Medical scientists and doctors

[Jin S Zhang]

I recently found out that M.D/Ph.D program, unlike M.D program, is especially designed to provide students for their Medical scientist career. That program focus much more on the medical research regarding developing vaccine and how diseases spread than providing treatment to the patients. It takes about 8 years after B.S degree. M.D program is designed to train the students to be doctors. Is there anyone who knows about that program? Do these prgrams provide broader job outlook? How about salary for Medical scientists compared to doctors?

 

[Dale]

In general the job outlook is narrower for a MD/PhD than for a MD. A MD can practice clinically pretty much anywhere, and additionally can do medical research at most academic hospitals. On the other hand a MD/PhD is specifically targeting medical research at academic hospitals. Salary-wise expect to make more than a MD researcher at an academic hospital, but less than a purely clinical MD.

In the end, it is not about the pay or the opportunities. Getting a MD/PhD is about doing medical research because that is your passion. Financially it is probably not worth it, but there is more to a career than simple financial considerations.

 

[mgb_phys]

I never understood the need for this - except that MD is a nice fall back job, and keeps you mother happy!
Why not just do an ugrad degree in biology/bio-chemistry and then a PhD - why would I need an MD to develop a vaccine?

 

[imabug]

The primary purpose of most MD/PhD program is to produce clinical researchers as opposed to basic science researchers (for which an MD is not really necessary). Something like vaccine development is what I would consider basic science research. Clinical trials to examine the efficacy and dosing of the vaccine is what I would consider clinical research.

One of the problems with a lot of clinical medical research (clinical trials, evaluation of new treatments and medications, etc) is that MDs generally don't get a lot of exposure into research methodology as part of their MD training. They end up spending a lot of time muddling along, which can result in problems with their research (flawed methodology, analysis, etc).

The MD/PhD program is meant to train MDs who will also have a good research foundation and the skills to carry out good clinical research.

The typical MD/PhD program is 6-7 years: 2 years med school class work, 2-3 years on the PhD, and then the final 2 years of med school in the clinic. The projects MD/PhD students typically work on are also different than your usual PhD, and are generally selected to have more relevance in clinical settings.

 

[Moonbear]

And MD/PhD, as imabug pointed out, is intended to train people to do clinical or translational research (i.e., bench to bedside). It is NOT something to do if you don't have a passion for research.

However, it is untrue that someone with an MD/PhD is more limited. They can certainly choose to apply to a non-academic, clinical position, and have the full medical training to work in such a purely clinical setting.

It is also a highly demanding training experience. Only a handful of students are admitted to such programs each year at a university, and many of them will drop out of either the MD or PhD part of it because they can't keep up with it all, especially the accelerated pace of the research component which the med school will expect them to complete in half the time it takes a typical PhD to train.

My personal experience with MD/PhD students is they wind up inadequately trained as PhDs because of the rush on their research project. I think many only come out with a Master's degree level of understanding of research (not all...there are exceptions). I have not seen too many pursue independent research careers upon graduation, but rather follow the clinical path and are good resources as collaborators to classically trained basic science PhDs who need a clinician to assist them with a clinical study.

On the other hand, I think they make outstanding clinicians. They are less likely to be fooled by pharmaceutical company propaganda, and keep more up-to-date on clinical research findings, and may be more in-tune with clinical trials that can benefit their patients, or new procedures and techniques that can improve patient outcome.

 

[mgb_phys]

On the other hand, I think they make outstanding clinicians. They are less likely to be fooled by pharmaceutical company propaganda,

I always though medicine should be a post-grad degree after a science ugrad for exactly this reason. The basic science knowledge of a lot of medics and medical students I have known is terrible.

 

[imabug]

I think med schools are starting to give more preference to people who have completed a Bachelor's degree. The hospital I work at requires a minimum of 3 years undergrad work, but gives preference to people who have completed their bachelor's degree. I think it would have to be a pretty special person who would be considered for admission here with only three years of undergrad.

 

[Moonbear]

I always though medicine should be a post-grad degree after a science ugrad for exactly this reason. The basic science knowledge of a lot of medics and medical students I have known is terrible.

Um...it IS a post-graduate degree here in the US. I'm not sure where you're from. We strongly emphasize the basic science curriculum for our medical students (the first two years is all basic science courses, with a smattering of clinical experience thrown in, and then the second two years is all clinical...the MD/PhD students do their PhD research project in between the basic science and clinical years).

