MD, MD PhD, and PhD programs differ in a number of ways including:
- Training goals
- Length of training
- Career path and outcomes
- Cost of programs
In this article, we will cover these differences in depth.
What is an MD, MD PhD, and PhD?
MD is the abbreviation of Doctor of Medicine. It is a medical degree. For instance, you’ve likely encountered an MD when you visited the doctor’s office for a physical examination or when you are sick.
Ph.D. is the abbreviation of Doctor of Philosophy and is awarded for a breadth of academic fields – from biology to ethnomusicology. This doctorate degree is an academic degree focused on original research, data analysis, and the evaluation of theory. For this article, we will be focusing on STEM PhDs.
For example, during the pandemic, you may have encountered media headlines describing scientists who were investigation the delta variant or studying the virus’ resistance. PhDs collect facts and evidence through their research and provide important foundations for the medicine we know and practice today.
MD-PhD is a dual doctorate degree where you get a medical degree and an academic degree. In particular, programs awarding MD-PhD are for students who intend to pursue careers as physician-scientists where they’ll straddle the roles of both an MD and a Ph.D.
After completing training, physician-scientists may spend part of their week practicing in the clinic or hospital. Along with this, an MD-PhD may spend the rest of their week conducting research on a specific topic such as the microbiome or cancer.
Training Goals Differences: MD vs. MD PhD vs. PhD
MD Programs
MD programs aim to train students to treat patients as a physician.
Firstly, trainees will gain fundamental knowledge in topics such as anatomy, physiology, pathophysiology, and pharmacology. This occurs during pre-clerkship years. Following are the clerkship years. These are typically years 3 and 4 of medical school. which students learn patient bedside manners and clinical skills. Importantly, medical students will also rotate in various departments of the hospital. These rotations help medical students decide on which medical specialties that they want to specialize in.
Additionally, their medical school years will also help them prepare applications for residency where they will further hone their clinical skills and knowledge in their chosen specialty. Examples of specialties include but are not limited to:
- Radiology
- Psychiatry
- Family Medicine
- Pediatrics
- Emergency Medicine
- General Surgery
- Plastic Surgery
- Eyes, Nose, Throat
- Dermatology
PhD Programs
Ph.D. programs train students to develop and apply critical thinking and technical skills to conduct research problems and pursue a career as an independent scientist. For example, disciplines that stem Ph.D. candidates perform research in include but are not limited to:
- Genetics
- Immunology
- Cancer Biology
- Computational Biology and Bioinformatics
- Molecular Biology
- Meuroscience
- Biochemistry
- Cell and Developmental Biology
- Pharmacology
MD-PhD Programs
MD-PhD programs equip students with the skills generally learned from sole MD and sole Ph.D. training programs described above, but with the aim to integrate skills from both doctorate degrees to pursue the path of a physician-scientist. The clinical specialties and research disciplines that they pursue are similar to those described above for MD-only and PhD-only programs.
Length of Training
It typically takes four years to earn an MD.
At my institution, it takes about 5-6 years to complete a Ph.D. in virology, immunology, cancer biology, microbiology, etc.
A typical MD-PhD program length is 8 years – 4 years of the MD and 4 years of the Ph.D.
Again, these are averages as certain institutions may differ and individuals may vary in their training timeline.
Also note that for all these degrees, there is more training involved before degree-holding individuals gain their permanent position of employment.
Bottom line is that earning an MD typically takes 4 years, Ph.D. takes 5 years, and MD-PhD takes 8 years.
Career Paths and Outcomes
MD graduates
When medical students graduate with their MD, the vast majority will continue their medical training in residency. In my anecdotal experience, a few individuals will not go onto residency from each class. For example, I know of someone who wanted to become a writer and therefore did not want to pursue residency after medical school.
After residency, some trainees will go onto fellowship. All the training combined, from medical school to fellowship, may involve 10 years. Eventually, the majority of MD-holding individuals will practice clinical medicine in a range of settings, including an academic hospital and private clinic. Some will also go into academic and industry positions.
