Question: MD, PhD, Med school, Grad school

[ChristineR]

I'm writing fiction and I'm hoping some of you medical and research types can clarify something for me. What are the differences between the following:

A PhD in biochemistry from a graduate school.
A PhD in biochemistry from a medical school.
An MD/PhD in biochemistry from a medical school.
An MD from a medical school.

Other than all the usual reasons people choose one school over the other, why would someone choose a medical school over a University grad school? There are even universities out there with grad schools and medical schools both offering PhDs in biochemistry. It seems kind of whacked to me...I would assume the big advantage of a medical school would be research opportunities in medicine, but the programs I looked have seem to have no clinical practice.

 

[Skeptic Ginger]

The first one would not be a licensed physician. The latter 2 would be physicians one with a research focus and my guess is the biochem PhD would be from the same university but not the med school itself.

I'm not aware you would get a PhD from a Med school without also becoming a medical doctor so someone else will have to answer that one.

 

[Physiotherapist]

Yes, I think that is correct. You would be an MD already before being awarded a PhD from a Med. School. I think most med schools now run joint MD/PhD programs, so that you can graduate with both at the end, although I would think the program would be longer than 4 years though?

However, I always thought it would be the University that awarded the PhD rather than the med school?

 

[JJM]

I'm writing fiction and I'm hoping some of you medical and research types can clarify something for me. What are the differences between the following:

A PhD in biochemistry from a graduate school.
A PhD in biochemistry from a medical school.

As stand-alone degrees they are the same. The quality is entirely dependent on the laboratory and professor. As suggested, above, the degree from the med school may actually be conferred by an associated University.

An MD/PhD in biochemistry from a medical school.

The combined program provides full MD education. However, before going into full-time clinical work, the students take a year to work in the lab and qualify for the PhD. Compare that to perhaps a year of coursework and 2-5 years of research (in the USA model) for a regular PhD; it isn't quite the same. The MD/PhD prepares one to do research, as mentioned above.

An MD from a medical school.
...

Medicine is based on many fields of science; but one is rarely an expert in any field of science- they are expert in diagnosis and treatment. I (organic chem PhD) once shared a lab with an MD/PhD who had submersed himself in chemistry as an undergrad, and had his doctoral year in enzyme reaction mechanisms, who was quite knowledgable in chemistry.

 

[yairhol]

A PhD stands for Philosophy Doctor. This title is an historical one since in the days of the Greek, the philosophers were the smart people who studied science, wrote books and contemplated on life.
anyone with a PhD is focused on research. this means that he has a Bachelour degree, a masters degree and a PhD.
An MD is a person who went to med school and studied towards his MD degree without first studying Bachelour, master etc... He is not focused on research but is only focused on practicing medicine to the public.

Regards,
Yair

 

[JJM]

A PhD stands for Philosophy Doctor. This title is an historical one since in the days of the Greek, the philosophers were the smart people who studied science, wrote books and contemplated on life.
anyone with a PhD is focused on research. this means that he has a Bachelour degree, a masters degree and a PhD.
An MD is a person who went to med school and studied towards his MD degree without first studying Bachelour, master etc... He is not focused on research but is only focused on practicing medicine to the public.

Regards,
Yair

I think there is some confusion here. A PhD, in the USA, does not require an MS, and I am pretty sure the same is true in the UK. An MD, which, apparently, is not conferred in the UK, usually requires a batchelor's degree before admission to med school. I know of one program that accepts high-school students into a two-year college program and, if they keep up their grades for two years, sends them into med school without a full undergrad degree.

 

[Dr. Imago]

What's your scenario, ChristineR?

I ask because it sounds like you are trying to come up with an expert for your fictional story. In certain circumstances, a PhD biochemist would get a bunch of wrinkled noses by medical doctors if they tried to "apply" their benchwork clinically. Likewise, an MD would probably be heavily scrutinized if they attempted to present some basic pathway research in front of other biochemists. It's just generally understood that these two distinct types of scientists have different goals and applications to their research.

An MD/PhD (in the U.S., which is conferred typically by a six-year MSTP program) is trained to both basic science and clinical research. Still, the research is aimed primarily at human diseases and expanding on known human pathways.

A PhD biochemist trained at a medical school (like we have at our institution) will probably focus more on illucidating and better understanding human biochemical pathways. But, their clinical knowledge of general human disease will be limited. Usually they are working on very specific pathways within one small subset of biochemical pathways.

A PhD biochemist trained at a non-medical school program will likely be a true "generalist", in that they may be studying any number of biochemical pathways in humans, animals, plants... you get the picture.

