Biomedical Research: Going MD/PhD vs. Going 100% PhD

This was adapted from advice I gave to a student with a strong interest in a research career in neuroscience, so it is written for someone who is more interested in research than clinical care.

I will begin by saying that a research career is absolutely possible with an MD alone, but I think it’s not a very advisable route considering the out-of-pocket expenses and lack of formal training in forming and answering scientific queries.

As you may know, the stated goal of most MD/PhD programs is to create physician scientists who aim to do 80% research and 20% clinical time. Therefore, they are well suited for people with a strong research interest rather than a primary interest in care. What’s more, clinical time can be defined in a number of ways. With an interest in neuroscience, for example, you could use your MD to become a neuropathologist and help the clinical side by analyzing patient samples without having to directly interact with patient populations if you prefer. If you’re deciding between an MD/PhD approach and a PhD approach, the MD/PhD programs may be somewhat more competitive, but they are not significantly more difficult than MD programs if you have a strong research background.

Below, I’ve outlined some of what I think are the key considerations in deciding whether to go dual degree or single degree.

Pros:
– Career security – clinicians will always be in demand regardless of research funding climate.
– Grant demand – MD lends a clinical credibility to research proposals that often makes grants more attractive to funding institutions.
– Institutional demand for Physician Scientists – At the faculty and postdoctoral phase, you would be a more desirable candidate in many cases if you possess the versatile education of a physician scientist.
– Flexibility – This applies to both during and after the program. Most MD/PhD programs do not require you to pick your program right away. This means that you could enter wanting to be a neuroscientist and change course to become a biochemist or pharmacologist if your interests change. After the completion of your program, you could continue into residency with or without a research emphasis, you could proceed directly into a postdoc and become a pure scientist that just happens to possess a background in clinical medicine, or you could take a still different course in industry, government, or consulting. Related to this, it’s worth noting that you avoid some of the turf battles between MD clinical scientists and PhD translational researchers if you decide to work with patients or patient samples, because your education would give you substantial authority in both realms. 
– Better understanding of clinical problems – There are an infinite number of research questions to be asked. There is a finite amount of time in a career. With a medical education and regular access to patient population, you’re more likely to understand the questions relevant to improving the health and happiness of the population. This point is less relevant if your passion is for pure scientific understanding, but it was a factor that drove me toward this career path.

Cons:
– Length – An MD/PhD program will take 8 years on average, compared to a PhD program which ought to be done in 5-6 years.
– Purity of Purpose – There’s only so much time in the day, it’s impossible to be all things to all people and choosing a single doctoral degree gives you license to focus on your research with fewer outside concerns.
– Program availability and Admissions – It’s still competitive to get into natural science PhD programs, but there will be more slots available for PhD programs than for dual degree programs, so you stand a better chance of attending a more elite institution, or one that’s better suited to your needs. 
– Opportunity costs – It’s worth considering that the extra time and mental energy spent in developing a clinical foundation could alternatively be poured directly into developing your research career. It is possible that choosing a PhD program rather than a dual degree program could lead you to become more well versed in your area of study sooner, giving you an edge over a less focused person. 

An important consideration is that your decision isn’t set in stone, either. Some MD/PhD students began as PhD grad students and transitioned into the program. Other people attend medical school or graduate school after completing the other program if their interests have changed. Still others begin as MD/PhD students and drop half to become a medical or graduate student during the process when they discovered that the rest didn’t appeal to them as much as they thought. 

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3 thoughts on “Biomedical Research: Going MD/PhD vs. Going 100% PhD

  1. I’m the editor of ASBMB Today, the member magazine of the American Society for Biochemistry and Molecular Biology. I’d like to discuss perhaps having you adapt this piece for publication in our magazine if that interests you. You can reach me at asbmbtoday@asbmb.org. Cheers! — Angela

    Reply
  2. God bless this post. I’m a Neuroscience major currently enrolled in a masters program in molecular biology, but I have decided to apply to medical school. I’m trying to figure out how I can become a physician while also still getting formal research training. I work at Emory and a lot of residents and fellows have been telling me to look into MD/PhD as well as a the or the option to get an MSCR during MD training. This is a really helpful look at the pros and cons. Thanks so much!

    Reply
    • Glad it helped! If the MD/PhD isn’t the right fit for you, there are also some good opportunities during residency on the MD track. If you have enough interest, there are always ways to make research activity happen. If you do go MD, just try to find physician scientist and/or basic scientist mentors who can give you some direction early.

      Reply

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