 

[mgb_phys]

In the UK it's really an ugrad degree taking 5 years although the first 2 pre-clinical years are more lecture/lab based. At some places you can do an extra 1-2 years in the middle and also get a BSc - so I suppose you could claim the clinical part is postgrad but mostly it's straight through from age 18.

I was proposing something more like a masters degree and then clinical training for people with a suitable eg life-science degree.

There was an attempt to do mature student medical degrees with patient-based-learning where instead of preclinical lectures they started with patients on day one.
Unfortunately they targeted this at people with no science background and it got a lot of flak from senior medics who had spent 2 years memorising latin names for muscles and didn't see why other people should escape!

 

[Revenged]

The systems are very different... In the UK, we don't have this MB/PhD qualifiication - it is an american thing... Very few universities even offer such a qualification...

A typical degree is...

5 year undergraduate degree = MBBS qualification + 1 year intercalated BSc (optional)...

99.9% of clinical researchers do a MD or PhD once they have become a registrar... To get 'MD' you need 2 year clinical research (whereas i think all doctors in america are 'MD') or 3 year clinical research to get a PhD... If anything, people in clinical research here are much better trained here than in America... A registrar is one step below consultant and so you would have been training in a hospital at least 5 years after you graduated from medical school...

 

[denverdoc]

Having been an MD/PhD student at a US university that does not have an official program for such in place, all I can say it is a grueling experience, and very difficult not to short one or the other. I ended up doing a post doc as well, but due to various circumstances now practice privately with no academic affiliations.

I have long believed that the US system could benefit from an overhaul, producing 2 types of physicians, those with a strong background in medical sciences, and those whose training was more practically oriented--something along the lines of the "barefoot doctors" of China who have enough training to treat much of the garden variety illness and recognize/refer more complex cases to tertiary care centers. After a fashion this has happened with much care now being provided by physician assistants and nurse practitioners. Moreover the stark divisoin Moonbear refers to where the first two years is pre-clinical and the last two, almost exclusively clinical seems to me a bizarre approach. If I am not mistaken, in many countries, students hit the wards from day one which provides some humanity to the process and places the study of microbiology, pathology, physiology, and anatomy in context--as opposed to a mountain of information to be learned in time for a test and then just as quickly forgotten.

 

[Moonbear]

Moreover the stark divisoin Moonbear refers to where the first two years is pre-clinical and the last two, almost exclusively clinical seems to me a bizarre approach. If I am not mistaken, in many countries, students hit the wards from day one which provides some humanity to the process and places the study of microbiology, pathology, physiology, and anatomy in context--as opposed to a mountain of information to be learned in time for a test and then just as quickly forgotten.

We've begun to do just that here. Students have required "shadowing" experiences beginning from day one of med school. It does help them balance out some of the basic science learning to see some of it in practice. We also do a problem-based learning class starting in the first year, which other schools would call a case-based learning. Again, this gives them a clinical perspective for the basic sciences. We've switched around the order of our first year curriculum from most med schools so students get gross anatomy in the winter/spring semester rather than in the fall. This means they have the physiology and biochemistry first to put more context on the functions of the body as they study the anatomy...while there's still a lot of memorization, it doesn't become exclusively memorization. Likewise, we emphasize clinical correlations as they study gross anatomy...if this nerve is damaged, what deficits would you see? If someone walked into your office limping like this..., where would you begin your exam for neuromuscular damage? How do you know if it is a nerve deficit or a muscle deficit? If someone comes to you in the ER with a stab wound to the upper arm and you have to ligate this artery to stop the bleeding, will there still be adequate circulation to save the arm? So, while they are not in the clinic yet, they are getting clinically-oriented training during the basic sciences courses. I have no idea how this compares to what medical training "used to be" since I wasn't around back then.

 

[mgb_phys]

I think the logic used to be to do anatomy first to scare the students! By confronting privileged, protected and pampered 18 years olds with a dead body to cut up on day 1 you weeded out the ones who wouldn't hack it as medics.

 

[TVP45]

A number of schools in the US do the MD/PhD program with the PhD in one of the engineering fields. I have worked with several of these folks; they are able to work in the cross-over areas (e.g., cochlear implants, artificial joints, etc) in ways that neither an MD nor an engineer normally could. Their earning potential is quite high, though not on a level with, for example, a top surgeon due to a fair number of hours being devoted to research (research grants typically produce an effective salary cap).