Dear MentorDoctor:I am currently an undergrad at Howard University, and my long-term career goal is to do research as well as clinical work. At first I thought I could do that by just getting an M.D., but I've heard it's more advantageous to pursue an M.D./Ph.D. Since the admissions committees are very selective, accepted applicants get grants and scholarships making most of these combined programs "free." Is this true? If so, how do I really know if getting an M.D./Ph.D. is the right thing for me?
Isabella Finkelstein: There are several things you need to consider as you make your decision:
Are you sincerely interested in being a research physician or are you more interested in being a clinical physician ( i.e., is treating patients your first interest or is doing research your first choice?)
How much research experience have you had? In selecting M.D./Ph.D. candidates, research experience is an important factor. M.D./Ph.D. programs are highly competitive, often requiring high MCAT and GPA scores.
It is true that M.D./Ph.D. programs often have financial support for students pursuing the combined degree. Many institutions have Medical Science Training Programs (MSTP) funded by the National Institute of Health. Typically in these programs, you complete the first 2 years of medical training, then the Ph.D., and finally the last two years of medical school. Individual MSTP programs may be structured differently, but all incorporate the necessary coursework and research required for the dual degree. Most programs require a 6-7 year training period; however, my experience has been that it takes 1-2 years longer. After completion of the M.D./Ph.D., you still have the residency years. Are you willing to commit the time required?
It is possible to do a traditional M.D. and do research training during your residency. If you are interested in doing clinical research, this is an alternative route for receiving research training.
In summary, if you are truly interested in being a research physician, consider the M.D./Ph.D. But if being a clinician with some research is your interest, you should consider the M.D. Good luck!
Thomas Landefeld: This is a common question, a good question, and a really tough one to answer, especially your last query, i.e . is it "right" for me. Many individuals want to practice medicine but also enjoy research. So thinking of an M.D./Ph.D. is obvious. There is nothing wrong with that and, in fact, these programs, e.g. MSTP (and yes, students in these programs have both graduate and medical school paid for), produce some of the best and most competitive physician-scientists in the world.
In fact, while at the University of Michigan Medical School, I had the opportunity to interview students applying to the MSTP and they were most impressive. Nevertheless, with all that said, an individual can also do excellent research as a physician with "just" an M.D. So how do you decide?
First, determine if you want to see patients, i.e., practice medicine. If so, then you have to have medical school as part of your post-baccalaureate education. Once you have made that decision, then you need to decide if you want to be actively involved in research. If this is the case, you have several options. You can decide on the M.D. alone--complimented by research experiences as an undergraduate, a medical student (usually between M1 and M2 years), or a resident/fellow--or do an M.D./Ph.D. Please keep in mind that just being involved in research projects isn’t enough; you must prove yourself a capable researcher through abstracts, publications, grants, oral presentations, etc.
Since you appear to be interested in the dual degree, consider the following:
As an M.D./Ph.D., you will probably not do as much clinical practice as you would with just an M.D.
The combined degree normally takes longer, but some doors will be opened because of it.
Since the combined program is really a research-based program, you must have lots of research experience to get accepted.
In summary, as I tell my advisees, the combined program is not for everyone, but if you can convince yourself and the committee that there is truly a reason that you desire both, then go for it. Be sure to make it a prominent theme in your personal statement, and be prepared to speak at length about the topic during your interviews. If research isn't as high on your list as practicing medicine, go for the M.D., get lots of research experience, and you can still have a very satisfying career in academic medicine.
The GrantDoctor: First, please have a look at our feature on M.D./Ph.D.  careers. There's a ton of information there; it will probably answer all your questions.
My colleagues have covered the options well, or most of them. The M.D./Ph.D. program is a great way to go, but there are ways of getting into research--especially clinical research--with just an M.D.
Then again, getting a medical degree without accumulating a massive amount of debt is a big advantage--especially if you plan to survive on research-scientist salaries instead of becoming a high-dollar medical specialist--and there aren't very many ways to get a medical degree without accumulating debt. M.D./Ph.D. programs--specifically, the NIH-sponsored MSTP programs mentioned by Finkelstein and Landefeld--are among the very few established routes to free medical training. Indeed, it's better than free--you get a stipend (a generous one by grad-school standards) while you attend. MSTP programs are a very good deal.
Then again, many schools can make strong financial aid offers to M.D. students from disadvantaged backgrounds, which may or may not apply to you. Finally, NIH has some very generous loan-repayment plans for M.D.s that choose clinical research for a living.
Medical school is expensive and emphasizes clinical practice. M.D./Ph.D. programs also deliver a medical degree, but they take longer and place far more emphasis on research--including bench research--and your education is free. Ultimately, it's a question of balance and a decision that only you can make.
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