Should I try to do an MD and a PhD?

Discussion in 'Community' started by themadchemist, Feb 6, 2004.

  1. themadchemist macrumors 68030


    Jan 31, 2003
    Chi Town
    Hey guys, I've been in a quandary for quite a while now and I thought I'd ask you, since there seem to be a fair number of PhDs (and MDs, too?) floating around about here. I would just like some advice. I'm going to lay out my situation and I hope some of you who have had experience with this stuff can help advise me.

    Ok, so I'm a sophomore in undergrad. I'm taking the MCAT this summer. I've been guaranteed a seat in Northwestern University Medical School, but I'm thinking about applying out to some other schools. I'd like to apply to Harvard, Duke, and Johns Hopkins. I doubt I'll get into any of them, because my grades need some work. My dream school would be Harvard, because they have the best med school in the country and the #2 neuroscience department in the country.

    And that brings me to my question. The NIH Medical Scientists Training MD/PhD Program. I've been debating doing both an MD and a PhD for a while and I'd likely only do it through MSTP, because it pays full tuition+$20k stipend. It's a sweet deal.

    But how will these degrees play into my life? I'm graduating from college in two years and I'll be 19. So I saved a couple years here and there.

    If I just do my MD, then I'll be 23 when I get out of med school. I want to do neurosurgery, so I'll be 28 when I'm done with everything.

    If I do an MD/PhD...Let's say I do neuroscience at Harvard (I'm not going to get into the program, or into med school period at harvard, but let's just set up a hypothetical). I spend two years doing the class part of med school. I'm 21. Then, I spend five years earning my PhD. I'm 26. I go back and finish my MD, and I'm 28. I do my residency, I'm at the ripe age of 33, ready to enter the workforce.

    But before I enter the workforce under either track, I want to do Doctors Without Borders for a couple of years. Now, under the MD track, that would be fine. I imagine I'll be married by the time I'm done with residency either way (so probably before the age of 28, just a guess), but under the MD track, I likely wouldn't have kids. So, especially if I married a similarly-inclined doctor, it would be easy to do Doctors Without Borders in Afghanistan or something.

    But under the MD/PhD program, I'd be 33. If I got married before 28, then I'd likely have kids at the age of 33. It would be hard to go do Doctors Without Borders for a couple of years. If I put off the whole starting a family thing until I'm back from Doctors Without Borders, I'll be around 34 or 35. That's quite old to marry someone and start a family, I imagine, especially since I would want to wait a little bit before having kids. So I'd be an old man sending my children off to college. Not exactly what I'd call ideal.

    So I'm not sure what I should do or if there's something I'm missing. I need to figure out whether I'm going to take the GRE and apply to this program soon, but I'm not even sure whether it's something that I would want.

    Professionally, I'd like to be on faculty at a university doing some research and teaching. However, and this is a big however, I still want to be involved deeply with patient care. I want to do surgeries and see patients, and so I'd like (maybe?) to have a private practice on the side or to make sure that I'm pretty heavy on the clinical rotations on the job. I know that if I want to be on faculty, research will be important, but I'd really ideally like to balance it out so I'm doing some of all three (practice, teaching, research). Is that even doable? Would a PhD help me?

    What are the real benefits of doing MD/PhD, anyway?

    Thanks for answering my questions and offering advice.
  2. jefhatfield Retired


    Jul 9, 2000
    you will do fine with any path you, phd, or even both

    so who cares if you enter the workforce at 33 if you take the longest educational path? that is not really ancient but to you that might seem very OLD, but believe me, it comes sooner than you can imagine ;)

    i took a class from an anthropology phd and he went to cal...he considered getting his md also and be a medical anthropologist and said that even though the training included two doctorates, the pay was not as much as if he just entered the workforce with an md and practiced medicine

    at the time in the 70s, he could have gotten a prestigious job with a double doctorate but only $8,000 a year from stanford...eight grand was a lot more thirty years ago, but still a very small wage for any professor and it was just a job as a resume booster and nothing more

    as far as the age issue, my wife's dentist is a very successful dentist with a good staff and private office and she is located in an ideal location...when she was in her 40s, she decided she wanted to do something different from being a stay at home mom and entered dental school...she went though and finished and then got a small office for her practice and only now in recent years did she get a staff and brand new digs to hang her shingle on

    the average american switches careers four times

    in my computer class, we had a chiropracter and an md who wanted to enter the computer field and they were in their late 30s and early 40s respectively and they were changing careers to do something different and money was not their main issue since they both did well in their medical careers, but they were now going for something they were interested in doing...having a job that fit their personality
  3. jxyama macrumors 68040


