Been watching various Doctor shows with research subplots and now I’m wondering how things really work with medical research.
Do regular doctors really tend to invent things, and spearhead research programs? Are there MDs who just sit in a lab doing experiments and never see real patients? Is there a special medical school for this sort of thing? Or people with both MD and PhD?
Suppose someone had a specific disease or medical problem that had afflicted a loved one, and so they want to devote their life to finding a cure / solution. Or some other specific goal like immortality. What’s the best career path towards that goal - doctor, scientist, or?
At my institution, most of the real ‘players’ in medical research nowadays are either MD/PhDs or straight PhDs. The advantage of getting an MD degree to accompany the PhD is, at the risk of sounding cliched, is that you will then, presumably, have a better sense of disease and how it affects people. Further, your patient encounters may stimulate you and/or provide the impetus for research questions. Along the same lines, by being an MD, you’ll likely have a good source of “material” for studies, i.e. volunteers for clinical studies, source of biopsy specimens, etc.
Of course, if you’re ‘serious’ about medical research, much of your time can’t be spent with patients - you need to actually do research and that takes time, usually lots of it. To accomplish this, most universities will guarantee “protected time” for their researchers. In other words, there will be large chunks of time when you have no patient care or teaching responsibilities. Very often, you will still be paid for such time (through university largesse and from research grant support).
With respect to research grant support, one thing that must be emphasized in the contemporary academic scene is that your competition for funding will almost always be by other researchers who are part of a research group. Group work allows big and important projects to be undertaken and also promotes academic cross fertilization. In contrast, the solitary investigator must have more modest research ambitions and will be at risk of being somewhat isolated. Of course, purchasing expensive equipment (which is often a research prerequisite) is easier to do when the cost is spread over a bigger group. Same for hiring lab assistants, computer programmers, etc. Not surprisingly, then, (in my opinion), granting agencies clearly favor people who are part of a research group (although there are exceptions).
There are indeed people who have both an M.D. and a Ph.D., and they are indeed the people who typically go into research specifically related to human ailments. They may or may not continue to see patients.
I actually have a friend who is a dentist Ph.D. That is, he has both a D.D.S. and a Ph.D. He has published many peer-reviewed arrticles in which he describes his advances in dental treatment. He is now a professor at a prestigious dental school, so he doesn’t have time to see as many patients as he used to.
It also depends on how far down the research chain you want to be. Initial discovery is almost exclusively the PhD. It could be a PhD in Chemistry, Biochemistry or even Biology. A lot of drug discovery is done “in silico”(with computer models of targeted protiens) so even a computational chemistry is useful. But those people will never see patients. Anything they come up with is likely 10 years from actual clinical use.
I have heard of small one and two man drug research operations, but from what I understand, they don’t last very long. If they are lucky, and have an interesting candidate, they will often get bought out. If they don’t, funding dries up fast. This type of operation relies heavily on outsourcing. Outsourcing has many perils.
Research is a complicated process, and there are many segments involved in any part of it. I’m sure M.D.s do research too, but I’m not familiar with that end of it. I don’t think most MD’s go into research, but I really don’t know what they do outside of seeing patients.
I should also note that by having your MD degree, it’s a helluva lot easier to generate income in the limited amount of time you have available when you’re not doing research. So, for example, if you’re in the lab (so to speak) for nine months a year, but can see patients during the other three months, you can probably earn what many pure PhDs earn in six, or more, months. In this sense, then, your MD degree supports your research.
I suppose it’s also the case that if you have an MD/PhD as opposed to ‘just’ a PhD, then should the day come when you want to give up research, you’ll have a lot more options open to you (and a lot more ability to generate income).
Not all that relevant to this thread, but I have two friends who are MD/PhD/JDs, who are both practicing patent lawyers. (Both had planned to do medical research, but became disgruntled during the course of the MD/PhD program.)
Yes, but they have a background not just in a clinical setting, but a research setting as well.
Yes, I work with a woman who has an MD, but does laboratory research exclusively.
Nope.
Many medical schools offer dual degree programs that grant the student both a PhD and MD, some even offer MBA/MD. Many vet schools offer a PhD/DVM or DVM/MBA as well. The program is usually 5-6 years and the qualifications are more rigorous than the DVM/MBA/MD or PhD programs alone. I’ve even seen MBA/PhD programs geared towards scientists.
