Become a Neuroscientist, Medical Doctor or both?
February 27, 2013 1:15 PM   Subscribe

Warning: Long ruminating monologue ahead. I would sincerely appreciate any input. I am 24, from Germany and have been running my own online business which I founded right after school for the last couple of years. As the business is location-independent, I travelled a lot lately but would like to do something else now. I have always had a keen interest in all things science ('brain science' specifically) but up to this point I have never really considered actually persuing a career in science or medicine. But now I do.

Things changed when I started to study psychology part-time (originally intending to continue to focus on my business).

I find subjects like biological and cognitive psychology just too fascinating. Whenever I consider other options, I end up feeling almost forced to become some sort of professional in the area of, well, nervous systems and mental processes.

I am interested in anything from the over 30 types of synesthesia to conjoined twins sharing a brain. My apartment looks like a neurological or psychiatric practice with paintings of Kandinsky and colorful posters of purkinje cells hanging on the wall. I used to hypnotize other people when I was like 15 and find myself reading psychiatry research papers online... duh. I really love all this stuff.

So now I am certain that I want to become either a (cognitive) neuroscientist or get an MD to become a neurologist, psychiatrist or physician-scientist (MD/PhD?).

Note: My current psychology programme does not have a focus on the biological side of things in terms of course contents and research, hence I want to switch to another university. I also see myself more as a natural scientist or physician than as a psychologist. For research, I might as well get a science degree. For clinical practice, a medical degree seems a lot more sensible to me.

Here's what troubles me when trying to decide between the two options:

Medicine (in Germany or Austria)

+ actually have good chances of getting into medical school
+ no need to look for masters or PhD positions somewhere, get in, stay for 6 years, done (no undergraduate studies necessary to get into medical school here)
+ over 50 specialisations (psychosomatic medicine, pediatric neurosurgery etc.)
+ training for a specific job plus possiblility to do research (or combine both)
+ would be useful for clinical research in industry as well (being able to give medication to patients)
+ job security
+ fastest way to get a doctorate (not that that is really a deciding factor, but I suppose it would be something worth having in all types of contexts, even outside of academia and clinical practice)
+ would have my MD at the age of 30 which is not unusual at all (whereas only having a life sciences bachelor at 27 sounds more scary than uplifting)
+ possibility to get the MD first to leave open the option of working as a medical doctor and get a PhD afterwards (one university I would have good chances of getting into, for instance, offers a PhD track in 'medical science' for people who completed their MD).
+ cheap (In Germany and Austria, getting a medical degree does NOT cost a lot in terms of tuition fees. Getting a medical degree here is cheaper than, err, getting any university degree at all in the US/UK, apparently.)
+ seems more suited for a more 'formal' career VS my entrepreneurial endeavors so far
+ better investment in my 'market value'?
+ would be able to 'work with brains' in the long run (VS not liking academia after getting a neuroscience degree and doing perhaps completely unrelated work in industry?)
+ possibility to open an own neurological or psychiatric practice at some point in the distant future
+ I really like the idealism and altruism which is part of being a physician (if one did not get into medical school to be called 'doctor' by everyone, I guess :-)
+ could get various hypnotherapy certificates, yay! :-)
+ MDs have a pretty strong political lobby, an own bank, all sorts of organizations, tons of possibilites for further training, medical knowledge and practice is and will be in much more demand than basic research, 'medical doctor' is an actual job etc.)

- a lot of rather mind-numbing learning by heart (what is the musculus abductor digiti minimi pedis there for, eh?)
- lots of topics I find less interesting than those of a neuroscience degree (practical side of things, often rather mundane, less philosophically interesting subjects)
- often more superficial (than e.g. molecular biology)
- might feel a little bit out of place with most fellow students being fascinated by the medical profession and not necessarily science (which I am primarily interested in)
- not all, but many medical students (in my admittedly limited experience a lot) seem to be more practical in their aspirations and diligent students rather than interested in 'deep' questions and really understanding in detail how something works for the sake of simply knowing how it works (obviously, this cannot be said about e.g. Eric Kandel, Vilayanur S. Ramachandran, António Damásio or Oliver Sacks, but I suppose some of you might know what I mean. I imagine studying with people fascinated by science to be much more enjoyable than studying with people who like certain TV shows, shiny white coats and perform medical procedures according to a scheme they learned by heart without questioning it.)
- no specific training to do research
- pay and working hours are not exactly spectacular for physicians in Germany right now (young physicians currently striking for higher wages and less than 60 or 70 hour workweeks with several 24 hour shifts each month - might not be the most brilliant backup plan as an alternative to academia ever conceived of)
- would already be 30 when taking up a PhD programme (if I could and would like to do that)