    Apr 3, 2003
    my friend is doing MD/PhD at case western. his path is not exactly like how you outlined. it's not 2 years of classes for MD, 5 years of research for PhD, then finish up MD... your PhD will overlap a lot with your MD studies. he's actually finishing both in about a year more than if he had done MD alone. but he doesn't have massive debt because he was supported as an RA for his PhD...

    if you can do it - it *is* a lot of work - then i think not having to rack up hundreds of thousands of dollars in debt is a very nice option.
  4. seamuskrat macrumors 6502a


    Feb 17, 2003
    New Jersey USA
    OK, I did the MPH, DVD, PhD thing. I just finished and I am 32.
    Was it worth it? Sure. I am doing exactly what I want to do. Did I miss out on some things? Yes and no. I found that you can live your life and do a professional degree with courseowrk ongoing with a PhD. without significant impact. The residency requirements of an MD program will be a bit more demanding of time than a veterinary residency, but I was at a hospital where I was on call for 24/7 for weeks at a time, and managed to still take classes and do lab research.
    As for age when entering workforce. Think of it this way. Most American work past 65 into 70, health permitting. That leaves you a full 30 to 35 years. I am sure, like me, you will rack up considerable depbt fron colelcting letters after your name, and as such wil have to work for a while topay it all off. If you want to make casem, retire at 55 and live on a tropical island, then so MD only, private practice and charge a lot. If applied research, with competative salry and long hours is more your style, then research is the way to go.
    Mots MD/PhD folks I know either do research, or management of hospitals, labs, universities. I would not think having the PhD. would help in a day to day job for most specialties as much as experience would. Meaning 4 years for a PhD vs. 4 years of applied training in your field as a practioner. I would suspect the latter would be a better caregiver.
    But it sounds like you are a motivated and talented indivdual who can suceed and make some inovations for the rest of us. But keep in ind, yo are young, and need to live as well.
  5. jefhatfield Retired


    Jul 9, 2000
    some doctors and lawyers get swamped by their student loans and other loans they might have taken out to get through school...even with their bigger salaries than the rest of us

    i have seen some doctors and lawyers take up a more profitable venture to make bigger money, such as a successful restaurant or store and they used their good income as a professional to leverage their way into bigger money being an entrepreneur

    i used to live above this extremely successful restaurant owned by a lawyer who also had his own law office in another town...but he is not practicing law anymore since his restaurant is making him several times more than if he were just a lawyer...he doesn't care that he went to school for 7 years and had to pass the bar...because he is a multi millionaire now...the lawyer money got him into a restauarant as a partner and now it takes hundreds of thousands to even start a restaurant in a prime location

    it was just his path to financial freedom...go to school, then up his marketability by becoming a lawyer, then get into a successful restaurant and really rake in the money...if he had stayed a lawyer only, he would not be one fifth of how rich he is now

    money, not the law, was his personal goal and he does not miss not being a lawyer and he works so hard at his restaurant and likes to take an active role and greet each and every customer and works as the restaurant's host or sometimes a waiter
  6. Dros macrumors 6502

    Jun 25, 2003
    If you want to be at an academic researcher with medical care on the side, you probably want both the MD and PhD. If you want to be a caregiver and participate in research like clinical trials or developing new procedures, then an MD alone is probably smarter. Getting a PhD takes really wanting to do research. I've seen a ton of MSTP students burn out getting the PhD because it wasn't really something they wanted to do. They became MSTP because they were all over-achievers from day 1 and couldn't imagine doing anything but the most selective, most difficult path. Or they liked the idea of a "free ride" and not having loans.

    Having loans is an issue if you are an English PhD student and have $30,000 in loans and will make $40,000 a year if you get a good job. Having loans is not an issue if you have $120,000 in loans and make $240,000 a year (I'd say that is low end for neurosurgery). You could still do DWB for a few years. Just get the loans deferred.

