Advice needed. Stable MD vs less reliable PhD.

<p>Next fall I will be starting my junior year. At this point, I should probably know what I want. The problem is that I only know (generally) what I LIKE. </p>

<p>When I look at course offerings, the majority of classes which interests me is in sociology and philosophy. I was previously a psych major with some philosophy bachground, but my interests focus on the ethics of practicing in the mental heath field, and ironically less psych actually applies to that interest. I've been bouncing around the idea of just going to med school to do psychiatry, since it would be an interesting and stable field that I would probably enjoy on a day to day basis. My problem is that, while I just* like* science classes (I love labs, but not the lectures), if I see a class like "Ethical Issues in Public Health" I immediately get really excited. This makes me nervous because humanities and social sciences have always seemed really easy to me. I worry that if I focus too much on these classes, grad or med schools will think that I just wanted to take easy A classes. More importantly though, I'm not sure if pursuing this area will lead me to an actual future.</p>

<p>The other idea that is bouncing around in my brain is that I could do a PhD. There are programs that relate to social medicine and ethical problems in health care, right? If so, what are they? I'm so confused about my options. I just think that I would really ENJOY studying this further, since I feel passionate about the topic. My problem with a PhD, however, is that I was basically raised to believe that it leads to nothing except a teaching profession. I don't think that I'd mind that, but the whole point of that path would be to keep studying ethics, not teach... I like the idea of doing research, but an anatomy professor of mine created some anxiety about that for me with his constant lamenting about the lack of grant opportunities and options. He basically said that PhD = POOR for most people. I realize that his experiences tainted his view, but I can't help agreeing that a medical degree seems like a more stable path. Am I misjudging? </p>

<p>I could really use some feedback about my options. Part of me is just saying to go for the MD, even if the path would be less enjoyable, since I could have the reliable option to practice and could just figure out something in medical ethics later. I don't know if that is really possible either though. </p>

<p>Help?</p>

<p>Are you going to be a junior in college?
To be able to fulfill premed requirements, you have to start from the very first day in college, take some HARD science classes, and get top grades in them. Over 50% of students who start out as premeds, change direction after freshmen year.</p>

<p>nngmm, I will be a junior in college, yep. I have taken sciences (i think that I mentioned the anatomy, and I've taken some chem already, etc). I would have a lot more to do, but it wouldn't be impossible. I'm pretty good at science, very bright, and obsessively motivated to do well, so I'm not afraid of bad grades. If I make up my mind to do pre-med, I will do it well. The question is whether that is the best path. </p>

<p>Don't most of the people who drop pre-med have problems with the chem? I like chem...</p>

<p>These days I'm not sure that the medical path leads to that much more money than Phds. We live in a town that is an easy commute to a couple of hospitals and med schools. Half our friends are MDs and the other half are Phds. We all seem to have a pretty similar lifestyle. </p>

<p>I think the real question is what do you really like to do. Going to work every day feeling happy about what you do makes a huge difference in your life. My dh loves doing cancer research, enough so that it makes up for the tedium of applying for grants and reading dissertations and being on committees. I love seeing my designs becoming real enough so that it makes up for zoning board meetings and building department red tape.</p>

<p>BTW my husband does med school admissions for those in the Md/Phd program at his med school. (Another possibility for you.) He doesn't look that much at the content of the courses outside the required pre-med courses. He looks primarily for top grades in those science courses, good grades overall, high MCAT scores and for the Phd portion - good recommendations from research experiences.</p>

<p>Hey Mathmom. I briefly checked out some info on MD-PhD programs with tracks in the social sciences. They looks absolutely fascinating. Medical anthropology seems to be one track and that could be a really good option for me! </p>

<p>I think that I would enjoy research, but I just fear that I will get into the field and be stuck with no actual research opportunities. The appeal of the MD is that I won't need to worry about getting a job in the field. </p>

<p>I wish that I could just be a professional student! I love social sciences and humanities because I like thinking about things in different ways. I love the theories, I love that analysis. I think that I'd like psychiatry because I like breaking things down and figuring things out. I think that I'd feel really happy every time I figured out what each client needed. Medications are fascinating to me, and it would be nice to help people while piecing things together. At the same time, I love those same subjects because I love to write and deconstruct and prove my points about concepts that we take for granted. Deviance and norms and reality and the formation of ethics based on those concepts just spark this something in me because I want to KNOW and understand. It is so frustrating to have a passion and curiosity about something, but have no clue what to do with it. </p>

<p>50% of med school applicants don't receive one med school acceptance... How bad is the application process for a MD+PhD program, comparably?</p>

<p>MD+PhD programs are extremely competitive - much more than medschools. They are a very attractive option for those who want to be physician-scientists. Some are fully funded (no tuition, and you get a stipend).</p>

<p>flowers - do you have access to a major medical center nearby? If so, find out who heads up their ethics department or committee and get in touch with them. Ask them what the prospects are in the field.</p>

<p>With technology constantly in the pipeline, medical ethics careers are more viable now. But you need to find out what is the best path to this, from a professional in the field. </p>

<p>Have you considered genetic counseling as a career? It encompasses many of the passions you speak of.</p>

<p>by the way... Ph.D. does NOT mean poor. It depends on what your Ph.D. is in, and the availability of jobs in that area. If you have a Ph.D. and teach at a community college, your chances of a higher salary are less than if you have a Ph.D., do a respectable post-doc, and get a job at a major four-year college/university.</p>

