Timeline: Does M.D./Ph.D *really* take longer?

[MiniFreud]

I always hear a big fuss about the extra time completing an M.D/Ph.D takes, and I hear even more fuss about how you make less money during the process.

My current understanding of the M.D. process is as follows:
~4 years of medical school
~4 years of residency

This ends up with you as a practicing physician.

My current understanding of the M.D/Ph.D process is as follows:
~6-10 years of schooling for both degrees, with 6 being the low end (VCU) and 10 being everywhere else.
~A stipend
~Optional training to enter medical practice

In an ideal situation, right after you finish school you can go straight into some industry position with a laid back schedule and lots of traveling, all while being able to actually research and contribute to science.

Now all things considered, given that a complete medical education takes approx. 8 years no matter where you go and M.D/Ph.D. training can take as little as 6 years, is the time complaint really valid?

Is there something gravely skewed about my understanding of either process or am I correct when I conclude that medical school and MSTPs actually take approximately the same amount of time, and most of the fuss about time is unfounded?

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[StIGMA]

In an ideal situation, right after you finish school you can go straight into some incredibly lucrative industry positions and make a private practice salary with a laid back schedule and lots of traveling, all while being able to actually research and contribute to science.

Then you just completed a worthless M.D. To be licensed you still must complete residency - the same amount of time, you get no shortcuts because of your PhD - and additionally may follow that with a post-doc or fellowship. It is uncommon to go straight to industry and a spit in the face to the NIH. If you went MD/PhD to go industry, you likely did it for the wrong reasons, and there were more effective routes to get to the same position. However, there are instances of fantastic MD/PhD's in industry who have started great companies, etc., but they are the exception.

Point being: What you can do is not what is commonly done. It is common to go to residency still.

Is there something gravely skewed about my understanding of either process or am I correct when I conclude that most of the fuss about time and money is unfounded?

You need a comma after 'process.' And nobody fusses except maybe people like you who don't do any research before picking a 7-10 year professional training program. The time to degree is excessive, in my opinion, at the 9-10 year mark, if your graduate years have been productive. You should be out in 8 years if you picked a reasonable project and work hard on it. More than that, your PI or department should be beaten.

Lastly, who fusses about the money? It is on par with other physicians/academic faculty, indeed in excess of PhD's. The post-degree training years are low salary, and that is a just reason for complaint in many instances. In many places, post-doc salaries are outrageously low (30k's).

 

[SaltySqueegee]

Do not pick a path because of financial reimbursement. If you pick a path you like, it is likely you will be good at what you do and will make a reasonable living from it.

Example:
One individual makes $90K per year, another makes $200K. I guarantee you that they both have food on their plates at the end of the day, have transportation to and from work, take time off from work periodically for vacation and may even have money for a family.

What's left is the question of, do you enjoy your job? At this level of professional careers, salary is a bit moot.

 

[MiniFreud]

Please, please - no accusations of greed or lack of research. I have done plenty of research and I'm not looking for either career only for the money. I have strong personal interests in certain fields of science and I want the career so that I can contribute to the growth of the medical field.

Merely mentioning time and/or money in a post does not in any way imply otherwise.

Edit: I removed all the references from money from the original post. Maybe now all of the chrematophobes will see that there was an actual valid question there.

 

[gbwillner]

In an ideal situation, right after you finish school you can go straight into some incredibly lucrative industry positions and make a private practice salary with a laid back schedule and lots of traveling, all while being able to actually research and contribute to science.

Now all things considered, given that a complete medical education takes approx. 8 years no matter where you go and M.D/Ph.D. training can take as little as 6 years, is the time complaint really valid?

Does the MD/PhD track really take longer? YES. Absolutely. No doubt.

If you want to make money, go get an MBA. You will make a lot more than a physician, with rare exception.

 

[StIGMA]

Now all things considered, given that a complete medical education takes approx. 8 years no matter where you go and M.D/Ph.D. training can take as little as 6 years, is the time complaint really valid?

To be licensed you still must complete residency - the same amount of time, you get no shortcuts because of your PhD - and additionally may follow that with a post-doc or fellowship.

Maybe now all of the chrematophobes will see that there was an actual valid question there.

For emphasis:

You are not a physician-scientist until you complete residency/ are licensed.

MD: as you put, rough estimate on 4+4 = 8 +More for fellowship.
MD/PhD: roughly 7-9+4 = 11-13. +More for fellowship/postdoc.

 

[gstrub]

Where do we get these premeds that can't figure out that (4+4)<(8+4)? Stop diluting the applicant pool...