B.Sc. Neuroscience (Netherlands)

+ found a university where I could study exactly what I am more interested in than in anything else. I could literally choose courses ranging from molecular neurobiology, general science courses (physics, biochemistry, computer science) to cognitive neuroscience, neurology, psychiatry and philosophy of mind. There are research groups in areas I find interesting as well (psychopharmacology, memory, neuroplasticity). I could even take courses in entrepreneurial management, social entrepreneurship and the like, in case I would like to focus more on the entrepreneurial side of things.
+ could study in English (which I would actually prefer over studying in my native language)
+ small groups of students (~12!) and problem-based learning VS one in a dozen situation in medical school
+ am not very keen on permanently living in Germany in the long term and would rather live in e.g. the Netherlands or Switzerland, anyways (rather sooner than later)
+ international environment
+ I might be happy like a guinea pig in a bowl of salad sitting in a room with only 11 other students basically getting a private lecture on neuroscience by a professional researcher in the field
+ could take entrepreneurship courses and create something like memrise
+ job prospects and economic reality aside, there would be nothing I would be able to identify myself with more than with being a biologist. As a little boy, I learned the Latin names of native species of amphibians, thinking it would be obvious one ought to know what Bufo viridis and Bombina orientalis are :-)

- 3 years B.Sc., 2 Years M.Sc., at least 3 years PhD in Europe. I would be 32 then, with no regular work experience and a degree which is not exactly in demand in industry (at the moment).
- is it even worth trying when I am already 24? Not that I would be the first to do this, but still?
- lack of permanent positions in academia, idea of getting tenure dangling as a carrot in front of me for years?
- might feel just a little strange sitting in a room with 18 year old, highly motivated people from India instead of having gone to medical school (not a cliché and not meant in a derogatory way at all, but I think you get the idea)
- being in my third postdoc position some day when other people around my age have regular jobs and families leading me to wonder what the heck I was thinking? :-)

Further notes: I am more interested in the biological and medical approach to neuroscience than in, say, cognitive science or computational neuroscience.

I have already read quite a lot about some of my concerns (or rather similar concerns) here and found some pretty good advice. But I would really like to hear from people who had to make a similar decision (as neuroscience VS medicine is not an unusualy dichotomy, as far as I know).

I'll do an internship at a neurological clinic soon which I am sure will help me decide, but what I would really like to hear are personal stories, recommendations, warnings and so forth.

Even worth it still getting a neuroscience degree? Did anyone here get into science in my age or later in their life? Did you get a neuroscience degree and become a lecturer, science teacher or the like? End up in the pharmaceutical industry? Be happy with it?

Loved it? Happy in academia? Went for medical school instead? Did something completely different?
posted by capgrassyndrome to Work & Money (12 answers total) 3 users marked this as a favorite
Best answer: Just to complicate things a bit further, have you thought about neuropsychology? Oliver Sacks wrote about one of the founding fathers of neuropsych, Alexander Luria, in the introduction to The Man Who Mistook His Wife for a Hat.

As a discipline, it's a clinical practice that focuses on the intersection of behavior and neurology. So, for example, performing assessments to deliniate specific deficits related to a brain injury or stroke and to make recommendations for intervention. A lot of it is the kind of "detective work" you see folks like Ramachandran and Sacks doing in their writing. Some are involved in cognitive rehabiliation or other therapies and a huge number of us (disclosure: I'm a very happy neuropsychologist) are heavily involved in research/academia in addition to clinical practice. I'm not sure of the circumstances in Germany/Austria, but some states here also allow licensed neuropsychologists to prescribe medication after the obtain some additional training.
posted by goggie at 1:37 PM on February 27, 2013 [2 favorites]

Don't go to medical school without deciding that you want to be a doctor. Whether you end up in medical practice or pure academia, it's a LOT of work that you're going to put into a degree and odds are that if you go to medical school, you'll end up in medical practice.

