MD/PhD in the military?

[dukejen04]

OK, I realize that most MD/PhDs are funded, and therefore it might make little sense to do HPSP, but I am truly interested in a career in the military.

Does anyone know if there is a place for physician scientists in the military? I am absolutely interested in seeing patients and doing clinical work, but I also would like to be involved in research. I am particularly interested in infectious disease work (I have been doing my Master's degree in ID), but I wonder where my place would be.

Any thoughts, advice, insight would be welcomed!

---

Members don't see this ad.

 

[TheGoose]

There are MD/PhD's in the military. HPSP does not fund joint degree programs though. (USUHS offers an MD/PhD however)

 

[IgD]

I worked with a MD/PhD. He was active in research. I think one of the issues he ran into is they deployed him just like everyone else so it was disruptive to his efforts. I think he ended up leaving and becoming a GS employee.

 

[Doctor Bob]

I worked with an MD/PhD at an AF base with a pretty atrophic research program. They stationed her there because they needed her MD specialty at the base more than they needed her PhD specialty elsewhere.

The good news is the research program is starting to pick up, but just as it swings into gear, she got sent off somewhere else.

The needs of the military come first.

 

[IgD]

I met a former military physician and he told me it used to be to be a department head/chair at a MTF you had to have a research portfolio. My how times have changed.

 

[dru2002]

I met a former military physician and he told me it used to be to be a department head/chair at a MTF you had to have a research portfolio. My how times have changed.

Seems like a good thing to me. I honestly cannot think of a way that having a research portfolio would make you more proficient at running a department. I'm just a former corpsman and haven't dealt with the demands MOs face. So, maybe that is why I can't think of how it would make them better dept. heads.

I do wish that the military maintained their research reputation they had during WWI and WWII.

 

[DogFaceMedic]

I did my PhD first then went back for MD. The PhD helps in almost any field because of research experience; the question is if it is worth the time. Any MD can do all the research they want.

As for ID: there are excellent ID research opportunities in the military because we go to so many wierd and interesting places with wierd and intereting bugs. My anecdtal perception -- not exactly evidence based -- is that the military does well in ID, trauma, and pathology research.

 

[orbitsurgMD]

Seems like a good thing to me. I honestly cannot think of a way that having a research portfolio would make you more proficient at running a department. I'm just a former corpsman and haven't dealt with the demands MOs face. So, maybe that is why I can't think of how it would make them better dept. heads.

I do wish that the military maintained their research reputation they had during WWI and WWII.

I think his point was that among other qualifications, you also had to have a research portfolio. And times have changed.

 

[orbitsurgMD]

My anecdotal perception -- not exactly evidence based -- is that the military does well in ID, trauma, and pathology research.

Sadly not so much anymore.

 

[DrMetal]

I did my PhD first then went back for MD

+1 Here's to degree collecting!

 

[former military]

if you get the PhD part to do actual research you have a huge potential for frustration. Most PhD researchers want to develop their own questions and run their labs. That is not the way it will work in the military.

I don't think the military thinks research is cost productive... except for maybe the experiments they want to do that involve war injuries on animals that some university is not going to do...

for example....

put an A-line in a goat
shoot the goat in the ass with an AK 47
wait 90 seconds
run over to the goat with a fibrin bandage, experimental clot gel, or placebo gauze....
measure hemodynamic stability, blood loss and survivability

you are not going to be taking apart different genes for familial colon cancer, etc.

 

[DrMetal]

if you get the PhD part to do actual research you have a huge potential for frustration. Most PhD researchers want to develop their own questions and run their labs. That is not the way it will work in the military.

Well, the same can be said of other, non-mil institutions. If you go into industry, say working for pharma, you don't get to always dictate the terms of your research, and you don't always get to take a project to completion. Hell even if you're in academia--the place where scientists are supposed to enjoy the most freedom--you may be bound by senior faculty, your tenure committee, access to students etc.

I don't think the military thinks research is cost productive... except for maybe the experiments they want to do that involve war injuries on animals that some university is not going to do...

Most of science isn't cost productive, in the business sense. Most of science does not lead a marketable product. But what it does do is bring notoriety to the institution, and for that reason I think research would also be celebrated in the mil. Now of course, you'll be able to do certain kinds of research, and not others. The example you gave seems pretty in line w/ mil med interests. On the other hand, if you're an aspiring synthetic chemist, I doubt you'll be able to do that in the military.

Regardless, there's a lot of intangible qualities that you acquire in getting a PhD (even if you never dable in research again afterwards) that I think can surely help in medical education/training/practice. In grad school, you learn how to burn the midnight oil, how to teach yourself, how to play a little politics . . .it's all fun.

 

[Erald Coil]

http://www.usuhs.mil/eid/EIDFacultyResearchInterests.pdf

As a 2010 USUHS applicant with a research background in immunology and ID and years of service as NCOIC of Immunizations for my ANG medical group, this link screams "DO IT!" louder than the five old buzzing -80 freezers surrounding my desk... which btw is pretty loud. >_>

 

[Neuronix]

Regardless, there's a lot of intangible qualities that you acquire in getting a PhD (even if you never dable in research again afterwards) that I think can surely help in medical education/training/practice. In grad school, you learn how to burn the midnight oil, how to teach yourself, how to play a little politics . . .it's all fun.

