Doctor^2?

March 14, 2012 1:10 AM

Thinking of dropping out of a British PhD program and going to medical school over the next year or so. Need opinions and advice!

Similar to this question:

I'm an American in a British PhD program in a social science field and not very happy about it. I'm studying innovation and technology from an interdisciplinary perspective, and I feel really uninspired by any of the things I'm studying. I've been trying to get excited what I'm studying for the entire time that I've been here and haven't found anything I really care about. I'm about halfway through a three-year PhD and about to do my "transfer of status" -- basically, like a qualifying exam.

I'm really thinking through what career options I would enjoy. Recent experiences with friends who are in the biological sciences have inspired me to explore a bit of my other options and I think I may want to go to medical school. As I think through my interests from the past, science, medicine, and health care innovation have long been passions of mine, and I find them endlessly fascinating.

I don't yet have the prerequisites, but I did fairly well in science courses at university and I think I could do the post-baccalaureate series over the next year or so without too much trouble. I have a great undergraduate GPA from a very prestigious university in the US and a Masters' degree from a prestigious British school. I'm a good standardized test taker.

I've been thinking about medicine as a career for reasons similar to the other poster:

- I'm drawn to science and technology studies because I am a bit of a frustrated scientist.
- I badly want to feel as though I have skills that are "of use".
- I don't really want to be an academic. I know already that I don't want to spend the rest of my life on this stuff.

So I like science; I like to feel useful; I know I'd like to do something that has the potential to be truly innovative and help humanity in a big way, and I want to do something that feels *important*.

Here is what I am asking:
- Should I drop out now or finish the PhD first? (I can do the prerequisites over the next year or two while I do the PhD because my research mostly involves reading and writing and I can take courses near where I live.) What are the pros and cons?

- I think I want to use the medical degree for nontraditional purposes, such as to get involved in medical device innovation, health care IT, etc. I would love to see some resources on how to do this.

- Along these lines, I may want to go to a British or Irish medical school instead of follow the traditional US path all the way through residency and internship, but I'm not sure. I'd love links to any materials that can help me decide. (I'm a dual EU/US citizen and am resident in the UK, so admissions/citizenship is not an issue.)

This path seems to so genuinely fit my goals. I could use some encouragement from anyone who has been along this path.

posted by carolinaherrera to Education (16 answers total)

1. Finish the PhD, and do prerequisities at the same time
2. Spend time with doctors - quite a few doctors I know finds a hard transition between learning (steep learning curve, difficult, intellectually challenging) and doing (rote, repetitive, a bit boring sometimes)
3. You could use the Phd as a bridge and got into epidemological studies/innovation medicine/behavioral stuff
posted by zia at 4:26 AM on March 14, 2012

First things first, you need to decide whether you actually *want* to be a doctor. I know you say that you probably don't want to work in a clinical setting, but you will still have to do several years of clinical medicine in medical school, and in the US, at least, medical schools are going to expect you to have some exposure to medicine, in the form of shadowing and volunteering. Do this before you spend any time or money on prerequisite coursework, and/or the MCAT.

I only know about applying to US schools, but feel free to PM me with any additional questions you have about applying, and what medical school is like
posted by honeybee413 at 4:26 AM on March 14, 2012

Just wondering if you have you looked into biomedical or healthcare engineering at all? As I read your question, that's what instantly came to mind for me.....very science/technology based and 'of use' plus you already have an interest in the healthcare side of things since you are talking to doctors (as supposed to, say, enviromental scientists). Just another option you might want to check out before jumping into a 5+year medical program.
posted by atlantica at 4:55 AM on March 14, 2012

I'm just some guy on the internet, but:

* Since you're in a British PhD program and can say that it's going to be another 1.5 years (as opposed to some American PhD's which tend to be less structured), I would suggest staying in and finishing it up.

* Does continuing on in your current university give you access to required med school courses? (O-Chem, O-chem labs, that kind of thing?)

