Tired of people saying MD/PhD program is useless.

[Golden-Future]

---

Members don't see this ad.

Tired of people saying MD/PhD program is useless. Its getting me annoyed, obviously the program exists for a reason people!

 

[Lucca]

2 things:

1) there’s no doubt that the dual degree is a very niche training program that does not make sense for most people interested in science or medicine. Most would choose one or the other and prefer to be fully invested in a single direction than make more sacrifices.

2) if your plan is to do research there will be no shortage of people telling you that it’s pointless/youre not good enough/ it’s not worth it at every stage of your career. Half of them will be yourself, if you’re anything like me.

Only person living your life is you and that’s the only person that really, seriously needs to understand why you do the things you do.

That being said, merely “existing” is not a good criteria for “worthwhile” or “meaningful”. There is a fairly strong argument — made on these boards several times — that MD/PhD programs should not exist and those resources would be better off supporting early career researchers and/or loan repayment for MD scientists who choose to go through postdoctoral research training.

 

[deleted480308]

There are a lot of worthless degrees. Existence does not necessarily mean worth.

As a researcher you are likely logical enough to know this

Do what makes you happy as long as you aren’t hurting others

 

[tortuga87]

if you are intrinsically motivated to make discoveries (i.e., care about the discovery process itself rather than titles/positions/money/awards) and can accept much lower pay than your clinical colleagues, then the MD/PhD program is ok

whether your spouse or kids will be ok that lifestyle is a different story

 

[Golden-Future]

Would you guys be able to tell me if this makes sense:

I want to study a certain rare disease and devote my life to studying that disease and finding improvments and cures for people with that disease. And be able to see those patients with that disease and help with their treatment plan.

I want to be a specialist in that rare disease and help people who don't have much options but hope in research advances.

 

[Syxx]

Would you guys be able to tell me if this makes sense:

I want to study a certain rare disease and devote my life to studying that disease and finding improvments and cures for people with that disease. And be able to see those patients with that disease and help with their treatment plan.

I want to be a specialist in that rare disease and help people who don't have much options but hope in research advances.

That describes probably a good number of physician-scientist. These are just examples that come to mind at my institution.
A peds surgeon went and got a PhD during his surgery residency to research NEC after treating kids with that disease. That's still his clinical and research focus today. A peds cardiologist went into research after treating kids with Marfans and being unhappy with the options available for them. He continues to research Marfans and see these patients in clinic. A peds geneticist runs a lab and clinic treating Kabuki syndrome. A psychiatrist directs the HD clinic and runs a lab researching HD. Another psychiatrist runs a treatment resistant schizophrenia clinic and does research on that in his lab. An ent sees hearing loss patients and runs a lab designing new hearing restoration implants and testing them all the way from rats to humans.

The PhD could certainly be helpful in some ways. It will allow you to start research and making connections in your field sooner. If you end up applying to PSTP residencies it's almost expected you have a PhD or an equivalent amount of research experience. Regardless, you will need to do some form of fellowship (either purely research or a clinical one that has protected research time) and hopefully your grant writing and experimental design abilities are more polished at the start from grad school. The previous research experience may also give you work to build off of or give you a better idea of what aspects of the disease you want to focus on. Lastly, you won't have massive amounts of med school debt which will be nice since you are aiming for an academic career which means you will make less money.

All that being said, the peds cardiologist I mentioned is MD only so it is possible to have a career like you describe without doing a PhD. To me it seems like it would be harder to do without doing the PhD but I'm probably biased.

 

[Golden-Future]

That describes probably a good number of physician-scientist. These are just examples that come to mind at my institution.
A peds surgeon went and got a PhD during his surgery residency to research NEC after treating kids with that disease. That's still his clinical and research focus today. A peds cardiologist went into research after treating kids with Marfans and being unhappy with the options available for them. He continues to research Marfans and see these patients in clinic. A peds geneticist runs a lab and clinic treating Kabuki syndrome. A psychiatrist directs the HD clinic and runs a lab researching HD. Another psychiatrist runs a treatment resistant schizophrenia clinic and does research on that in his lab. An ent sees hearing loss patients and runs a lab designing new hearing restoration implants and testing them all the way from rats to humans.