    On the other hand, you may love research if you did it full time for a year. Your life sounds pretty mapped out (married at 28, kids at 33). Hard to imagine you are guessing right while still in your teens. Do you really want to be chopping up brains when you could be exploring the unknown of how they work?
  7. Dippo macrumors 65816


    Sep 27, 2003
    Charlotte, NC
    Yeap, that is the only way to make real money.
  8. themadchemist thread starter macrumors 68030


    Jan 31, 2003
    Chi Town
    Yeah, you're right, it's just a guess. I'm pretty much looking at how that aspect of other people's lives seems to be falling together and making an estimate as to where I'd fall and seeing how that would play into the rest of my life. I'm just very confused. I'm not quite sure.

    I am doing some research now. I just started at this lab at Northwestern med school and I'm doing some electrophysiology and structural anatomy stuff. I haven't gotten too deep into anything yet, but I'm hoping to do it between 10 and 20 hours a week for the next couple of years. I really think research is cool. I'd especially like to take a pharmacology or drug design course and maybe at some point in the future do some work in the field like that. And the operation of the brain just really fascinates me a lot. So I think research is really great.

    But I'm just torn...I really think clinical stuff would be awesome and that surgery would be really cool, but I think that research would be, too. And I've always enjoyed teaching people, so I think that would be fun, too. I just want to do stuff from all the categories and I want to find a way to do it without just becoming a jack of all. I want to be a good researcher and a good practitioner. So I don't know.

    Again, I really appreciate the advice everyone. It's a bit perplexing. I know that if I do MSTP, then I won't have to pay for anything at all and they'll pay be about 200k for my pocket to go to school. So that's fine. I'm not too worried about loans--I'll be able to pay them back, I'm sure.

    I'm just not quite sure what in life I want to do specifically, and I don't want to wake up when I'm 40 and say, "Jeez, I wish I'd gotten a PhD so I could get more involved in research," or to wake up and say, "Jeez, I wish I'd spent those 4 years getting the PhD actually practicing medicine so I could be more skilled at it."

    Oh, I don't know. Please keep the advice coming! Thanks!
  9. hornandsaxguy macrumors newbie

    Jan 5, 2004
    Denver, CO
    I'm not an MD or a PhD but that sort of thing runs in the family. Whatever you do, don't pick something for the money. Do it because you like the work or because you feel the work needs to be done.

    Read this from a book I bought recently, called "Meaningful Marketing" by Doug Hall. There's a great stat in there about how a pursuit of something you feel passionate about leads to more wealth than the pursuit of wealth...

    "Srully Blotnick...studied the careers of 1500 business school graduates from 1960 to 1980. At graduation 1245 of the students were categorized as being focused on making money, while 255 of the graduates were focused on pursuing something that was personally Meaningful to them. Twenty years later, there were 101 millionaires. One came from the first group, 100 from the second."

    Good luck,

  10. jefhatfield Retired


    Jul 9, 2000
    a very similar study showed that, looking at many years of harvard mba grads, that the ones who made a ton of money and retired lived a lot shorter than those who didn't usually get independently wealthy and thus had to work way past retirement

    the working old of the group actually, despite their lower percentage of independently wealthy people, lived longer because they had to and suffered fewer debilitating illnesses

    it's good to stay busy and not just make a ton of money and just kick the harvard study, most did not live five years past retirement, even when they retired rather young
  11. Dippo macrumors 65816


    Sep 27, 2003
    Charlotte, NC
    Wow, that sucks.

    Probably all the stress from trying to retire early got to them.

    I bet those people spent their entire life looking forward to retirement, and look what it got them, very sad.
  12. jefhatfield Retired


    Jul 9, 2000
    harvard mba types are not lazy and kick back types otherwise they wouldn't get into such a selective university such as harvard or complete six years of college they run their whole life like ferraris and then one day just stop? it would prolly kill anybody in five years if they went from crazy fast pace to idleness or near idleness

    in the large samples...retired and non retired, only one retired person lived past 65 and only one contiually working person died before 65 and they looked at harvard mbas from the earlier part of the 20th century into the 1960s

    not only for harvard mbas, but for people in general it's a good thing to have work and to feel needed in society
  13. acidrock macrumors 6502

    Jan 30, 2004
    The Evergreen State College
    hey I'm a little older undergrad and this year i started studing neuroscience at The Evergreen State College, in Washington, they actually don't have major's here and this full time program is one of the first in depth programs in cognitive neuroscience. i am finding it fasinating and enjoyed reading your post. Oh and I have a learning difference so my spelling is probalby really bad, sorry.

    Anyway I don't know much about the field, but what I've heard is that masters in sceince don't mean anything. This is just what a friend told me, but she said if you're going to grad school you should really look into PHD or combo programs.

