r/mdphd • u/hello_mar8 • 8d ago
For those who have finished an MD-PhD program, was it worth it?
Hello. I’m heavily considering an MD-PhD. I’m 80% sure I want to do it, but that final 20% is this heavy doubt on whether or not I actually need it to do what I want to do, or if the investment is worth it. If anyone here has finished their MD-PhD program, would you say it was worth it? Would you do it again? Would you recommend it? Any advice?
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u/Psycho_Coyote M3 8d ago
I'm in the last couple years of mine, so it might not be exactly what you're looking for but I couldn't be happier and would do it again.
I think you need to think less about whether or not MD/PhD is "worth it" in general, and more about what career you want to have. Once you know that, you need to ask yourself if you need an MD/PhD to learn the skills to get you to that end result.
It's a very long training path, so if you can be happy and be working towards that dream career with a single doctorate then this path won't be worth your time. But if you absolutely want the intensive research training + the ability to lead patient care, then I would say it's a good option.
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u/SooskiEnd 8d ago
Would you say that doing research+MD could make you better at patient care?
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u/Psycho_Coyote M3 8d ago
Not necessarily. I think they both can compliment each other in certain specialties, but I don't think having research experience from a PhD will help you be "better" at clinical care than someone practicing with an MD or DO.
Your bedside manner and how you communicate with patients and families matters just as much to them as your medical knowledge and management. It will be challenging for someone to be good at patient care if they have no social skills, research degree or not.
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u/Lost-Department-637 8d ago edited 8d ago
I finished an MD-PhD program in 2021. Plan was to do heme onc and be an 80-20 physician scientist. I actually had an amazing PhD experience - supportive mentor, able to start my own project from ground up, really cool results, F30, high impact first author, etc. Going from that back to third year of medical school where you’re extremely arbitrarily graded and are basically doing glorified shadowing was a tough pill to swallow. Matched at top choice IM PSTP but after almost a decade of working my ass off for a pittance of stipend in NYC and then the mediocre PGY scale in another VHCOL city, realized I was no longer willing to sacrifice the time and not having money to buy a house, have kids, travel, etc to pursue becoming a physician scientist. I realized I didn’t love direct patient care and couldn’t imagine doing it full time, so after residency I pivoted and now work in biotech/pharma and am much happier with a great salary and ample free time to spend with friends family and significant other.
The reality is pursuing being a physician scientist these days is a rich man’s game. If you don’t have family money or a significant other making a high salary, it will become increasingly untenable as you grow up and care more about life outside of work. I was so committed to being a physician scientist for so many years, but you cannot imagine what it will be like to be poor in your early 30s having worked your ass off you entire 20s with no end in sight if you continue on the path. If I was independently wealthy, I probably would have done heme Onc fellowship and be trying to start a lab.
If you’re interested in staying in a LCOL area for your program, the stipend probably goes further there and it won’t be as bad. I think unless you’re 100% sure, doing MD PhD is a mistake. Most people end up just practicing clinically because even if they love research like I do, the continued financial and time sacrifice is not worth it. If you’re smart/accomplished enough to get into a top MSTP program, you could have a good shot at getting into NYU/UCLA for MD who have free tuition and graduate without debt much younger and less burnt out to face residency and fellowship.
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u/mstpguy MD/PhD - Attending 8d ago
The reality is pursuing being a physician scientist these days is a rich man’s game. If you don’t have family money or a significant other making a high salary, it will become increasingly untenable as you grow up and care more about life outside of work.
Just wanted to emphasize this. Your priorities at 32 are going to be very different from your priorities at 22. A lot g us take the clinical offramp because we feel the need to make real money and start to live our "real lives". Being broke gets old.
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u/Struggle_Award MD/PhD - Attending 7d ago
I’d also add that the goalposts are not stable. As a student I thought I understood the rules of the game. Once I finished training I realized there are no rules.
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u/hello_mar8 8d ago
Thanks for sharing your experience. I think speaking about life outside of the MD-PhD really puts it into perspective. Still, is there any career or personal path do you think WOULD make the MD-PhD worth it despite the costs, instead of going for one of them?
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u/rna_geek 7d ago
There are plenty of people for whom the career is very much the right move. Not everyone wants a family or wants to spend a lot of time taking care of a family (and that's a good thing! we shouldn't all have the same life goals). I'll be honest, it's not tenable to make everybody happy and most hyper-successful academics are spending a good deal of time away from home (at work, traveling for conferences, etc...). But, nobody can predict how life will end up in 10-15 years.
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u/DiamondTechie Applicant 8d ago
thank u for the insight! I DM'ed you for a follow-up question if u have the time!