Usually less than 5 or 10% students will choose or even qualify for the dual degree option. My friend who did it really regretted adding the PhD. When he entered the program he was fully expecting to be a researcher/clinician when he graduated but during the course of med school he decided he really only wanted to be a clinician. When all his med school friends were matching for residencies, he still had to finish his PhD project.
Either, really. As long as you are affiliated with a good research program and/or hospital with a large patient base you will not be short of subjects. My boss is not a clinician, he has a PhD. We study immunology and blood cancers. We do not have a shortage of available patient samples because of his lack of an MD.
My brother-in-law is doing an MD/PhD. Me, I shudder at the thought of medical school. I’d rather do just about anything else than be a doctor. Plain ol’ PhD for me, thanks.
I had an uncle who had a PhD (biochem) but taught and did research in a medical school. He said that while he was more highly trained in doing research than he colleagues, they got all the honor (in that med school). It would of course have been different had he been in a biochem department. As a result of his experience, he advised his son (whom he described as “gifted in the lab”) to get an MD and a PhD. The son got the MD, but felt that the money and, eventually, access to drugs, outweighed his interest in research and just went into practice (interrupted by a dryout interlude).
Maybe it has changed but I was told that if you get a MD and don’t do a residency/internship right away you can’t go back and do it later. I knew a guy who got a MD but then went into research full time so he skipped the rest of his training.
Nitpick: DVM/PhD (or VMD/PhD) combined programs tend to take 7 years (or a bit more). It takes four years to complete the veterinary curriculum and usually 3 additional years minimum to do the PhD portion. The most common pattern in veterinary programs is to do part (usually half) of the veterinary program first, often with some electives or summer courses or projects, then do the PhD, then finish the veterinary curriculum. I think that MD programs are similar, but I am less familiar with them.
For those who didn’t decide early on research or didn’t make the cut for a dual degree program, there are also some combined residency/PhD programs (both human and veterinary).
I’ve worked with some MDs doing research. Some of them were doing that research in pursuit of a PhD. They were all residents at teaching hospitals and did some clinical work as well. But I think all of them had a greater interest in research than clinical work. If they needed to further their formal education for that research, it was probably easy to do it as part of a PhD program.
Clinicians are uniquely placed in medical research - they’re the ones at the coal face, seeing just what is happening with drug treatments and where the opportunities for discovery are. Problem is, it’s so difficult to cross major boundaries (science / medicine) with your thinking.
I collaborated a lot with a medical group in my last university and some of the medics there were very much spearheading research programs. But it was in a managerial capacity - not an intellectual one. They were in charge because they understood the clinical need, and they generally had the capability and talent that you’d want them in charge of large projects. But they had no insight into the science. No actual grasp at all tbh. This is not a particular shortcoming, though - modern drug discovery is so multidisciplinary that no one understands all of the science and it’s management of the entire exercise that gets the job done.
There was one medic I worked with there who did in fact understand science - he had no knowledge base but could think like a scientist and understood the boundaries of the field(s). These are the type of people are rare, and they’re the breed who win Nobel prizes in medicine.
I’ve got a PhD in medicine and worked with quite a lot of medical people during my project.
My personal experience of MD’s doing research was pretty unfavourable. MD’s have a significant advantage in the form of access to patients, but they seemed to have a major shortfall in training in scientific techniques, and the programs that were meant to address that seemed to be something of a joke (my PhD supervisor was explicitly told that he wasn’t allowed to fail BMedSci students, which, by all accounts, was a short course that was supposed to be considered equivalent to a 3 year biomedical science degree and blatantly wasn’t even if it was possible to fail it)
That said, I would expect this to change pretty quickly as a clinical researcher gain experience, that many of them will likely acquire both degrees anyway (it’s not particularly difficult to find the extra time to do the PhD if you are already doing novel medical research), and that the vast majority of MD researchers are entirely competent. This may also be colored by the fact that the particular medics I ran into were complete idiots in a more general sense (I sure as hell wouldn’t have wanted them treating me for a clinical problem either)
But I was kind of left with the impression that it’s probably too easy for a medic to play at science, do terrible terrible research, and get paid significantly more to do it, which is the kind of thing that leads to sour grapes from us humble PhD’s, and I’m still not entirely sure that I really buy that it’s easier and more cost effective to train medics to do science than it is to train scientists to interact with patients without setting them on fire
