why do YOU want an MD?

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zgotts

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hello all, I am a recent college grad who majored in Neuroscience and is now doing research on the genetics of autism at a university.

i chose the research route because it seemed that getting a PhD was what i wanted... i really want to learn about things like neuroplasticity and human cognition, learning, and perception.

obviously it would be best if i could be in a Neuro lab right now, as that would give me experience in what i actually think i want to do later on, but this job was all i was offered, and i wanted to get some solid experience in the doing of science research (... and i just needed a job!).

anyways, i'm really starting to wonder if this is for me. i have many different scientific questions that i want to answer in my lifetime, or at least try to, but for me the laboratory environment seems to be too repetitive and mundane, and also stark and cold to the point that i feel like my soul/personality is decaying (alright, maybe an exaggeration, but close). i also really can't see myself continuing to work with lab animals.

i'm wondering if going the route of an MD and becoming a neurologist might be a better way of answering my questions. i have a passion for learning, especially from people, and i also truly love the excitement of a constantly changing environment (which is what i'd imagine med school/hospital work to be like).

so, i'm just curious to see how my thoughts/ideas of med school (which are only briefly touched on here) match up to those of other people what are in or have completed med school.

has anyone here made the switch from research labs to the hospital?

more importantly... why do YOU want your MD?

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The work of a neurologist, or at least an MD, can also be repetitive and mundane. Most cases you encounter are ordinary and you will find yourself repeating the same concept in everyday language to different patients day after day, dealing with frustrating things like insurance and noncompliance, etc. Yeah, if you do psychiatry or oncology things will be more interesting, if not bewildering or flat out depressing.

Any field can be boring or interesting, depending on your perspective. But the mundaness will not change, that's the nature of life. People want to and do build skyscrapers, and they start from the ground floor.
 
People want to and do build skyscrapers, and they start from the ground floor.

Hmmm not exactly the response I was looking for.
What exactly do you mean
by this quote?

I understand that eveyone has to start from the ground up and do the "grunt" work so to speak, I still feel like later on the life of a researcher remains quite repetitive.

Like you said it all really depends on how you look at it... Hopefully when/if I get a chance to do some true neuroscience research my opinions will change.
 
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OP: I've always wanted to be a physician for literally as long as I can remember. I enjoy working directly with others, I believe I would find the ability to directly improve the quality of life for others very rewarding, and it's something that I feel like I could potentially be very adept at.

I didn't even consider PhD until I happened to be looking for a PT job as an undergrad and was invited into a biochem lab as a research assistant. That helped me to understand that I wanted to also do research, and it was actually possible to do both.

Another reason I think MD is highly advantageous even for someone interested mainly in research, and not so much the clinic, is that MD can do everything PhD can do, but the situation is not reciprocal. I know beyond any shadow of a doubt that my PIs clinical training helps us to get things into preclinical and clinical trials, IND submission, FDA approval, etc. far quicker than any PhD ever could.

I was actually a bit frustrated because I got scooped recently by a MEGA-lab on a project I was working on, and I was pretty depressed. It's well known that this lab has like 50-100 Chinese post-docs sweating away 16 hrs a day just drooling to get their Nature paper. How can 1 grad student possibly compete with that?!? My PIs response "We'll still beat them to the clinic... because we got the MDs!" :laugh: And she was right.

Here's some of the fluff I put in my AMCAS essays:

"I have chosen to pursue the joint degrees of M.D./Ph.D. as a result of my interest in laboratory research that goes beyond a clinical setting..."

"I believe the principles of medicine begin at the bench and a strong foundation in research fundamentals..."

"While continuing to see patients, I would still have the opportunity to actively conduct research and report my findings so that they could be applied to the better practice of medicine overall."

"These experiences have helped me to realize that an M.D./Ph.D. curriculum would allow me to reconcile my deep interest in scientist research, as well as my desire to work in the clinic."

But most of all (and I know it's a generic bull**** response that AdCom committees hear all day and are sick of, but it's sincere and the truth) I want to be an MD because I enjoy working with others and helping to improve the quality of their lives and health.
 
I'm convinced that the life of doctor is actually far more repetitive than that of a researcher. Like Ariodant said, as a doctor, you'll probably be dealing with the same set of complaints/disorders over and over again, with an interesting exception here and there. A researcher is always working on something more or less conceptually novel - he's answering a question or working out a mechanism that no one has worked out before. Of course the day-to-day carrying out of experiments will get repetitive (especially if you get stuck and have to keep repeating stuff just to get any results), but that's why you have to focus on the bigger picture (which is easier to do if you're working in a field that truly fascinates you).

