Benefits and Problems with MD/Phd program(?)

Pre-Med & Medical School Pre-Med Topics
1

<p>Ok please keep in mind I am a high school senior, so I might be a little naive. I found this link:</p>

<p>The</a> long road to medical school: Why do an MD AND a PhD?</p>

<p>It basically lists the pros of being a md/phd, and the time it takes to become one and I have a few questions:</p>

<p>(1) Probably really shallow, but why do md/phds get a salary a bit more than phd scientists? If they have both degrees, shouldn't they have higher salaries than mds?</p>

<p>(2) If you become a md/phd, can you still "work" as a doctor; basically do what a doctor does most of the time with a little research on the side rather than largely research with some clinical hours?</p>

<p>(3) The guy listed this:</p>

<p>Now for how much time these things take: (times are approximate)</p>

<ol>
<li>PhD only -- 6 years PhD + 3 years post-doc = 9 years</li>
<li>MD only -- 4 years med school + 3 years residency* + 3 years fellowship + 1-2 year K-award application = 11-12 years</li>
<li>MD-PhD -- 8 years MD-PhD + 2 years residency** + 3-4 years fellowship*** = 13-14 years</li>
</ol>

<p><em>Some residencies take longer, but then fellowship may be shorter.
</em>Assuming you fast-track residency to fellowship, then fellowship is 4 years instead of 3.
**I know a few people who don't end up having to do a fellowship.</p>

<p>K-award = NIH grant for junior investigators </p>

<p>(4)What is the K-award; is it required? And lastly, based on the three different career timelines, it looks like md/phd is a great program and you can get two degrees in 1 more year (if you do the fast-track thing) - so what are the cons to it?</p>

<p>I know it is extremely-competitive, but I am curious whether or not I should pursue this. </p>

<p>Thanks in advance for all the help.</p>

2

<ol>
<li><p>You are paid by what you do, not what degrees you have. Most Md/PhD’s spend the majority of their time doing research, not seeing patients. They’re going to be paid therefore more like a researcher than a clinician. Hence, the lower salaries.</p></li>
<li><p>If you are planning on doing a lot of clinical work with some research “on the side,” then you should get a MD. There’s no reason to spend the extra years on a PhD.</p></li>
</ol>

3

<p>The answer to your question about salary is that there is less money in research than there is in clinical practice. Many MD/PhDs are funding their salary from grants, similar to PhDs. Also there isn’t the pressure for MD/PhDs to repay hundreds of thousands of dollars of debt, since most of them have tuition remission and a paid stipend for their program. If MD/PhD grads had to pay full tuition for their MD years, I guarantee you’d see many more of them going into private practice…and that kinda defeats the purpose, doesn’t it?</p>

4

<p>The pay scales for MD doing clinical work or MD/Ph.D. doing 80/20 research/clinical are similar. In fact, 80/20 pay scale is slightly higher, particularly those tenure or tenure track faculty in a research hospital. However, if you do private practice, you can easily make twice as much as those doctors in academic settings. So, if you are a MD choosing to stay in academic hospital, it is a big financial sacrifice. Research hospital values research dollars, breakthrough and prestige a lot more than practice. I have not heard any university hospital considering number of surgical operations or clinical dollars generated as a criteria for promotion or tenure. Teaching won’t do it either. But research funding is counted down to the penny to judge whether a faculty is good enough for promotion or tenure. If a MD does no research at all (not even clinical research), he will have absolutely no chance to advance through the rank in a university hospital. On the other hand, majority MD/PHD doctors get no tenure because of failure to obtain and renew their RO1 grants. Things have been getting tougher lately because NIH payline to get a RO1 grant is 6-7 percentile. This is quite daunting even for seasoned and well established investigators. If you stay in academic, either way is tough regardless whether you are a MD or MD/PH.D. In reality, a well funded investigator doing some clinical side work garners much more respect from peers, and is treasured by medical school and hospital alike. A MD doing an excellent job of saving lives but not much of research, well, will be ignored for promotion (clinical research carries much less weight than basic and translational research) in any university hospital. Tenure for a clinical MD is a pipe dream, period. </p>