The PhD could certainly be helpful in some ways. It will allow you to start research and making connections in your field sooner. If you end up applying to PSTP residencies it's almost expected you have a PhD or an equivalent amount of research experience. Regardless, you will need to do some form of fellowship (either purely research or a clinical one that has protected research time) and hopefully your grant writing and experimental design abilities are more polished at the start from grad school. The previous research experience may also give you work to build off of or give you a better idea of what aspects of the disease you want to focus on. Lastly, you won't have massive amounts of med school debt which will be nice since you are aiming for an academic career which means you will make less money.

All that being said, the peds cardiologist I mentioned is MD only so it is possible to have a career like you describe without doing a PhD. To me it seems like it would be harder to do without doing the PhD but I'm probably biased.

Thank you for this reply! I really appreciate the outlook you gave me. The two options I'm trying to decide on is md and then a fellowship involving research or the md/phd program. Because I have just obtained my master's degree and did a thesis, so I have some research experience (no pubs yet though).

 

[Medstart108]

Thank you for this reply! I really appreciate the outlook you gave me. The two options I'm trying to decide on is md and then a fellowship involving research or the md/phd program. Because I have just obtained my master's degree and did a thesis, so I have some research experience (no pubs yet though).

Not to dissuade you or anything but training time is quite significant for all the things you are suggesting. Assuming you have already spent 6 years on a bachelor's and masters, a MD PhD will be another 7 or so, residency lets assume you did peds or IM+subspec would be 4-6 more years and if you end up doing a clinical fellowship or post-doc that would be 1-3 more years as well. You could very easily be in your mid to late 30s before you land your first proper job with a proper income, but by that time you will also be an assist prof working incredible hours to juggle clinical and research responsibilities. Ultimately, think of your endgame, if you are at all unsure, most people suggest doing the MD first and then decide after that, since the MD is essentially what secures your future in medicine and deservedly or not your financial future as well.

However, if you know what you want, then go ahead and do not and don't let anyone stop you. Ultimately, everyone wants what is best for you, but no one knows you as well as yourself. It will be you who makes that decision for yourself.

 

[Fencer]

On the other side of the coin, the age of first R01 is the same for MDs or MD/PhDs, which only tells you that you will have to earn the experiences to be successful. A research degree with no publications is not going to advance your credibility as an independent researcher. Despite the duration of training, your professional life-expectancy will still be likely >30 years.

 

[docmckinney]

That describes probably a good number of physician-scientist. These are just examples that come to mind at my institution.
A peds cardiologist went into research after treating kids with Marfans and being unhappy with the options available for them. He continues to research Marfans and see these patients in clinic.
All that being said, the peds cardiologist I mentioned is MD only so it is possible to have a career like you describe without doing a PhD. To me it seems like it would be harder to do without doing the PhD but I'm probably biased.

Dietz?

 

[dl2dp2]

This has been discussed before. Interestingly, the more timely addendum for all the previous thread appears to be that the MD is now worth more, and increasingly so, because, as it turns out, PhD is becoming "useless".

MD + fellowship is now a much more viable and competitive pathway for anything other than the most basic of research. For what you are interested in, that's a good pathway, especially if medical school tuition is not a concern.

 

[BB Cream]

Hi everyone, this has been a very interesting and helpful discussion. I'm currently deciding whether I should apply to MD/PhD programs or go the MD-only route. Here are my concerns:

1. I don't come from a wealthy background, so having student loans would be a consideration. Most of the clinical specialties I'm interested in are traditionally low-paying (infectious diseases, clinical pathology, pediatrics, etc.) so I'm worried paying back debt would be difficult.