I switched from wanting a straight PhD to an MD/PhD. At first I just wanted to work on something that had slightly clearer clinical applications, but I've since realized that you can still do plenty of "translational work" with a PhD. What clinched the deal for me (and I know this sounds horribly lame and I should save it for my AMCAS essays but..) was clinical experience, and realizing that working with patients was ridiculously gratifying, and something I would want to continue doing in the future (though probably not a whole lot :p). As far as motivations for pursuing an MD, IMHO, these have to revolve around a desire to work with patients as a physician in a clinical setting (and not just as a researcher in a clinical study) - something you haven't really mentioned in your post.
 
Hmmm not exactly the response I was looking for.
What exactly do you mean
by this quote?

I understand that eveyone has to start from the ground up and do the "grunt" work so to speak, I still feel like later on the life of a researcher remains quite repetitive.

Like you said it all really depends on how you look at it... Hopefully when/if I get a chance to do some true neuroscience research my opinions will change.

You probably have to define grunt work to me...Is, for example, trying to elucidate a pathway involved in glioma grunt work? What about using shRNA to knock down an important gene in that pathway? Designing such a shRNA? I agree that passing cells and weaning mice are grunt work, and if that's all I do, without getting to do experiments utilizing the results of my grunt work, then I probably won't be here today. But those are the means, not the goals of science. The ground and the 100th floor are built using the same materials, through repetitive hammering and concrete pouring; but it doesn't mean you don't get your majestic skyscrapers at the end:)

Later on the life of a scientist becomes loaded with grunt work--grunt paper work (aka grant):DIf I were you, I'd probably worry more about that than weaning the mice.
 
I was actually a bit frustrated because I got scooped recently by a MEGA-lab on a project I was working on, and I was pretty depressed. It's well known that this lab has like 50-100 Chinese post-docs sweating away 16 hrs a day just drooling to get their Nature paper.

I thought the one scooped you was relatively obscure...Now they are a mega-lab?
 
I thought the one scooped you was relatively obscure...Now they are a mega-lab?

No.. they are a mega-lab

They had just never published anything noteworthy in our field before, never presented at Nat'l Conferences, etc. They had previously been working on something totally unrelated.. must've gotten a new grant or something

In other words, they weren't on the map as being one of our peers (or in this case a competitor).
 
No.. they are a mega-lab

They had just never published anything noteworthy in our field before, never presented at Nat'l Conferences, etc. They had previously been working on something totally unrelated.. must've gotten a new grant or something

In other words, they weren't on the map as being one of our peers (or in this case a competitor).

A situation like yours underscores the need for some sort of 'research mafia.' Competition is bad for business.
 
anyways, i'm really starting to wonder if this is for me. i have many different scientific questions that i want to answer in my lifetime, or at least try to, but for me the laboratory environment seems to be too repetitive and mundane, and also stark and cold to the point that i feel like my soul/personality is decaying (alright, maybe an exaggeration, but close). i also really can't see myself continuing to work with lab animals.

i'm wondering if going the route of an MD and becoming a neurologist might be a better way of answering my questions. i have a passion for learning, especially from people, and i also truly love the excitement of a constantly changing environment (which is what i'd imagine med school/hospital work to be like).

more importantly... why do YOU want your MD?

Zgotts,
I was sort of in a similar position as you- I knew i loved science and didn't consider medicine until I heard about the MSTP programs in my junior year. Let me clear up a few things...

1. The "mundane" stuff you do day-to-day in lab is really a passing phase. Remember that right now you are simply a grunt- probably free labor. There is a difference between having someone tell you to run a PCR and then a gel and having you come up with your own hypotheses and ways of testing them. That is what awaits you in the next phase of your training (grad school). When you are a PI you won't really be doing any of that stuff- you'll be the "idea man" and pay people to do the pipetting for you. Life will be all about coming up with good ideas/hypotheses/tests, instructing others, sharing your ideas at conferences with other brilliant people, and writing papers and grants.

