Do I need an MD/Phd to do research?
If you are interested in combining research with a clinical career you might be considering an MD/PhD. You might want to consider that it is possible to become a physician-scientist without obtaining a Ph.D. degree.
The AAMC conducted an analysis of 5,917 physicians in the 2022 National Sample Survey of Physicians (NSSP).
91% of physician-scientists in this survey did NOT have a PhD both within and outside of academic medicine.
Only 4% of the total pool of physicians surveyed had a PhD. 33% of MD/PhDs were engaged in research vs. 13% of physicians with an MD only.
Clinical research was the most common type of research physicians were conducting. The most common types after that were educational research and health services/health systems research.
A higher proportion of MD/Do-PhD scientists were engaged in basic science and translational research than those without a PhD.
Interestingly, the composition of the physician-scientist workforce in terms of gender, race, and ethnicity was similar to the overall physician workforce.
One common myth (and it is a myth) is that your chances of getting into medical school are better if you apply MD/PhD rather than straight to MD.
In 2022-2023, 1793 students applied to MD/PhD programs and 709 students matriculated into MD/PhD programs.
The average total GPA of matriculants was 3.82, the average science GPA was 3.78, and the average MCAT was 516.2, which are higher than those of matriculants to MD-only programs.
There are approximately 50 funded MSTP programs in the US, however, 100 medical schools enrolled MD/PhD students.
On average MD/PhD applicants applied to 17 MD/PhD programs.
Pursuing an MD/PhD is typically a seven-year journey, two years of medical school followed by four years of PhD, with a final year of clerkships. Then you do four to seven years of residency followed by a postdoc (four years). On average the length is 14 years. It is a long journey but can be extremely rewarding if you like doing medically relevant research. Over the last few years, the time to a degree and time to a first full-time job has been increasing. There is some psychological impact of not staying in the same cohort as other students starting at the same time. So when you apply MD/PhD you need to know that you are committed to that time frame.
One bonus is that MD/PhD programs are often fully funded. Medical tuition is waived and you get paid a stipend during your PhD years through NIH funds from the Medical Scientists Training Program (MSTP), but even programs without MSTP funding have their own funding to support students. Financially, the White Coat Investor has a blog post doing an economic evaluation considering whether the MD/PhD is a good financial decision (spoiler - yes). Interestingly, MD/PhD students are more likely to choose lower-paying specialties with 14% choosing pathology (vs. 1% MDs).
If you choose the MD-only route you can focus on medical schools with a strong research infrastructure and have space and opportunity in the curriculum to do research. You can choose research electives or even earn a PhD during residency or join a research fellowship and be funded in the Physician Scientist Training Program (PSTP), a post graduate program that provides training to physicians who have an MD or combined MD/PhD with a strong commitment to becoming a physician scientist. THE PSTP tintegrates residency training, clinical fellowships, and basic and clinical postdoctoral trainng to facilitate the transition between degree and first faculty position. If you choose the MD only route you can also get your loans repaid through the NIH Loan Repayment if you spend more than 50% of your time in research even if you don’t pursue a PhD degree.
In the end, if you have a passion for research you can get there in your career with just an MD degree. Whether or not you choose to get a PhD should be something you work out with a mentor, however, if you are interested in bench or translational research you should strongly consider it. You might also take into consideration how much clarity you currently have on your research questions or goals. Your PhD is best pursued when you have some experience to base this on - some program directors argue that is about 2000 hours in research.
No matter what you decide there are plenty of options to opt into a PhD after you are admitted to medical school and it is a bigger deal to opt out of an MD/PhD program once you have committed then to decide later that you want to pursue a PhD.
If you are interested or thinking about MD/PhD the place to start is by speaking to a mentor or advisor who is involved in research. Other good resources include the American Physician Scientists Association. Unfortunately, the MSTP list from the NIH is not on their website currently but you can find the AAMC MD/PhD program list here, you can look in the Medical School Admissions Requirements (MSAR) website to find schools offering an MD/Ph.D. or access this spreadsheet which clarifies which specific programs are MSTP here. Don’t be afraid to reach out to MD/PhD program directors with questions.