    I'm not sure i want to go to grad school, but there are some very select things happening in neuroscience that I am interested in. I"m trying to arrange an internship at the u of washington in Seattle this summer. Anyway let us know what you decide. I recommend you try and talk to some people in the field and do sort of information interviews. I've found that people at grad programs are always interested in talking to perspective students about their work and what they're doing.

    Instead of just going on the names of places for their program, I'd really suggest you look at the research they're doing and make sure it's something that you really want. You may also want to look at Brown University, they have a really good grad program too. My parents and sister went there and they loved it. PHD neuroscience programs can be a 4 -5 year thing so take it serioiusly. That can help you decide what path to take also. Good luck and hope it works out. -n
  14. jefhatfield Retired


    Jul 9, 2000
    in some fields, a master's degree is just as good as a phd in terms of pay such as business, computer science, and engineering and usually the phds in those fields (almost always teachers) do not make what their master's degree counterparts make in industry...but their goal is not money with phds in those fields...if you want to make money with 8 yrs of school, become an md (or dentist) like posters on this forum suggest

    but other fields such as chemistry, physics, and marine biology differentiate pay scales greatly according to if a person has a master's or if they have a phd where the phd is the working gold standard in the field...but then again, a phd physics teacher at the local school where i live top out at 46k a year if they are not a department or division head...and i have never heard of a physician who made only that :p
  15. true777 macrumors 6502a


    Dec 30, 2000
    California, Austria, Arkansas
    If research interests you, then I'd go for the PhD if I were you.
    Otherwise you'll never be doing any interesting research.
    And the PhD will never be a hinderance, it'll just mean extra opportunity.
    Plus, as someone else has stated, it makes it much more likely you'll get a research assistant job while a grad student and thus won't end up with much debt. And I'm sure if you're serious about it, you can have a happy private life while still in training. Lots of residents at Stanford Hospital where my son is being treated have families and children, and even many grad students do.

    And you'll still see patients (if you want to) with the PhD. Many of the pediatric neurologists at Stanford who see/treat my son on a regular basis (he has a rare neurological disorder) have PhDs. They see both in-patients and out-patients on a daily basis, and in addition do their research which is often closely tied in with their patients' problems. I'd say you get the best of both worlds with the PhD, at not much extra cost to you.

    The only time I think the PhD route is not a good idea is when you really don't care all that much about the research itself and want to do it mostly for the prestige & $$. That's usually a bad idea.
  16. jefhatfield Retired


    Jul 9, 2000
    in the fields of business, computer science, and engineering, a phd is not a very hireable person in silicon valley or any major job market in the world outside of academia and research...people with master's degrees and sometimes with bachelor's degrees are the "right" fit for industry jobs in leadership positions in those fields since they are perceived as trained for the non academic workforce...the academic workforce however loves phds for college profs, administrators, and k-12 in those fields of business, computer science, and engineering, at least, getting a phd without a serious look at academia is a foolhardy waste of time and money

    phds are a rare breed, but in the above fields mentioned and many other discilines, jobs for phds outside of academia are extraordinarily rare and many want ads that ask for non academia phds almost always hire someone with a lesser degree in the end *it was one of the hard knock facts i learned as an hr officer

    ...when i went to westtech job fair in san jose, the world's largest high tech job fair, i spent two days looking at every position in the computer science field...only one company listed a job that wanted a phd in industry

    i knew of several ex-teachers with phds who wanted to branch out into the "real" world outside of academia and they spent the rest of their lives in utter frustration...i have seen this phenomena for more than thirty years so i don't see the trend changing anytime soon

    my wife worked for a company that used to hire only ex teachers with phds for a testing company but a company with commerce and profit as their main other words, he he, they were a business...and this company employs almost all of the ex-teachers with phds who are not in teaching (mostly because they found that teaching college was not their thing) in a three county area

    if that company ever folds, these people will have to either go back to teaching or take a menial job making very little money...and between teaching and going to this testing company, many of these phds spent months or years unemployed

    it is a sad thing that our culture does not accept most phds if they are not in an academic should be that society honors somebody who went the whole distance in education from kindergarten to phd...that's at least 21 years of education and sometimes more
  17. Dros macrumors 6502

    Jun 25, 2003
    I don't think themadchemist is thinking of computer science or engineering. In the life sciences, a PhD gives you lots of options. Most faculty at major research institutions are on the board of several biotech companies, and a significant percentage are founders of at least one biotech start-up. And any pharma company is going to be looking for PhD level positions to work in their research arms. Pay is good, hours are reasonable... it is a tempting option for many people that considered themselves on the academic track.

