To MD or not to MD?
February 24, 2010 8:10 AM   Subscribe

CrossroadsFilter. PhD or MD? I could invest an extra year into attending a one-year special master's degree program that, upon success, would pretty much guarantee admission into medical school. I'd be a 28-year-old first-year medical student. But what about babies?

I am female and 25. It's been almost year since I got my B.A., and it's time for me to start thinking about continuing my education – that's a promise I made to myself. I could do what is generally expected of me at this point and apply to a doctoral program in a bioscience field. However, I am not sure that I would enjoy a research career as much as I would one in the medical field, and being a physician is very appealing to me for a number of reasons. I have been seriously considering taking that path since I was in middle school.

Due to my initially low undergraduate GPA, the only realistic plan for me to attend a well-ranked medical school would involve a one-year "special" M.S. prep program. I assume that I'd have little trouble getting into one with my high GRE, GRE subject test, and MCAT scores, extensive biomedical research experience (it's what I currently do for a living), and solid community service record – anyway, I'm willing to take a chance. But it's one extra year of my life, and my biological clock is ticking.

Fortunately, thanks to my significant other's salary, money is not an issue and should not be in the forseeable future. On the other hand, that also means that I have the option of not working at all and being a full-time parent. This appeals to my significant other who believes that stay-at-home moms are the best thing in the world, but we have no doubt that an arrangement like that would likely render me depressed and thus intolerable – prior periods of unemployment or summer vacations attest to that.

I have no doubt that I would succeed in either a PhD or MD program, but I know that as a researcher (I have no desire to go academia) I would probably be able to spend more time with my family, at least eventually, and would most likely not be overly focused on my career. I'm not sure it's what I want, as I do not feel passionate about research but like the flexibility it offers.

I feel that one year M.S. program and four years of medical school followed by several more years of training would be pretty taxing on my significant other, especially considering that we both want children before I turn 30. He is supportive of either option and not opposed to moving, although I would feel guilty for uprooting his life if I do decide to pursue a medical career (but if we do move, we'd be close enough for his parents to help out with any future offspring, which would be fantastic).

What would you do? Is it unrealistic to dream that I can have it all?
posted by anonymous to Education (17 answers total) 6 users marked this as a favorite
I do not feel passionate about research but like the flexibility it offers.

This is a recipe for an unsuccessful PhD and research career.

People have babies during med school. It's not ideal but that's a trade-off you'll have to consider. There are also medical specialties, like pathology, where you don't work crazy hours.
posted by grouse at 8:19 AM on February 24, 2010 [1 favorite]

Why MD? why not nursing or something with a shorter time to a stable schedule? It's not that babies and MDs are incompatible in general... they just seem to be incompatible with the schedule you've set for yourself here. To me, it reads like babies are the only thing you clearly know that you want and you're trying to fit potentially difficult/impossible things around them. If you're committed to reproducing before 30, then some re-prioritization might be in order. If you're flexible, then further education seems feasible.
posted by Cold Lurkey at 8:23 AM on February 24, 2010 [1 favorite]

I currently work as a research assistant, and up until recently had been planning on going to graduate school. However, I've decided not to go for the time being. Like you, I'm wary of making such an enormous time/energy commitment when I'm not sure it's what I want. Also like you, I feel attracted to the idea of medicine.

One option I've been considering is nursing school. Apparently, you can do a 2-4 year direct-entry program and emerge with either a masters or a doctorate that allows you to open a private practice. Some of these programs allow you to get an RN along the way, so you could stop and do less specialized work, although might be less appealing to you.

Part of what appeals to me about this path is the simultaneous flexibility - nurses are in such high demand that it appears they can work seasonally, per diem, part time - but also opportunity for advancement (being able to specialize in a subfield that really interests me, being able to run my own practice on my own terms). I'm also intrigued by the possibility of becoming a "research nurse".

I can't say whether that's a good path or not, since I'm only just considering it, but it may be something for you to investigate.
posted by shaun uh at 8:25 AM on February 24, 2010

I'm a 26-year-old finishing a Ph.D. in a biomedical field. My husband and I would also like to have kids before I turn 30, money is tight for us, and I'm stressing out trying to figure out what to do.

My advice to you: Please don't go into a Ph.D. program if you aren't passionate about research. I started my Ph.D. passionate about research and I'm still burnt-out and miserable. If you go in without a passion for research, you're really quite likely to leave several years later without a Ph.D. and with a bad taste in your mouth. Furthermore, you can't really succeed as an independent research investigator without a passion for research. If you are angling for a job in industry as a Ph.D.-level research scientist but still working under a P.I., be aware that these jobs are not as easy to come by as some academics may believe. Many companies do not hire freshly-minted Ph.D.s straight out of academia with no post-doc experience. So, if you get a Ph.D., to have a "successful" career, you can look forward to at least 5 years of graduate school, by which time you will be 30, and you will need to post-doc for a few years on top of that. If you are lucky, your post-doc salary will just about pay for quality child care, but you will need to work hard as a post-doc in order to be competitive for the industry job you want.

