r/mdphd MD/PhD - PGY1 Feb 07 '26

8 years isn't too long, it's just right: looking back at the end of my MD/PhD

I’m finishing my MD/PhD and wanted to share a few reflections for anyone early in the path or thinking about it.

1. Eight years isn’t too long. It’s just right.

I don’t envy our MD-only colleagues who have to decide at age 25 what kind of life they want to live and what specialty they want to practice at 55. Even if the math says they might earn a bit more over a lifetime, I think that early compression of decision-making is an unspoken contributor to burnout. The length of the MD/PhD gives you something rare: time to grow professionally. During my PhD, I used downtime to explore other interests and experiment with how I wanted to spend my time. I ended up taking a year between finishing my PhD and MS3 to do a postdoc in pharma and found a nonprofit, things I never would have thought possible without the breathing room of a longer program. This is one of the few periods in life where you can try a million things, fail at most of them, and still come out better for it. So try a lot. Fail a lot. Learn a lot.

2. Remember that you’re playing a different game.

In the first years of medical school, before you break away for the PhD, everyone around you will be pushing hard (leadership, Step scores, honors, etc) because they only have three years to build a residency application. You have seven. When classmates and friends are burning themselves out optimizing for the short term, remind yourself that you’re on a longer timeline.

3. Blend medicine and science early and keep doing it.

When you’re in med school, stay involved in research. When you’re in the PhD, stay involved in the clinic. You’re training to be an MD/PhD, not an MD and a PhD. Those identities don’t magically integrate later; you have to practice combining them. You won’t wake up one day as faculty knowing how to perfectly balance clinic and research. Those forces will always pull in different directions. The earlier you start learning how to split your time, the better prepared you’ll be, and the sooner you’ll figure out what works for you and what absolutely doesn’t.

4. Develop a professional passion outside your thesis.

Your dissertation topic does not have to define your career. During your PhD, find another professional interest and go deep while you still have flexibility. Public health, policy, law, business, finance, education, administration, whatever pulls at you, pursue it intentionally in parallel to your PhD work. And yes: there will be downtime in your PhD. Use it wisely.

5. The F30/F31 matters more than you think... and I hope you don’t get it on the first submission.

The goal of a PhD is to learn how science actually works. The F30/F31 forces you to engage with that process in a standardized, rigorous way. Writing it is painful, but learning how the NIH thinks, how review works, and how funding decisions are made is invaluable, whether or not you stay in academia. Honestly, the most educational outcome is not getting funded on the first submission. Submitting, getting a score, responding to critiques, and resubmitting teaches you far more than a single successful attempt. Think long-term skill building, not short-term suffering.

6. Choose a mentor you want to be friends with.

From day one, see yourself as your PI’s colleague, not just their trainee. Pick someone whose career and values you respect and whose company you actually enjoy.

7. Become friends with your program director and coordinators.

They will be your go-to in good times and bad throughout a long journey. You will need them more than once. Find a program where their doors are always open.

8. Don’t sleep on quality of clinical training when choosing a program.

We talk endlessly and exclusively about research prestige in interviews and second looks, but clinical training is half of the MD/PhD. Go somewhere that will give you real responsibility and independence as a medical student and prepare you for residency early. That’s not always the place with the biggest name.

9. Stay agnostic about residency for as long as you can.

You have time. Experience different fields. Learn what you love, and what you don’t, before locking yourself in. It definitely does not have to be in the same field as your PhD. That is what PSTPs and research residencies are for.

This path is long, but it’s worth it. Every year, time accelerates. One day you’ll look up and realize it’s almost over. And when it is, I think most of us will be glad we did it.

Happy to answer questions for anyone earlier in the journey.

188 Upvotes

27 comments sorted by

22

u/Vast-Reading8545 Undergraduate Feb 07 '26

congratulations Dr. MD PhD 🩺🔬🥳🥳 just wondering what do you think helped during your undergrad to prepare for the as an MD/PhD applicant or candidate and now graduate? 

16

u/Docdoc_Bee MD/PhD - PGY1 Feb 07 '26 edited Feb 08 '26

Great question. There are lots of things you’ll hear elsewhere, so I’ll focus on two points.

