#physician-scientist

An old labmate from undergrad is applying, and asked me if I thought MD/PhD was still a good idea. I figured I should blog the reply because it was a) really long, and b) potentially useful to more people this way. This reply is slightly edited from what I sent.

tl;dr - it's awesome for future academics. But I'm young and naive.

So far, yes. I like retreats, structured mentorship, and interdisciplinary learning you only get from participating in a journal club with 9 other talented students working in different areas of research than you.

MD/PhD is the most selective graduate program, meaning if you are good enough to get in, and you are set on a career in academia, you should do it. The perks are very helpful. You get to network with powerful people in academia. People treat you much better than in undergrad. Department chairs, program directors, and big-name PIs are more than happy to meet with us. MSTP alumni go on to the best residencies.

As far as hearing negative things, I've heard negative things about almost everything in life I wanted to try. Which professor did you hear negative things from? Is he/she a successful (happy) clinician-scientist who managed to balance a career between patient care, research, and teaching?

Indeed, dual-degree physicians are not going to have the same amount of time to spend in the clinic or the lab as single-degree counterparts. Whether that makes you mediocre or better (because of the ideal synergy of MD/PhD where your patient care and research help and motivate each other) is really up to many factors.

Like everything in life, I can name people who are "failed" MD/PhDs who did not meet the ideal of what the training envisioned. They ended up a purely clinical or purely research-focused career. This is not to say they "failed" due to a shortcoming of skill or intelligence or work ethic. A lot of them started families, realized making triple the salary in private practice made sense, and went for it.

Likewise, there are many MD/PhDs that balance a career of many things and love it (though they are super busy). You should be aware that there is a distribution of quality across any group, whether it be a undergrad chem, MD/PhD students, or even faculty. Of course not everyone succeeds, and some of them are vocal. The funding situation is especially competitive. There will also be superstars. You have to be the best in undergrad, then graduate near the top of your class in MD, then do research on par with the best PhDs, be accepted to competitive academic residencies, then be an excellent clinician to get that fellowship, and then fight for dwindling grant money and faculty positions. So yes, it's going to be insanely hard, and I am aware that not  everyone makes it. But I plan to make it.

While it's good to be realistic and knowledgeable, I've found that attitude, like optimism and curiosity, takes you much further in life than talent or standardized test scores (well, once you are past a lower limit). As far as the longer training time, it would be foolish to do an MD/PhD because you want the degrees and career but hate doing the thesis research or clinical training. The journey is part of the destination. You actually have to earn both degrees and I think that fact really escapes some people. As individuals, we have a huge amount of control over our attitudes and what we gain from our experiences.

Ask more people before you apply. Talk to MD/PhDs who have achieved the ideal of what a dual-degree is about, not just those who didn't. Find examples who can pass on attitude, not just experience. There are tons of great MD/PhD physician-scientist role models. Some examples:

http://www.hhmi.org/news/ressler_bg.html http://www.stanford.edu/group/dlab/about_pi.html http://www.bme.gatech.edu/facultystaff/faculty_record.php?id=152 http://www.neurosurgery.emory.edu/FacultyGross.htm http://med.emory.edu/faculty/profile_highlights.cfm?id=999