You'll have a similar situation as a med student -- you'll bust your ass for 4 years of med school, and you'll have an ass-busting residency at the end of that.

I would suggest figuring out what exactly you want to do with your life, career-wise. Do you want a high-status but high-workload career that requires an MD or PhD, or would you be more satisfied with a career that requires slightly less education, doesn't carry the high social status of an MD or Ph.D., but will let you spend more time with your kids by not requiring 60+-hour weeks? Maybe you would be happier as a research technician (if you want to do research), or as a nurse. They're both extremely important and useful jobs, and only fools believe that being Doctor So-and-So automatically makes you a superior being anyway.

Another option, if you decide that you really DO want to be a physician, or a scientist, or whatever, is to have your kids before or during grad school or med school. The downside to this is that you might not be there for them when they want you to be there -- you might be on call when they're doing their homework, or you might be in the lab until 2 AM doing an experiment with a 16-hour time point, so you won't be able to put them to sleep.

Really, the way things are right now, you can't be in two places at once, meaning that you can't have it all.
posted by kataclysm at 8:26 AM on February 24, 2010 [4 favorites]

You may not get another opportunity to go to med school and that seems like what you really want to do. Personally I think it would be incredibly hard to have a child and go to medical school. If you're only 25 now and did a year of grad school plus 4 years of med school that would only make you about 30 by the time you're done. Add in a few more years of residency where the hours are crazy. So you would probably be about 32, 33 by the time you're "settled" in your career. I don't know what your reasons are for wanting a baby before 30 but if you're only about 32 and having a baby that's not that far off of your goal.

As someone who is slightly older than you (I'm 31) and in a career that I don't want to be in I would say do what YOU want to do. Don't settle into a career (research) that you don't seem passionate about.
posted by bingwah at 8:36 AM on February 24, 2010

There's only one brief mention of wanting kids in here, and it's almost an aside. Are you sure you're not in more of a hurry to have kids because of pressure from your SO?
posted by PhoBWanKenobi at 8:39 AM on February 24, 2010 [1 favorite]

If you get an MD, you can still be a researcher. You just do a research fellowship after finishing med school, though obviously you should do a residency and become board-certified.

A Ph.D. program will be more stressful and provide much more limited job opportunities after finishing. Also, as you say, you're not "passionate" about research, and this is a formula for ending up being a Ph.D. program dropout.

In short: and M.D. gives you everything that a Ph.D. in the biological sciences gives you, but with a fixed completion schedule, the ability to direct clinical research studies when you finish, which there is more research funding for, and more flexibility for career choices afterwards. The only tradeoff is the money issue: you are going to get paid to get a Ph.D., while an M.D. will cost you lots of money and leave you deep in the hole, but with the upside of a much higher earning potential.

An option lots of M.D.s are leveraging is the ability to build up seniority in an emergency room after a few years allowing them to work a more flexible schedule. You won't make the ungodly amounts of money that a specialist makes, but you will make very good money and have a flexible schedule.

The difference I find between Ph.D.s in the biological sciences and M.D.s is this: Ph.D.s have to beg and hustle their ass off to find work and research funding. M.D.s have people begging them to work.
posted by deanc at 9:03 AM on February 24, 2010

I really don't know anything about med school or medical careers in general, but while you're contemplating your desired career path, you may also want to consider whether or not what you might want to do with an MD requires a degree from a top-ranked institution.

I get the sense that whatever you do, you're not sure you want a high-powered "star" career. Might it be easier to achieve the balance you're looking for by going to a lesser-ranked, more local med school that you could get into without the 1-year M.S., and which might be more supportive of parenthood depending on how you time things?

Finally, I'd encourage you to think a little more flexibly about your babymaking timeline. Your desire to have children while you're still younger is quite understandable, but your womb won't turn into a pumpkin at the stroke of midnight as you finish your 29th year on the planet.
posted by drlith at 9:19 AM on February 24, 2010

My sister decided to go to medical school when she was forty. She had a masters in marine biology, a position as a researcher, and a 6 year old kid. The day before the MCAT she discovered she was pregnant again. She delayed med school for a year, and then went off to a med school in a city many hundreds of miles away leaving her husband to take care of the kids, and work full time. Med schools don't much like older students and it was the only one that accepted her. My brother in law is a saint, they've been together since they were teenagers, and he's always done all of the cooking. If you're not married to someone like him med school with young children would be mighty difficult. Fortunately, my sister was able to transfer for her last two years to a school near their home.