I should also probably further clarify that you should decide that you want to be a doctor in whichever country's medical system that you end up living and working in. I have far too many medical classmates and now co-workers who ended up in medicine without really understanding much about the US medical system, who are now feeling pretty disenfranchised and would rather not be practicing medicine. I would venture to guess that most of them were still hoping for an idealized, high-income field, which medicine in the US is most decidedly not.

I liked medical school. I'm working my ass off in my intern year, but it could be a lot worse. But, I knew what I was getting myself into, and I still couldn't see myself being happy doing anything else. Shadow a couple of doctors in your country, in a couple of fields you might be interested in, and then decide whether or not to apply to medical school.
posted by honeybee413 at 1:43 PM on February 27, 2013 [1 favorite]

Response by poster: That is an excellent point, goggie. I actually know it is possible to to become a 'clinical neuropsychologist' as it is called here when one has a diploma or a M.Sc. in psychology. The training takes only 3 years and is apparently cheaper and takes less time than the training to become a 'psychological psychotherapist'. Neuropsychology also deals with some of the phenomena I find particularly interesting (e.g. memory disorders, akinetopsia, prosopagnosia and the like). Definitely seems like an option worth considering, as I also greatly admire the work of people like Alexander Luria or Brenda Milner (I am sure you know her). I might look for an internship in that area. Can you tell me a bit more about what you do (on a regular basis)?

Thanks for the input, honeybee413. I hope I will have a better perspective once I have completed an internship in neurology, psychiatry or other fields of medicine. I will indeed have to shadow some more doctors. Some I asked were apparently quite unhappy and said they would personally not choose that route again. Will see.
posted by capgrassyndrome at 2:07 PM on February 27, 2013

How interested are you in pursuing research, and what kind (clinical, translational, basic)? Bench science is not always what people expect, and I know many who felt that it was ultimately unsatisfying and gravitated towards clinical work instead. I highly suggest getting some research experience under your belt if you're considering a PhD -- this will help whittle down your choices.
posted by extramundane at 2:41 PM on February 27, 2013

I agree, get some research experience before you enroll in anything. Scientific research can be really frustrating for people with broad-ranging interests - often you end up focusing on one very small area, so small that you can't even explain it to most people. And most of the time your experiments don't work.
posted by mskyle at 3:11 PM on February 27, 2013 [2 favorites]

You said, "- is it even worth trying when I am already 24? Not that I would be the first to do this, but still?"

Only you can answer this, but if you think this is something you will enjoy and love doing, then YES. IF children and families are something you are interested in, then keep those goals in mind as you plan your life after uni. When you are done, even if you go the PhD route and end at age 32 or so, you still have plenty of time. Forget what "other people [your] age are doing." If that was the best course of action for our species, we'd be sheep.

I started my Ph.D. at the ripe old age of 34, and that was after getting a professional master's, starting at the ripe old age of 27. All in all, after my bachelors, I will have spent 7 years getting a professional master's degree and then a Ph.D. I did it because I love it and it has given me a profession that is in high demand and the chops to be a researcher when I'm done with my doctorate. It was the right decision for me. So, you've got to decide what is best for you. If at all possible, don't look at "time" or "age" as limiting factors. Ask yourself: If you had all the time in the world and no threat of false deadlines like "marriage" or "kids" or "degrees" or "age", what would you do?

Then, do that.
posted by absquatulate at 3:19 PM on February 27, 2013

Just for future readers, in the US you generally need a Ph.D. or Psy.D. to practice neuropsychology independently.

I don't want to get too specific with my job, but I'm in an academic hospital setting. It includes seeing several patients per week for a lengthy evaluation, consulting with colleagues on shared cases, conducting research, and teaching/supervising students. Research projects I or my colleagues are involved in range from developing new assessment instruments to measure specific phenomena, functional imaging, helping to characterize phenotypes of different disorders and helping to measure changes in cognitive function in response to novel drugs. The exact breakdown of my time changes periodically depending on how much grant funding I have, and how much clinical work I need to do to manage patient loads.