* Having a PhD (from what I've been told) makes it easier to get into med school.
posted by Comrade_robot at 5:00 AM on March 14, 2012

Honestly, there's no way that this isn't a good idea. The things to keep in mind are that med school admissions are extremely competitive right now, do you really have to go "all in" when it comes to getting your application together.

There are a fair number of Americans who attend Trinity med school, but keep in mind that foreign med schools, even when they are designed to follow the American curriculum, will limit your choice of residencies in the US.

- I think I want to use the medical degree for nontraditional purposes, such as to get involved in medical device innovation, health care IT, etc. I would love to see some resources on how to do this.

Keep in mind that you are going to spend 4 years in med school and 3-5 years in residency before you can start making serious inroads to this. That said, read more about this guy or see when he's giving a talk somewhere and attend.
posted by deanc at 5:14 AM on March 14, 2012

If you finish the PhD programme you get an exta point on your Foundation Application at the end of medical school if you stay in the UK.

I'm a bit wary that you don't actually want to do medicine. I'm in my fourth year and it's punishing - I can't imagine doing this if it wasn't the thing I wanted to do. Yes, you've got an interest in science and helping people - but you don't mention anything about direct personal interactions with people. Have you any experience, for example, working with people in health or social care settings? It's that bit which is so important that you enjoy, otherwise you won't be happy in medicine.
posted by Coobeastie at 6:21 AM on March 14, 2012 [1 favorite]

Have you looked around at other graduate studies programs that might get you where you want to be, ie epidemiology or health technology assessment (which is often a branch of health economics)?

These are master's level jobs ie all you need is a Master's degree instead of 7+ years of extra training. The London School of Hygiene and Tropical Medicine has some good programs - in fact there are many strong programs in the UK.

Good luck!
posted by lulu68 at 6:47 AM on March 14, 2012

Epidemiology and public health are fascinating areas of research, and as someone with a social science background you would be very qualified to move into those.

HOWEVER, epidemiologists who have PhDs but who do not also have an MD can find themselves being paid a lot less than someone doing the same work who also has an MD. The healthcare world is very stuck up, and MDs rule the roost.

if your interest is in health research, the best program is an MD/PhD combination program - and if you can get into one of those, you also get funding to help pay for your MD.
posted by jb at 10:00 AM on March 14, 2012

Also, there are a great many MDs who do not work in direct care roles, and even more who only do care part-time (1/2 of the hospital that I work at is research, not care). If your interest is in becoming a practicing MD, then I would think seriously about how much you like working with people. But if your interest is in research, that's much less important.
posted by jb at 10:03 AM on March 14, 2012

I've got a pretty good perspective on the process for Graduate Entry Medicine in the UK, on account of being towards the (so far unsuccessful) end of this year's application process. Entry conditions to 5 year courses are similar for people who didn't do A levels in the UK.

The academic hurdles to enter a medicine course in the UK are exactly that. Once you've cleared the barrier of showing that you're able to keep up with the intellectual demands of the course, all they're interested in is your aptitude. The aptitudes they'll particularly examine are communication skills, a background understanding of medical practice, ability to cope with stress, motivation to study medicine and experience of patient contact.

I would say that from this point of view finishing a PhD would remove any question that you can cope with the stress of the course. I don't think any of my entry interviews specifically addressed the year I spent as a 'supervised postgraduate student' before dropping out of a PhD, but I'm sure when it comes to the "how do you cope with stress" questions, referring to finishing up your thesis writeup will pretty much settle the issue. And assuming a decent amount of TAing and presentations, then you'll be good from a communication point of view.

But I don't think it'll help you much with experience of patient contact, motivation or background understanding. The background understanding those interviews are looking for is that of the resource and ethical constraints of delivering medicine, and to look that you've understood the ongoing training program that medics have [in the UK].