I think grad school is very low yield in this regard. You spend several years getting your PhD to learn those things? But in clinical medicine you also have to learn to teach yourself, work many hours, and play politics. I don't see the point of spending several years of your life just so you can learn the same thing twice. In general I don't see the point in doing a PhD at all if you think your life will be mostly clinical.

You could ask user Andrew Doan of the Ophtho forum. He's a current military MD/PhD. My impression from talking to people is the same as that of the attendings posting in this thread. It's extremely hard to run a research program with billeting changes, deployments, and imposed clinical demands. The needs of the military come first, and those needs are extremely clinical.

 

[Gastrapathy]

In the time you spent doing a PhD, you could have completed an ID fellowship and spent 2 years stationed as the OIC at a remote location doing research. . There are Navy ID docs in South America, Africa, South East Asia and I even know one posted to Geneva. Ask yourself which of those is a better use of 4 years.

Of course then you have to become an uber-flea and know that I would rather stick hot bamboo under my fingernails than consult you...ever.

 

[DrMetal]

I think grad school is very low yield in this regard. You spend several years getting your PhD to learn those things? But in clinical medicine you also have to learn to teach yourself, work many hours, and play politics. I don't see the point of spending several years of your life just so you can learn the same thing twice. In general I don't see the point in doing a PhD at all if you think your life will be mostly clinical.

True, I don't mean to sugget that grad school is the only place where you can acquire such attributes. But in grad school, you do learn/leverage these attributes to the n-th degree. And yes it's true that you can do very high-impact research (of any kind) as an MD. So why do an MD/PhD program in the military??? A: to have a ridiculously long name tag

 

[Gastrapathy]

True, I don't mean to sugget that grad school is the only place where you can acquire such attributes. But in grad school, you do learn/leverage these attributes to the n-th degree. And yes it's true that you can do very high-impact research (of any kind) as an MD. So why do an MD/PhD program in the military??? A: to have a ridiculously long name tag

Ah, but the way to get the most letters after your name is to become a fellow of various organizations: ie Gregor G. Gastrapathy, M.D. FACG, FASGE, FACP.

 

[DrMetal]

Ah, but the way to get the most letters after your name is to become a fellow of various organizations: ie Gregor G. Gastrapathy, M.D. FACG, FASGE, FACP.

True. My goal in life is to one day have a 2" x 8" business card:
LCDR Thrash A. Metal, MD, PhD, USN, MC, FACG, FASGE, FACP

Isn't it silly how we decorate our names in the medical community? That's the one thing I'll miss about the scientific community; the good scientists rarely decorate their names, with even a Prof. or PhD (it's assumed everyone has one). You're known by first name, last name, and the work you produce, period!

 

[Erald Coil]

Does anyone know if there is a place for physician scientists in the military? ...I am particularly interested in infectious disease work (I have been doing my Master's degree in ID), but I wonder where my place would be.

I had the pleasure of meeting Col. Duane Hospenthal, MD, PhD, US Army Medical Corps this week. His title is "Infectious Disease Consultant to The Surgeon General, and Chief, Infectious Disease". If you're wondering what a physician scientists in the military might do, and are particularly interested in ID, then here you go!

http://www.afids.org/

I asked Col. Hospenthal whether I'd be able to do clinical ID research in the military, or if I'd be taking care of sprained ankles and shin splints for the rest of my life. He said you can definitely do research and specialize in ID, but may be required to do some general practice work first... I told him I was leaning Air Force, but he said all ID training and work goes through Army, so might be best to go for Army right from the start. BAMC will be the place to be -- or else Bethesda.

Hope this helps! I thought his advice was encouraging.

 

[psychbender]

I had the pleasure of meeting Col. Duane Hospenthal, MD, PhD, US Army Medical Corps this week. His title is "Infectious Disease Consultant to The Surgeon General, and Chief, Infectious Disease". If you're wondering what a physician scientists in the military might do, and are particularly interested in ID, then here you go!

http://www.afids.org/

I asked Col. Hospenthal whether I'd be able to do clinical ID research in the military, or if I'd be taking care of sprained ankles and shin splints for the rest of my life. He said you can definitely do research and specialize in ID, but may be required to do some general practice work first... I told him I was leaning Air Force, but he said all ID training and work goes through Army, so might be best to go for Army right from the start. BAMC will be the place to be -- or else Bethesda.

Hope this helps! I thought his advice was encouraging.

While the bulk of the ID work is through the Army, that does not mean that there are no ID specialists in the Air Force or Navy. While I was on ID at BAMC (Dr Hospenthal was actually my attending for two weeks), I met some of the fellows (and one fellowship applicant), and they were fairly evenly split between Army and Air Force.

 

[Erald Coil]

Right - I should have been more clear. He did say you could specialize in ID from any branch, just that the program is Army-centric.

edit:
psychbender - any insight into how best to navigate from HPSP/USUHS to an ID fellowship with research opportunities?

