why not just phd?

[midwest_turtle]

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i have been thinking about this question for a while. i'm gonna be a junior this fall with 2 years left til i get my bs in chemistry. i have told myself that i will take my mcats this august, but i keep thinking about how i would like to teach chem at the college level. i love chem, and i could see myself doing it years from now, but i also could see myself working in a hospital years from now too. when i think chem, i think 😍 , when i think about md i think 👍 . i really start leaning towards md when i think about all the people i could help, lives i could save, etc. is it even possible to do phd in chem and md?


why are y'all going into medicine and not just getting your phd?


i know y'all are gonna say, "follow your dreams" but i just want others inputs

 

[Neuronix]

I'm in MD/PhD for three reasons primarily.

1) I'm unsure what I want to do with my life.
2) The job market is better for MD/PhDs than PhDs. This applies especially to industry, but there's ways this applies to academia as well.
3) I have to do medicine. Medicine has always been a big part of my life. The research part came later for me.

If you want to be a college professor, get a PhD. If you become a MD/PhD, the ideal is that you will use those skills to address clinical questions relating to chemistry. You will primarily a researcher at an academic medical center and train graduate students and/or teach at the grad level and medical school level. It certainly is possible at many schools to get a PhD in chemistry. You could also do a PhD in Pharmacology that would be very rooted in chemistry, but with a clinical focus.

 

[Gfunk6]

Consider this as well. If you are a PhD who runs out of funding, then you are out of luck. Considering that the NIH payline has been creeping ever higher lately, this is a real potential problem.

If you are an MD/PhD in similar circumstances your responsibilities will be shifted to clinical duties. Though you may lose your lab, you can still apply for grants in the interim.

 

[biplane]

In a nutshell, yes I considered doing only a PhD in synthetic organic my first two years of college. However, I realized a few things

1) Even in the best research groups, 50+% of postdocs were going to industry. Great academic positions were rare.

2) Research is risky--saw a lot of people blow up and die, even as an undergrad. MD/PhDs can defer making a life-altering commitment until their CV is further developed (i.e. have a better idea how you will fare as a scientist only)

3) To me, synthetic organic as an isolated discipline was not as interesting as the interface with biology/medicine. I felt the MD degree would be helpful in this regard.

4) Financial security is much better if one's life priorities change.

5) MD/PhDs are exposed to minimal/no financial risk in return for two degrees in a period not significantly different from PhD only: 5/6 years vs 7/8 years. You are not committed to pursuing clinical medicine as a career.

6) Even if one is not brilliant as a physician-scientist, you can almost certainly obtain head of lab status if you want it. This cannot be said for a pure PhD.

 

[j8131]

Hi, I'm a first-time poster. A few people on this and other threads have said that the industry job market is much better for MD/PhD than PhD and that there's often a large pay differential. What jobs are available to MD/PhD but not PhD? Is this true even of post-grad entry level? Also, does the same apply to MD alone vs. PhD?

Also, a poster on this bplane, mentioned that MD/PhD offers more certainty of achieving head of lab status. Why is that? Don't you still need to get the grants to support your lab.

Info is greatly appreciated, thanks!

 

[biplane]

Provided one has clinical training, you will have less difficulty obtaining a head of lab position for the following reasons. 1) Can obtain a lab head position in a clinical department--if they can hire a physician they will gladly do so in preference to a pure Ph.D. 2) The existence of physician investigators is central to the mission of academic medical centers. They can perform clinical duties, conduct research, and mentor students. They can understand basic science aspects of clinical problems and clinical relevance of basic science problems. 3) They can offset some of their salary by performing service work (e.g. one month a year attending). 4) The number and quality of competition against an MD/PhD is nothing like that encountered for a Ph.D. A typical basic science opening will result in several hundred applicants. MD/PhDs or scientifically well-trained MDs are smaller in number. If they are willing to be flexible with their search constraints (e.g. not heme/onc jobs in Manhattan), chances are good that they can find a job.

This just speaks to the finding of *a* position. Whether the startup package or ego satiation will suffice is another question. However, the bottom line for a scientist, like an artist, is to live to continue to practice one's craft (the creation of knowledge and ideas) and to live to fight another day. Can this happen as assistant professor of medicine at South Podunk State School of Medicine? I think so.

Of course, you have to get grant funding to maintain long-term viability.

