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The MD / PhD Track : MSTP Discussion 1

MD/PhD Discussion 1

The following discussion is from our archives. It's a heated, but meaningful discussion, that occurred when an MD/PhD article on studentdoc.com in 2000.

KRISTIN writes: Since you mentioned the MD/PhD track, I was just wondering if you have any advice for me, as I'm going to try to get into that field. I'm getting my master's in chemistry, at a fairly young age (I'll be done at 21), because I really like research. I'd like to be able to teach eventually, but also want to practice good medicine and research. Is there anything else I should be doing?

Moderator: Having gone down the MD/PhD track myself I have a lot to say on the topic. It sounds like you've got a good handle on the basics: have a solid research history (1 or more publications would be a great help), solid grades, a life outside the lab, and have an understanding of what you're getting into.

Most MD/PhDs end up doing either research or medicine. Few can do both well concurrently. I thought I'd be the exception, but I wasn't - I haven't met the exception from my generation yet. That means doing A LOT of soul searching before committing to an MD/PhD program.

Remember, almost all MDs interested in research will do a sub-specialty fellowship. Since a large component of that fellowship is research, you get your research fix and qualifications. It also means that you're a qualified researcher and clinician much earlier than you would if you went the MD/PhD route. If a faculty search committee looks at a candidate who took 12 years for an MD/PhD with residency and compares that to a candidate who took 12 years for an MD/residency/fellowship - the MD/fellow almost always wins. For a clinical department, the specialist brings very specific expertise and the ability to bill.

You'll have to decide for yourself if an MD/PhD program makes sense. If you do choose to do an MD/PhD, I'd look for the combination of a good medical school and a good graduate school, in a place you can live.

I'd be happy to spout more on the MD/PhD track, just get me started.

KRISTIN: Wow, thanks...I think given your recommendations in terms of the requirements, I might be okay for an MD/PhD. I've got about a 3.6 GPA,and lots of research experience already, plus what I'll get during my MS. I'm on the swim team for my school, and should have some solid recommendations from both my thesis advisor and people I've worked for in industry. But now that you've mentioned the MD/fellow being better than the MD/PhD in the MD world, I was wondering under what circumstances the MD/PhD is better..I know that a lot of times a tuition stipend is given, but that's not really a motivation for my going into the program. Ideally, I'd like to be able to practice medicine, and then either teach or research at a university. Is this really the best route for me? Why would/wouldn't it be? I hadn't really thought about the other options in terms of my degree, as no one had really pointed them out to me...thanks for making me think about it.

Continued in the next MD/PhD discussion

Main MD/PhD page

Moderator: So I've spent some time thinking about when an MD/PhD is useful, and when it's not. If I were you, I would talk face to face to some MDs, some PhDs and some MD/PhDs, to get a variety of opinions. Here's my experience.

- Doing my PhD gave me a great basic science background, even compared to most MD/fellows. I have a better understanding of the issues and techniques associated with my basic science field than almost any straight MD does.

- I have a much worse understanding of the clinical problems that need research. Many non-clinicians can make significant advances in clinical fields, but often any clinical problem seems worth studying - even though it might be an unimportant one.

- After I finished my PhD and returned to 3rd year med school, I had 2 professors in internal medicine who had started medical school with me. I had several surgical residents who taught me. In a way it was nice because as a 3rd year I got to do a lot more than I might otherwise have. Of course, had I gone straight medicine I would have been teaching or doing surgery by then.

- The stipend you get as an MD/PhD is trivial. Definitely don't let that sway you one way or another. It's just a way of keeping you eating while you're in lab.

- Will the extra 4-6 years in a PhD program help you reach your ultimate goal of teaching, doing research and practicing medicine? It could, but is the incremental improvement in opportunity worth the extra time? That's subjective, but for me the answer is no. If I had things to do over again, I'd go either straight PhD or straight MD.

Again, get a variety of opinions - and make sure to ask specific questions because the answers change when you start pressing for specifics.

KRISTIN: Thank you again! I actually paid a visit today to one of the medical schools on my list, and tried to do as you suggested. I talked to the admissions personnel for the program, and asked them very straightforward questions regarding where each of the options (MD/PhD vs. MD/fellow) will take me. I know I have a lot of thinking to do, as I'm still not sure if I A) want to make a choice between clinician and researcher and B) what the choice would be. I very much want to practice medicine, which is what makes me think the MD/PhD might not be the best for me. From what the admissions people and some of the professors from both the medicine and biochemistry people said, most that opt for the dual degree end up doing about a 80/20 research/clinical ratio. That sort of bothers me...I really like dealing with people, and more directly helping them. However, I like the idea of being at the very source of a solution as well..hence why I need to think about this a lot. As of now, I'm leaning towards the MD option...like you, many dual-degree-ers that I've talked to have said that they would do one or the other. What I'm most afraid of is getting through the 8 years or so needed for the dual degree, and not liking research as much as I do now...but I also don't want to entirely shut out the opportunity to be a great scientist. Please feel free to tell me anything that might help..you've really given me a lot to think about so far. Thank you again!

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