What Questions to Ask Youreself: MD-PHD vs. MD

You should read some of the threads from the Physician Scientist forum OP, they may supplement some of the answers here and even answer some questions you haven't thought about asking.

Even though I'm fairly confident I will be doing both degrees, I wrestle with this question myself on a weekly basis, especially as my application cycle draws closer and closer.

Here's the best I can do as one of the starry eyed pre-meds @URHere described:

If you feel that you would be satisfied with a purely clinical career with a potentially academic (read: clinical research, teaching, administrative) bent to it then I would go MD only. Based on the very limited insight I have to you as a person in your few posts I would say do not do the dual degree and stick with the MD. Wanting something closer to 50/50, being apparently excited by direct patient care and working through cases, etc the MD/PhD might be unnecessary for you. Furthermore, there are MD-only pathways to becoming a physician scientist and even some MD/PhDs are in favor of those since your clinical interests are already mostly defined by that point and you can start your research career in your intended field as opposed to some other field (which may be the case of you do a PhD).

So why do I currently want both?

First, I want to be a scientist and I want to work on human problems, specifically I want to build on what we know about the mechanisms of disease. That's the physician scientist bit. However, I want to be a very good scientist. I've been in the same lab for about 2 years now and spent about 1 year in another lab. I've seen how PhD students develop from first year to graduation and I feel that the PhD training is actually substantial. The difference between a graduated PhD and a new grad student is pretty huge in terms of organization, intuition, ability to plan, and ability to synthesize new information and find an interesting question to work on. Maybe I've been very fortunate in the labs I've worked. A moment that sticks in my mind is when a graduate student I worked with graduated last semester and he told me that he could probably reproduce his entire PhD in 1 year now that he understands how to put together a research plan and knows how to avoid the pit falls that weighed him down during the first half of his PhD. That's what I want. I want the training to be a good scientist.

Will it be incredibly difficult to find a research-centric career where I can also practice medicine? Most likely yes. Will I be able to do it? No idea, none at all. I am less concerned with the quantity and quality of opportunities available to me than I am with becoming a well-trained scientist. If that means spending an extra 2-5 years in the pipeline compared to my MD + Postdoc colleagues then so be it. I am willing to trade those years for a structured, dedicated (read: no clinical responsibilities getting in the way), intense period of scientific apprenticeship. I love the lab. I love solving problems. I love thinking about the way things work and being able to come up with something totally new. Whenever I make a new insight into a problem or I think of a clever experiment to advance our lab's work (very rare instances) I am absolutely elated. Science is just really freaking awesome, it makes me very happy to be part of it in even a small way along with all of the BS, annoying, inefficient, obtuse or just plain stupid aspects of modern academic science.

The second reason is far more practical. One might ask me: why not just PhD? Well I don't think I would be satisfied with just a PhD. I love science but I also love people and working with them and I don't know if the joy of doing science could sustain me past my first (hypothetical) faculty position after which I'll be just another cog in the grant writing and publication apparatchik, especially through the long and protracted periods where interesting and new things aren't happening. Patients are there to provide soluble and meaningful problems and provide a human grounding to my work which I feel will make it more meaningful. Lastly, if you think getting a faculty position with an Md/PhD is hard then try getting one with a Bioscience PhD lol.

In the end, I think Md only is the optimal choice for most people, even science nerds. It might even be the right choice for me. But at this point in my life I believe what I wrote in my post and I believe that it can at least sustain me through that portion of my training. Whether I'll become cynical and bail for PP remains to be seen but the dual degree gives me the best shot at my dream job, I think, so that's something.

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What Questions to Ask Youreself: MD-PHD vs. MD