An M.D. is trained to be a clinician, and forgets most of the specifics of biochemistry by their third year of medical school after they pass their 2nd-year boards if I'm any indication (haha). Seriously, I cannot remember the specifics of the Kreb's cycle anymore, nor is it applicable or necessary to have memorized for what I do on a daily basis. However, I can tell you the intimate details of neuromuscular blockers at the cellular level, opioid agonism/antagonism, and a whole host of the pharmacokinetics/pharmacodynamics of the drugs I use everyday. That's because it's specific to my specialty, anesthesiology, and it is necessary that I know and understand those things. For everything else, I look up (but, the key is I know where to look... and I have a foundation. So, it's not like I have to relearn concepts everytime. You get it?)

So, it all depends on what type of expert you want to create. If one of your characters has diabetes, it would be much more believable if an MD/PhD endocrinologist at a major treating institution were to be an expert in court. If your scenario OTOH involves some bench discovery in insulin resistance or something, then a PhD working at a medical school - or even an animal lab - may be more believable.

I'd be happy to read what you write and offer additional input, if you want. It may take me some time, though, because I just can't get back here as much as I used to.

-Dr. Imago

 

[ChristineR]

The character is a biochemist. The original idea was that he went to med school, never practiced, went to work for a drug company and ended up being more of a corporate type than a physician.

The original scenario was that he would be called upon to do some simple doctoring in an emergency situation. I figured that if he got a med school biochemistry PhD he would be capable of doing that, but this may not be the case. But if actually went through a six or eight year MD/PhD program I'm not sure he'd end up deciding which experimental drugs to throw money at.

 

[T.A.M.]

sounds to me the best route for this would be an MD who majored in biochemistry as his pre MD degree (many schools require a full degree prior to acceptance into medical school now), who then left medicine after recieving his MD, and decided to finish his PhD in Biochem...

TAM

 

[Ben Tilly]

I'm writing fiction and I'm hoping some of you medical and research types can clarify something for me. What are the differences between the following:

A PhD in biochemistry from a graduate school.
A PhD in biochemistry from a medical school.
An MD/PhD in biochemistry from a medical school.
An MD from a medical school.

Others have answered, but I'll answer again since my answer has a slightly different slant being that it is based in part upon watching my wife go through both a PhD and an MD seperately. (That said, I am speaking for myself. She may not fully agree with my opinions.)

Both types of PhDs are equivalent. The PhD from a medical school is more likely to be based on research that is directly applicable to humans, but the difference isn't very big.

An MD/PhD is a combined degree where one is theoretically qualified as both. In practice the result is a person who has a stronger than normal MD (they go through all regular MD training, and the people who do it are normally better than average MD candidates) and a weak PhD (they don't get as much time as a normal PhD to learn about research). Despite the weakness of the PhD, MD/PhDs who go into research usually make more than straight PhDs for a number of reasons. First of all it is easier for them to get permission to do research on humans. Secondly they get compensated for the fact that they could make so much more in private practice. Thirdly everyone is aware of how competitive MD/PhD candidates are, so people expect them to improve very rapidly if they stay in research.

There are several reasons why people pursue MD/PhDs. A common one is that frequently your medical school tuition gets waived. Another is that
(depending on what you want to specialize in) it may be easier to get into competitive residencies. A third is that people sometimes don't know which direction they want to go, and like keeping both options available.

An MD from a medical school is a technical degree, not a research degree. Do not expect a doctor to have learned very much about how to conduct research or think about novel situations. Rather the doctor has learned a very large body of detailed knowledge, and become proficient in applying that knowledge to a specific family of practical situations. Doctors are very good at understanding and applying knowledge, not at generating or evaluating it. (Which I suspect is one of the reasons why you see so many doctors advocating various "woo" theories.) I should note that, like many competent people, most doctors are unaware of where the boundaries of their competence is. So they don't see this shortcoming. (And, in fact, they are far better than the general public at generating and evaluating knowledge. They are just worse than people who specialize at that, namely PhDs. Similarly PhDs are worse than people who specialize at fooling people at detecting how people are being fooled. Which is why more PhDs get fooled by psychics than stage magicians like Randi. Everyone has their relative weaknesses...)

If you want a very good idea of what medical school is really like, I liked http://www.amazon.com/Becoming-Doct...0535963?ie=UTF8&s=books&qid=1174850288&sr=8-1 quite a bit. It is an autobiographical account of one student's experience, and it is very honest about the reality. Even parts of it that tend to get whitewashed by others. (Want to know what the doctors call your grandma behind her back when she's in the hospital? They call her "gomer". It stands for "Get Out of My Emergency Room" and they call her that because they hate wasting a lot of their energy taking care of old patients with lots of problems who are going to die soon no matter what you do. No, I'm not joking.)

