Why MD/PhD?

Med school is SO long - why spend another few years getting a PhD?  I've gotten this question a lot since I started med school.  Like applying to straight MD programs - there are plenty of good BS reasons to apply to MD PhD programs.  [The REAL reason I want to go to med school]

MD/PhD - the rough outline by year
Sidenote - if you're wondering what MD/PhD programs are - see image on right - they are essentially med school (MD) and school for scientists (PhD) so we combine medical and scientist training.  We exchange spending a few extra years in school with free tuition.  

Here on sidenote, we give the people what they want.  Once we pare away all the BS of med school admissions, there are 3 reasons why I chose to pursue two doctorates, when I would have been equally as useful with an MD.  

1- The incredible tution bill of med school.  The average 2010 med school graduate left with $160,000 in debt.  15% of all med school graduates left with a quarter million dollars of loan money.  And when you graduate med school you're still a resident which means you make in the neighborhood of $50,000, not quite doctor money.  And don't forget that loan money is definitely not interest protected.  It keeps growing and growing and..  

As an MD/PhD student, the government pays my medical school tuition bill.  Thanks tax dollars!  
running gels gets a bad rap.. but I love science

During my admissions year I kept hearing that the financial incentive to pursue an MD/PhD wasn't worth it, but it still seems smart to me.  Spend 3-4 years working in a lab, which I love, and come out with a free MD, which my wife loves.  Everyone wins.

2- I needed a backup plan.  One day, I really want to be a scientist and run a mega lab to the tune of 20+ scientists, Cell papers by the month, and grant money flowing in like Brandon Roy's bank account.  The point is - I only want to be a scientist if I can be a good one.  

If you've ever worked in a lab you know the 40 year old burned out postdoc that's bitter at the research world for screwing over his opportunities to publish in Science/Nature/Cell and get independent grants.  You also know that guy questions his life on a daily basis - should he quit and go into advertising?  teaching?  

great book
I didn't want that to be me, but frankly it's only so much in my hands.  Science is a volatile career, and a high impact publication is usually the result of right-place-right-time phenomenon.  (See Malcolm Gladwell's Outliers).  

I really want to have a family some day - preferably sooner rather than later - so I wanted to make sure I had a viable backup plan before I tried to launch a risky career in science/academia.  At the end of the day I want to do science so I can use my brain to help people, so I figured being a doctor would be a good alternative - still intellectual and still helps people.

3- I believe I do things right and other people don't.  Don't hate me for it. I despise med school because all we're doing right now is learning the status quo and how medicine has been done for years.  I know we have to learn this because we need to pass boards.. but it is BORING.  Sidenote - when I run academic medicine we will be done with standardized tests and memorizing rote BS. Instead med students will learn, you know, actual medicine.  

I'm a cynical med student, and I know in 6 yrs I won't be the kind of intern that's going to see the medical world and accept it at face value.  I know I'll be a pissed off resident, and a pissed off attending.  There's a lot to be cynical about in science, but at least science is trying to come up with new solutions.  I wanted to be part of a world that asked, what if we could come up with a better way to do this?

 Overall conclusions.. perks to the MD/PhD - it saves $ and you get to do science.

See you on the other side,

from ken
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6 comments:

  1. AnonymousNovember 25, 2012 at 3:42 PM

    I look forward to the Ken-overhaul of medical school.

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    1. kenNovember 25, 2012 at 4:22 PM

      Thanks Mikah, you might have to wait a long time.. but one day.

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  2. UnknownNovember 25, 2012 at 4:04 PM

    Interesting article, Ken! This is the first time I have read your blog myself, but I have heard Jacob talk about it for a while. I too look forward to the day that you get to break free from the status quo and explore a better way for health. Even as a RN, I am already fed up with a lot of aspects of medicine, rolling my eyes every time I fill a patient's medicine cup with diabetes and blood pressure meds and statin drugs and a cocktail of other pills I don't agree with as the end-all solution to their ailments. So apart from my official nursing practice, I have branched out into Nutrition as a fascinating world, full of many answers to today's health issues. So I feel like I understand your frustration with the status quo and support you in that. Go Ken!
    ~Miriam Wolf :)

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    1. kenNovember 25, 2012 at 4:24 PM

      Thanks Miriam! I would love to hear your complaints about medicine - surely nurses have insights into fixing medicine that doctors are too scared to share. I also agree - nutrition/preventative medicine is the future.

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  3. Daniel RigginsNovember 25, 2012 at 4:37 PM

    Ken, do you think MD/PhD is worth it if I am flip-flopped and I'm more interested in the clinical side of things. I kind of envisioned using the PhD part to coordinate collaborative studies with multiple docs on patients with difficult to treat or unknown conditions.

    Also do you know if there are financial incentives for going into Primary Practice, I could look it up but I'd rather ask what you know about it.

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    1. kenNovember 25, 2012 at 5:13 PM

      Dan -

      At this point in our lives, how are we supposed to predict what sort of job we'll want in fifteen years? The bottom line is that many MD/PhD graduates go on to be full-time clinicians. I feel like the choice to go MD/PhD isn't about future career goals, but more about the next 7-8 yrs of your life - will you like being an MD/PhD student? Based on that, I feel like MD/PhD is worth it if you meet these three qualifications:

      1- you have the application to get in
      if you don't, no big deal - an MD is just as good

      2- you are willing to spend an extra 3-4 yrs in school
      3-4 yrs of your mid 20's isn't trivial

      3- you wouldn't mind working in a lab for 3-4 yrs
      if you don't like science.. don't bother. the money isn't worth hating your life for 4 years.

      I'm almost positive there are incentives for going into primary care. I never really considered it.. so I don't know much about specifics, but if I were you I'd ask Kaleb. My uneducated advice if you're interested in primary care.

      1- I would try my damn hardest to get into the cheapest school I could because paying off loans could be a struggle.
      2- I would try to care about grades and board scores AS LITTLE as possible because the demand for primary care docs is so high that your stats won't matter. I would spend my energy figuring out how to stay committed to primary care and not burning out on it because there's probably a reason it's not that popular.

      Anyways, good luck. Are you applying now? Update me.

      from ken

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