<p>Regardless what degree you have, please stays away from major university hospitals at all cost if you are not great in science. You will struggle for decades without much self esteem or financial rewards. Over ambition will destroy you. I don’t think any people feeling great at the rank of clinical instructor at the age of 60s. Private practice is much more rewarding and less stressful. On the other hand, if you can get your RO1 and renew it consistently, you should be fine in academic. But your salary is nowhere near private practice level unless you are the chairman of the department. The writer in the article appears young and superficial. Sometimes it is quite misleading.</p>

5

<p>Last summer I had the opportunity to gain a lot of valuable insight into what MD-PhD program administrators want their students to do after graduation. Bottom line is: these programs are putting a lot of money into you. Instead of you paying your way through med school, they give you a stipend and pay your way through, as if all 7-8 years were strictly grad school (almost all PhD schools provide a stipend). If they make that much of an investment, they really want you to spend the rest of your life doing majority research. It’s gotten to the point where if you even hint in your interview that patient care is your main objective, they may not accept you.</p>

<p>The K-award is only necessary if you are planning to go into research after graduation with an MD. It used to be the case where pretty much anyone could go into research, including MDs who have very limited research training. Now, that is not the case. If you decide that patient care is your main goal, stick with the MD and get a job right out of residency/internship. You’ll get a job and start paying back your debt much faster.
If, on the other hand, you are genuinely interested in research, go for the PhD or MD-PhD. Not only will you have an easier time getting grants, you will be much better trained for the job than an MD-only could possibly hope to be.</p>

6

<p>

Hmmm…maybe I exaggerate it too much when I say this: To some extent, can we say the same thing about most highly ranked medical schools? After all, the (US N&R) rank is a research rank; the higher the rank, the more high profile researchers they hire and more demand for their students to get into the research rather than just learn the “trade.” Or, alternatively, a highly ranked medical school can not rely those in their MD program to do sciences; they need to rely on those PhD tracked students or full-time postdocs to help them maintain their rank?</p>

<p>The whole thread here gave me the impression that it is only the premeds who need to learn a lot of sciences and to do a lot of research. Once they get into medical school, they need to keep a “safe distance” from the hardcore science (especially basic medical science) as there is not much money in science research.</p>

7

<p>I was actually hoping to do research and clinical work and “other doctor stuff” 50/50. I don’t know what specialty I want to do, but if I become a surgeon, I would also like to do surgeries rather than only clinical work - that’s what i mean by “other doctor stuff”. </p>

<p>Is that possible?</p>

8

<p>Clinical work = direct patient care (Surgeons doing surgery would fall into this category)</p>

9

<p>@WayOutWestMom, thanks, didn’t realize it was classified into clinical work.</p>

<p>@everyone/anyone else reading this thread, is it possible to do clinical work and research 50/50? If so which one would entail that kind of work distribution: MD or MD/PhD or something different that I didn’t list?</p>

10

<p>There are people who do 50/50, but it’s not the “typical” model (which is the 80/20). Surgical specialties are going to be more difficult than other specialties because of the demands of the field (on average, a longer residency, and also I imagine that maintaing your proficiency as a surgeon is more effortful/time consuming than fields that require less manual skills).</p>

<p>K awards are not required by any means. They are NIH grants that you can apply to and they are typically for younger scientists who are not lead investigators. I believe the K08 is the most popular one for students to apply to (but I’m not in grad school phase yet, so I haven’t really read about all this). Getting a K grant usually gives you a small bump in your stipend, helps pay for materials, and of course looks good on a CV.</p>

<p>The cons to the program is that it’s ultra competitive, long with low salary, and doesn’t guarantee that you’re in a better position than people who take shorter routes (although it does increase your chances). If you don’t want to do significant basic science work, the 4 years of PhD work while earning 30k or less (instead of getting a jump on the much higher salaries of clinicians) just doesn’t justify it. If you want to do really basic science work/don’t want to interact with patients, 4 years of med school is a complete waste of time/effort. There is of course also the fact that if you don’t appear to fit the proper MD/PhD mold (which I have discussed my own views of at length in another thread on the pre-med forum) you’re probably not getting into a program in the first place.</p>