Other than all the usual reasons people choose one school over the other, why would someone choose a medical school over a University grad school? There are even universities out there with grad schools and medical schools both offering PhDs in biochemistry. It seems kind of whacked to me...I would assume the big advantage of a medical school would be research opportunities in medicine, but the programs I looked have seem to have no clinical practice.

In my opinion a PhD from a medical school is equivalent to one from a graduate school. Here is how you should choose between them: Apply to all of the programs you're interested in, and choose the best one you got into. That program might happen to be at a medical school or a graduate school. Either way, your decision is made.

Cheers,
Ben

 

[Ben Tilly]

A PhD biochemist trained at a medical school (like we have at our institution) will probably focus more on illucidating and better understanding human biochemical pathways. But, their clinical knowledge of general human disease will be limited. Usually they are working on very specific pathways within one small subset of biochemical pathways.

A PhD biochemist trained at a non-medical school program will likely be a true "generalist", in that they may be studying any number of biochemical pathways in humans, animals, plants... you get the picture.

Based on experience, I'd disagree that a PhD biochemist trained at a non-medical school program is likely to be a true generalist. They're going to be specialists in whatever they studied. It is just that it is slightly harder to predict what kind of problem they'll have specialized in.

That said, both biochemistry and biology are far less specialized than, say, mathematics. For instance a biologist can expect to take virtually any biology paper, read it, and understand it. By contrast mathematicians don't generally expect to be able to read most of the papers published by other people in their department.

Cheers,
Ben

 

[Ben Tilly]

The character is a biochemist. The original idea was that he went to med school, never practiced, went to work for a drug company and ended up being more of a corporate type than a physician.

The original scenario was that he would be called upon to do some simple doctoring in an emergency situation. I figured that if he got a med school biochemistry PhD he would be capable of doing that, but this may not be the case. But if actually went through a six or eight year MD/PhD program I'm not sure he'd end up deciding which experimental drugs to throw money at.

It would be realistic for an MD/PhD to wind up in this situation. It isn't the expected path through life, but lots of people don't follow an "expected" path through life.

It would also be realistic for this to be a student who went to medical school, hated it, dropped out and did a PhD instead.

You could even make this be a PhD who had received basic medical training in some other context. A few potential interesting ones are lifeguard (summar job in highschool?), wilderness tour guide, fireman, and ambulance volunteer.

Cheers,
Ben

 

[ChristineR]

Thank guys, you are all very helpful.

Mayo Clinic offers a PhD in biochemistry for students with a BS only. I also found some medical schools that offer a PhD in biochemistry for students who are already an MD. University of Michigan, which is (literally) near to my heart offers "biochemistry" in the med school and "chemical biology" in the grad school, as well an interdisciplinary "chemical biology" in both the med school and grad school. However U of M is notorious for offering these sorts of redundant programs across competing departments.

I also found six year PhD/MD programs for BS students.

Doctors have to work so damn hard. In my experience, the people who successfully become doctors decide what they're going to do at about age 12, and never look back. Because of that they tend to be rather narrowly focused, and alas, more easily fooled than other people, and less likely to admit they're wrong when it happens. (Of course doctors are also usually right when they are not being deceived, at least in medical matters.)

Anyhow, the character is not one of those super-focused types, although he did have a change of heart and decided to be less hands-on and more managerial, so maybe I'll just make it a more profound change.

On the other hand, the idea of him being a volunteer ambulance worker also seems very plausible and I really like it.

 

[Dr. Imago]

Based on experience, I'd disagree that a PhD biochemist trained at a non-medical school program is likely to be a true generalist. They're going to be specialists in whatever they studied. It is just that it is slightly harder to predict what kind of problem they'll have specialized in.

That said, both biochemistry and biology are far less specialized than, say, mathematics. For instance a biologist can expect to take virtually any biology paper, read it, and understand it. By contrast mathematicians don't generally expect to be able to read most of the papers published by other people in their department.

Cheers,
Ben

I didn't mean to insinuate that they weren't an expert in their particular field of study and had a specific focus in their research, just that they may have a broader context under which they'd train/study. My undergrad program offered a "non-medical" biochemistry PhD. Ironically, one of the senior professors on faculty was a world-reknown expert and researcher on taxanes, the cancer fighting chemicals derived from the bark of the Pacific Yew tree. While he certainly could describe in painful detail the cellular interplay at the molecular level as well as the synthesis of taxol in the bark, I'm sure that he would've scratched his head and offered a blank stare if you'd asked him to talk about clinical cancer staging.

