A different approach to the dual degree

I wrote an article in a newsletter for a medical conference over 2 years ago about my unique way of getting an MD-PhD. What follows is a modified version of the original. Some things have turned out slightly different than I envisioned here, but it's still accurate for the most part.

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MD-PhD. Sounded a tad excessive when I first heard about it. Seven to ten+ years of schooling in addition to residency and fellowship/post-doc. After all of that, it seems like it’s almost time to retire! Is it really worth it? This is a big question for many who consider committing to such a program. And how should it be done? Break up the MD in the middle with the PhD (as is traditionally done)? Immediately after finishing the PhD is arguably when you're the most skilled and ready to go onto a good post-doc. Also, starting to see patients after not having studied any medicine for 3 to 6+ years can be a difficult experience, trying to catch up with your colleagues who had only 3 to 6 weeks between their second and third years of medicine. Are there better alternatives? The following is a synopsis of my path toward joining an MD-PhD program, why I think the dual degree is worth pursuing, and why I think the route I'm taking is very beneficial.

When I was a Biology major at my fine undergraduate institution, I worked in a virology lab and really enjoyed research, yet I was intimidated by the prowess of the professors, all giants in their fields. As I compared myself to them, I doubted my ability to contribute to research. Since I was interested in medicine also, medical school seemed like a logical option. Instead, upon graduating I landed a job as a research associate at a near-by cancer research center in a lab doing DNA damage and repair. After working there for one year, I committed to being a graduate student in the same lab as I followed my mentor to a different university. That year of focused research without classes helped me to build confidence that I had something to offer as a researcher. Data I obtained laid the foundation for two later publications in a peer-reviewed scientific journal.

During my first two years as a PhD student in biochemistry, in addition to taking graduate classes and continuing my research, I was given the freedom to explore medicine, as this university had a medical school. I took a few medical school classes, helped tutor some struggling medical students in biochemistry, and also shadowed an oncologist who does both clinical and basic-science research. These opportunities were invaluable in opening my eyes to the benefits of getting both degrees. By receiving training in both basic science and medicine, I realized I could more effectively identify the most pertinent medical questions that need to be solved, work on solving them, and thus carry innovative research to the bedside in a more significant way. After these two years, and knowing much better what I was getting myself into, I then applied and joined the MD-PhD program there and took the first two years of medical school. Though research-time was very limited, I also attempted to work on my PhD. I found that my previous three years of research in addition to a finished thesis-proposal helped greatly in being more efficient in lab during this time.

Now having taken USMLE Step 1 (the first of many “Board” exams) about a month ago, there has been another twist in the road toward my dual degrees. Instead of going back to the lab for 1 or 2 years to finish up the PhD, I was given the freedom to start the 3rd year of medicine and split it into two years. Each rotation I do will be followed by a rotation in the lab, e.g. pediatrics, then 3 months research, then internal medicine, then research, etc. for two years. If my research isn't finished by then, the 4th year of medicine could likewise be split into two. The pros? I will be just as fresh for the hospital wards and clinic as the rest of my class, a luxury many MD-PhD's forgo as they do two years of medicine, followed by their entire PhD, and then finally start to see patients. Also, the 3-month-on-3-month-off plan will potentially help with the rut that graduate students can get in when they lose motivation and productivity because of lack of direction. The cons? I'm sure it will be hard to jump back and forth, especially with getting meaningful research accomplished in short blocks of time. But if I'm going to be in both medicine and research as a career, now is the best time to practice and get good at jumping between both worlds.

Through my research and medical interests, I have been very excited about the field of neuro-oncology, particularly in the pediatric population, and have had the opportunity to contact some leaders in the field about my interests. I hope to eventually be seeing patients as part of a multidisciplinary team, developing new therapies for brain tumors and bringing them to clinical trial. Hopefully the abysmal prognoses for some of these tumors will turn into high remission rates or cure rates, as has happened in the last couple of decades with leukemias and lymphomas through the hard work of researchers, clinicians, and physician-scientists.

In summary, freedom to test the waters in each stage has been extremely important for me. Doing research solid for a year gave me the joy of immersing myself in a project without the pressure of classes and it rekindled my passion for research. Taking a few medical-school classes before jumping into the MD-PhD program gave me an idea of what I was getting into. Having had three years of research previous to doing medical school gave me a set of eyes for possibilities that I never would have had straight out of college. I believe my current 3-month-wards-3-month-research plan has great potential, but a final evaluation of that will have to wait. In the mean-time, I'm having the time of my life and couldn't be happier about the direction each new turn in the road has taken me. Even if I'm old and grey by the time I finish all my training, I still think it's worth it.