To MD/PHD or not to MD/PHD?

[NTF]

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Had an interview the other day. I was having a great conversation with the faculty interviewer about my interests in immunology and clinical medicine. And he really started pushing me about applying to MD/PHD programs.

The funny thing is is that I had actually been mulling that over the last few days, and started to realize that the MD/PHD route probably is the best "fit" for my interests and career goals (ie medicine subspecialty and academic medicine).

I originally had rejected the MD/PHD route, well to be frank, because of my age. I'm 35 now, there is a part of me that doesn't really relish the delay of my clinical training. As any non-trad knows, while we are an uber-motivated bunch that our energy resources are finite. We excel by being efficient and very productive, but also conserving our energy. Case in point, I think any non-trad will agree that we actually consider what it will feel like for us and our families to have an intern year at 41 versus 44, 45, 46. So I guess knowing myself and trusting myself I assumed I'd have the drive and wherewithal to make basic research apart of my career even without the PHD.

I said as much to my interviewer and he agreed, but he said that the examples of MD only's having that kind of career are getting fewer and harder. He stated that especially for subspecialty fellowships that are designed to create academic physicians the drive toward MD/PHD is accelerating. He basically said if you want an immunology-heavy medical subspecialty and basic science research as a part of your clinical career, MD/PHD is your most sensible route. He felt my age shouldn't be a factor in this decision.

So I've had alot to think about. I'm pretty set on applying to PHD portions of MD or DO programs I've applied (with a few exceptions). But still studying and investigating the pros and cons of each route. Honestly, the thing that leans me to doing it is, that I love research (10 years in 3 labs) as much as clinical care (I'm currently a nurse's aide). I love teaching too (3 years as a tutor and teacher in public schools), hence my love of academic medicine. I know I'll actually really enjoy the PHD part of my training. Those 3-5 years inbetween pre-clinical and clinical training will actually be alot of fun for me.

Unfortunately, my wife probably won't like the idea. We have a baby on the way and I'm sure she won't like the idea that I would delay attending salary an additional 3-5 years let alone the 3 years for subspecialty. But this has really never been about money to me (not that money is irrelevant). From my experience you live happy within your means. When I made more money I spent more money, but it didn't make me happier.

I guess what I'd really like is to hear the "CON" side of this argument. Because I'm leaning toward doing it if I can find a program that is full funded (some programs only pay for the PHD portion) or at the very least doing an MD/MS.

Thanks for your comments.

 

[DrMidlife]

Whoa.

If you're not talking MSTP, then I vote hell no. If you are talking MSTP, then hell yes. You may be too far along in the app cycle to do MSTP now.

Financially, you can't even compare getting your MD "fast" with doing an MSTP. Think about having no debt instead of $300k. Think about how many more choices you have when you don't have that $2k/mo to $5k/mo payment for 10 years. Make sure the wife knows about that $2k/mo (or more) obligation, regardless...

Lastly, look for academic faculty who don't have PhDs and get their advice. At my school (which is NIH's #2 bitch, evidently), maybe half the clinical researchers have PhDs.

Best of luck to you.

 

[hende076]

Sounds to me like you already know what to do. I have been kickin around the same idea, and I think I will probably go the MD/PhD route myself.

 

[NTF]

Whoa.

If you're not talking MSTP, then I vote hell no. If you are talking MSTP, then hell yes. You may be too far along in the app cycle to do MSTP now.

You're probably right about the MSTP thing, but alot of the schools I applied to have fully-funded MD/PHD programs that are not MSTP.

 

[beepbeep]

don't do it. seriously. you can do quality research without the PhD... in fact, MDs tend to get bigger and better grants than PhDs. if med school is your dream-- go. spend some time throughout med school and residency doing research if this is what you enjoy. then, when you are finished with residency, you can decide whether a career as a physician-scientist is STILL what you want. if that's the case, you can tailor your career as necessary. the financial argument for pursuing an MSTP is sooooo weak. 5 extra years in med school means 5 years you won't be practicing.... let's see: 5 x ~200,000 = $1,000,000. please don't tell me that you'll come anywhere near that in med school debt. if you were a 21 year old with no wife/kids, my advice might be a little different. but your priority as an older student should to stop messing around and jump on the short path towards your career. you'll have a loooong road of training ahead of you as is.... and i think it's sort of selfish to put your wife/kids through any more than necessary to pursue your goal.