A work at a university that has a BSN program for people who already have BAs, check them out.
posted by mareli at 9:19 AM on February 24, 2010

I know several pathologists and psychiatrists who went into that field specifically because they could ultimately work (privately) part-time and thus negotiate family as well. I am married to an (academic) pathologist who, despite the fact that he does research in a large hospital/med school and signs out an insane amount of cases per year, starts work at 9am most days and 4/5 days a week is home to put our daughter to bed. More importantly, being a pathologist means that his time is flexible. He has, I believe, an hour of scheduled time per day. The rest of the time he has been able to come home immediately if for example our daughter needed to be picked up from daycare (I used to work - as a research post-doc, incidentally - an hour away from home, and my husband was the emergency point-person).

Just saying, that it's possible to have a successful medical career and a successful family.
posted by gaspode at 9:39 AM on February 24, 2010

Listen to kataclysm (above). Kataclysm is right on target.
posted by Knowyournuts at 10:17 AM on February 24, 2010

I know someone in your shoes who went to graduate school in physical therapy, and someone else who became a physician's assistant (PA)--which also gives you the ability to practice at the community health level, if you so desire.
posted by availablelight at 1:07 PM on February 24, 2010

I'd just say that given the experience of many professionals recently, I'd be I tiny bit skeptical of this statement: "thanks to my significant other's salary, money is not an issue and should not be in the forseeable future." Whatever you do, I hope you come up with a backup plan for what happens if your SO becomes jobless and/or all of your/your SO's investments go sour. Along the same vein, I'd look for a degree where, if you stop for a bit you can pick back up, or transfer credits to another program that would be quicker to complete. This also insures you against loss of interest or burnout.
posted by lorrer at 1:13 PM on February 24, 2010

Med schools don't much like older students and it was the only one that accepted her.

This isn't true. I'm guessing in this anecdotal point, the applicant had something imperfect with her application aside from her age. I know a few people who got into med school in their 30s without any problems and with lower GPAs than those right out of undergrad. You're really young still.

a well-ranked medical school

Rankings don't matter as much as the school you attend being accredited. It is not like going to law school where going to the highest ranked schools is going to get you the best opportunities. If you don't need to do an SMP because you haven't been rejected from med schools yet, then you should just apply directly and not waste the money. Concentrate on getting a really great MCAT score. If that doesn't work, do the SMP. However, if money is not an object, it's yours to throw away however you want. And people do have kids while going through med school.
posted by anniecat at 1:32 PM on February 24, 2010

Also, in response to your "Is it unrealistic to dream that I can have it all?" question, I would say, no, it's not unrealistic, but the chances of having fun doing it are going to be based on your temperment. If you have a higher than normal stress threshold, then you'll be fine. If you're normal, you might lose a lot of hair over dealing with kids and school at once.
posted by anniecat at 1:35 PM on February 24, 2010

Well you can have a baby by 30 and do either a PhD program or MD program (you sound like you want to do MD more). You just have to realize that it will take you longer to complete your program or you won't spend as much time with your kid, or likely both.

I don't get teh children by 30 thing. Why can't you have a baby when you're 34 and done an MD program and have residency under your belt? If you have baby fever so bad that waiting till 34 seems impossible, then maybe you should just go for the parenting thing and put off school indefinitely.

Also, DONT HAVE BABIES WITH YOUR SO UNTIL YOU ARE BOTH CLEAR ON WHAT TYPE OF PARENTING IS APROPRIATE!!! That is, if your SO is going to get mad at you and think you are not "the best thing in the world" because you are not a stay at home mom. Be aware that if he ends up being Mr. Mom due to your heavy workload, he may resent that if he is a traditionalist and thinks moms should stay home and dad should bring home the bacon.
posted by WeekendJen at 1:44 PM on February 24, 2010 [3 favorites]

If you want to go to medical school, then do the masters that will allow you to go to medical school. One extra year of education isn't going to make a difference compared to the minimum of 7 years it will take you to complete med school and residency. What if you loved a specialty that had a four year residency more than all the specialties that require 3 years? You wouldn't give up your future career in a field you loved because the training was longer, I hope. (Pray you don't fall in love with a competitive field that requires a fellowship!) As for family planning, I'm currently an MS3, and we've had women (and men) classmates have babies in every year since matriculation. It can be done. I also know of residents who are currently pregnant or have toddlers at home. It's not going to be easy no matter when you decide to start your family, and it may lengthen your education even more. But think about it- this is going to be a career you can have for at least 40 years. Keep the larger goal in mind. 7-10 years of hard work and a balancing act at home are worth it if they will fulfill you for decades to come.
posted by alygator at 6:10 PM on February 24, 2010

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