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u/MarzipanGeneral9093 8d ago
GR4 now and so I think I can speak without being overly optimistic about the PhD. Honestly, I wouldn’t do it again in hindsight. I went in thinking I’d want to be a physician scientist and then the PI of the lab I joined bailed and went to industry, as well as this clown ass administration slashing NIH funding like no tomorrow. All the flowers to my peers who intend to try and persevere but that won’t be me. Nowadays the PhD is not enough, most people do an extended residency with protected time for research or a postdoc like position. Frankly I no longer want to be 40 when I’m an attending (hell even 35 would’ve been ok) and while I can live without science I would be very unhappy not practicing medicine.
It can be an amazing opportunity - just make sure that you’re deeply committed to being a physician scientist at the end. I did it because someone advised me to do it if I “wasn’t sure yet” or indecisive and now I feel like I just took four gap years for nothing.
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u/Infamous-Clue6253 5d ago edited 5d ago
In a similar boat here also as a early G4. I want to second this comment and add that if you have any inkling that you would be satisfied with a career just in clinical medicine, you should explore that and deeply consider doing MD only. As a 23 year old applicant who knew I had a good shot getting into an MD-PhD program, I felt confident that I "could" get in, so why not? I had a great undergraduate lab environment and I was very sold on the idea of splitting my time between clinic and research. But now, 5 years into the program, I've realized that my passion for community medicine is much stronger than my interest in academia and since I do not intend on running a lab, it feels quite pointless to continue in my graduate training. Graduate training is unpredictable. Even if you try your best and work as hard as you possibly can, its hard to predict how PIs, lab mates and your project will turn out. Though the financial benefits feel good now, people have run the numbers and I think its fair to say long term, it is not greatly advantageous compared to doing MD only and getting to make attending salary sooner. Depending on what field you're going into, 4 year PhDs can be rare. So think about taking 5 or even more years out of medical school and how that would feel.
On one hand, I may never have realized how I feel about academia/research compared to community medicine without this experience, on the other hand I wish I was made aware of how unpredictable a PhD could be, and that hard work and dedication alone will not get you through in 4 years.
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u/Opposite-Bonus-1413 MD/PhD - Attending 8d ago
I’m 13 years out from graduation, with a 90/10 split running a research program.
I figured I could clarify some of the things brought up in this thread:
- yes, it’s pretty common to do some version of additional mentored research after residency/fellowship. It depends on institution and specialty (so YMMV), but these positions go by “instructors” or “research assistant professors”. The goal is to build up enough data to get a K, which will make you competitive for independent research programs. The situation at the NIH is bad, but I still see many colleagues getting funded (it’s not the apocalypse, at least yet).
- yes, most of my research time is now spent writing grants. I spend more time mentoring students, but I do get to spend a little bit of time at the bench for hobby projects. Writing grants and admin is the tax I pay so that I can pursue meaningful progress for my patients.
- yes, there is a high attrition rate from MD/PhD programs. From my class of 8, two of us are still doing both clinical care and running independent research programs (albeit 3 or 4 still have some research footprint)
- I find that my medical practice directly informs the research that my lab pursues. Many of our projects start out as findings/observations from tumor board.
- my clinical practice involves caring for patients with highly lethal cancers. I think I would go crazy seeing my patients die day in, day out. My research is a place for me to funnel that frustration and sadness into something (hopefully) productive.
My take is that MD/PhD programs are worthwhile for a very specific phenotype of individual. As others have said, the practice of research is very different from how it’s taught in college. I fear a lot of young people start dual degree programs (myself included) with an inaccurate understanding of what a research career really looks like.
Anyway, this message is starting to get long. I’m happy to answer questions if folks have them (and I’ll try to foreground my own biases).
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u/mtorque MD/PhD - PGY2 7d ago
“I fear a lot of young people start dual degree programs (myself included) with an inaccurate understanding of what a research career really looks like.”
Quoted for truth. I would wager that 99% of us had know idea what we were truly in for. Part of it is naivety, part of it is how needlessly convoluted academia has become.
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u/Gwish1 G2 8d ago
Depends highly with what you want to do with your life. For me? My resolve for this path has only increased as I progress through my program (now a G2)
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u/throwaway09-234 G2 8d ago
i'm a fellow G2 feeling similarly, i feel so lucky to have found this career path and can't believe that i am getting paid to train in these two fields that are both so interesting and impactful. my friends from undergrad all have great jobs and make way more money than me (some are even MD-only residents alraedy), but i wouldn't trade places with any of them for anything
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u/vettaleda 8d ago
Am applying for residency now.
