is a saturation of PhDs who are using patent law as an escape from academia.

It seems to me as well that the OP has an idealistic view of what a PhD does... as do most during undergrad (myself included). To the OP, keep up the grades and get a MD...

 

[Neuronix]

Also, I'm wondering if I should just do the MD-PhD since

-It takes about the same amount of time to get as a biomedical PhD
-And, I have an interest in the coursework of the MD, just no interest in going through residency and becoming a practicing physician.
-And, the money thing helps with the MSTP being funded, but that's not my top concern.

What's the average biomedical PhD take? I have no data, but conventional wisdom is 5 years. The MD/PhD takes 8 years on average. So you are investing an extra 3 years there to go to med school.

If you don't want to be a physician, don't do MD/PhD. Medical school requires a lot of patient interaction and hospital team activity.

PhDs are typically funded too. I don't see why this is an issue versus MD/PhD.

I'd just REEEEEALY rather focus 100% of my time on research and teaching. Like, 75% research, 25% teaching. If I had to add practice in there, it would be like 34% research 33% teaching 33% clinical. That would suck.

I don't know...it probably WOULD be an advantage to have the knowledge that an MD has under my belt. But, if I'm not going to do a residency, is it really worth it? Just to get that extra knowledge? And that extra degree? Or should I just solely focus on PhD?

The triple threat doesn't really go in thirds. It becomes more like 80% research, 20% clinical, 10% teaching if you end up as a majority research MD/PhD. Yeah ok that doesn't add up. You have to give it 110%. You get the idea.

Personally I don't like the idea of teaching with a large chunk of my time. Majority or large amount teaching positions basically means teaching undergrads basics. MD/PhDs almost never do this.

The more interesting teaching to me--graduate school courses once a year or teaching residents in the hospital, is something that is not structured to take a large chunk of your time. You teach a grad class once a week for a semester once a year. You spend an hour on rounds teaching your residents. You spend 2 weeks once per year teaching med school classes (an overestimate). This sort of thing cuts a bit into your research/clinical time, but not much. That's how the physician-scientist-educator is structured.

IMO, doing a MD as part of a MD/PhD program and not completing residency is a complete waste of time. My post-doc mentor (a successful 100% research MD/PhD) called the idea of doing an MD/PhD program and then not completing a residency "a really stupid idea." The MD doesn't add much to this equation except lengthening your education. So if you don't want to be a clinician, don't do MD/PhD.

Just food for thought, all MD-PhDs I've ever met apparently do not spend less than 80% of their time on research. You cannot expect to compete with 100% research PhDs if you only put 33% of your time into research.

You are meeting a small select group of MD/PhDs then. See: http://journals.lww.com/academicmed..._PhD_Programs_Meeting_Their_Goals__An.35.aspx

Only about 25% of MD/PhDs end up doing this much research depending on how exactly you interpret that data. These are the types that run MD/PhD programs and hang out in large academic medical centers, and hence your bias. But this is selection bias. The reality is you can do whatever you want with your degree on a broad spectrum from MD to PhD.

you know, on a side note, MD/PhDs also have special grants available to them that PhDs do not have. i know post-docs who have been 'post-docs' for 9-10+ years and most of them tell me to just do an MD or MD/PhD. the amount of work you're expected to do as a post-doc and the reimbursement for your time is really not that great.

What special grants??? There are career development awards for physician-investigators (K grants), but there are also development awards for post-docs and junior faculty. This is a wash for me.

What MDs tend to get is funding for their job from doing clinical work and so they tend to get hired more easily. However, they are getting hired and paid for clinical duties. This makes it very difficult to get the time and funding to then do research. There are thus special issues on the MD/PhD side, and I don't necessarily believe it becomes easier to become a scientist just because you have that MD. It's just easier to get a job--as a clinician.

 

[PfNO22]

There are a few fields that doing a PhD could be worth it, such as computer science (google regularly hires phd cs ppl at 80-90k) but biomedical sciences is not one of them. Many people get brainwashed in undergrad because their professors are PhDs.

That's why I think if you really love research, just do it and marry up in the financial ladder. I'm counting on a rich spouse. hopefully an MD

 

[PfNO22]

.

 

[soundnin]

... if you don't want to earn a postdoc salary for the rest of your life ($38k/yr) ...

slightly OT, but nobody else thinks this number is way too low? granted i'm in boston/HMS and that might have some impact on my sense of the numbers, but postdocs i know start closer to 50k/year (techs start around 30k/year and depending on the PI can jump up to 38k/year within a few years), and if they secure fellowships, can easily boost that up to 70k+/yr (which is in the neighborhood of what some of my classmates made in industry straight from college with a bachelor's degree :cry

 

[emericana]

slightly OT, but nobody else thinks this number is way too low? granted i'm in boston/HMS and that might have some impact on my sense of the numbers, but postdocs i know start closer to 50k/year (techs start around 30k/year and depending on the PI can jump up to 38k/year within a few years), and if they secure fellowships, can easily boost that up to 70k+/yr (which is in the neighborhood of what some of my classmates made in industry straight from college with a bachelor's degree :cry

Huh. I too am in Boston. I know many people who are doing post docs at MIT... all in Neuroscience. They have a salary of $42k give or take. Not 50.

IDK. I mean to each their own. I know ******ed girls who have just a BA in Marketing who get starting offers of $55k out of school. I personally found it incredibly degrading to be working 60+ hours/week in the lab, getting a PhD, and still have to struggle while paying the bills.

