Biomedical PhD vs MD/PhD...

<p>I am wondering what are people's thoughts on deciding between doing a biomedical grad school program vs doing an MD/PhD program for pursuing a career in biomedical research.</p>

<p>I’m not sure there’s a reason to do MD/PhD unless you also want to practice as a physician. It’s a much longer program, and much much harder to get into than simple PhD programs are.</p>

<p>You need to decide whether you want to do clinical work. I was choosing between the two routes for the longest time. I realized during my clinical work that I spent too much time missing the lab. Hence I went the PhD route.</p>

<p>You must absolutely want to do clinical work throughout your entire career. If you do not want this do PhD only. Now as a grad student I am very glad I decided to go PhD only, since I would dont think I would have used the MD.</p>

<p>If you really are not sure about the MD, just get the PhD and you can get the MD after if you still want it. From talking to a director of an MD/PhD program there is a lot of talk about funding people that go the PhD to MD route. So there is a decent chance that they would have a better method of doing this if you decided you want the MD later.</p>

<p>Good luck deciding. I hope you figure things out quicker than I did.</p>

<p>I was torn between the two for quite some time as well, but I’ve decided to apply to PhD only this Fall. Like the poster before me mentioned, I found clinical research intriguing, but not to the point that it would warrant 4 years of medical school (since I don’t want to actively practice). Instead, I’m considering getting a Masters in Clinical Research while I do my PhD (it only takes one extra class a term for 3-4 years to complete).</p>

<p>If you haven’t, shadow a clinical researcher (MD/PhD) and see what it’s like, and ask them questions about the path. But be prepared…I have yet for anyone to recommend the PhD path to me, EVERYbody tells me to avoid grad school like the plague. Luckily (or unluckily) I’m too stubborn to believe them, and I think the PhD is the best fit for my career goals.</p>

<p>Most MD/PhD’s do not end up doing research. In part this is because after completing a residency, there is not much support and momentum to return to research. Balancing clinical responsibilities and research is a difficult task. In part the failure to return to research after residency is also because most who are attracted to the MD/PhD, had primary interests in the clinical practice.</p>

<p>That said, the MD/PhD researchers who do follow-through and who do successfully balance research and clinic are often in outstanding positions to do translational research-bringing findings closer to the bedside. </p>

<p>If you do not have a strong interest in the clinic and interacting with patients, a PhD is probably more practical. Many PhD programs call themselves Biomedical. Look for programs that actually have a strong curriculum in human biology and pathophysiology.</p>

<p>MD/PhD is good if you want to do research where you need to work with patients or need access to human samples. It just makes it easier. You don’t have to get a PhD/MD through the program. I know someone who mid-way through residency took a leave to do his PhD and then will come back to finish up his residency.</p>

<p>To Katatonic - interesting that people told you not to do the PhD path – all of my profs at school strongly encourage grad school (because, as profs, they all have PhDs so they tend to encourage students to take the same path as them) and actually discourage MD/PhD. I have debated between the two options for about 1.5 yrs, so I have heard a lot of arguments both ways from a lot of different people (PhDs, MD/PhDs, MDs etc). Now, I could easily convince myself to go either way, which isn’t that helpful in actually deciding.</p>

<p>I also really like the sound of these programs: [HHMI:</a> Opportunities for Cross-Disciplinary Graduate Training](<a href=“http://www.hhmi.org/grants/office/graduate/gradstudent/medintograd_opportunities.html]HHMI:”>http://www.hhmi.org/grants/office/graduate/gradstudent/medintograd_opportunities.html) I have read all about them online, but does anyone have impressions/experience with them first-hand?</p>

<p>

Professors will never tell you to avoid graduate studies - after all, they’re among the ones who “made it” and therefore do not regret a decision that paid off in the end. I’m also told all the time I shouldn’t do graduate school, but only by post-docs and the occasional graduate student.</p>

<p>I should have clarified and said that I’ve only asked post-docs about this, and a couple grad students. The grad students didn’t seem to care either way whether I decided to or not, they just gave advice about if I choose to. The post-docs generally said “just go to medical school”, and of course profs (and PI’s) have been encouraging.</p>

<p>An interesting conversation about what advice people have told you. Here is my experience:

  1. Post docs- a lot of them said to stay away before I started grad school, but I have not heard that in my rotation labs during grad school. I think a lot of this depends on the quality of the postdocs. Most of them that said to go to med school were unhappy with research and/or were not successful post-docs (wont get a job)
  2. PhD only PIs- most told me to go PhD only but a few said to go both.
  3. I know some MD/PhDs very well and they have all told me to choose between the two now since I would most likely have to eventually</p>

<p>Here are arguements I have heard for the combined degree (my arguement against it):

  1. need an MD to see patients (absolutely true and should be your decision factor)
  2. MD gives you access to patient samples (seeing patients gives you access to samples: If you dont see patients you still will not get samples with an MD/PHD. You can colaborate with physicians to get samples and you can even just call the lab to get samples. I have seen labs successfully do this both ways)
  3. MD/PhD have better success at getting academic jobs and grants (The stats say this is true. The con is that MD/PhD starting up have to be more focused on clinical work than getting a lab started up -that is how they are paid-. They pretty much need data and lots of funding to get their clinical load lightened, but it is extremely difficult to get all of this when you are rarely doing bench work. I have worked with a few physician scientists that are trying to start up, and they have all adopted the philosophy that they will do both if they are given the long term opportunity but they would be satisfied doing only clinical work). If they dont have this philosophy they have joined the basic research only track).
  4. MD coursework will help you develop more relevant research projects (This is true, but you dont need the degree to get the benefit. Most grad schools will let you take med school classes and some schools have started the HHMI certificate programs to give you a clinical background. You can also higher physician scientists as a PI in hopes of achieving this goal).
  5. PhD only job prospects are not that great, so an MD gives you a fall back career (If you are good, you will get a job. There are also a lot of other career options open to PhDs: teaching, science writing, policy, etc. You can even go back and get the MD).</p>