    If themadchemist gets into a top-tier MSTP program (or even if he stays at Northwestern), he'll have no problem doing a residency and fellowship at a good academic hospital, and a choice of jobs after that, unless he totally screws it up. Academic hospitals are gaga over researching MDs. I have some friends that have gone that route and trust me, they aren't worried about fitting into the marketplace with a PhD.

    If you are in the life sciences and going to a lower tier program (think a state school that isn't the primary campus), life is more difficult if you want to be an academic. There is a good chance of ending up in temporary teaching positions and never getting a tenure track job. But biotech still is a viable option.
  18. jefhatfield Retired


    Jul 9, 2000
    he he, i knew that...i just didn't want him to get the idea that a phd in every field had a corresponding job...but where he is in medicine and the biological sciences, he seems to be in a great position to find something in his plans

    it is very hard, from a teenage point of view, to map out one's life all the way until middle age

    when i was 18, i wanted to do one of two things (and i was dead serious)

    1) use my guitar playing to land me a professional career in rock music and be signed to a record company by 22

    2) but if that didn't work, finish a bachelor's in business at 22, get married to my high school sweetheart kathy that year, and then take over my dad's business when he retired

    but as it turned out, none of my plans came true...i never made any real money playing guitar, i never set foot in a record company, i didn't finish college until i was 30, and my dad went out of business after 34 years, but i did get engaged to my high school sweetheart but we never married since we drifted apart when i was at school and she married a man she met at a concert and was married five years

    while she was single, she had a kid with a homeless/drifter man who later developed a crack cocaine addiction...this was a constant threat to the daughter who lived through her dad's addiction

    life has a strange way of turning out and when i didn't get married to kathy the first time around, we hooked up again in our 30s we were engaged again, but it wasn't to be but we remained friends...instead the man she had a kid with got his act together and quit drugs and left a tough life on the streets and she married him

    their daughter turned out fine and she is doing well in school and she skipped a grade and is now in high school
  19. jefhatfield Retired


    Jul 9, 2000
    mapping one's life 10 or more years into the future


    i do know of a couple of people who mapped out their lives from early 20s (or even teens) through middle age in mid-30s/late 30s

    i went to high school with this one girl who had the goal of becoming a stanford mba...she was a fairly good student in high school and when she graduated, she got into uc berkeley *but that did not stop her (note that berkeley is also a fierce rival to stanford and few people consider going to one, and then the other...the thought is just incestual in such an unspeakable manner in mixed company)

    knowing that stanford mba school was hard to get into, at 22 as a cal grad she embarked on a successful career for 6 or 7 years and got a pile of money and managerial experience in a high tech company near the school (stanford likes the mba candidates to have at least five years of serious managerial experience under their belts)

    when it came time for her to apply to mba schools with the experience under her belt, she only applied to stanford even though the school had less than a 7 percent chance of getting in...she got in and finished by age 31 or so that was planned to the T and i commend her for sticking to a plan step for step for a dozen years

    in the other case, i met a man who had the goal of being a fire chief with a master's degree since he knew a fireman who was a chief that had a master's degree and he admired him

    so at 18, he joined a fire department and rose to the rank of lt. in several years

    after that, he embarked on and succeeded in getting an AA degree from the local junior college

    while he was working full time, he completed his bachelor's degree and eventually got promoted within his fire department to chief of the night this point he achieved one goal but only had two degrees..

    but even with his increased duties and increased hours, he embarked on graduate school and finished his third college degree (second goal achieved) and just like he imagined when he was a teen, he achieved the promotion to chief and had a master's degree

    he didn't have to have a master's degree since he had already made night shift chief level but he wanted to be like his mentor who was "educated" and he mapped out his next 15 years to achieve it and lost out on a lot of sleep often taking two jobs, juggling buying a house and having a girlfriend who he married, but put her specifically between the bachelor's/lt. level and the master's degree/night chief level (who knows how his girlfriend thought being pingeonholed into a time period in his life and possibly having to wait ;) )

    his surrogate mom told me it was like he followed a small page out of a notebook with single sentence tasks:p
  20. wordmunger macrumors 603