Motivation to study medicine is linked to experience of patient contact. I spent a little while (not long enough) as a hospital visitor, and also worked as a medical secretary for an adolescent psychiatry service for a couple of years. This is all about showing how you engaged with patients and thought about how to put yourself in their mind, and generally showing that you understand you have to do difficult things and help out people in anxious and difficult situations.

So, back to the academic hurdles: there's a couple of different entry exams for UK & Ireland medical schools. The main ones are the GAMSAT and UKCAT. Good scores in both of these will get you to the interview stage at 8 (IIRC) graduate entry programs in the UK (all in England) and the, err, 3 graduate entry programs in Ireland. They're aptitude rather than syllabus based exams, but you'll need to know organic chemistry naming (pretty much nothing else) for the quantitative reasoning part of the GAMSAT exam. I used the Khan Academy for that, with GCSE level science as my background (so basically no background at all), and I scored very highly.

In terms of UK residence, you'll need to have 'Home' fees status, so that may or may not apply to you. You might need to show other (residence, not citizenship) ties to the country than just having come over for your PhD. I'm sure if you ask someone in your current university's bursar's office, they can confirm it for you. This will mean that your total out of pocket costs will be limited to a £3,260 (for 12-13 entry, future years may well change. And yes, I do know fees are going up. The rest goes on a student loan package, which is of course only repayable after starting (well-paid) work, and repaid as a proportion of income until repaid rather than on a fixed term loan basis.)

For Ireland, fees are c.€25,000 per year, and bank loans are only available to Irish nationals.

But the summary is that you'll only get in if you actually want to see patients, and if you're keen on it, it shouldn't be too hard. I think from a career point of view, the UK's a good place to work. And doctors really are better off here than in any other country, with pay levels second only (and only just) to the US, and working conditions (particularly for the house officer year) far less stressful and far more medicine focussed than in the US.
posted by ambrosen at 11:48 AM on March 14, 2012 [1 favorite]

One practical question you need to answer is where you want to end up, in US or Europe. Because if you want to attend med school in US, you pretty much have to get your post-bach pre-requisites in a US undergrad school as US med school may not like courses from outside the country.

Echoing above, I would definitely get more hands-on clinical experience. You say you don't forsee yourself doing clinical medicine and that's okay, but if you go to medical you will spend YEARS of hard training in clinical medicine.
posted by Pantalaimon at 11:57 AM on March 14, 2012

Hi there--I did this. I'm in an American allopathic medical school and in my thirties. I came from a really strong English/humanities background. A few things to think about:

1. GPA. You said your undergrad GPA is good. That's great. You need excellent grades in all your postbacc classes. (But seriously--you are in such a good place already with a high GPA.)
2. MCAT. You said you're a good test-taker. Great. Only thing I'd think about is that you may not be able to complete your postbacc and study for the MCAT at the same time--that's usually not advised, actually, since you won't actually know the info. So you may be looking at 2 years of prep.
3. Application year: expensive (most people apply to 15+ schools) and stressful (and also really fun once you get to the interviews stage). Will also add more time to the whole process.
4. As someone else mentioned, it's ridiculously, stupidly competitive. There are a million kids with 4.0 GPAs and awesome MCAT scores. You're at an advantage coming from a different field--use it! My experience is that American med schools really value "nontraditional" applicants and the different experiences they bring, as opposed to a 22 y.o. who is brilliant but has zero life experience. (That's assuming the nontraditional student, though, also has great grades, MCAT, clinical experience, volunteer work, etc.)
5. You've got to volunteer/do community service, preferably health-related. It sucks, but you've got to do it, and it's in your best interest to find meaningful work. You also probably need to shadow some physicians. (You said you're interested in medical devices, QI, etc--look for interesting internships with organizations that work on this stuff. But keep in mind you WILL need clinical experience for your application.)
6. Some med schools may wonder why you dropped out of a PhD program, and it may look like a red flag to them. If it's not too painful, finish it. (Though, full disclosure: I dropped out of master's program. Nobody asked me anything. But I also spent five years rerouting my life to apply to med school, so we had other stuff to talk about.)
7. If you don't want to be in clinical medicine--look for some other route. I'm serious. Because med school is 4 years of prepping you to be a clinician, and the process can be painful. (And then there's residency.) If you don't want to see patients, I assume it's even more painful. Also, my med school, for example, is invested in putting out primary care/internal med physicians, because there's such a shortage in the United States. They would NOT be impressed with an applicant who said he doesn't want to see patients this early in the game. (Of course, many people with MD's don't work in clinical medicine and do other fascinating, important work in other fields. I'm just thinking about it from the admissions committee POV.) Also, a friend of mine is also interested in medical device innovation. His route: he graduated from med school, immediately did a master's degree in engineering, and is now in an orthopedic surgery residency.
8. Someone mentioned the MD/PhD route--that's looking at *at least* 10 years more of training depending on what field of medicine you want to go into.
9. Encouragement: you can TOTALLY do this. I never in my life considered medical school until my mid-twenties. I don't know how old you are, but I definitely sometimes got comments from people in my age group about taking on something like in my thirties. I just smiled politely and moved the hell on. I made the right choice. Finally, as you're preparing for med school--taking the classes, volunteering, shadowing doctors, etc--always give yourself an out. If at any point you start getting some nagging feeling that this isn't what you want, pause. Feel it out. Be true to whatever you're feeling. Because once you get on this train, it's incredibly hard to get off.
10. Oh, and don't rush. You'll get there when you get there.