-Dr. Imago

 

[Ben Tilly]

I didn't mean to insinuate that they weren't an expert in their particular field of study and had a specific focus in their research, just that they may have a broader context under which they'd train/study. My undergrad program offered a "non-medical" biochemistry PhD. Ironically, one of the senior professors on faculty was a world-reknown expert and researcher on taxanes, the cancer fighting chemicals derived from the bark of the Pacific Yew tree. While he certainly could describe in painful detail the cellular interplay at the molecular level as well as the synthesis of taxol in the bark, I'm sure that he would've scratched his head and offered a blank stare if you'd asked him to talk about clinical cancer staging.

-Dr. Imago

I agree with what you say, but let's just say that I'm dubious about how frequently that "borader context" results in candidates who take advantage of that context and become generalists.

Conversely a medical school PhD who is inclined to generalize, will likely have no trouble doing so. And furthermore plenty of research within medical schools takes place on a large variety of animal subjects. Whatever the institution, people doing research go where their research takes them. (And many experiments are far easier to perform on animals.)

Cheers,
Ben

 

[Dr. Imago]

An MD/PhD is a combined degree where one is theoretically qualified as both. In practice the result is a person who has a stronger than normal MD (they go through all regular MD training, and the people who do it are normally better than average MD candidates) and a weak PhD (they don't get as much time as a normal PhD to learn about research).

Oh brother... where do I start. You've offered many simplistic outsider opinions on something you appear to have little actual understanding. Your perceptions are, quite simply, sophomoric.

Despite the weakness of the PhD, MD/PhDs who go into research usually make more than straight PhDs for a number of reasons. First of all it is easier for them to get permission to do research on humans. Secondly they get compensated for the fact that they could make so much more in private practice. Thirdly everyone is aware of how competitive MD/PhD candidates are, so people expect them to improve very rapidly if they stay in research.

You should avoid making such sweeping generalizations, most of which are wrong. What is a "weak PhD" (which is not weak)? The candidate has to do novel research, write and defend a thesis, and publish just like every other PhD candidate. It is not any easier for a MD/PhD to get permission to do research on humans, and many principle investigators in human trials are PhD's alone. How did you come across that notion? And, I have no idea what "they get compensated for the fact that they could make so much more in private practice" means. Are you talking about working for a pharma company? And, the last underlined statement is an argumentum ad populum fallacy... if "most people" actually do believe that, which I don't know to be true myself. In fact, it may be easier to get into a MSTP program than getting a general spot. It can be harder to attract qualified candidates who actually want to do research and have an academic career, and often there are fewer candidates for those spots.

There are several reasons why people pursue MD/PhDs. A common one is that frequently your medical school tuition gets waived. Another is that
(depending on what you want to specialize in) it may be easier to get into competitive residencies. A third is that people sometimes don't know which direction they want to go, and like keeping both options available.

Your med school tuition does NOT get waived! Where did you get that notion? It is NOT any easier to get into competitive residencies with an MD/PhD, not that you even delineated which are the "competitive" residencies. And, none of the MSTP candidates I knew were unsure as to "which direction they want to go". Who in their right mind commit to an extra two years of school and having to defend a thesis when the MD degree alone offers so many opportunities? Likewise, you are NOT precluded from pursuing a research-only career with just an MD. In fact, at our institution we are doing novel bench research with the mu-opioid receptor. One of the lead investigators is an MD-only guy. You just simply don't have your facts straight, Ben.

An MD from a medical school is a technical degree, not a research degree. Do not expect a doctor to have learned very much about how to conduct research or think about novel situations. Rather the doctor has learned a very large body of detailed knowledge, and become proficient in applying that knowledge to a specific family of practical situations. Doctors are very good at understanding and applying knowledge, not at generating or evaluating it. (Which I suspect is one of the reasons why you see so many doctors advocating various "woo" theories.) I should note that, like many competent people, most doctors are unaware of where the boundaries of their competence is. So they don't see this shortcoming. (And, in fact, they are far better than the general public at generating and evaluating knowledge. They are just worse than people who specialize at that, namely PhDs. Similarly PhDs are worse than people who specialize at fooling people at detecting how people are being fooled. Which is why more PhDs get fooled by psychics than stage magicians like Randi. Everyone has their relative weaknesses...)

How old are you? 15? That's a serious question. You have a lot of very strong opinions about things you appear to have very little actual knowledge of. I get the impression from your response that you are a cocksure teenager. It's almost stream of consciousness. And, it's just incorrect. Blatantly incorrect. Have you ever been to PubMed?