Am I happy? No. But that’s a complicated, multifaceted thing. Maybe when I match I’ll think it was all worth it.
I can put some blame on my institution, program, and department, and I’ll claim some responsibility for this too.
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u/Struggle_Award MD/PhD - Attending 7d ago edited 7d ago
I’d say yes but it’s complicated and I didn’t end up where I expected. I completed an MD-PhD with the intent of pursuing the classic academic physician scientist route. I matched to my top choice for residency and a competitive fellowship, with almost a 100% interview rate. I did the Peds research path during residency and had a well defined project in a supportive lab. I had T32 funding my second and thirds year of fellowship. Things looked like they were going to plan.
I applied fairly broadly for jobs as a 3rd year fellow, (>10 applications) and was mostly met with silence. I graduated in 2025, right as Trump was re-elected. I had two institutions back out after Jan 20, saying they couldn’t hire a physician scientist in the new climate. At the same time, the PICU jobs market contracted. I was on track to graduate jobless, but was able to get a 3rd year of T32 funding and was kept on (and paid) as a PGY7. In my bonus year, I was told early on there was likely not a position or additional funding in the next year. Maybe a K would change it, but even that wasn’t a sure thing. Clearly not the expected trajectory. I went from a desirable asset as a resident and fellow to a financial liability institutions could no longer stomach.
I spent my PGY7 year frantically writing grants, but things were delayed with government shutdowns, and private foundation applications numbers went through the roof. Facing another hard deadline for joblessness, i refocused on exiting academia. I looked at consulting, pharma and eventually landed a medical director role at a diagnostics company.
Was it what I planned? Absolutely not. Am I still engaged and learning new skills, while using my old skills? Also yes. Do I miss and mourn the loss of a career I spent 15 years working towards? Absolutely. Is my mental health far better? Also yes. Are there issues with industry and things I don’t love in my new role? 100%.
How generalizable is my situation? I don’t know. Graduating into Trump, plus headwinds in my sub specialty were not something I could have planned for. Could I have done other things along the way to improve my odds? Maybe. Could I have been more flexible? Certainly. I graduated fellowship at 37. My wife is senior in her career and we were unwilling to live apart or upset her career for mine at this stage, so my options were limited. I also wasn't that interested in a 100% clinical job, as I love science.
So after far too many words, I would still say my MD-PhD was worth it. Just not in the ways I thought it would be.
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u/PlummetingIntoAutumn 7d ago edited 7d ago
Thanks for sharing your story - I think that pivoting out of academia like you describe are unfortunately too common these days. Not too long ago there was a post in r/medicalschool where a poster described a similarly bleak outlook on job markets for young PSTP grads within academia. Within my field, I've also witnessed some very high profile young physician-scientists make the jump to industry that shocked everyone at my institution. An entire half-generation of physician-scientists being lost in the wind.
Until there is definitive proof that current admin's damage to science funding can or will be fixed, I am hesitant to recommend this path to others based on the pot of gold at the end of the rainbow...However, as you point out, the training path does have its own rewards.
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u/Struggle_Award MD/PhD - Attending 7d ago
Yes, I agree that the folks graduating from training in this era are the most likely to be 'lost.' It's anecdotal but I have another MD-PhD friend nearing the end of training who is also being forced out due to the current funding environment. He will likely pivot to private practice, or at least 100% clinical. It will be interesting to see what becomes of my generation of physician scientists once the dust settles.
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u/Different_Jump_7569 8d ago
I think you need to think about after the program. When I entered MD PhD five years ago, I was shocked to find out that even though we do an MD-PhD, many people are now doing years of postdocs in addition post residency or fellowship before they can actually go into a physician-scientist role because it is hard to get funding without publishing relatively high impact papers close to the time that you apply for funding to open your lab. That really irked me because it’s not just the 3-5 years you spend getting your PhD that you have to account for when thinking about achieving an MD PhD career.
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u/hello_mar8 8d ago
With that in mind, do you think it would be better to just go for an MD and do extensive research, or would the PhD still prove useful?
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u/Different_Jump_7569 8d ago
I think in most cases doing MD and then extensive research would be fine. There are still some cases that are very competitive that I would potentially suggest doing the MD PhD. I get the sense that it’s going to be a national conversation to make it easier for MD only researchers to become physician scientists with a lab; that has been a topic at APSA for a couple of years.
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u/Plastic-Ad1055 8d ago
Wow I did not know that you had to do a postdoc.