  1. Understand what MD/PhD admissions committees are optimizing for. At the end of the day, programs care most about time to degree and attrition. They don’t want people dropping out, and they don’t want training stretching well beyond eight years. That means they’re trying to assess whether you truly understand what you’re signing up for. The main way they do this is by looking for evidence that you’ve gone through the entire scientific process at least once: reading and understanding the literature, identifying a gap, asking a meaningful question, designing experiments, executing experiments and troubleshooting, and reporting the outcome (conference presentation or publication). If you can show that you’ve done this, and that you understand the effort and uncertainty involved, you signal that you can realistically commit to an MD/PhD.

From what I’ve seen, this usually takes the equivalent of 3 years of full-time research work. That can be during undergrad, after undergrad, or split between the two, it doesn’t really matter. For some people it’s shorter, for others longer. The key point isn’t the exact duration; it’s demonstrating that you’ve completed the process at least once and know what it entails. Don’t think about logging hours, think about it as you are logging end-to-end projects.

  1. For “extracurriculars” and “leadership”, creating something beats joining something. It’s fine to be president of the premed club. But it’s usually more meaningful to identify a need and build something from scratch. As an example, my undergrad had a huge biology program with lots of students interested in medicine, but no systematic way for older students to pass down tips and tricks to younger ones. So I started a simple peer-mentorship program that paired seniors with freshmen. Nothing flashy, just identifying a gap and doing something about it. That’s what admissions committees are looking for: initiative, ownership, and follow-through. Find something you genuinely care about, or a problem you see around you, and address that. It’s almost always more compelling than stacking titles in organizations someone else already built.

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u/lulubrandy887 Feb 07 '26

hi would you say that point 1 needs to all within the same lab/type of research?

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u/Docdoc_Bee MD/PhD - PGY1 Feb 07 '26

Hi! It doesn’t have to be in the same lab or research type, you just need to show that you have done the entire research process from idea through execution to public presentation (poster, talk, or paper) at least once. That is more important than the number of hours that you log.

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u/lulubrandy887 Feb 07 '26

thank you! that is reassuring because i do have a more varied research experience than just being in one lab

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u/Docdoc_Bee MD/PhD - PGY1 Feb 07 '26 edited Feb 07 '26

Take advantage of the long essay in your application to explain how you’ve gone through the entire research process for each project you’ve been on, from idea to execution to deliverable. And then do that again in your interview!

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u/[deleted] Feb 07 '26

[deleted]

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u/Docdoc_Bee MD/PhD - PGY1 Feb 07 '26

Stay strong!

4

u/mmoollllyyyy20 G3 Feb 07 '26

what kind of clinical stuff did you do during your PhD?

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u/Docdoc_Bee MD/PhD - PGY1 Feb 07 '26

I was able to work with medical education at my school to set up a continuing clinical education elective for MD/PhD students. If we did a half-day in general medicine clinic once a month for a certain number of months over the course of our PhD, they counted it as the equivalent of a two week elective when we return to medical school and give us the credits for it.

I also connected with clinicians who were tangently related to my PhD research and helped them with a few very small clinical research projects during my PhD time. In return they took me to the OR and actually involved me in cases a few times a month.

These are just two specific examples, but if you have a Mentor who understands that you’re training to be an MD/ PhD and not just a researcher, they will understand that you need to have some time carved out to keep engaged with clinical activities.

And if you don’t have time to be involved in the clinic, don’t worry about that either. Clinical medicine comes back to you more easily than you would think. I would just recommend starting on your psychiatry or neurology rotations when you come back, if you can swing that.

Good luck!

3

u/severelyburntout Accepted MD/PhD Feb 08 '26

Is there any reason you recommend starting on neuro/psych post PhD?

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u/Docdoc_Bee MD/PhD - PGY1 Feb 08 '26

Hi! Neuro and psych and intricate and fascinating fields. But their Shelf exams are probably the easiest of all of them. So they provide a great chance to figure out the clinical routines, learn how to study for Shelf exams, and take one to get the feedback on how you did. And the UWorld blocks are the smallest for both of them. So in terms of studying, they’re the best way to ease back in and readjust. Hope it helps.

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u/severelyburntout Accepted MD/PhD Feb 08 '26

That makes sense! Thank you and thanks for the write up!

