"Value" of an MD or MD/PhD w/o residency for a research career

[pathdr2b]

Not sure if this could better be answered in another forum, but I'm wondering if anyone has any info on the "value" of an MD for a physician that wants to do research?

I've personally never given this ANY thought whatsoever, but I am curious.

---

Members don't see this ad.

 

[dl2dp2]

what do you mean? can you elaborate this question a little bit?

someone who has an MD who conducts basic science research exclusively is generally not considered to be a physician. Again, as I have emphasized numerous times before, a degree is just that a degree. A degree is not a job description.

Now, is there an ADVANTAGE for an MD (w/o residency) compared to a PhD training for a career in research in science? Personally, I think so. I think the vast majority of biological science PhD students are undertrained today in the US, where there is very little required coursework. If you look at modern biological research, it is really being attacked from two angles: one, from the molecular/biochemical perspective--this requires a firm background in physical chemistry/statistical mechanics etc. two, from the organismal/disease perspective--this requires a background in the organismal level biology, such as gross anatomy, etc. In my opinion, the first two years of medical school is still THE BEST COURSEWORK material for a PhD student interested in doing research in biological sciences. I think this partially accounts for the fact that some of the most significant biological research done, to this is day, is still coming out of people who have strict MDs, or have PhDs in the physical sciences.

The clincial years in MD is pretty useless for research...except the fact that seeing patients in misery may provide an emotional incentive to work hard in your lab.

 

[Nuel]

I agree with sluox for the most part.

 

[pathdr2b]

Originally posted by sluox
what do you mean? can you elaborate this question a little bit?

This question is in part based on the assumption someone made in another thread that some people don't complete residencies.

I have a friend who's completing her MD/PhD and because of the very generous offer she has from industry, she's considering bypassing the residency following graduation (apparently the residency doesn't matter to them).

Maybe many of you are too young to remember the time when public health physicians working in epidemiolgoy didn't complete residencies, instead pursued an MPH and went straight to work.

As I said before, I was just curious and since I know this can be a viable option I wanted to see what people's experinces/thoughts are on this.

 

[dphoenix]

Hey guys, I really had to reply to this thread as I was just looking about, but it made me really laugh when I saw that some of you think that MD is better than PhD for research since the coursework is more focused on biology.

Now in my opinion, PhD is really better for research, MD is better for clinic. The reasoning is not because of coursework, because that's not what makes you a good researcher; the difference is in how MDs vs. PhDs think. PhDs will question everything and focus on details and techniques, whereas MDs are very used to the reward system of knowing everything in some book. For an MD, there's always an answer somewhere, due to some case study or some article, whereas for a PhD, there are never really any answers. I know that this may sound trivial, but believe me, state of mind and how you think is drastically influenced by what kind of training you have.

Just to give you background, I'm an MD/PhD in my 4th year so I've had a taste of both sides. Now there are some notable MDs that have done extremely well in research (Eric Kandel, Roderick MacKinnon), but I think they are the exception to the rule.

 

[dl2dp2]

I think you might have misunderstood me. My point is, the phd coursework in biosci is a joke. Of course, ultimately, the only training for a research career is research experience.

My point is, I don't know of any advantage of doing a PhD over doing an MD + post-doc (the so-called "late boomers" in an NIH study), except perhaps the finances. In fact, PhDs don't do any better (and according to some studies, worse)at getting tenured than MD + post-doc people (and in fact this later route is the faster route). The NIH study showed that late boomers tend to be MORE productive, get funding more often and get tenured more than a PhD graduate.

And in my opinion, a PhD degree is not a training degree. It doesn't "train" you to do anything. You work in a lab. Exactly what you would've done anyway had you done a post-doc. You just do it earlier and with more free time to explore things. Most PhD graduates can't find a job in academia after they graduate.

Obviously, an MD only is not going to train you to become a scientist. Someone who only has an MD degree will not get tenured for a basic science department. But, a PhD won't generally get tenured either. So either way you'd have to do a post-doc. And, i think you are mistaken in thinking that a degree program could transform the way people think.

And, to refute your argument, Kandel and Mackinnon are not exceptions. If you count the number of Nobel prizes in Physiology and medicine, you'll see it's pretty much dominated by MDs. Then there are the physical science invasions (i.e. Crick, MRI people etc). If anything, the contribution by biology phd programs is highly incommesurate with the actual number of graduates they have produced.

 

[Nuel]

I think a PhD helps the MD. From what I have garnered and perceive, a PhD trains you in basic science and such training presumably sharpens the investigative skills of the trainee.

But I think a PhD in the hardcore sciences like biophysics, bioengineering and other quantitative programs actually complement the MD, and that is one reason why I feel I may need the PhD. However in such programs as molecular bio, immunology, etc, an MD with a post-doc might do, but having the PhD can make things much better.

In the end the outcome of one's scientific career, if other things stand, will depend more on the individual and the kind of research work he/she does than the structured path the said individual follows. It's all different routes to the same goal.

 

[DarkChild]

For an MD, there's always an answer somewhere, due to some case study or some article

Patently false.