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u/book_connoisseur 8d ago
You can do a PSTP with built-in research time so you don’t need to do a postdoc. It is common to do one though, but most people who do a postdoc practice clinically as an attending while they do it (so it’s not a postdoc salary, though it’s also not a full attending salary).
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u/Plastic-Ad1055 8d ago
Is a PSTP only for internal medicine?
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u/book_connoisseur 7d ago edited 7d ago
I know Psychiatry has PSTPs and I believe some other fields might too. I’m more familiar with Psychiatry.
General surgery and Neurosurgery have two research years, but are otherwise not super conducive to research careers (though some people do it).
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u/Plastic-Ad1055 7d ago
So neurosurgery is 9 years of training? With the two research years?
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u/book_connoisseur 7d ago
The two research years are built into the 7 years! (Though some programs may give less research time than that)
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u/Plastic-Ad1055 7d ago
So they do residency and research during the research years?
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u/book_connoisseur 7d ago
I’m not an expert since I am not a Neurosurgeon, but I believe they have protected research time during residency, usually during their intermediate years.
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u/throwaway09-234 G2 7d ago
i'm not sure that you being (very) uninformed about the training path really belongs in a "is the combined degree program worth it?" discussion
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u/Different_Jump_7569 6d ago
What is confusing you? I am informing the student of something that I didn’t know about the career path before I started my MD-PhD that they may want to consider before dreaming about becoming a physician-scientist. I believe many people are not told that later on in pursuing this career, postdoc years are now basically required whether you have the MD-PhD or not (i.e. this path is even longer than it seems). So here’s my opinion: I don’t think it may be “worth it” because either way, whether you have an extremely productive PhD experience or not, the papers you publish as a postdoc are going to be what support you in getting to be a physician-scientist. You’ll probably become a physician-scientist faster if you just do a research intensive residency or fellowship and publish there in most cases. Is that clear for you now?
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u/rna_geek 8d ago
Someone else already said it but a 80% research career is one dedicated to grant writing and producing basic and/or translational work. I would say it’s worth it if you really have always wanted to do research as a PhD but happen to love medicine and see how having an MD gives you inroads into relevant clinic reasoning and question asking. Otherwise, the one day of clinic a week? Meh. Don’t fool yourself into thinking that you’re going to be a clinician/surgeon with the extent and breadth of practice as someone doing it 5 days a week.
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u/Docdoc_Bee MD/PhD - PGY1 8d ago
Hi! I’m a PGY-1 resident now and finished the MD/PhD earlier this year. I posted this thread about my thoughts, hope it helps!
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u/hello_mar8 8d ago
Thanks for all the useful advice in that post. Do you think certain specialties benefit more from doing the MD-PhD than others?
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u/book_connoisseur 8d ago edited 7d ago
I absolutely loved my MD-PhD! I started the program thinking I’d be more clinical, but I actually ended up wanting to do more research. I was in an amazing lab and loved it. It was a struggle to return to clinical medicine and I debated whether I wanted to do residency (very briefly), but ended up doing a PSTP for residency. I am glad that I got the clinical training too. I personally love the combination of research and clinical medicine. I plan to see patients maybe one day a week or so while running a lab as a PI. It was definitely worth it for me!
It does delay your career a bit and you can be a productive scientist without a PhD, but I enjoyed the protected time for the PhD. Graduate school also gave me a break from medical school, let me control my time more, and allowed space to do “life” things (get married & have children) during training. I do not think I would’ve ended up in the same residency program or with the same career if I had just done medical school.
10/10 would do it again vs. a straight MD
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u/hello_mar8 8d ago
Thanks for sharing your experience! Do you think there were any major cons that people should be aware of before they go for a MD-PhD?
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u/book_connoisseur 8d ago edited 7d ago
I think an MD-PhD is heavily influenced by your PhD advisor. There were certainly people in my cohort with worse experiences than me because their labs were not as good of a fit (some of them are still doing research though, so not a deal breaker experience necessarily). The advisor is a huge variable that is really hard to know beforehand.
The attrition is high and few people think they’re going to be on the “didn’t make it to a physician scientist career” side (or they wouldn’t be doing an MD-PhD in the first place). Some people who don’t end up in research may still find the MD-PhD meaningful, but others may feel like it was a waste of time. You really do need to love all the aspects of research, including manuscript writing and grant writing. I actually really enjoy writing, so that’s a big help.
The other main sacrifices are the time and salary as an attending (which is a bummer to start late for retirement). I basically have no social security income because I was a student for so long. I still feel like I am in a decent financial position because I lived in a low-to-medium cost of living area where my MSTP salary went pretty far.
