In medical school it is now possible to combine your medical degree with a JD, MS or even a PhD. Many of my students have asked me about combined- degree programs. The experience of applying to medical school and combined degree programs is unlike applying to college. The stakes (both financial and other) are higher, and the career implications are much greater. I tell students there is a crucial question they need to answer before applying. Is the PhD dual-degree right for your career goals?

The answer depends on your academic interests and career plans. Do you want to be a physician-scientist? Do you see yourself doing research and making discoveries? Is this pursuit even important to you? Many students enter medical school with some idea of their eventual specialty. If an MD-PhD is of interest to you, determine if the specialty(ies) you are considering is one that is compatible or associated with PhD training.

For example, if you know that you want to do basic cell biology research and run a lab in the basic sciences, a PhD is the most appropriate degree, not an MD or DO. On the other hand, if you would like to do clinical research, an MS combined with your clinical degree may be your best option. While you don’t need to know exactly what research interests you, you should decide if the PhD is right for you at all before you apply.

Many MD-PhD programs have more rigorous academic and research requirements compared to the MD/ DO only application. Previous research experience is important to your chances of admission, if not outright required. You should also realize that medical schools and graduate schools are like apples and oranges. Medical schools focus on teaching the practice of medical science. The curriculum is designed to train you to be a physician, not a researcher or scientist.

Graduate school is meant to instill the skills necessary for scientific exploration, and how to develop as a principal investigator. Medical schools emphasize the acquisition and application of current medical knowledge; graduate schools emphasize search for new medical knowledge. Most MD-PhD graduates spend more time on research than on clinical practice and are employed in academia or at research institutions.

If you are interested in research but worried about extra time in school, you should know that medical schools do not typically provide research training. If you choose to attend medical school but not a dual degree, and you want to enter clinical research, you will end up spending considerable time as a fellow after your clinical training learning how to do research. Analysis of National

Institutes of Health (NIH) data shows that medical graduates and dual degree graduates who are able to win research grants usually achieve this milestone around the same age. This means that skipping the PhD on your way to a research scientist career will be unlikely to save you much time. If you “know” you want to be a physician but less sure about your goal of becoming a scientist as well, apply to medical school.

If you change your mind, many schools offer the opportunity to transfer into a dual degree program for qualified students (check with schools before you apply). If you get all the way through medical school and then decide to enter a research track, you can also get your research training then. Transferring from a PhD program into a dual degree is much rarer, more difficult, longer and usually more expensive.

In short, you should consider a dual degree PhD program if you want to make your career as a physician-scientist. There are several things you want to consider when you examine schools with a combined degree program. One of the attractive things about doing a dual degree program is that many schools offer fellowships that cover tuition for medical school and graduate school and offer a stipend of around $30,000 per year. While the size of the stipend is not a major factor, you should talk to students in the programs you interview with to see if the stipend received is sufficient for the costs of living where the school is located. If you do decide to apply, apply early.

The goal of an MD-PhD program is to train physician-scientists. If a majority of a school’s MD-PhD graduates end up in full-time private practice, you should consider carefully and ask the school to explain, if they can, the misalignment. Many students use perceived prestige or US News & World Report rankings to decide where to go, like they may have done when applying to college. Do not put too much weight on those rankings. Better to look at the school’s research financing, their rate of placement of graduates in NIH and other governmental research fellowships and career training grants. You may also consider the time it takes the average student to complete the program. The national average is about 8 years. With these factors and the advice above, you will be in good shape to find a program that suits your needs and will provide you the best route to your desired career.