Anecdotally, MD/PhDs I know that want a lab have eventually got them. A lot of PhDs I know (and in some of the very same labs) have had to settle for a lot less with equivalent or substantially better CVs. My impression is that R01 funding rates are currently sufficient for people to eventually support their labs. Maybe not support a lab the size of Baltimore's at his peak but enough. This excludes funding sources to physicians that are often totally off limit to non clinicians: departmental/med school funding kicked back from the Dean's taxes on clinical earnings, private philanthropy support (e.g. American Diabetes Association, Cancer Association, Rheumatology association, "My Deceased Loved One" memorial foundation.)

 

[Caristra]

I'm in a similar situation. I love chemistry but I also love medicine. I want to get my MD/PHD because aside from better job opportunities, I think the degrees really do compliment each other. The MD informs your research. It's really fascinating to see the way that medicine interrelates with science. Most people think I sound like a huge dork when I say this, BUt I think if you really have a passion for both things then MD/PHD is a great way to go. You get to integrate both things into your life. 😍

 

[j8131]

Thanks, biplane, your response was very informative. Do you have any insights into why the industry job market is much better for MD/PhD? Is it simply a matter of supply and demand given the number of positions and less competition in the MD/PhD group? And do the industry and head of lab advantages mainly apply to MD/PhD with residency training (i.e. those who can practice a specialty), as your post seemed to suggest?

 

[biplane]

Truthfully, I don't know much about industry including salaries etc. However, I think you will find that you rise to a much better position (power, renumeration, people supervised etc.) the later you enter industry, even if all you do is wait until you get an assistant professor head of lab position. The chief scientific officers of many biotech/pharma companies are recruited from academia. Fishman at Novartis and Peter Kim at Merck and Tessier-Lavigne at Genetech and Perlmutter at Merck-->Amgen etc. Fishman and Perlmutter have M.D.s or MD/PhDs.

If you go straight into industry without clinical training +/- postdoc, you don't have very much unique to offer a company. You can join the queue with everyone else waiting for the guy above him/her to die/retire or you can try to transfer horizontally between companies. However, it seems to me that the entry level pay will not be remarkable: you certainly are not entitled to "clinical compensation" pay like the way NIH bumps up the salary of clinically trained individuals. When you work at an entry level staff scientist position, your success will be linked to the small world that you work on in the lab (note the frightening similarity to a basic science postdoc). Your M.D. credentials may or may not help you approach a problem better, but I would be surprised if you were promoted "just because" you have an MD/PhD. If you wait, you come in at a more senior position, you are effectively more diversified in career risk and take the credit for whatever works (note the similarity to a head of lab position).

Another route to industry would be along the lines of clinical research, drug trials, and clinical/regulatory affairs in pharmaceutical companies. These positions require clinical training. I have no evidence to back this up, but I am under the impression that they pay reasonably. I am unclear how difficult it would be to lick you way to the top of the ice cream cone from there. A lot of the pharmaceutical/biotech companies I am familiar with are led by the scientists or businessmen, not the "clinical affairs" guy. Also, (personal editorial), clinical drug development sounds boring as dirt to me. It seems to me all the intellectual action is occuring in the lab there.

 

[Fixed Gear]

biplane, by your logic, a 'clinical department' would rather have Joe Schmoe, MD as it's chair than Tyler Jacks, PhD or Bob Weinstein, PhD.

Clearly, you know NOT of what you speak.

 

[biplane]

Well, it wouldn't be the first time I've heard that...

Look, reasonable people may disagree. However, I am unaware of any clinical department headed by a Ph.D. regardless of how good they are as a scientist. I can accept that this has happened occasionally, but I have not encountered it in my experience. I readily concede that pathology and neurology departments in particular have a fair number of Ph.D. lab heads. This is especially true when these departments are de facto basic science departments. However, I still believe that clinical departments want clinically trained researchers, and they will hire accordingly. I also feel it is defensible to argue that physicians with scientific interests have a much easier time finding a head of lab position somewhere compared to their Ph.D. colleagues.

By the way, I am not suggesting that the dual degree is necessarily the best way to pursue a phenomenal scientific career. It's just the safer way to approach one's career. Clearly, you can get a lot more done at an earlier age without the distraction of clinical training (though I feel the generalist approach of medical school is academically helpful). He who dares wins--though he also occasionally is martyred.