MD-PhD graduates
After earning both doctorate degrees, most MD-PhD trainees go into residency programs as well. Eventually, their career will likely be in academia where they do a mix of medicine and research.
2018 National MD-PhD outcomes study surveyed graduates from 80 MD-PhD programs. It collected information from 6,786 respondents and was combined with data for all MD-PhD program alumni. This publication highlights key outcomes for MD-PhD program alumni including the following:
“Nearly 60% of all program alumni show up in the AAMC Faculty Roster as full-time faculty at U.S. medical schools. Among survey respondents, nearly 80% are either full-time faculty members or work for the NIH, research institutes, industry, and federal agencies. 91.2% of 2,109 survey respondents still in postgraduate training reported that their expected first workplace will be in academia, the NIH, federal agencies, research institutes, or industry. Notably, these numbers were not significantly different for men and women.”
2018 National MD-Phd Outcome study, AAMC
Another research study conducted by Akabas & Brass (2019) utilized data from the National MD-PhD Programs Outcome Study to ask and answer questions about the career paths of program graduates.
They found that among women and men, 63% and 66% went into academia full-time, respectively. 16% and 14% of women and men went into private practice, while 5% and 7% of women and men took on industry roles, respectively.
Akabas, M. H., & Brass, L. F. (2019). The national MD-PhD program outcomes study: Outcomes variation by sex, race, and ethnicity. JCI insight, 4(19).
The 2018 National MD-PhD outcome also found that 77% of program alumni were doing some level of research activity. Research time for physician-scientists in academic institutions varies widely.
52.7% of survey respondents with full-time academic appointments reported devoting at least half of their time to research. Only 22.7% reported devoting most of their time to clinical activities.”
2018 National MD-Phd Outcome study, AAMC
PhD graduates
Once Ph.D. students earn their degree, they will likely go into a post-doctoral position in an academic institution for further training. Eventually, they will apply for professor positions to run their own lab and teach.
Some Ph.D. graduates may go into industry to work at pharmaceutical or biotech companies. Post-doctoral positions also exist in some companies.
There’s a surprising dearth of outcomes post-PhD training. Science covered this gap in data and the need to address this. For now, there are a few institutions that cover their training outcomes.
The University of Toronto in Canada has an online database, 10,000 PhDs Project, which follows the professional outcomes of 15 years of doctoral graduates.
This graph shows that 26.18% of graduates go on to a multitude of professionals roles with the top identified employment sectors as follows: tenure-track professors (26.18%), private sector (18.32%), public sector (9.65%). The article later goes on to differentiate employment sectors of life science PhDs.
Finance
MD Costs
In 2020-2021, AAMC reported that tuition at public medical schools for state residents was an average annual cost of $32,384 and $57,394 for non-residents. Tuition at private medical schools was an average annual cost of $57,394. With additional fees and health insurance, the total cost at a private medical institution averages out to $61,490 per year. Tuition, fees, and health insurance included resulted in an average of $62,230 for non-residents and $61,858 for residents at private universities. For example, the following 2020-2021 medical school education cost data was pulled from the 2013-2021 Tuition and Student Fees Report:
| Cost Type | Type | Residence Status | Average Cost |
|---|---|---|---|
| Tution, Fees, Health Insurance | Public | Resident | $41,438 |
| Tution, Fees, Health Insurance | Private | Resident | $61,490 |
| Tution, Fees, Health Insurance | Public | Nonresident | $58,246 |
| Tution, Fees, Health Insurance | Private | Nonresident | $57,619 |
| Tuition | Public | Resident | $32,284 |
| Tuition | Private | Resident | $56,151 |
| Tuition | Public | Nonresident | $54,502 |
| Tuition | Private | Nonresident | $57,394 |
PhD Costs
Ph.D. students typically receive a stipend and a scholarship to cover the cost of tuition. At my institution, students don’t pay for tuition and receive ~$40,000 stipend and get health insurance.