2. An MD is not a good way to answer questions. It is a good way to keep you busy instead of answering questions. Many people on this board like to tell you to just go to med school because it gives you more options. While this is true, unless you WANT TO BE A DOCTOR there is really no point in going to med school. If you know you want to do research, please add 7-10 years before you can start if you go to med school and then residency. While MDs technically CAN do research while PhDs technically CANNOT practice medicine, it is foolish to suggest that MDs are thus somehow better. In general, MDs are crummy scientists and stick to clinical research. If you want to do basic science/pathophysiological research a PhD is a huge advantage.

3. As other have said, the life of an MD is repetitive. It is a job, focused on customer service. People glorify it as some superhuman/overachieving miracle, but let me tell you when you start residency the paperwork and the responibilities remind you of that every day. Scientists have a unique position in our society where they can do whatever is interesting to them and provide no commodities to our economy. We are basically bums living off the welfare of the state to satisfy our intellectual curiosity. Sometimes (rarely) we really make huge advances in the way we think/live and that's what keeps us going.

4. You don't have to work with lab animals. My entire PhD project was done on cell culture, and my PhD is in Human Genetics.
 
gbwillner, I have a question in regard to MD/PhD. How does one know what field to do their MD & PhD in? I have heard from many ppl that it would be smart to correlate to two degrees in some way. Although this is wise, do most MD/PhDs know as soon as they enter the program that they want to do their MD in this field and Phd in that field. I mean isn't it possible that one's MD and PhD are two unrelated fields? How does one avoid that-- lab and clinical rotations. I mean say for example that one likes doing cancer research, but does not want to be an oncoogist, but a physician in another field. Is that a weird situation? I am just curious b/c I would think that ppl should try to avoid such cases by getting adequate shadowing experience during college. Is that the way to do it?
 
gbwillner, I have a question in regard to MD/PhD. How does one know what field to do their MD & PhD in? I have heard from many ppl that it would be smart to correlate to two degrees in some way. Although this is wise, do most MD/PhDs know as soon as they enter the program that they want to do their MD in this field and Phd in that field. I mean isn't it possible that one's MD and PhD are two unrelated fields? How does one avoid that-- lab and clinical rotations. I mean say for example that one likes doing cancer research, but does not want to be an oncoogist, but a physician in another field. Is that a weird situation? I am just curious b/c I would think that ppl should try to avoid such cases by getting adequate shadowing experience during college. Is that the way to do it?

No, you don't have to know what you want to do when you start. Yes, it is wise to correlate the two- your clinical and research interests- but not mandatory. In the end you need samples for your research, and these tend to come from your clinical practice. For instance, if you are interested in inherited disease, Peds is good. If you are interested in cancer, Medicine is good. Doesn't mean you can't be a surgeon, but in general surgery is bad for research.
When I started I knew I was interested in human genetics, but did not want to rule out neuroscience or molecular and cellular biology. I had no idea what my clinical interests were- I considered Medicine, Peds, Neuro, and even Surgery. In the end, Pathology was the best fit for my career interests.
 
...2. An MD is not a good way to answer questions. It is a good way to keep you busy instead of answering questions. Many people on this board like to tell you to just go to med school because it gives you more options. While this is true, unless you WANT TO BE A DOCTOR there is really no point in going to med school. If you know you want to do research, please add 7-10 years before you can start if you go to med school and then residency. While MDs technically CAN do research while PhDs technically CANNOT practice medicine, it is foolish to suggest that MDs are thus somehow better. In general, MDs are crummy scientists and stick to clinical research. If you want to do basic science/pathophysiological research a PhD is a huge advantage.

3. As other have said, the life of an MD is repetitive. It is a job, focused on customer service. People glorify it as some superhuman/overachieving miracle, but let me tell you when you start residency the paperwork and the responibilities remind you of that every day. Scientists have a unique position in our society where they can do whatever is interesting to them and provide no commodities to our economy. We are basically bums living off the welfare of the state to satisfy our intellectual curiosity. Sometimes (rarely) we really make huge advances in the way we think/live and that's what keeps us going...
Even giving you the benefit of intern stress, are you for real? Scientists not providing a commodity? Scientists create new knowledge, and then give it away for the benefit of society. That's making something from nothing, the essence of being human, not nothing. And living off of your wits (i.e. selling funding agencies on your ideas) is not being a bum.

I agree that making research a mandatory part of residency will probably get you a lot of crummy research, but that thought doesn't allow for stereotypes. Not a good way to answer questions? Half of my last two years was spent memorizing minutiae the PhDs wanted us to know, simply because it was their area of research or it was on their thesis. Those may be answers, but they were a waste of my time.