<p>Another thing to think about: You really will not have time to excell at being both a physician and a scientist. As most MD/PhDs say, you need to pick between them eventually for this reason. I have been told that most of the people in MD/PhD programs are there because they cant decide between the two, and most of them will end up picking the one that they were leaning towards when they started. </p>

<p>One of my long term goals is to become a reputable and established scientist. This was one of my decision factors when I decided to go PhD only. I knew that it would be nearly impossible to achieve my goals if I also had to practice medicine. In addition I knew that I could not sacrifice my clinical skills for research, since that would negatively impact patients.</p>

<p>I know TONS of physician scientists and MD/PhDs that have gone the clinical or research only route. I do not know a single physician scientists that I would call a great researcher and/or a great clinician. There are a few that are close to this, but they all have someone else running their lab. On the otherhand there are tons of MD/PhDs that excell at research or clinical work, but they all are only doing research or working in the clinic. Some people need to do both clinical work and research, and they are willing to sacrifice the quality of their work in both fields. These people are still needed, so if you are in this boat absolutely do the combined degree. If you are like me and you know you will not be happy if you are not excelling at something, you need to pick between them ASAP. You are better off doing this before you start the dual degree, but if you will not be alone in an MD/PhD program if you cant decide before then.</p>

<p>Other current grad students may be able to help confirm this at their schools, but my take on the MD/PhD students at Duke is that most of them did the combined degree program to get their MD paid for or to improve their residency application. Most of them I know love clinical work, but they do not show the same excitement about research (even in their early years). Most of the senior students I know are not even planning to do research after residency. Having witnessed the attitude of these individuals, I am extremely glad I did not go the combined route. As research focused as I am, I would not have fit in well with the combined degree students here.</p>

<p>Good luck deciding. It took me like 4+ yrs to decide, so I know it is a difficult decision.</p>

<p>Lac Operon,</p>

<p>If you having lots of problems deciding, I recommend taking some time off to further explore each degree and the physician scientist career path. Time off allows you to do both clinical work and research (like a physician scientist) without the stress of school, and it really allows you to get an idea of what a physician scientist really does before you take that leap. My time off also gave me a lot of access to physician scientists in various phases of their career.</p>

<p>My main love is research (I know that I won’t be happy with the lab) but one my hang-ups against going only PhD is that I also have a passion for international travel and working abroad (which I did in college). I am interested in the health problems of developing countries, and I feel that getting grants/visas/access/doing-something-useful would be easier/more productive with an MD. Is that valid? Does anyone know of PhDs doing good international work?</p>

<p>As a PI, you can travel to and work (on research projects) in other countries. We have a fair number of PIs here that go on sabatical to other countries for several months every year. We even have a PI that runs a lab here and in (singapore?).</p>

<p>In regards to health problems in other countries I do not know what you could do. It would be difficult to do that even as a practicing MD/PhD. What exactly do you want to do in terms of research/ health problems in other countries. That info may helps us come up with ideas. From your description, I have no idea what you can/want to do.</p>

<p>There is no advantage for a dual degree versus single degree in international travel or research. It sounds like you need to do more volunteer/internship research in biomedical labs to get a better idea of what the career choices are. </p>

<p>Talking to graduate students and post-docs is useful, but you really need to speak to individuals who are successful as independent PIs with MD only, PhD only or dual degree.</p>

<p>I do have 5 years of biomedical lab experience, so more lab experience is not what I think I need and have been volunteering in a clinic for the last few months and will be doing so for the next year; however, I still feel no closer to deciding. I can’t seem to find the “one thing” (or the couple of things) that will be that deciding factor (like, when people say, “I thought about different programs, but finally I knew that PhD was right choice for me because __<strong><em>” Or, “I knew MD/PhD was wrong for me because</em></strong>”). Maybe the real problem is that there is no eureka moment? There is no one thing that will make me feel like I am making the right decision on the program type but it will be more a culmination or feeling? What do people think about this poorly worded idea?</p>

<p>(the problem with the idea in my last post is I hear that MD/PhD interviews can smell any drop of doubt or uncertainty like sharks smell blood in the water. So I know I need to be 100 percent MD/PhD before I would apply…)</p>

<p>The reason I suggested additional research experience in a biomedical lab is because your posts indicate a lack of real-world knowledge about the various career pathways (and international opportunities). Again,to gather this information, do not rely on grad or med students who are still at the early stages of the education. Or even post-docs who haven’t really begun to embark on an independent research career. Instead, make appts with established investigators with MD only, PhD only or dual degrees. </p>

<p>And yes, when we interview applicants for dual degree programs and detect significant doubts about career pathways, this does affect how the applicant is viewed. This is simply because there are more individuals applying for positions in these programs than there are positions.</p>

<p>Don’t wait for a “eureka” moment LAC, for me it was just something I realized over time (and over this current summer internship). Eventually, as you keep doing research about both paths, you will most likely find yourself start leaning one way, and then looking backward, you can identify why that is. At least that’s how it was for me.</p>

<p>I don’t think you’ll have a eureka moment, as awesome as that would be, because I don’ think there <em>is</em> a real answer. All in all, from reading what you said, it seems like MD/PhD is a good option. Considering you have given it so much thought, whereas most people I know, know pretty well they want to do an MD or just a PhD.</p>