I have some friends who do only clinical work, some in hospitals some in private offices or clinics and some friends who are engaged in nothing but research. Some prefer just the assessment portion of the practice and some mix therapy with assessment. Some work only with children, some with adults, and some with a mixture. Once you move beyond the academic requirements, it's a flexible career in many ways.

Feel free to MeMail if you have more questions.
posted by goggie at 3:56 PM on February 27, 2013 [1 favorite]

Clinical work, research, and clinical research are three very different lines of work, even when they share a common focus (e.g., neuroscience). You really need to dip your toes in and get some practical experience before you can start to work out if one of them is right for you. Seconding everyone recommending internships, shadowing experiences, etc.

Age is only of indirect consequence; these careers and the education needed to attain them require an enormous investment of time and money, and thus may affect your ability to start or raise a family. Outside of this, it doesn't really matter how old you are, provided you're functionally healthy and are likely to remain so for the foreseeable future.

I'm currently in the process of transitioning from research to a clinical career. Feel free to MeMail me, though I'll add the caveat that there are some major differences between the US and Europe in terms of both the academic tract and careers that follow them.
posted by dephlogisticated at 4:08 PM on February 27, 2013

I can't speak at all to cognitive neuroscience, but I can speak to not knowing what you want to do with your life when you're 18 or 24 and then deciding you want to do science.

In the US, finishing a PhD at 32 is not unusual. I finished at 34 (after working for two years after finishing my BA, changing fields, getting an MS, taking another year off, and then getting a PhD) and was surrounded by people who were mostly +/- 5 years of my age.

I know time to degree for European programs is often shorter than in the US, but people everywhere frequently take time off between degrees. Once you're in your 30s, a few years here or there doesn't really matter as much as you might think in your 20s.
posted by hydropsyche at 4:20 PM on February 27, 2013

Response by poster: @extramundane: I think I would be most interested in cognitive neuroscience (e.g. research on memory or neuropsychological phenomena) or psychopharmacology (e.g. clinical research with human subjects or behavioral experiments with animals, studying how psychoactive compounds affect memory in rats, for instance - which is something actually being done at Maastricht University which I mentioned). I have heard quite a lot of stories about how tedious and frustrating 'wet' science is supposed to be. I have no research experience yet (but will try to find something here at my current university which does a lot of neuroscience research at the bio/med/pharm faculties). Is behavioral or neuroimaging research less tedious? E.g. statistics heavy work vs wet lab experiments? Not that I would expect that to be easy in any sense, but which type of research in the very broad field of neuroscience would could be considered less famous for being really tedious with a risk of nothing coming out of a whole lot of work? Behavioral? Computational? The more simple varieties of psychological experiments? History of science? :-)

@mskyle: Thank you for your input. Would like to hear your thoughts about what I asked extramundane as well.

@absquatulate: Hearing myself talk here. Cannot really add much except that you very concisely convicted me of a line of thinking that I usually am the first one to avidly question.

@goggie: Thanks again. I just realized something that I did not consider before, which is that I might be able to get a bachelor's degree in neuroscience (or, more precisely, a general science degree where I choose courses ranging from cell biology to psychology) and still do a master's degree in neuropsychology if I intended to ultimately do clinical work. Will have to inquire about this. I mention it because in Germany that would be impossible to do that without a regular bachelor's degree in psychology which encompasses very specific coursework. It seems that in other countries these things are often much more flexible. Would love to see undergraduate studies here in Germany similar to what is common in the US (e.g. being able to major in neuroscience, botany, physics or whatever you want and then be able to go to medical or pharmacy school given good grades. In Germany, you study medicine and the like right after school). This way, I might be able to take up the natural science courses I would like to take and decide later on whether to further persue that path or choose a more clinical orientation.