I agree with a lot of your other points, but drop the arrogance. :thumbdown:
 
Read the intro to my blog (the 3 entries I've put up so far) and you'll see why I decided to persue an MD. The PhD part came later.

PS: gbwillner just pissed off half this forum :laugh:. I agree with RxnMan. Why is the USA the world leader in the pharmaceutical industry? Why does so much high-tech manufacturing happen here? Because we developed it! Without research, all of the high tech products that are produced or developed here would not be produced or developed here, but instead in some other country, leading to a drop in the overall GDP and prosperity of the average citizen. It's hard sometimes to directly quantify the contribution of individual researchers, but on a bulk effect, that contribution is there and and is one of the major reasons for the superpower status of the USA.

We are basically bums living off the welfare of the state to satisfy our intellectual curiosity.

I just consider this silly. Sure, most grants are government grants. Is it a benefit to society? Yes. Does this mean it is "welfare"? Are government employees welfare? No. They provide essential services to our society and economy, just like we do. We are highly skilled employees providing a service. The system is extremely capitalist. If the government really wanted 100% control they would conduct all research at the NIH, but they don't. They put out a public bidding service so the best and the brightest can fight for the money. Is it purely to satisfy our intellectual curiosity? If it was, you wouldn't get very much funding. Sure, part of the game is curiosity. That's one of the things that brought me into this game. But in biomedical research especially, a big part is to see how this can benefit humanity--for whatever reasons, altruism, personal glory, personal benefit, etc...

As for the part about MDs being crummy researchers, are you sure you haven't been brainwashed by the PhDs? I get the "MDs can't do research" sentiment a lot from straight PhD types, including similar sentiments about MD/PhDs. Supposedly we're crummy researchers, don't have real PhDs, etc... Now I'm always one to mention it so people aren't shocked by it when they hear it, are aware of the sentiment, and are able to combat it when they do hear. But, I never said I thought it was true :) Most my lab feels that way to be perfectly honest, and just by being an MD/PhD and a supporter of the MD/PhD program not willing to just bow my head to these sorts of comments, I've been subjected to a lot of scrutiny and negative comments. Fair enough. I never expected it from you though. Do most MDs persue a mostly clinical career? Of course. Should it be that way. Absolutely. We need more doctors than biomedical researchers. Can an MD pick up research training that doesn't include a PhD and become a solid investigator? Surely.
 
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PS: gbwillner just pissed off half this forum :laugh:.

As for the part about MDs being crummy researchers, are you sure you haven't been brainwashed by the PhDs? I get the "MDs can't do research" sentiment a lot from straight PhD types, including similar sentiments about MD/PhDs. Supposedly we're crummy researchers, don't have real PhDs, etc... Now I'm always one to mention it so people aren't shocked by it when they hear about and are aware of it and able to combat it when they do here. But I never said I thought it was true :) Most my lab feels that way to be perfectly honest, and just by being an MD/PhD and a supporter of the MD/PhD program not willing to just bow my head to these sorts of comments, I've been subjected to a lot of scrutiny and negative comments. Fair enough. I never expected it from you though.

Hey, I didn't say gbwillner was WRONG, I said his comment was "insulting". These are different things.;)

I happen to think it's wrong, but that wasn't my point. My point is what you've written above. That is, the constant insulting of MD's by PhD's and Phd's by MD's (and MD/PhD's by everyone) is not helpful to anyone, especially those trying to decide on career paths. Insulting a group of people (put in your favorite racial, gender or national group for MD's in the "crummy" sentence and you'll get the idea) is not a necessary part of the debate and is counterproductive.

Now, any of you are welcome to say that I personally am a "crummy researcher". Heck, I get that back all the time on my grant applications. :laugh: (j/k). But my failures are personal, they wouldn't have been helped by my getting a PhD during my 5 years of 90+% time laboratory based post-doc training.
 
Man, you guys seem pretty sensitive today for an internet forum crowd!!!!