 

[QofQuimica]

OP,

It is possible to get a job in industry as an MD/PhD without a residency. But your math is still off, as others have pointed out, because you will still need some kind of post doc training, just like a PhD would. Post docs typically last about 2-3 years, at least in my field (organic chem). In addition, if you want to be licensed as an MD, you must do one year of internship. (Without the license, you're not any more valuable to a pharm company than you would be with just a PhD.) So you're looking at a *minimum* of 3-4 years post-MD/PhD to get yourself to a point where you'd be hireable, even if you don't do a residency.

If you don't want to do clinical work, you might consider just going to graduate school and forgoing the MD altogether. That might save you a year or two, and you don't need an MD if you just want to work in a lab and/or lecture around the world. I'll also caution you that if you want an industry job, you may find that you are much more competitive with just an MS than you would be with a PhD. In my experience, there aren't nearly as many jobs in industry for PhDs as there are for MSes.

 

[Neuronix]

As has been pointed out, around 95% of MD/PhD graduates go on to do residency. If you wish to proceed into biomedical research, it is very likely you will do fellowship to be a specialist, as opposed to a generalist, making your residency even longer by tacking on that fellowship. The MD not going into research has no similar pressure to do fellowship, except a personal one or a desire to make more $$$ in many situations.

In an ideal situation, right after you finish school you can go straight into some industry position with a laid back schedule and lots of traveling, all while being able to actually research and contribute to science.

It's an option, but it's quite uncommon. Good luck finding this laid back schedule and not everyone wants lots of traveling.

Now all things considered, given that a complete medical education takes approx. 8 years no matter where you go and M.D/Ph.D. training can take as little as 6 years, is the time complaint really valid?

I don't know specifically about your VCU comment, but I seriously doubt until someone provides me evidence otherwise that if you start your program there now that the MD/PhD will take you 6 years. Also, this idea of 10 years is overestimated. I made a blog post about this. You should be thinking 8 years +/- 1 year for anywhere you go. We should talk in generalizations, hence we're talking about an AVERAGE 4 years of med school versus an AVERAGE 8 years of MD/PhD. Presenting the MD/PhD as a 6 year program is a major exception, and not a rule.

Is there something gravely skewed about my understanding of either process or am I correct when I conclude that medical school and MSTPs actually take approximately the same amount of time, and most of the fuss about time is unfounded?

Considering that the vast majority of both MD and MD/PhD graduates go on to do residency and optional fellowship, yes, you are presenting a skewed and misleading view of the situation. It is possible to graduate from your MD/PhD program and go straight into industry or some other position that does not require residency. It is also possible to do so from a MD program. However, this is exceedingly rare for either.

The reality is that MD/PhD = 8 years of MD/PhD + residency
And MD = 4 years of MD + residency

The only argument that makes sense for the timeline of MD/PhD not necessarily taking longer is in the case that the MD and the MD/PhD both decide to do basic science. It is assumed that the MD will have to have more fellowship level training or spend more time as an assistant professor to get their basic science career going, and this would take as long as an extra 4 years. Thus, that would equalize the training time for the two, as the MD/PhD spent that extra 4 years getting a PhD.

 

[MiniFreud]

Ah, well that makes sense. I was led to believe by many people that M.D/Ph.D students didn't necessarily have to complete a residency. Nevermind then.

At least somebody was nice enough to point that out without personal attacks.

Why, obviously I am a total dunce for not having my next ten years mapped out perfectly! Shame on me! It's not like I'm on some kind of... you know, internet forum dedicated to disseminating information to aspiring doctors, or anything like that.

 

[QofQuimica]

Why, obviously I am a total dunce for not having my next ten years mapped out perfectly! Shame on me! It's not like I'm on some kind of... you know, internet forum dedicated to disseminating information to aspiring doctors, or anything like that.

Hon, of course you're not a total dunce. This is why we have these forums, so that people can get accurate information. We've all been exactly where you are now.

 

[Neuronix]

Ah, well that makes sense. I was led to believe by many people that M.D/Ph.D students didn't necessarily have to complete a residency. Nevermind then.

I hear that on occasion as well. I hear it for MD students as well. I think it's easier and better to think in terms of--the vast majority of students go on to do residency. There's some links in the forum stickies with data as to this exact percentage (and breakdowns as to what residencies MD/PhDs choose). Personally I only have experience with one guy who decided to go from MD/PhD straight into industry. He seems to like it, but I think for him it was a default pathway because he didn't really want to continue in reseach or academics. I don't think his position was particularly lucrative.

We could discuss a bit about the options for MD/PhDs who do go straight into industry without residency, but I'm not sure anyone around here has any experience with the subject. Certainly the advice I most commonly hear is to go do residency for a variety of reasons. Only secondary sometimes I hear ok go straight to post-doc if you must. Almost no advisor I meet says it's a good idea to go straight to industry. Though I recall reading one blog that expoused going to finance straight out of the MD and I can try to dig this up if you like.

At least somebody was nice enough to point that out without personal attacks.