@dephlogisticated: Will try to get some practical experience soon. Luckily, studying is nowhere near as expensive here than it is e.g. in the US or UK. I would probably not even consider getting any 'fancy' degree which is not directly leading to a job in that case. Personally, I would never get any student debt by paying student fees in the 10k per year type of range that seems to be common in many places. As I mentioned before, even medical school is much (!) less expensive here than it seems to be to get, duh, a degree in English elsewhere? Luckily, you only have 1k per year (€) tuition fees here in Germany. Only in a few states, too. Students in my state including me are protesting right now and chances are high tuition fees will be abolished entirely this year. Tuition fees in the Netherlands are not that bad, either. As long as I am able to sustain myself and pay for tuition fees month after month, I would at least not have to pay any debt and perhaps might be able to sustain my current financial status or even save a bit running a low-maintenance internet business. Will see if I figure something out to get through all of this even making a profit instead of accumulating debt in the process. That, at least, would be my plan to not interefere with any family plans too severely.

@hydropsyche: Very encouraging. Thanks!
posted by capgrassyndrome at 6:03 PM on February 27, 2013

My PhD was in cognitive neuroscience and I was fascinated by exactly the same things as you. However much I liked the big picture and the new learning, I loathed the day to day reality of doing research - little contact with anyone outside my lab, staring at a computer screen all day every day, experiments failing for every reason under the sun, one week experimenting and six months analysing data, endless drafting and redrafting with feedback that made me make changes and then 3 weeks later change it all back again. Get a job as a research assistant and try it out before you take any steps in this direction.

On the other hand, I also hate rote learning and therefore decided not to be a doctor. Plus day to day work as a doctor (at least until you get to super specialist level) doesn't look much fun. Might be worth it once you get to be a neurologist but it's worth looking into how long it would take you not only to qualify as a doctor but also to get to specialist level.

I agree you should look at neuropsychology. Here in the UK you qualify via a clinical doctorate but it sounds much closer to what you actually want to do.

Personally because my research topic was psycholinguistics I became a speech and language therapist instead and now I spend my days working with people who have just had strokes. There are disadvantages but I get to spend longer with my clients than doctors ever do and I get to talk to them in depth about their communication difficulties.
posted by kadia_a at 11:06 PM on February 27, 2013 [2 favorites]

Response by poster: @kadia_a: Thanks for sharing. Your arguments are exactly the same I heard from other people and which I ruminate about a lot.

Your concerns are exactly what make me question whether I would ever want to follow such a path (whether academia or medical practice) in the long term. The thing with the duration of training until one actually is, for instance, a neurologist with an own medical office, is something that troubles me as well. It would take at least 11 years until I would be a neurologist or psychiatrist (not able to open an own practice, yet).

I just received an email from a neurologist who is currently an assistant physician in a German hospital and his reported experience of 14 hour workdays with hours spent on bureaucracy alone and 2 or 3 minutes time per patient for ~1800 € net income per month did not exactly sound inspiring. It did not sound like the most effective way to help other people, either, to say the least.

I only doubt that anything is going to stop me from having these experiences myself - I probably will only be full convinced when I, to make but one example, have completed a bachelor's or master's in cognitive neuroscience or similar, wondering whether going any further in that direction is worth the blood, sweat and tears.

The problem is that, no matter what, I want the actual professional education / training in one of these areas. I suppose it is not a bad thing I am not dead set on an academic career at all and consider other options early, unlike some of these folks for instance. Heard of many people already who ended up doing something different (sometimes science journalism, sometimes something completely different). Nonetheless, many people did not seem to regret getting the training and acquiring the knowledge they got.

The input of everyone here really helps me a lot. Currently (might be of interest to people in a position more or less similar to mine) I think that these options might be worth considering:

1) Get a neuroscience bachelor's and (if possible, which I will inquire about) get a (clinical) neuropsychology master's (and PhD, if required) if I want to go the clinical route. Would be more tailored to my primary interests and might leave me more time to focus on patients and have an actual personal life as well.

2) As courses such as 'entrepreneurial management', 'social entrepreneurship' and 'commercializing science and technology' can be chosen as part of the bachelor's degree I am interested in, I might further follow that path.

3) Found a blog entry recently from someone with a similar passion for 'brains' who is currently working on a PhD in history of (neuro)science after initially trying to get a neuroscience PhD. I might consider something along those lines and use my knowledge to become a science communicator of some sort.
posted by capgrassyndrome at 12:35 PM on February 28, 2013

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