For example, here is a table of a few PhD programs and their stipend that is published on their website at the time of this article’s publication.
| Institution | PhD Stipend |
|---|---|
| Albert Einstein | $38,000 |
| Duke University | $28,950 |
| UCSF | $42,500 |
| Baylor School of Medicine | $34,500 |
| Cornell | $33,032 |
MD-PhD Costs
The typical MD-PhD student receives a stipend, insurance, and full coverage of medical and graduate school tuition. The level of financial support differs by program, but this support helps trainees avoid debts that would deter them from becoming physician-scientists. MD-PhD students typically receive a stipend and health insurance. Moreover, trainees do not pay for medical school or graduate school.
For example, at my institution, the trainees don’t pay for tuition and receive a ~$40,000 stipend and health insurance.
Here is a table of a few MD-PhD programs and their stipend that is published on their website at the time of this article’s publication:
| Institution | MD-PhD Stipend |
|---|---|
| NYU Grossman School of Medicine | $42,840 |
| Duke University | $30,200 |
| UCSF | $42,500 |
| UT-Health | $32,000 |
| Baylor School of Medicine | $34,500 |
Application Process
MD and MD-PhDs
Applying to MD and MD PhD programs overlap in many parts and look very similar. For testing, you take the MCAT. To apply to programs, you apply to MD and MD PhD programs using the same portal and application called AMCAS (American Medical College Application Service).
Exceptions include Texas Medical School TMDAS). Look at those schools’ websites to see how the TMDAS schools process MD-PhD programs. For example, when I applied only to UT-Health MD Anderson’s MD-PhD program I didn’t need to fill out the TMDAS. Again, check the school’s individual requirements and make sure to follow these instructions.
The AMCAS primary application requires the following components:
| Section | Info |
|---|---|
| 1-3 | Background and biographical information |
| 4 | Undergraduate transcripts and courses |
| 5 | Work and extracurricular activities |
| 6 | Letter of recommendations |
| 7 | Select medical school program you are applying to |
| 8 | Personal statement |
| 9 | MCAT score |
| Additional | MD-PhD only: complete two additional essays to 1) state why you are applying MD-PhD and 2) describe your research experience |
After primary application, you will receive secondary applications. If you are invited, you will then attend interviews. MD-PhD interviews are longer than MD interviews. I had an MD-PhD interview spread across 2 days. MD interview can be a full day or only two hours.
PhD
For graduate school, you take the GRE. You then apply to the PhD program using the school-specific portal. Each program has its own deadline so plan accordingly. In general, the application will ask for basic biographical information, GRE score, GPA, personal statement, and potentially additional essay prompts.
Choosing between MD, MD PhD, and PhD
Ultimately it comes down to what you are passionate about and what your goals are. The most important considerations include research, patient care, and length of training.
Do you desire a career where you treat patients? Then that narrows down to MD and MD PhD.
Do you desire a career that balances treating patients with a significant research component? Then MD PhD could provide the training to be an independent scientist.
Do the extra 4 years of MD PhD programs make it worth pursuing the research training? While MD-PhD programs provide an excellent choice for individuals who want to become physician-scientists, there are certainly other ways to become one.
Some ways include transferring into the MD/PhD program after applying as a medical student at schools that allow this. There are also shorter programs such as the CCLM program within Case Western Reserve University of Medicine. This is a five-year program that awards an MD and special qualifications in biomedical research upon graduation.
Harvard Medical School’s Health Sciences and Technology (HST) program prepare students for a research career in academic medicine. This program offers an opportunity to spend a minimum of 4-6 years working as a research professor but can elect to do research full-time for an additional year.
The questions and goals are important to consider when deciding on which path to pursue. MD, PhD, and MD-PhD programs are rigorous and prestigious programs with a wealth of career opportunities awaiting after training. Good luck with your decision-making process!
Suggested Readings:
How to Secure a Lab Position as a High School or College Student
How to Email a Research Professor to Secure a Lab Position – Templates Included
18 Important Medical School Interview Questions to Prepare For