If you want a very good idea of what medical school is really like, I liked http://www.amazon.com/Becoming-Doct...0535963?ie=UTF8&s=books&qid=1174850288&sr=8-1 quite a bit. It is an autobiographical account of one student's experience, and it is very honest about the reality. Even parts of it that tend to get whitewashed by others. (Want to know what the doctors call your grandma behind her back when she's in the hospital? They call her "gomer". It stands for "Get Out of My Emergency Room" and they call her that because they hate wasting a lot of their energy taking care of old patients with lots of problems who are going to die soon no matter what you do. No, I'm not joking.)

Ben. Your broad, sweeping categorizations are out of touch with what actually happens in the real world. Until you actually go to medical school and become a physician (along with all the rigorous challenges that go with this - including conducting clinical or bench research which most medical students - contrary to your belief - actually are required to do before graduation, making clinical decision that have direct effects on human lives, and ultimately becoming the leader of an entire healthcare team that requires effective interpersonal interaction, conflict resolution, and the ability to compile and synthesize a multitude of sometimes conflicting data to determine the best course of action often under incredible time constraints - we're not automatons who can't "generate and evaluate" data... we ARE the ones often generating the data, and it is up to us to evaluate how it affects our patients), you are way off base to make such statements.

You would have us believe that the majority of physicians are incompetent boobs who've learned what a shoe is and know what a foot is - and have seen and can recognize a shoed foot - but have no capacity as to how they are put together. Do you believe everything you hear and see in the lay media? Is the rare quack the representative sample? Do you actually have any firsthand knowledge about which you seem to have formed such strong opinions? Your over-general comments are not only mostly incorrect, they are personally offensive to me. It's clear you have little actual understanding of what you purport to know.

In my opinion a PhD from a medical school is equivalent to one from a graduate school. Here is how you should choose between them: Apply to all of the programs you're interested in, and choose the best one you got into. That program might happen to be at a medical school or a graduate school. Either way, your decision is made.

Cheers,
Ben

Your opinion, as you sufficiently demonstrated here, is not worth much. Sorry to be so brutal, but this is among one of the worst posts purporting to be "helpful information" I've seen in a while.

-Dr. Imago

P.S. If you actually are a 15-year-old, my apologies. You know not of what you speak. Make it a life skill to actually possess more information before coming across as an expert.

 

[HopkinsMedStudent]

Hello, I am an MD/PhD candidate (PhD in biomedical engineering related to interventional MR). I finished my disseration defense several weeks ago and have resumed the last part of my studies completing the clinical rotations at the medical school.

First off, let me say that you can do research with just an MD (any many do that). However, I will also say that medical school does NOT train someone to be a scientist. Most of the bigshot MD researchers did some kind of postdoc work. If you know from the beginning that you want a research career in academic medicine, I strongly believe that MD/PhD is the way to go.

As for residency match, I dont have solid data to prove this but my hunch is MD/PhDs do better than regular MD folk. I know that at my institution, MD/PhDs have had a 100% FIRST CHOICE match rate the last 15 years or so. Thats compared to a 95% match rate in the top 3 choices for the regular MD class. Supercompetitive fields like radiation oncology have a very strong representation from MD/PhD folk. I dont think thats a good enough reason to pursue the combined degree though, you really need to be passionate about research.

Most MD/PHD programs are funded by the NIH MSTP (Medical Scientist Training Program). The NIH MSTP pays MD/PHD students a stipend (approx 30k per year) and full tuition reimbursement. The average length to finish is 8 years.

 

[HopkinsMedStudent]

I'm not aware you would get a PhD from a Med school without also becoming a medical doctor so someone else will have to answer that one.

To be a physician or medical doctor you must have an MD or DO. Even if you have a PhD or other degrees issued by a medical school, you dont fall under the title "physician" or "medical doctor"

Hopkins has several departments that grant PhDs housed under the "school of medicine" but those graduates are not physicians/medical doctors.

Personally I'd say there's very little difference between a university PhD and medical school PhD. I think the only reason they have med school based PhDs is due to logistics reasons (i.e. easier to organize it under a SOM and give researchers better access to patients). But its also very easy for university based PhD programs to do patient-based research as well, so I dont see a big distinction there.

 

[HopkinsMedStudent]

The combined program provides full MD education. However, before going into full-time clinical work, the students take a year to work in the lab and qualify for the PhD. Compare that to perhaps a year of coursework and 2-5 years of research (in the USA model) for a regular PhD; it isn't quite the same. The MD/PhD prepares one to do research, as mentioned above.

Sorry but this is totally wrong. The average length of an MD/PHD program is 8 years, with about 5 of those devoted to PHD studies. I know hundreds of MD/PhDs and NONE of them were granted the PhD with only 1 year of lab research.

Now I agree with you that the average length of a straight PhD program is longer than the combined MD/PhD, but its not by as much as you suggest.

