Some things you are saying are true. Yes, you can absolutely go into research after only obtaining your MD. I want to make it clear from the beginning that I am not arguing with that point. MDs can be phenomenal researchers.
Glad we agree on that considering that MOST physician-scientists are "MD-only."
Yes, not all MD/PhD students end up splitting their time between research and clinical medicine, but there is a BIG difference between the students going into research from longer programs and the students going into research after one incorporated year or a research fellowship after earning an MD only. If you go through an MD/PhD program, you are required at many schools to apply for grants a certain number of times, crank out a certain number of publications, and present your research publicly at least 1-3 times per year. The students who have done that will have more experience, and I would argue that that experience will be vital for them when it comes to establishing their own labs. You just can't gain experience like that in one year.
The information that I gave above about the MSTP's having the same outcomes was from an administrative perspective. No one's arguing that the training is equivalent between the two paths, just that you are equally likely to get to the same place with either route. I, for one, would choose the quicker route as I feel I can pick these things up once I gain a faculty position. Just by being proactive in medical school, I have had multiple publications and have given platform presentations at international conferences. If you're motivated, you can do these things without having to add extra years onto your curriculum.
Also, PhD programs are valuable because they actually focus on things like statistical analysis and critical reading of scientific articles - things that medical school and research fellowships often largely ignore. I have known many MD-only PIs over the years who absolutely cannot pull the same thing from papers or run the same statistical tests that I could by the end of my masters year. While that may not be true of everyone, it is a huge detriment to the PI and to their lab.
Collaborations can and will be established with labs who can perform the things you cannot. Sadly, you'll be surprised how much you forget of your medical knowledge a year after you learned it. You'll master a specific discipline and will need to refer to others on the rest. I was once fantastic at statistical analysis, but have forgotten a great deal of it. However, if I have things I need to analyze, I have 'friends' who can help me out. No one can master everything, unfortunately. And with the rapid development of laboratory equipment, half of what we use now won't be used in 10 years so lifelong learning is a necessity anyway.
The residencies that allow substantial research, with or without adding extra time, are not as common as you probably think. These spots are hard to come by, and in some fields there are not even enough of them from MD/PhD students to find. If the students with PhDs and many publications aren't guaranteed one of these spots - even if they have amazing stats - what guarantee is there for the MD only students with much less impressive research resumes?
I can't speak for every specialty, but I'm applying for Radiation Oncology in the coming match. Every program that I've looked at has 6-12mo of dedicated research time. That amounts to 1/8th - 1/4th of my residency training (not including internship) which I think is pretty generous. Between 1/3 and 1/2 of RadOncs take an academic appointment after residency so I don't think a lack of research time is impeding their goal of becoming a physician-scientist.
I've never seen any stats like this. Most of the ones I've seen suggest that grant approval odds are fairly even between MDs, PhDs, and MD/PhDs. While this may look on the surface as if it proves your point, remember that many grants are for clinical research also. MDs are obviously ideally qualified for that type of research, and those are the projects MDs usually try to fund with their grants.
Those stats were for RO1 grants. As a matter of fact, MD/PhD's make up ~2% of the applications and are awarded ~10% of the money. MDs do almost as well and PhD's do the worst. I wrote these stats down during a lecture from a guy that sits on the board of extramural funding for the NIH.
I don't know anything about this. Do you mean that these MDs are hired to work in existing labs, as postdocs of sorts or that they found and fund their own labs? Either way, I can't imagine that the NIH would be able to afford anything much more substantial than a standard research salary...certainly nothing comparable to the salary that comes from clinical work.
Yes, if you are an MD employee of the NIH (i.e. government employee) and not a contractor, you WILL be paid more than your PhD counterparts and are eligible for loan repayment up to $35,000/yr. It doesn't matter whether you work for the lab, run the lab, or fetch coffee for the lab. True, you aren't paid as much as an MD in private practice, but that's the nature of research in general and you make about as much as at other academic institutions.
A couple of points about this. You cannot keep a personal clinic afloat by working one day a week, and many teaching hospitals are not going to want you if you cannot commit more time than that. Yes, there are ways to work part time in medicine, but why would one day or less even be worth it?
What generally happens is that your research is in a given field, let's say IBD. Then you opt to see the IBD patient's one day per week. This isn't your "personal clinic." It belongs to the University and they pay all overhead, etc. You just see the IBD patients once a week and do IBD research the rest of the time. It seems like a funny arrangement I know, but the way these things come about is that the University really needs a clinician and you really want to do research full-time so it becomes a game of push-me-pull-me until an arrangement is reached. Obviously the researcher won in this case
(BTW, this is a true story).
As for path and rads - if you want to land a rads residency, with lots of research time and no additional years added on...good luck.
It's called the Holman Pathway and it's in desperate need of applicants! (
http://theabr.org/ic/ic_other/ic_holman.html). 2 FULL YEARS OF RESEARCH BUILT IN! I also thought it was too good to be true at first. My PI is a graduate of the program. You know what's better? You're eligible for NIH loan repayment while you're in it!
Choosing a research career is a beast...but the problem isn't the PhD degree, it's the set of hoops that are intrinsic to research itself. If you go into research, you will spend countless hours pandering to reviewers and submitting and resubmitting grant applications. You will make much less money than you could have made elsewhere, and sometimes, you just might hate your life.
Agree with what you've said here. But I think it's human nature to hate your life at certain points along the way. I think the intangibles make a career in research worth it. But it's not for everyone.
None of that will change if you earn an MD instead of a PhD, and if your only goal is non-clinical research, why on earth would you even want to go through 4 years of medical school + a research year + residency + a probable research fellowship to begin with? Just get a PhD and the extra research training that comes with it.
You only need to do the 4 years of medical school + residency (arguably) if you know research is what you want to do. Why do it? Because you'll be paid more and have an easier time obtaining funding!