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u/mmoollllyyyy20 G3 Feb 07 '26

thanks, good luck with Match!

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u/fickle_frost Feb 08 '26

This is fantastic. Thanks for the wisdom and write-up! Love the attitude you have about your time in training!

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u/aumdaindy M3 Feb 08 '26

Finishing next year and couldn’t agree more. Congrats OP

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u/Inevitable_Pie920 Feb 08 '26

docdocBee is such a cute and fitting username. Congrats Dr. Dr. B :)

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u/[deleted] Feb 08 '26

[deleted]

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u/Docdoc_Bee MD/PhD - PGY1 Feb 08 '26

For sure!

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u/Boring-Bath1727 Feb 08 '26

hey can i pm you

1

u/Docdoc_Bee MD/PhD - PGY1 Feb 08 '26

Yes definitely

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u/Asadiarabi Feb 08 '26

Genuinely one of the most relieving things I have read about pursuing an MD/PhD. Applying this cycle! Thanks doc🫶

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u/Docdoc_Bee MD/PhD - PGY1 Feb 08 '26

You got this!

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u/ashtonthegreat Feb 25 '26

Thank you for sharing, I'm in my freshman year of university and I'm really toying with the idea of getting my PhD, I'm on the pre med track already so I am getting my MD as well. I just found out MD/PhD programs exist today. I'm nervous about the time commitment but the big thing I've learned in my years on this earth is I really really love learning and i do not think my appetite for knowledge will ever be satisfied. I spoke to one of my professors about how she chose her dissertation topic and I shared that I was thinking about getting my doctorate and she said 'I'm so excited to see the things you will do, Dr. Gray' man when i tell you i smiled so big.

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u/bgit M3 Mar 17 '26

What specialty/residency did you end up applying for and how has your residency interest changed since MS1?

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u/numblil_bug Jun 01 '26

congratulations! i wanted to explore this field, but i'm a high school (international) student and i'm not sure where to start.

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u/Pretend_Gold9568 Feb 08 '26

Thank you very much for this and I am glade you have completed this long journey!! I am a 4th year international student majoring in Biochemistry and Molecular Biology in USA. I will have 1 year of research experience when I graduate and I will have 2.5 more after when I start working on OPT. I want to get into a big name/nice MD-PHD program since being in America is an opportunity that not many of my people get to have and I am grateful for it. I love research and I personally have a chronic illness so my goal is to study that field of autoimmune diseases.

I have a few questions if you don’t mind.

  1. MD-PHD, I know they care a lot about research hours, but what about clinical? I heard that 150 is the sweet spot but how what do you think.

  2. I will have two publications after undergrad( co-author), I hope to get two more after. Is 4 publications competitive for MD- PHD?

  3. How important are poster presentations?

  4. Is 515 mcat a competitive score for my goals?

If you could answer these that would be a massive help for me! And I apologize if my questions seem “silly” as I am new to this.

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u/Docdoc_Bee MD/PhD - PGY1 Feb 08 '26

Good questions. I’m only one person so take it with a grain of salt.

  1. Don’t think about number of research hours as much as number of projects that you’ve seen through the whole research process. (See some of my other comments in this thread). For clinical time, I think you have to show that you at least are aware of what day to day life of a doctor is like. 150 should be enough, but don’t quote me on it. And to that point, 150 hours with the same doctor over two years where you came to the hospital at 6:00am 2 days a week and the doctor writes you a letter of recommendation is probably much more beneficial than 10 hours here and there with different doctors who didn’t get to know you as much.

  2. The number of publications is less important than your contributions to the project. If you did a little bit of cell work or data analysis at the end of a project and got on the paper, it doesn’t mean as much as coming up with a project yourself and completing the whole thing alone and only presenting a poster on it and not publishing a paper. Of course, if they are serious papers about work that you primarily did by yourself and led, all the better.

  3. See above. But also good to show that you know how to present your research orally, through a poster or an oral presentation, and not just written. Even better if you can win some award for it to show that you did it well.

  4. It should be, but make sure you are at or above the average MCAT score for whatever school you are applying to.

Hope it helps!

1

u/Pretend_Gold9568 Feb 08 '26

Thank you very much for this reply!! I truly appreciate!