<p>teri, I live less than a half hour from a university hospital, and pretty close to a few other hospitals. I will take your advice on that, thanks! </p>

<p>I never considered genetic counseling, but I will look into it. =)</p>

<p>I think that my professor's complaint was that there were few availabilities for many PhDs, so chances would be low for what I want. He told us horror stories about having his degree, but being unable to get ANY job for a long time, even at Home Depot. Crazy, right? I know that it depends on the field though. He was in bio, and I imagine that that is one of the worst.</p>

<p>Believe it or not, another possibility for dealing with ethics in mental health is - law school! I practiced health care law for quite a number of years, and was involved in writing protocols to protect the rights of research subjects, debated the ethics of do not resuscitate orders on incompetent patients, represented incompetent patients, etc. BU has a Center for Law and Health Policy as part of the law school, and publishes the American Journal of Law and Medicine, the Journal of Science and Technology Law, and the Public Interest Law Journal. A JD would prepare you to work in the field of ethics in a variety of places, without needing to be a "courtroom lawyer". And you'd be employable.</p>

<p>"MD+PhD programs are extremely competitive - much more than medschools. They are a very attractive option for those who want to be physician-scientists. Some are fully funded (no tuition, and you get a stipend)."</p>

<p>Md/PhD programs come in 3 varieties:
1. Unfunded
2. Funded by the med school
3. Most common: MSTP programs funded by the NIH</p>

<p>I'm not sure if the NIH would be willing to fund a PhD in something like medical anthropology though.</p>

<p>And, yes, MSTP programs are very competitive. 3.8+ GPA's and 35+ MCAT scores are the norm.</p>

<p>
[quote]
I think that I'd like psychiatry because I like breaking things down and figuring things out. I think that I'd feel really happy every time I figured out what each client needed. Medications are fascinating to me, and it would be nice to help people while piecing things together.

[/quote]
</p>

<p>How do you feel about listening one-on-one? About listening with full attention and empathy to someone for an hour and saying next to nothing? How would you feel about doing that for an entire day, every day?</p>

<p>How would you feel about "failing", about the client who simply doesn't get better, won't get better, who resists being figured out?</p>

<p>With shrinking insurance funding a lot of psychiatry has turned into prescriptions and the job of the psychiatrist is assigning and managing medications. </p>

<p>A friend is a psychiatrist. His practice has evolved into prescribing for Alzheimers patients and giving lectures about same. He works 5 - 6 days a week. His wife, also a good friend, is a dermatologist who earns twice as much working 3 - 4 days a week. However, her practice is sadly evolving into giving botox injections.</p>

<p>Medicine is a wonderful profession for those really committed to it. The days when it was a safe, lucrative, highly respected profession are over.</p>

<p>And just so you know,(not you, ADad) I as a community college teacher earn more than my good friend at a much more prestigious four year institution. Other friends at four years envy my work schedule. They are responsible for bringing grant money into their institution. I spent summers with my kids; they spent theirs working 9 - 5 in their offices chasing grants, not for themselves, but for their departments.</p>

<p>Now, I can see wonderful reasons for pursuing a more prestigious institution -- more advanced students, potentially brighter students, more interesting courses, more time for research -- but money is necessarily one of them.</p>

<p>The degree you are picturing is something like a Ph.D. in bioethics and health policy. There is one at Johns Hopkins.
Ph.D</a>. in Bioethics and Health Policy</p>

<p>As a start, look at MPH programs, Masters in Public Health programs. Some of these have health policy tracks, and all will have at least a course or two in bioethics.</p>

<p>Look at the list of classes required for an MPH in various programs. Based on what you have described, I think these may look interesting to you; they may look like what you are looking for. You might also look at Epidemiology masters degree programs.</p>

<p>If you had a Ph.D. in biostatistics or bioinformatics, you could get a job anywhere, in a flash. Your prof shouldn't be badmouthing Ph.D.'s in general. It depends very much on the field.</p>

<p>I'd also suggest, if you can still make schedule changes to your spring semester, and if your school offers a religion and ethics class, try to get into that. Knowing what religious traditions people come from can educate you on what informs others as they debate ethics.</p>

<p>My H is an MD with an MPH and does a lot of administrative things in his group. BTW, I am a (child) Psychiatrist. I used to do admin stuff within a large group but found the ethical dillemas too demoralizing. I am now in private practice, making choices I can afford to make because of my H (i.e. he gets us insurance ). I found this thread interesting.</p>

<p><a href="http://talk.collegeconfidential.com/internships-careers-employment/445866-doctors-lawyers-professions-declining-appeal.html%5B/url%5D"&gt;http://talk.collegeconfidential.com/internships-careers-employment/445866-doctors-lawyers-professions-declining-appeal.html&lt;/a&gt;&lt;/p>

<p>Mythmom, I know that you are right about psychiatry. Do we now think that psychiatrists need not have an interest in, an ability for, listening to clients? I'd like to think that those considering entering the profession should still have that interest and ability.</p>

<p>"My problem is that, while I just like science classes (I love labs, but not the lectures), if I see a class like "Ethical Issues in Public Health" I immediately get really excited"</p>

<p>Trust me, med schools love to see interest in the non-science aspects of medicine. I think they even overestimate the value of involvement in such things. So don't worry about it looking bad.</p>

<p>You can always try a PhD in science--if you don't like it then just leave with a masters and go to med school. Don't think you have to know one or the other at this point.</p>

<p>ADad: Good point!</p>