 

[Neuronix]

Originally posted by dphoenix
Now there are some notable MDs that have done extremely well in research (Eric Kandel, Roderick MacKinnon), but I think they are the exception to the rule.

Look at the big list of HHMI researchers at http://www.hhmi.org. You will see that the numbers of MD and MD/PhD researchers are about even. This of course assumes that HHMI researchers meet your criterion for doing "extremely well". There's also been way more MD-only nobel prize winners than MD/PhD nobel prize winners.

 

[hockebob]

neuronix,

in all fairness, until recently the number of md/phds relative to mds doing research has been very low. and nobel is always about 10-20 years behind (eg- hunt getting the 2001 prize for medicine for work first published in 1983, etc).

that being said, the HHMI statistic is probably more telling.

it will be interesting to see how these trends continue or change in the future.

- aaron

 

[crickster]

one of the main reasons that i chose the md/phd route versus md only is due to the emphasis on each type of training (med school's "width" v. grad school's "depth"). clearly in my mind, one is trained to be a better scientist by going to graduate school versus medical school. med school is focused on absorbing an insane amount of material at a rather shallow angle, while grad school's aim is to take a serious look at a very detailed problem. grad school also trains scientists in areas of lab techique, paper/grant writing, and simple experimental follow thru and execution, while med school one looks for a symptom to match a dx--> pt treatment-->end of case-->next symptom/pt. i think this fact is indeed important at many school's that are more case/patient based versus a more traditional science heavy curriculum.

 

[pathdr2b]

So do most or all research focused MD only individuals complete residencies or do MD/PhD's complete more residencies? Does anyone have any ideas?

For the type of reseacrh I do, I have to have the microdissection of tumor tisue performed by a board cerified pathologist, that means residency. Furthermore, slide intrepretation has to be conferred by a pathologist as well.

Now I would think that for basic science focused researchers either MD or MD/PhD a resicency wouldn't be "required" at all. Therefore the residency would appear to be more of a plus for scientist in clinical/translational research than in basic science areas.

 

[MPS]

In my opinion, having to do set coursework for a PhD is a joke.

There is no question that a PhD will give you a far better grounding in research than a MD. The advantage of gaining the latter is that it a) enables you to put research into perspective and b) enables you to apply findings to the clinic.

 

[pathdr2b]

Here's an interesting presentation on the residency choices for MD/PhD graduates over the last 20 years or so. I think it's interesting to note the declining number of individuals that appear to be doing post-docs as opposed to residencies. I wonder if these are graduates with primarily basic science PhD's.

http://www.aamc.org/research/dbr/mdphd/bsullivan_residencychoices.pdf

 

[Fixed Gear]

Originally posted by sluox

And in my opinion, a PhD degree is not a training degree. It doesn't "train" you to do anything. You work in a lab. Exactly what you would've done anyway had you done a post-doc. You just do it earlier and with more free time to explore things. Most PhD graduates can't find a job in academia after they graduate.

Did any of you guys hear that?

It was the sound of a million PhDs/PhD students slapping their foreheads and grimmacing in unison.

All I'm going to say is that you are uninformed, sluox. I'm not saying you're dumb or anything like that. I'm saying that you'll probably change you mind in a few years.

However, I will say that I thoroughly agree with your statements about MDs, PhDs and tenure at academic centers. At my school you can not be a chair of (certain) departments unless you have an MD and are board certified as a physician. So absolutley, I agree, tenure track position may be hard to obtain at certain insitutions. The flip side, of course are high-powered places that do tons 'o biomedical research with few/no MDs, such as the Whitehead, where some of the big names are PhDs, like Tyler Jacks, Bob Weinberg, Eric Lander, blah, blah, blah.


I am now waiting for the palm-print on my forehead to disappear.

later.
xFGx

 

[pathdr2b]

Originally posted by Fixed Gear
At my school you can not be a chair of (certain) departments unless you have an MD and are board certified as a physician.

Sounds like the completion of a residency to me....................

 

[Fixed Gear]

Originally posted by pathdr2b
Sounds like the completion of a residency to me....................

Precisely.

At my former institution (a research hospital) the Chair of the division of genetics was a PhD. He got to be chair becuase the previous chair, a MD/PhD, committed suicide and he was "next in line". He has since been demoted and the new chair is an MD/PhD.

 

[cmz]

Originally posted by Neuronix
Look at the big list of HHMI researchers at http://www.hhmi.org. You will see that the numbers of MD and MD/PhD researchers are about even. This of course assumes that HHMI researchers meet your criterion for doing "extremely well". There's also been way more MD-only nobel prize winners than MD/PhD nobel prize winners.

For the MD-only HHMI investigators... all I have to say is that MOST of them did a residency + fellowship and a ****-load of post-docs to get where they are. They might as well have done a PhD.

 

[pathdr2b]

Originally posted by cmz
For the MD-only HHMI investigators... all I have to say is that MOST of them did a residency + fellowship and a ****-load of post-docs to get where they are. They might as well have done a PhD.