 

[SilverBvllet]

You are meeting a small select group of MD/PhDs then. See: http://journals.lww.com/academicmed..._PhD_Programs_Meeting_Their_Goals__An.35.aspx

Only about 25% of MD/PhDs end up doing this much research depending on how exactly you interpret that data. These are the types that run MD/PhD programs and hang out in large academic medical centers, and hence your bias. But this is selection bias. The reality is you can do whatever you want with your degree on a broad spectrum from MD to PhD.

Yea that's what I meant. I was talking about the large academic center MD/PhDs that do the 80/20 thing. Obviously one of the great things about MD/PhD is the flexibility after training.

 

[soundnin]

Huh. I too am in Boston. I know many people who are doing post docs at MIT... all in Neuroscience. They have a salary of $42k give or take. Not 50.

IDK. I mean to each their own. I know ******ed girls who have just a BA in Marketing who get starting offers of $55k out of school. I personally found it incredibly degrading to be working 60+ hours/week in the lab, getting a PhD, and still have to struggle while paying the bills.

yeah so our numbers are somewhat in agreement. "42k give or take" is "close to 50k".

and regarding your second point, yes, very very depressing. my friend who had a bachelor's in chemistry and went to merck started at 65k/year or something. all my friends who went to the Big 4 in accounting/finance in boston start around 55-60k/year with arbitrary bonuses. but nobody really does research for money at this age.

 

[gbwillner]

Don't forget about the possibility of doing a PhD outside of the US. I know for France, programs are 3-4 years, 5 max; they cut out a lot of the BS and just get you at the bench from the beginning and get you ready for research. Also, tuition and health insurance costs only hundreds of euros and you can find very good grants. PhDs from other countries are not really less valuable than US PhDs.

There are other choices.

I disagree. The European PhDs (there are exceptions) that are fixed to 3-5 years are not as good as an American PhD, IMHO. Not anything to do with the training itself- more that the resuts eventually have to be the same for you to be successful. From what I've seen of European PhDs, they tend to graduate with one or no first-author publications, and need to ask for special permission to continue their work in grad school or they are basically kicked out. When they come for post-Doc they end up doing multiple post-Docs since they have virtually no publication record. Their American counterparts spend a lot more time in grad school and are typically much more productive, and therefore don't require as many post-docs to prove to their departments they are ready for their own laboratories.

 

[Raziela]

I disagree. The European PhDs (there are exceptions) that are fixed to 3-5 years are not as good as an American PhD, IMHO. Not anything to do with the training itself- more that the resuts eventually have to be the same for you to be successful. From what I've seen of European PhDs, they tend to graduate with one or no first-author publications, and need to ask for special permission to continue their work in grad school or they are basically kicked out. When they come for post-Doc they end up doing multiple post-Docs since they have virtually no publication record. Their American counterparts spend a lot more time in grad school and are typically much more productive, and therefore don't require as many post-docs to prove to their departments they are ready for their own laboratories.

+1. I work in London right now, and while I would disagree that European PhDs are not as good as American PhDs, they are definitely different. Most people here tend to do shorter PhDs, and longer post-docs (or more than one, as you said). Ultimately, it amounts the same time training-wise, as far as I can tell. Edit: The plus-side is that you spend more of this time on post-doc pay vs. phd stipend in Europe

Also, the 3-4 years cited for European PhDs doesn't include the 1 year Masters programs most students complete before applying to their PhD programs.

 

[PfNO22]

Also, the 3-4 years cited for European PhDs doesn't include the 1 year Masters programs most students complete before applying to their PhD programs.

Students without prior post-grad research training, like a Masters, definitely take longer.

 

[peanut11]

Do the summer research program and talk to the MD/PhDs there for their opinions. As an MD/PhD you can divide your time as you like. A few I know chose not to go to residency, but that was an afterthought. Going into your interviews certain you don't want to see patients likely won't earn you any brownie points with the interviewer.

 

[Joaquin]

go to graduate school and work hard.

also, getting an MD is not like getting an MBA...you don't get one to "have it under your belt." that's a waste of your time, your money and even worse: everyone else's time.

 

[eighty-twenty]

I agree with many of the other opinions expressed here...if you have absolutely no interest in clinical medicine, I would just go to graduate school. Just remember though that one of the buzzwords these days is translational research, and having a broad medical knowledge where you can see gaps where your research can be applied might be helpful when generating ideas for projects. I think that would be the main benefit of doing MSTP over PhD.

If you have some predilection for clinical medicine and are on the fence, like another post said, talk to other MSTPers, MDs and PhDs and perhaps spend more time in a clinical setting. Your opinion can change once you delve into it given how broad medicine is. Myself, I primarily will do research and view myself as scientist more than a clinician. I initially thought residency was just a step to fellowship. But during residency, despite long hours and tough cases (don't worry, you won't have to do 30+ hr shifts anymore), I learned to love clinical medicine. I actually like teaching my patients about their condition, because a lot of times no one really explains to them what's going on in lay language. And I enjoy the team concept of medicine in that you deal with the whole gamut of personalities and people at different levels of training.

One minor benefit of being an MD/PhD is that if you do a clinical post-doc, you will generally get paid more than a research post-doc at most institutions. Granted you'll have clinical duties, but programs generally have built-in protected years of research with minimal clinic. You also can moonlight as a clinical post-doc. Money may not be an issue for you now, but picture yourself in 10 years living on a post-doc salary of ~$40-50K/year or a clinical fellow salary of ~$60-70K/year with potential to earn more moonlighting at $100/hr. (These are DC area numbers.) Extramural funding is very tough these days, so it's nice to have a fallback career to support yourself/family while you're waiting for your first grant to get funded. With potential for more NIH and NSF budget cuts looming, this is something worth considering.