Good luck.
posted by namemeansgazelle at 12:11 PM on March 14, 2012

Response by poster: Thank you so much, everyone! This is amazing. Much appreciated!

Just for the record, I'm not opposed to seeing patients. I really love one-on-one interpersonal interaction and would enjoy having seeing patients be my job! I'm interested in innovation and science as well, though, so I thought I could save time on residency and internship by just doing the medical part and then getting involved more in other applications. But this may show how much more I need to learn about the process.
posted by carolinaherrera at 12:39 PM on March 14, 2012

I thought I could save time on residency and internship by just doing the medical part and then getting involved more in other applications.

This defeats a lot of the key advantages you would have by getting an MD rather than a Ph.D. If you're a board-certified physician, then you can see patients, do clinical research (and get funding for clinical research), play a front-line role in the development of medical devices, etc. Without being a board-certified physician, you're in the same position as a Ph.D. but with less research experience and a heckuva lot of debt.

This might be a good time to talk with your friends who are grad students in the sciences. See if you can talk to their advisors, postdocs, and anyone you know in academic medicine or biological sciences research, just to get a better idea about what these people "do." (and why they made the choices they made, particularly why they got PhDs in one field vs. an MD or why certain MDs chose the residencies they chose, etc.)
posted by deanc at 12:53 PM on March 14, 2012

8. Someone mentioned the MD/PhD route--that's looking at *at least* 10 years more of training depending on what field of medicine you want to go into.

It depends on what you are working in. The MD/PhD I knew finished his joint degree in 6 years (which is typical for a US PhD alone), and had a tenure track job doing what he wanted to be doing (teaching history of science) before he graduated. Had he wished to practice, perhaps that would be longer, but residents have paid training and are truly into their careers - they are not students. They are junior doctors.
posted by jb at 1:12 PM on March 14, 2012

This defeats a lot of the key advantages you would have by getting an MD rather than a Ph.D.

I am just speaking from my experience having worked in healthcare research (research support) and knowing both MDs and PhDs in healthcare. I don't know what the pay situation is in the US, but in Canada, MDs engaged in research are paid substantially more than PhDs, even if the PhDs have more experience or even are their supervisors. This has to do with our high pay scale for MDs generally - people engaged in full-time research are paid like they were doing full-time clinical service.

Advice from a colleague who has 30+ years experience in healthcare research: she wishes she had gotten an MD as well as her PhD.
posted by jb at 1:17 PM on March 14, 2012