MD/PhDs have to meet the exact same requirements for the PhD as the straight PhD guys. We have to take the same graduate level coursework, do the same qualifying exams, write a similar quality dissertation, same publishing requirements, and same dissertation defense requirements.

 

[Ben Tilly]

An MD/PhD is a combined degree where one is theoretically qualified as both. In practice the result is a person who has a stronger than normal MD (they go through all regular MD training, and the people who do it are normally better than average MD candidates) and a weak PhD (they don't get as much time as a normal PhD to learn about research).

Oh brother... where do I start. You've offered many simplistic outsider opinions on something you appear to have little actual understanding. Your perceptions are, quite simply, sophomoric.

Well apparently you'll start with an ad hominem attack...

Despite the weakness of the PhD, MD/PhDs who go into research usually make more than straight PhDs for a number of reasons. First of all it is easier for them to get permission to do research on humans. Secondly they get compensated for the fact that they could make so much more in private practice. Thirdly everyone is aware of how competitive MD/PhD candidates are, so people expect them to improve very rapidly if they stay in research.

You should avoid making such sweeping generalizations, most of which are wrong. What is a "weak PhD" (which is not weak)? The candidate has to do novel research, write and defend a thesis, and publish just like every other PhD candidate.

While it is true that PhDs have to do original research, it is not true that the research done by different PhD students is always comparable. Some theses are stronger than others. Some PhD students come out better prepared to do research. The opinion that I've heard from a number of PhDs, and a few MD/PhDs, is that finishing an MD/PhD is so much work that there is a tendancy for MD/PhDs to stop and wrap up a thesis as soon as they think it will be sufficient for the degree, rather than trying to fill it out and make it more impressive than needed. (That opinion may be sour grapes on the part of the PhDs, but I've certainly heard that opinion.)

You may dispute this, but if you do, then consider the following. Finishing an MD/PhD takes less time than finishing the two degrees independently. They do not cut out any of the necessary course-work and rotations needed for the MD. There is not that much overlap between the requirements for an MD and a PhD. Either these individuals do more in the same time, or else something gets dropped.

It is not any easier for a MD/PhD to get permission to do research on humans, and many principle investigators in human trials are PhD's alone. How did you come across that notion?

Whether it is easier depends on what kind of research is being done. For instance suppose you're researching a new surgical technique. Then the investigator is either going to need to be a surgeon, or will need to be working closely with one. It is more likely to find an MD/PhD who is qualified to do that research than a PhD.

That was an extreme example. However even for many less extreme examples you'll need to work closely with MDs to do the research. For instance an experimental treatment may need to be conducted by someone with a medical license. This kind of barrier is less of a problem for an MD than a PhD. (PhDs generally get around it by working with MDs.)

This is not to imply that human trials cannot and are not conducted by plenty of pure PhDs. It is just that in many cases it is easier for an MD/PhD to do so.

And, I have no idea what "they get compensated for the fact that they could make so much more in private practice" means. Are you talking about working for a pharma company?

While salaries vary widely, most MDs make somewhat more than $100,000/year. In certain specialties they may make quite a bit more than that. For instance you claim to be an anesthesiologist. According to the first link I googled, http://www.payscale.com/research/US/Degree=Doctor_of_Medicine_(MD)/Salary, that specialty averages about $250,000. That wouldn't be a starting salary, but it is significantly more than a typical tenured professor. And the knowledge that the MD can leave academia and make so much more naturally helps them in salary negotiations.

And, the last underlined statement is an argumentum ad populum fallacy... if "most people" actually do believe that, which I don't know to be true myself. In fact, it may be easier to get into a MSTP program than getting a general spot. It can be harder to attract qualified candidates who actually want to do research and have an academic career, and often there are fewer candidates for those spots.

Let's google for a link on this topic. Ah, yes. http://www.bestpremed.com/MD-PHD.php says as typical requirements that they want a GPA of 3.5 or greater, MCAT of 11 and higher, and they want you to have done research in undergrad. I didn't quickly find anything that quotes similar statistics for getting into an MD program, but my sense is that it is somewhat more competitive than what I remember MD requirements being.

There are several reasons why people pursue MD/PhDs. A common one is that frequently your medical school tuition gets waived. Another is that (depending on what you want to specialize in) it may be easier to get into competitive residencies. A third is that people sometimes don't know which direction they want to go, and like keeping both options available.

Your med school tuition does NOT get waived! Where did you get that notion?

You know, you're not helping your case by claiming something that is so easily proven wrong. From the link that I gave before, any MSTP program which is sponsored by the NIH (there are about 30 of these in the USA) will waive both your tuition for the PhD and the MD. Other schools may or may not. Hence my statement that people frequently get their tuition waived.