Good ol SDN eh! What was your question about money anyways? I for one have always viewed this as a place where any question about MD/PhD can be asked. I will answer any and all questions to the best of my knowledge even if you do get flamed by others.

 

[MiniFreud]

Good ol SDN eh! What was your question about money anyways? I for one have always viewed this as a place where any question about MD/PhD can be asked. I will answer any and all questions to the best of my knowledge even if you do get flamed by others.

Wow. That's refreshing. I'm glad you're moderator of this place.

I hate money. The only real reason I would ever worry about money or time is because I will soon have a wife to take care of, and whether academia likes it or not, I will have personal financial goals that must be met in a (somewhat) timely manner.

Other than this little timelining question, most of my questions are aimed at learning about possible industrial roles of physician-scientists or finding out about their possible roles in other countries (France, England, Japan, Germany, Norway), assuming fluency in the native tongue.

Do you think I could PM you if I have other questions? Your profile says you're a current student yourself, and I'd always be interested to know what your experience is like and what you're researching.

 

[Neuronix]

Wow. That's refreshing. I'm glad you're moderator of this place.

Vote Eric for president, 2040 or something.

I hate money. The only real reason I would ever worry about money or time is because I will soon have a wife to take care of, and whether academia likes it or not, I will have personal financial goals that must be met in a (somewhat) timely manner.

How can you hate money? If money is the root of all evil, ask yourself, what is the root of all money? Anyhow, I don't mind discussing money. It is important, for both academics and private practice. When you become a PI your job comes down to your ability to bring in money for the department you work for. When I submitted my patent to the University office, they wanted to have a buyer for the product before they would even file the paperwork. So why should anyone tell you not to worry about money when it's also their primary concern?

Anyhow, I think that while money shouldn't be one's PRIMARY concern in life, it is a concern for everyone. How much you rate it within your own life is up to you. Will you take the $100k/year job and do 90% research or the $200k/year job and do 50% research or the $400k/year job and do 0% research? This is a very real choice for MD/PhDs in Radiology. Before you start with the $100k/year is enough money argument, remember that you haven't yet tried to buy a house and send kids to school and have a wife that makes minimal or even nothing. It's amazing that $100k/year all of a sudden doesn't really get you far in the city (where a lot of the jobs are) in that situation. Yet that's our expected starting salary in most of the 80-90% research jobs within academics that I've seen.

Do you think I could PM you if I have other questions? Your profile says you're a current student yourself, and I'd always be interested to know what your experience is like and what you're researching.

Just AIM me, Neuronix2. That goes for anyone else who wants to.

 

[GWD]

Ah, well that makes sense. I was led to believe by many people that M.D/Ph.D students didn't necessarily have to complete a residency.

A full-fledged medical scientist does BOTH a residency AND a post-doc

 

[Wylde]

You forgot the

-Residency ~3-7years. What would be the point of getting an MD if you couldn't use it? 4 years of additional education is not worth 2 letters after your name (if you don't use them).

-Postdoc ~1-3 years.

So, in the end, MD/PhD takes about 9-12 additional years (including postdoc).

 

[xanthines]

I went to a postdoc career seminar last year, and they said the average biomedical postdoc was 4 years. Apprenltly, the days of doing a 1-2 years of postdoc work before professorship are long gone.

-X

P.S. Eric, it's the love of money that is the root of all evil. $$$

Post docs typically last about 2-3 years, at least in my field (organic chem).

 

[Neuronix]

I went to a postdoc career seminar last year, and they said the average biomedical postdoc was 4 years. Apprenltly, the days of doing a 1-2 years of postdoc work before professorship are long gone.

In the MD/PhD world almost nobody does a post-doc. We call it fellowship. I'd almost like to standardize this vocabulary so people stop getting confused.

The major difference between post-doc and fellowship is that fellowships have some clinical component. The fellowship may be entirely clinical or include research for the research interested. If you are trying to launch your own research career, the fellowships tend to extend, and the more research-oriented places will let you extend this kind of like a post-doc doing mostly research. For this you are paid about $10k more than a post-doc with the same amount of training at most institutions. This is usually on the order of half of what you'd be paid if you just stepped into an assistant prof spot and maybe 1/4 or less of private practice salary.

It is easier for MD/PhDs to transition into assistant professor jobs again because of this clinical component. Departments know at the least they are getting an MD out of the deal.

P.S. Eric, it's the love of money that is the root of all evil. $$$

I was just trying to sound slick by paraphrasing Ann Rand Besides, I don't necessarily think loving money and seeking it ethically is evil at all. To love anything to an extreme is bad, and for money it's no different. Besides, money won't betray you the same way girls will

 

[Ariodant]

Or guys will

Anyway, if it's about making $$, then MD/PhD does take longer. I assume everyone has finished agonizing over the timeline of $$ rolling into their pockets before they start sweating over MD/PhD acceptance