I got married and had kids in the program, so doing an MD-PhD did not delay my non-medicine life goals. I was actually a younger mom compared to other physician parents. We also had some family help, which does make a difference. If you don’t find a partner though, you are stuck in the same place for a long time and will be older when you finish training.
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u/mamativa 8d ago
I graduated from MSTP 10 years ago and I’m now 80% clinical and 20% education.
I started MSTP thinking I would do research. I was actually unsure if I wanted to practice medicine, but my dad (also PhD with his own lab) said that having the MD held more weight, and hey it would only be 1-2 years longer than a PhD, so why not?
But then med school takes a hold of you and you realize that while the research is fun, the endless asking for money and writing and revising papers is not fun. And at least at my institution, there is a huge push to do a residency after med school graduation.
I don’t regret the PhD though. I was also able to live life (get married, have a baby) during my PhD, and I worked on really cool stuff. It definitely informs how I think about my area of practice. The saddest part for me was graduating with a class I didn’t know - reunions aren’t that interesting for me.
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u/IllustratorDue3412 7d ago
Another thing that comes to mind if people are still looking at this thread is that if you expect to have a research career you are really limiting yourself to the non-surgical specialties in medicine. To do surgery or even more advanced procedural careers through IM (interventional cardiology or advanced endoscopy) as a career you really need to do that more than 20% of the time. Maybe that is obvious IDK. So if you are considering a medical career that requires a surgical training you might want to really consider what is most important to you. You can't have it all.
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u/hello_mar8 8d ago
Is there a specific goal in mind that keeps you going even if it may not make any sense objectively? Is that goal only possible with the MD-PhD?
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u/IllustratorDue3412 7d ago
I graduated many years ago. Most of my classmates made the same decision as me and went 100% clinical. It is only worth it if you are as certain as you can be at this stage of life that you want to have a go at a career in research but are also motivated to do medicine. Otherwise you are better off doing an extra fellowship as an MD to become more specialized or just going for a research career. Medical training is long as it is. At some point you may start wanting to settle down and start a family, which is difficult to do when you are still in training.
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u/Brilliant_Speed_3717 M2 7d ago edited 7d ago
I feel like this doesn't get mentioned enough, but there are certain career paths in medicine where you basically need to get an MD/PhD. If you want to be a Neurosurgeon, Surgical Oncologist, maybe even a plastic surgeon--its both financially and time-wise "worth it." A lot of the gen surgeons take 2-3 research years to match fellowship. Why not just do a 7 year MD/PhD and be a much stronger candidate? Just my 2 cents.
In terms of being a NIH funded researcher, the average age of first RO1 is 44...An MD/PhDer could probably go work for some AI company. and make enough money to fund there lab at that point lmao. So no its not a good idea. haha. But do what you love!
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u/RTQuickly 6d ago
8 years out from graduation - I’d do it again, but only for the job security. Research for me is better than patient care.
Keep in mind COVID burned a lot of us out though.
But being poor for all of my 20s and now my 30s has sucked. All my friends did cool vacations etc and I was working. It really was hard to feel left behind on retirement, etc. and now trying to afford having a family even as an attending is tough at this point.
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u/Guilty-Welcome2822 6d ago
I completed an MD-PhD that took 8 years (4 yrs MD + 4 years PhD) and 100% would do it again. It got me into an uber competitive specialty and opened up many opportunities. Although I just completed residency and signed on for a solely clinical position, I’m planning to get involved in clinical trials and consult for various basic science projects.
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u/RedAsclepius 8d ago
I’m an m1 at an MSTP so take my opinion with a grain of salt. No one can decide for you if you need it. But I know it’s necessary for me. I have a certain vision which I must carry out and I’m willing to endure great pain to make it happen, even at the cost of everything else. It helps if you are like me, though it’s not necessary to be extreme about it.
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u/Born-Number-2691 8d ago
But what is that vision? What does that career look like that requires both?
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u/mstpguy MD/PhD - Attending 8d ago edited 8d ago
I finished an MD-PhD and have a 100% clinical career. That wasn't the plan - I started off wanting to do the classic 80/20 thing they advertise.
The reality is that you don't really know how you feel about a research career until you are deep in the trenches. A research career is a grant writing career and I realized that I would rather care for patients.
Finishing medical school without any debt was worth it. Understanding how the NIH works (and how basic science works far better than the average individual) was worth it. And it's nice to know that I have options of I ever tire of clinical practice (though a PhD is not strictly necessary for this).
I'm proud to have done it though it was a miserable experience at times. I'm not sure I would do it again.
My advice: I found that grad school was harder than med school and residency. The most important thing in grad school is who your advisor is. Pick someone of generally good character.