 

[psychbender]

Right - I should have been more clear. He did say you could specialize in ID from any branch, just that the program is Army-centric.

edit:
psychbender - any insight into how best to navigate from HPSP/USUHS to an ID fellowship with research opportunities?

Not really. If you go Army and want an IM residency, you will get it. If you do well during your residency, and want an ID fellowship, you'll probably get it. From what I recall last year, talking with the resident interviewing for a fellowship spot, there are frequently more spots than applicants for ID. If not, then the worst that would happen is you have to spend a few years as a general internist, accumulating points for the JSGMEB, before reapplying for fellowship.

 

[Erald Coil]

I interviewed at USUHS (both SOM and GEO) last week. Personally, I'd love to get into the MD/PhD program there, except for the part about delaying commission for 3 years... I met with MD/PhD students, faculty, and program directors, asking everyone these same questions: "What sort of career path could I expect as an MD/PhD in the military?" and "How would an MD/PhD benefit me as a career military physician?"

I heard a few fair answers, but nothing solid, just positive anecdotal stories. I'm guessing this is because there are so very few MD/PhD's in the military...? Seems to me that the best thing to do, as an active-duty MD/PhD, would be to take great liberties in defining your own career path, and focus on finding support (and applications) for your research interests.

Personally, the big question seems to be "Would the time and hardship be worth it?" The risk/reward or pros/cons breakdown is still somewhat unclear.

 

[GeoLeoX]

There is a significant amount of research being done in infectious disease in the Army and I have personally been the medical monitor for an ID patient study conducted at WRAIR. There are multiple foci of interest, but it seems like malaria and HIV are at the top (as one would expect). There's also the opportunities for all the travel if one is so inclined. There are also programs, such as the EID at USUHS previously mentioned, the tropical medicine course at USUHS, the research fellowship at WRAIR (if it is still offered).

That being said there is no outright "PhD requirement" for any research. A PhD will teach several skills that one might not get during MD training, but that's something that the individual needs to determine whether they need or not.

GeoLeoX, MD, PhD, FCAP, FASCP, MAJ, MC, USA

 

[IgD]

Seems to me that the best thing to do, as an active-duty MD/PhD, would be to take great liberties in defining your own career path, and focus on finding support (and applications) for your research interests.

I don't think there are any "great liberties" in military medicine, especially these days. There is an overall shortage of physicians and the mission/clinic work have to come first. It's difficult to engage in research at a small command and when you have to balance it against deployments. I've heard this described as "research under adverse circumstances". The only exception I found was if you were a very senior medical officer and could be placed in a designated research billet like at DCOE or some other center.

 

[GeoLeoX]

I don't think there are any "great liberties" in military medicine, especially these days. There is an overall shortage of physicians and the mission/clinic work have to come first. It's difficult to engage in research at a small command and when you have to balance it against deployments. I've heard this described as "research under adverse circumstances". The only exception I found was if you were a very senior medical officer and could be placed in a designated research billet like at DCOE or some other center.

I agree with everything except with the senior officer part (though it does make it easier, we had both junior and senior officers who worked out "protected time"). It depends on your specialty, your department, your chief, etc. There is money available for research, but you have to be in the right specialty with the facilities to support it. Very much the "research under adverse circumstances". In addition to doing everything that everyone else is doing you have to find a way to write for funding (if necessary), find time for conducting research, and not manage to get yourself shipped away. It's possible, but very, very hard. If you can manage to get some "protected time" it's going to very quickly violated by your real work if you don't protect it yourself.

 

[Erald Coil]

There is money available for research, but you have to be in the right specialty with the facilities to support it.

Can anyone offer any insight into how the DoD funding for research pipeline works and how I might use it to cultivate an active duty medical research career? Specifically, how might I leverage DoD or DHS research support against the demands that my Air Force chain of command might have for me?

 

[GeoLeoX]

Can anyone offer any insight into how the DoD funding for research pipeline works and how I might use it to cultivate an active duty medical research career? Specifically, how might I leverage DoD or DHS research support against the demands that my Air Force chain of command might have for me?

It depends on you and your chain of command. Are you willing to work longer hours than your colleagues? Some commanders (dept. chiefs) are more inclined to allow research time than others. You may want to enquire when you are considering assignments how your chief views research. Then once the climate is ascertained you can either do your research on "your time" or have protected research time off from the "regular schedule". Like any research funding you have to go looking for it. The DOD and in my case, the DA have specific projects that they fund in addition to sources of funding for development.

 

[DrMetal]

Specifically, how might I leverage DoD or DHS research support against the demands that my Air Force chain of command might have for me?

You can't (and don't let anyone tell you otherwise). If you're in uniform, the demands of your service (and the military in general) comes first, period. You could be doing ground-breaking nobel-prize-winning research . . .but if it's your time to deploy, then you have to go.

 

[GeoLeoX]

You can't (and don't let anyone tell you otherwise). If you're in uniform, the demands of your service (and the military in general) comes first, period. You could be doing ground-breaking nobel-prize-winning research . . .but if it's your time to deploy, then you have to go.

yep.

 

[Erald Coil]

You can't. . .

haha - noted. Thank you.