Perhaps I should have been clearer, but I really didn't feel like writing 3 paragraphs explaining myself on the MDs in research bit. Of course they can be excellent researchers/PIs. What I meant to say was they typical type of reseach they do is clinical, and not pathophysiological or basic science research. During residency, for example, many pick up research projects. Most of the time they are not the type of work you would consider during graduate school. They are clinical case series/cohort studies, retropective studies, etc., much of the time with little to no controls. You sometimes hear about high profile studies that make the news like "cell phones cause cancer" and "drinking red wine prevents atherosclerosis"... These are the result of this type of work. In my mind much of this work is crummy. The results of this are also suspect. I remember vividly in med school 2nd year, ACE inhibitors were only first-line antihypertensives in one patient population- diabetics, and B-blockers were the best for everyone else. When I returned 4 years later ACE inhibitors were used all the time and now no one is on B-blockers. What changed? Huge studies showed that some other HTN med decreases mortality 1% more than the other drug. Whoopy-freakin' do.

Now, true enough there are AMPLE examples of AWESOME PIs that are MDs that work on very interesting problems dealing with pathophysiology and mechanisms of disease methodically. But in my opinion, and from my experience, most MDs in research are just not interested in the types of questions, prehaps in part because they lack the insight into the specifics of mechanisms to probe further into how stuff works. That's basically what PhD training is, after all.

As far as the "scientists are bums" comments, surely you see the hyperbole in that statement. The grain of truth is that we do not provide a real tangible commodity to anyone. And you guys seem to focus on medical research. What if I wanted to study the flight patterns of birds or the frequency of the brown note? No doubt society benefits from these endeavors, but it really does not fit into our capitalistic system. Free from government "hand-outs" we would all be left to starve because no one is in "need" of our services. Even if the pharmaceutical industry relies on our research, they can always do their own. Sure, when you are submitting a grant it helps to state that whatever you are working on will one day cure cancer so the reviewers will see the urgency in funding you, but this is not a requirement. You can become a famous scientist studying why some fruit flies are gay.
 
...As far as the "scientists are bums" comments, surely you see the hyperbole in that statement...
This sounds a lot like the New Yorker's defense of their Obama cover gaffe.

Most of the time they are not the type of work you would consider during graduate school. They are clinical case series/cohort studies, retropective studies, etc., much of the time with little to no controls...
Remember that the big difference between clinical research and basic science is that we're working with humans. One is fundamentally confined to these types of studies 'cause 9 times out of ten you can't put a person through a controlled experiment like you would a cell or a rat. It's not that the clinical researcher doesn't want controls, or doesn't have the fine understanding of what controls are, it's that you don't have the freedom to give people cancer just to see how a new drug will affect the disease outcome.

...I remember vividly in med school 2nd year, ACE inhibitors were only first-line antihypertensives in one patient population- diabetics, and B-blockers were the best for everyone else. When I returned 4 years later ACE inhibitors were used all the time and now no one is on B-blockers. What changed? Huge studies showed that some other HTN med decreases mortality 1% more than the other drug. Whoopy-freakin' do...
CV disease is the biggest killer in the US today, and with the number of hypertensives out there, 1% of several hundred thousand patients makes a difference. I get that you don't care about small changes in practice, but that doesn't mean that the work done was poor.

...But in my opinion, and from my experience, most MDs in research are just not interested in the types of questions, prehaps in part because they lack the insight into the specifics of mechanisms to probe further into how stuff works. That's basically what PhD training is, after all...
Poor quality does not follow from a lack of interest. It only means a difference in interest. As much as I didn't like learning about the different structures of fatty acids (and this is coming from a chem guy), I didn't think the PhDs teaching me were poor scientists.

The grain of truth is that we do not provide a real tangible commodity to anyone. And you guys seem to focus on medical research. What if I wanted to study the flight patterns of birds or the frequency of the brown note? No doubt society benefits from these endeavors, but it really does not fit into our capitalistic system...
This is sort of a straw man. None of the profs at my undergrad did medical research, and many of them had combinations of industrial and gov't support. They got that money because their ideas are valuable, and valuable to a capitalistic system. Why do you think the NIH is fixated on translational research? And what does an Office of Tech Transfer do?

I won't argue that there is bad science being done out there. I agree that the media will play up a (mis)interpretation or extrapolate (poorly) the results of a study. But just because something isn't interesting to you, doesn't mean it's poor quality.
 
I don't know if this is a relevant reply or not, since I'm mostly interested in an MD/Ph.D.

My goal is private-sector research, and as far as I understand, having an MD in addition to your Ph.D makes you qualified to run clinical trials far more independently than having a Ph.D alone.
 
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