    Sep 3, 2003
    North Carolina
    I'm married to a Ph.D. and I know several doctors and one MD PhD. I'd say you need to narrow down your choices--you may need to give up on either marriage (at least the traditional marriage with kids), Doctors without Borders, or one of the degrees. Any one of those choices could make for a fulfilling life, but you're trying to do them all (and you've admitted that your grades aren't that great--the multiple degrees won't even be an option unless you fix that). If you focus in on one thing now, it won't limit your options later. If you decide you don't like it, you can always change. Just remember there's more to life than a "successful" career.
  21. themadchemist thread starter macrumors 68030


    Jan 31, 2003
    Chi Town
    Everyone, thanks for all of the advice. It has given me a lot of perspective...I'm still on the fence about everything, but I might plan on applying for MD/PhD anyway and decide whether it's right for me as I gather more information. Good news: It takes less time than I thought. More like 7 or 8 years instead of 9. Not much, but definitely positive.

    Anyway, I really appreciate all of the different viewpoints. They challenged my motivations and provided me with information--I can't ask for anything better than that!
  22. jefhatfield Retired


    Jul 9, 2000
    best of luck to's a very honorable undertaking
  23. Doctor Q Administrator

    Doctor Q

    Staff Member

    Sep 19, 2002
    Los Angeles
    My two cents: Go for both degrees. Aim high. With the experiences, training, not to mention degrees you'll have, so many roads of opportunity will be open to you that anything will be possible. You might stick to the plans you state or you might change your mind, either of which is fine. I think the age-when-finished issue is minor. Your life won't be on hold until you finish school. It'll just be part of your life.
  24. Thom_Edwards macrumors regular

    Apr 11, 2003
    jefhatfield is right on the mark. you never really know what's going to happen. here's my story, and it's very similar to his.

    i'm 32 and i had plans similar to jefhatfield's for myself, except i was going to either be an investment banker or make it big being the next one-man 808state (an electronic music band from manchester, in case people don't relate to the state of 808...). i quickly caught a dose of reality and realized the music thing wasn't going to work out, but i thought for certain i'd have the high-paying white-collar job, the wife, the white picket fence, the bmw, the 2.5 kids, etc., right out of college.

    well, that didn't quite work out, either. i have an average paying job, i'm single (and about to lose a girlfriend that i've dated for about 3 years), driving a lumina with a dent in the door, and living in a little one room apartment in waco, tx! and as things worked out, thank goodness i don't have the 2.5 kids.

    thing is, i have a pretty good life, really. i've got a decent job doing something that i love, writing educational software. it's not the best paying job, but it is a (good) job. i've got a great girlfiend that i'd like to marry. (hopefully i can work out the aforementioned trouble we're having.) things may not have worked out exactly as i planned, but what did i know when i planned it? maybe this is the better result. maybe the high-stress life of investment banking would have stressed me out and eaten me alive.

    i'm a reasonably smart guy, but i spent the first 10 of my out-of-high-school years chasing women, whiskey, and women that drank whiskey :) and not chasing the plan i thought would "just happen". so i *still* don't have a bachelor degree, only an associates, but i want to go back and finish. i did really well in high school, but had next to nothing of a social existence. once i got to college, those two entites switched positions. i don't have regrets, but it did kind of impede my intial out-of-the-gates momentum. all of the partying didn't really help out with the accomplishing of the initial plan, but i got to have a lot of fun and live an extremely care-free life, which is something i wouldn't have had a chance to do had i started a career when i was a decade younger. now i've got a balance of the two, and things are pretty good. all work and no play makes jack a dull boy. vice versa makes him unproductive.

    i don't know if any of this will help someone decide whether or not to get some extra letters after their name, but people might be careful before they try to map things out too much. you can't tell for certain if the map is a good one...
  25. blowingass macrumors newbie

    Aug 10, 2003
    I agree with applying for the MSTP if it's not too much extra work. You always want to give yourself the option of a free ride. Most of my classmates in med school had about $130K in loans when they finished up. The MD/PhD's had a free ride + stipend. But it goes without saying you need to see if you enjoy your time in the lab. As (just) a physician you can always be involved in clinical research. The Ph.D. will make you a more attractive candidate when you apply for residency and prime you for a career in academia. (But how you would know this is your calling without having set foot in the hospital or the lab I don't know?) $$$-wise I can't imagine an academic post being more lucrative than a private neurosurgical practice; but I admit I know nothing about potential income from consulting for pharma/biotech. Best of luck - You definitely can't go wrong if Northwestern is your back-up plan.

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