Incidentally I got the notion that tuition gets waived from conversations with MD/PhD students whose tuitions were getting waived, and conversations with MD students who had considered that route then decided against it.

It is NOT any easier to get into competitive residencies with an MD/PhD, not that you even delineated which are the "competitive" residencies.

Funny, this is exactly opposite to the advice that my wife got when she was considering what residency to go into.

Whether a PhD is an advantage strongly depends on what the residency is in. For instance a PhD won't help you one bit if you want to go into cardiothoractic surgery. But, for instance, dermatology residencies frequently have a preference for PhD candidates, and this preference is stronger at top schools.

And, none of the MSTP candidates I knew were unsure as to "which direction they want to go". Who in their right mind commit to an extra two years of school and having to defend a thesis when the MD degree alone offers so many opportunities?

Then you've known different MSTP candidates than I have. Because I've known several that were unsure. Furthermore the first link that I provided you supports what I said, it comments that very frequently MD/PhDs are unsure of what direction they want to go in. (Else they would just go for a PhD or an MD.)

Likewise, you are NOT precluded from pursuing a research-only career with just an MD. In fact, at our institution we are doing novel bench research with the mu-opioid receptor. One of the lead investigators is an MD-only guy. You just simply don't have your facts straight, Ben.

You're right that MDs are allowed to do research. And some truly great research has been done by MDs. However I've witnessed enough conversations among PhDs behind their backs to know that pure PhDs are generally not that impressed with the research abilities of most MDs who try to do research. If you really know that you want to do research, it makes more sense to go for a PhD.

An MD from a medical school is a technical degree, not a research degree. Do not expect a doctor to have learned very much about how to conduct research or think about novel situations. Rather the doctor has learned a very large body of detailed knowledge, and become proficient in applying that knowledge to a specific family of practical situations. Doctors are very good at understanding and applying knowledge, not at generating or evaluating it. (Which I suspect is one of the reasons why you see so many doctors advocating various "woo" theories.) I should note that, like many competent people, most doctors are unaware of where the boundaries of their competence is. So they don't see this shortcoming. (And, in fact, they are far better than the general public at generating and evaluating knowledge. They are just worse than people who specialize at that, namely PhDs. Similarly PhDs are worse than people who specialize at fooling people at detecting how people are being fooled. Which is why more PhDs get fooled by psychics than stage magicians like Randi. Everyone has their relative weaknesses...)

How old are you? 15? That's a serious question. You have a lot of very strong opinions about things you appear to have very little actual knowledge of. I get the impression from your response that you are a cocksure teenager. It's almost stream of consciousness. And, it's just incorrect. Blatantly incorrect. Have you ever been to PubMed?

If that is a serious question, then you need to work on your reading comprehension.

Go back to http://www.internationalskeptics.com/forums/showthread.php?postid=2459030#post2459030 and re-read the first paragraph. You'll discover that I've been married to my wife while she went through independent PhD and MD programs. I don't think that I need to tell you how ludicrous it is for a 15 year old to be married, let alone to have been married to someone long enough for her to go through two lengthy advanced degrees.

As for how little knowledge I have of the subject, your response has so far included several "corrections" that were blatantly false. The most obvious of which was your claim that MD/PhDs can't get their medical student tuition waived.

If you want a very good idea of what medical school is really like, I liked http://www.amazon.com/Becoming-Doct...0535963?ie=UTF8&s=books&qid=1174850288&sr=8-1 quite a bit. It is an autobiographical account of one student's experience, and it is very honest about the reality. Even parts of it that tend to get whitewashed by others. (Want to know what the doctors call your grandma behind her back when she's in the hospital? They call her "gomer". It stands for "Get Out of My Emergency Room" and they call her that because they hate wasting a lot of their energy taking care of old patients with lots of problems who are going to die soon no matter what you do. No, I'm not joking.)

Ben. Your broad, sweeping categorizations are out of touch with what actually happens in the real world. Until you actually go to medical school and become a physician (along with all the rigorous challenges that go with this - including conducting clinical or bench research which most medical students - contrary to your belief - actually are required to do before graduation, making clinical decision that have direct effects on human lives, and ultimately becoming the leader of an entire healthcare team that requires effective interpersonal interaction, conflict resolution, and the ability to compile and synthesize a multitude of sometimes conflicting data to determine the best course of action often under incredible time constraints - we're not automatons who can't "generate and evaluate" data... we ARE the ones often generating the data, and it is up to us to evaluate how it affects our patients), you are way off base to make such statements.

I have not pursued an MD, but I spent several years working to pay the bills and as much of the tuition as I could for someone who was going through the process. You'd better believe that I heard enough about what she went through to form some opinions.