Exactly !!!

 

[dl2dp2]

What you are saying is exactly what I'm saying. There is no disadvantage for just doing a pure MD. As long as you fulfill your training as a scientist at some point. And by the same token, I don't see the advantage of doing a PhD in substance, because a post-doc basically the same thing as a PhD, except with more focus and a higher paycheck.

I have heard that people who only has an MD can get turned down more easily when they apply for a grant, etc. There may be a small point for getting a PhD if one wants to focus on pure basic science. But all in all, I think in academia the name of the institution carries more weight than your degree. For instance, I would speculate an MD researcher from UCSF would have a more favorable impression than an MD/PhD from Michigan State. This is simply because most of the people on NIH's grant review committee are from big name institutes (same for editors of big journals etc.)

To make this discussion more productive, I think i've made some arguments suggesting that someone who gets into an MD program with a really strong research program in a particular area and a very high institutional reputation should probably forego an MD/PhD program at a less reputable institution. Keep in mind I'm talking strictly about the reputation of a particular field.

secondly, I think those who are interested in research but can't make up their minds shouldn't be rushed into MD/PhD or PhD programs. First of all, I don't think there is a disadvantage if you go for the "late-boomer" route. Secondly, rushing into a PhD program may be a really bad idea, especially for young people who constantly change their minds. If you have an MD and decided research's not for you, worse comes to worst, you drop out and become a highly paid, well off admired physician. If you have only a PhD, you either get a job in the industry or get a teaching job in a college, jobs that are much less well compensated and socially valued. (Obviously I think social values have their intrinsic and fallacious bias, but that's besides the point.) Instead, be happy that you got into a med school! You can always do research once you become a doctor.

Originally posted by cmz
For the MD-only HHMI investigators... all I have to say is that MOST of them did a residency + fellowship and a ****-load of post-docs to get where they are. They might as well have done a PhD.

 

[flyingillini]

I just want to comment that sometimes the golden standard on these forums for successful accomplishment in research seems to be the Nobel prize. Why is this?

Nobel prizes are like Oscars. The people who recieve them are well deserving, however for each Noble Laureate there are thousands of other scientists with very significant contributions as well. I'm not downplaying the award by any means, I think it's great, but there's only 1 to give out per field, and theres only so many fields. Someone is bound to be left out who contributed something great.

But the talk about how, "MDs have a higher Nobel rate output to degree output" does not matter at all. The award can only honor a few people per year. We know that it takes more than a couple of people to make science happen. So don't be distraught if you don't win the Nobel prize in your lifetime. Most don't. 😉

 

[Neuronix]

Originally posted by flyingillini
But the talk about how, "MDs have a higher Nobel rate output to degree output" does not matter at all. The award can only honor a few people per year. We know that it takes more than a couple of people to make science happen. So don't be distraught if you don't win the Nobel prize in your lifetime. Most don't. 😉

Agreed. Ignore that I said it. What we need is a good indicator of the success of MD vs. MD/PhD researchers. The problem is that I haven't found any that compare the two directly in useful ways. I wrote it because I'm trying to argue a point--that an MD/PhD is not REQUIRED to do medical research. Most people respect that there are about the same number of MD HHMI researchers as MD/PhD HHMI researchers.

Now, while it may not be required, I still think it's a good idea. 🙂

 

[cmz]

Originally posted by Neuronix
Agreed. Ignore that I said it. What we need is a good indicator of the success of MD vs. MD/PhD researchers. The problem is that I haven't found any that compare the two directly in useful ways. I wrote it because I'm trying to argue a point--that an MD/PhD is not REQUIRED to do medical research. Most people respect that there are about the same number of MD HHMI researchers as MD/PhD HHMI researchers.

Now, while it may not be required, I still think it's a good idea. 🙂

Perhaps I don't know how HHMI determines who they fund, but perhaps they fund "X" number of MDs, an "X" number of MD/PhDs, and an "X" number of PhDs. X=X=X.

At any rate, what are the stats of MD-only NIH R01s vs MD/PhD NIH R01s (likewise, vs PhD-only)? If I'm not mistake, I think the number of pure MD-only grants is dropping quite steadily.

I guess in the long run, if you're going to do spend a significant amount of time on laboratory research, then it probably doesn't matter when you get your PhD OR how you get your hardcore science-training (multple post-docs).

However, I think you could make your case more appealing if you completed a residency and were board certified in SOMETHING (I know this can come up on the big NIH R01 grants). I don't know the facts, but I personally believe it makes a world of a difference, both, in the political and scientific forums.

 

[pathdr2b]

Originally posted by cmz
However, I think you could make your case more appealing if you completed a residency and were board certified in SOMETHING (I know this can come up on the big NIH R01 grants). I don't know the facts, but I personally believe it makes a world of a difference, both, in the political and scientific forums.

Yep, I was thinking completing a residency would be the politically correct thing to do even if you never plan to have any clinical responsibilities. Thanks for responding to the original question😉

Although I'd bet the number of MD only nobel prize winners were board certified too!