2. Potentially having kids and raising a family are also important to me. While I'm sure it's possible to fit in a physician-scientist career with being a mother, it sounds extremely challenging and also brings the dilemma of deciding when to have a baby.

3. While I enjoy doing basic science research, I don't see myself becoming a full-time PI (see #2). I would like to earn the PhD to learn more techniques and do research I am interested in (novel antimicrobial therapies), but I don't have the desire to run and manage a lab full-time. Is it possible to participate in research projects part-time as an MD (either basic or translational), or is this unrealistic?

 

[Golden-Future]

Hi everyone, this has been a very interesting and helpful discussion. I'm currently deciding whether I should apply to MD/PhD programs or go the MD-only route. Here are my concerns:

1. I don't come from a wealthy background, so having student loans would be a consideration. Most of the clinical specialties I'm interested in are traditionally low-paying (infectious diseases, clinical pathology, pediatrics, etc.) so I'm worried paying back debt would be difficult.

2. Potentially having kids and raising a family are also important to me. While I'm sure it's possible to fit in a physician-scientist career with being a mother, it sounds extremely challenging and also brings the dilemma of deciding when to have a baby.

3. While I enjoy doing basic science research, I don't see myself becoming a full-time PI (see #2). I would like to earn the PhD to learn more techniques and do research I am interested in (novel antimicrobial therapies), but I don't have the desire to run and manage a lab full-time. Is it possible to participate in research projects part-time as an MD (either basic or translational), or is this unrealistic?

Yes it is possible to do research projects as an MD. I know many MD students at my school who have done summer research rotations and have presented posters. There are also scholarships you can apply to that will pay you for those rotations. Additionally, some schools also offer an MD with thesis option. Lastly, as discussed above, you could do a fellowship involving research. If you don't see yourself having a career in research, I wouldn't do the PhD.

Take out loans and pay a little each month when you reach residency. Never do the MD/PhD for the money.

Also, I knew someone pregnant while she was in med school and was just fine. Also, I knew someone in my lab who was pregnant and she also did fine. It helps to have people at home, and also some schools offer reduced day care for the students/residents.

 

[Syxx]

Dietz?

Yep.

On the other side of the coin, the age of first R01 is the same for MDs or MD/PhDs, which only tells you that you will have to earn the experiences to be successful. A research degree with no publications is not going to advance your credibility as an independent researcher. Despite the duration of training, your professional life-expectancy will still be likely >30 years.

I have been scouting out early independence awards and have noticed that it's overwhelmingly MD/PhDs being selected. These are newer grants and most not NIH so they weren't included in the PSW-WG report. 22 of 24 NIH Early Independence Awards to physician-scientists have gone to MD/PhDs. The UCSF Physician-Scientist Scholar Program has gone 9 out of 9 to MD/PhDs. The only physician-scientist Rockefeller Independent Fellow is MD/PhD. The one physician-scientist Salk fellow is MD/PhD. The one physician-scientist Carnegie Staff Associate was MD/PhD.
Not an early independence (it's early career) award but 12/13 physician-scientist HHMI Faculty Scholars are MD/PhDs.

I haven't looked too much at the K award data but saw a table from Dr. Korn (NINDS) that showed applicant success rates for NINDS K awards from 2012-2016 and the MD/PhDs had a ~5% greater success rate for K08s and ~20% higher success rate for K23s over MDs. Additionally, I was lead to believe that MD/PhDs would have an advantage when applying for R25 support over MDs (unless the MD had PhD level research experience) and that one of the main focal points of the R25 is to shorten time to independent funding for physician-scientist.

These are small numbers and they might not be representative but could we be entering a time when being MD/PhD is advantageous for early career awards ?

 

[Fencer]

I have reviewed K-awards and acted as interim chair for a year. If you only have one position every 3-4 years in your department to support an entry level physician-scientist with some start-up, you save it for some one with a track record of papers and fellowship grants. Typically, it is a MD/PhD or a MD/MS rather than a MD only graduate.