To the best of my recollection, in medical school she had opportunities to conduct research, but was not required to do so. My recollection could be wrong - but if there was a research requirement then I'm sure that she found it trivial compared to what she did for her PhD. I have no idea how common a research requirement is, but if there is one, I'm sure it is insignificant compared to the requirements of learning both the theory and clinical practice required of a doctor.

Furthermore let's go to my actual comment. I do not know how widespread the slang "gomer" is. But I know that it was common at multiple hospitals in the NYC area. If you claim to have never heard it, well slang does vary from place to place. But if you claim that doctors don't make comments like that behind patients' backs, then I know that you're lying through your teeth. When you put people for that time under that kind of pressure and lack of sleep, people cope how they can. And one of the ways that MDs wind up coping is by resorting to cynicism and sarcasm. I'm not criticizing them for this, nobody should who has not experienced it. I'm just saying that this is reality.

As for my characterizations of doctors, re-read them. I said that, the doctor has learned a very large body of detailed knowledge, and become proficient in applying that knowledge to a specific family of practical situations. Is this characterization wrong? Doctors need to know a tremendous amount. And they don't need to just know theory, they need to be able to apply this knowledge under pressure. This is far from a mechanical process. For instance a patient comes in. The correct diagnosis will never as clear and clean as it looks in the textbook. Furthermore your first guess is often wrong. So you don't just come up with a diagnosis. You need a differential, then you need to look for things that will let you distinguish between them and rule out one or the other. Sometimes there is no way to tell and you have to guess. Sometimes you'll guess wrong. Sometimes the patient dies.

To do that you need to not just be able to recite off a list of facts. You need to understand those facts, understand their relevance to the person in front of you, and then use those to come up with a course of action. When I think about it, it impresses me that doctors are expected to be able to do this on their own after they've seen a specific type of situation three times. (See one, do one, teach one.) Particularly with how many situations they wind up seeing during their training!

But as impressive as this skill is, it is at heart a technical skill. It is different from the skill of taking an unknown problem, coming up with novel experiments that might shed light on it, and coming up with novel theories about the unknown problem. You aren't supposed to do that as a doctor. You're supposed to take a person, produce a diagnosis of a type that is known, and apply what is believed to be an appropriate treatment to that person. You aren't supposed to constantly look for opportunities to find a novel explanation. You want to find a pedestrian one, because most people suffer from fairly common problems, and doctors know what they'll do for those types of problems.

You would have us believe that the majority of physicians are incompetent boobs who've learned what a shoe is and know what a foot is - and have seen and can recognize a shoed foot - but have no capacity as to how they are put together. Do you believe everything you hear and see in the lay media? Is the rare quack the representative sample? Do you actually have any firsthand knowledge about which you seem to have formed such strong opinions? Your over-general comments are not only mostly incorrect, they are personally offensive to me. It's clear you have little actual understanding of what you purport to know.

I suspect that your offense at what I've said has prevented you noticing that I have plenty of respect for doctors. Furthermore as I've stated, I do have firsthand knowledge that is relevant to this topic. That firsthand knowledge is based on being married to a doctor, and having known lots of people training to be doctors. (When you live for a few years in medical student housing, you wind up meeting medical students. Funny how that happens...)

In my opinion a PhD from a medical school is equivalent to one from a graduate school. Here is how you should choose between them: Apply to all of the programs you're interested in, and choose the best one you got into. That program might happen to be at a medical school or a graduate school. Either way, your decision is made.

Cheers,
Ben

Your opinion, as you sufficiently demonstrated here, is not worth much. Sorry to be so brutal, but this is among one of the worst posts purporting to be "helpful information" I've seen in a while.

-Dr. Imago

I'll note that you are currently rather upset at me, and consider your response in that light. In the mean time, I've never known a PhD who worried very much about whether another PhD got their PhD from a medical school or a graduate school. I've known plenty who paid attention to the reputation of said school. (Along with, of course, more important criteria like where that person did a postdoc and what their publications were.)

P.S. If you actually are a 15-year-old, my apologies. You know not of what you speak. Make it a life skill to actually possess more information before coming across as an expert.

Go back and re-read my post. In the very first paragraph I clearly stated exactly what my source of knowledge on the subject is, and made it clear that nobody should take my knowledge as more or less than what I stated. In particular I am the husband of a woman who has gone through both a PhD and an MD during the course of our marriage. I have therefore experienced both types of programs second-hand, and known first-hand multiple people of both types. I did most of a math PhD, but math and biology are sufficiently different that I wouldn't compare those two experiences.

That is my expertise, and people are free to weight what I say accordingly. (In fact I'd suggest that they do so. That is why I started by making clear the source and limits of my knowledge.)

Regards,
Ben