 

[NTF]

don't do it. seriously. you can do quality research without the PhD... in fact, MDs tend to get bigger and better grants than PhDs. if med school is your dream-- go. spend some time throughout med school and residency doing research if this is what you enjoy. then, when you are finished with residency, you can decide whether a career as a physician-scientist is STILL what you want. if that's the case, you can tailor your career as necessary. the financial argument for pursuing an MSTP is sooooo weak. 5 extra years in med school means 5 years you won't be practicing.... let's see: 5 x ~200,000 = $1,000,000. please don't tell me that you'll come anywhere near that in med school debt. if you were a 21 year old with no wife/kids, my advice might be a little different. but your priority as an older student should to stop messing around and jump on the short path towards your career. you'll have a loooong road of training ahead of you as is.... and i think it's sort of selfish to put your wife/kids through any more than necessary to pursue your goal.

Yeah I hear ya. Lol. It's funny, I've been ping-ponging back forth during this waiting period between hearing back from my interviews (and schools where I'm complete). But I'm definitely on the finish med school sooner route now. Though I'm still considering a Masters in Immunology if I can get full funding. 1 year delay is better than 3-5. Thanks for the sober and honest advice. So I think the MD/PHD debate is over now. I'm not gonna do it.

Plus, I'd rather pamper my pregnant wife than study for the GRE anyway.

 

[UMED122]

Though I'm still considering a Masters in Immunology if I can get full funding. 1 year delay is better than 3-5.

Personally, I think the smarter thing to do financially is to not even bother with the masters. If you want the training in immunology, do it later on as a fellowship after residency, so that you're at least getting paid, and you aren't delaying your career. It sounds like you plan on eventually doing a fellowship anyway, so getting a masters in the same thing would be unnecessary.

 

[sindadel]

Glad you decided to skip it! Pamper the pregnant wife, and do research as an MD. You will be great.

 

[Gut Shot]

Personally, I think the smarter thing to do financially is to not even bother with the masters. If you want the training in immunology, do it later on as a fellowship after residency, so that you're at least getting paid, and you aren't delaying your career. It sounds like you plan on eventually doing a fellowship anyway, so getting a masters in the same thing would be unnecessary.

Listen to this person.

Sincerely,

Gut Shot, MD, PhD

 

[QofQuimica]

Yeah I hear ya. Lol. It's funny, I've been ping-ponging back forth during this waiting period between hearing back from my interviews (and schools where I'm complete). But I'm definitely on the finish med school sooner route now. Though I'm still considering a Masters in Immunology if I can get full funding. 1 year delay is better than 3-5. Thanks for the sober and honest advice. So I think the MD/PHD debate is over now. I'm not gonna do it.

Plus, I'd rather pamper my pregnant wife than study for the GRE anyway.

Dude, you already have a medical school acceptance. There is no way in hell that any sane person should give that up to go to grad school and/or reapply for MD/PhD programs assuming you definitely want an MD or DO! Getting into grad school is a cinch compared to getting into med school. Like others have already said, you can always add on an MS or PhD at any point along the way if you still want one later, or you can do a research fellowship. Go to med school in the fall at Ohio or wherever else you like, and never even think about reapplying again.

 

[NTF]

Dude, you already have a medical school acceptance. There is no way in hell that any sane person should give that up to go to grad school and/or reapply for MD/PhD programs assuming you definitely want an MD or DO! Getting into grad school is a cinch compared to getting into med school. Like others have already said, you can always add on an MS or PhD at any point along the way if you still want one later, or you can do a research fellowship. Go to med school in the fall at Ohio or wherever else you like, and never even think about reapplying again.

lol. I never said I would delay medical school. I was weighing the pros and cons of delaying clinical training (ie rotations, residency etc.) by doing a dual degree. But I appreciate your passionate advice.