When you are a clinician-scientist or whatever you become 20-30 years in the future, do you think the extra 4 years will really make as much of difference as you think it does now? I ask this because the average pure PhD length is creeping to ~6 years often followed by multiple post-docs (aka a long time where you might have the same issues setting down roots) and I know people pursue the dual degree because they enjoy the research aspect of it. When you compare yourself to your MD peers, I can see how this feeling arises, but not so much when you compare yourself to your grad school peers. Just curious about your perspective on the issue.
I think looking that the years spent numerically may ignore one of the aspects that is particularly challenging, namely when those 4 years are spent. I think it would be much easier to spend some of the more hectic years in the beginning of one's residency in your mid 20s, vs early 30s. In particular, if you are in a committee relationship/married, its not only your life that gets put on hold. Also, depending what your spouse does, given the time commitment you must spend at the hospital, it can certainly put a hold on any plans for children as well. More to this point, if you are married to someone who is also pursuing a higher degree, it can make the process even more difficult. So although those 4 years may be a drop in the bucket over one's career, the time which they are carried out can make them more difficult.
I think the hesitation to start seeing your location as home, for me at least, arises in the uncertainty of the residency. At this point, i know its unlikely that I will not be at my home institution because they do not have a home program for my current specialty of interest. Further yet, given that I'm applying for a more competitive specialty, its likely i will not be able to pick and choose my location either. So not being able to provide any reasonable projection of where i'll be/what ill be doing in ~2 years can be unsettling to both partners, especially if you want to start making long term plans in a relationship.
As for total time commitments of PhD vs MD/PhD, assuming a 3-4 PhD in the combined program, I like to think the total time spent when looking at (PhD+post-docs) and (MD/PhD+residency) has the MD/PhD as the longer track. Even though my PhD took 4 years, i spent 2 years in medical school before that and will spend another two years in MS3-4. After this, I'm looking at a 5 year residency. Ignoring any possible fellowships, that puts me at 13 years total. Assuming a 6 year PhD for the pure track, a person would have to spend 7 more years as post doc to match that timeline and the nature of the work is considerably different. More importantly in my opinion, most post-docs I know had a lot more say on where they did their post doc vs what one gets in their residency. It's difficult to directly compare the two because they are very different worlds and styles, but hopefully i provided some insight to it
