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When is the best time to do a PhD? During med school or residency?


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That depends, but personally, I feel like doing it during your residency is more useful because by that time you have a better idea of what kind of clinician you will want to become, so you can orient your research towards that goal. There are many stories of MD/PhDs who do PhDs in areas that they ultimately choose not to specialize in. While their knowledge of research methodology stays with them, much of their actual work may or may not be for naught. 

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Advantages during residency:

- The clinical investigator program (CIP)  allows you to pursue a PhD in your subspecialty while getting paid ur regular residency salary. From my understanding of the program, you still have to apply for funding though, but the school will top off your funding if you were unable to secure enough funds.I highly recommend looking into CIP. I thought it was a super cool program when I heard about it.

- When you do it in your residency, you research work is more specific to your clinical work, it may be a bit easier to get a staff/academic position. 

Advantage during medial school:

 - you 'll be  more competitive applicant for CaRMS for some specialties. 

- You get to do a lot of research work during meds, which can be super exciting.

- you get a break from all med school related activities/ get to  focus on your own independent work and doing your own thing.

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Devils advocate here. 

Doing a PhD before residency will *usually* result in a higher quality PhD by virtue of the fact that most PhD trainees in residency are pushed through way too fast and end up not being able to do substantial independent research. Doing it before residency may also help improve your chances of landing a highly competitive residency or one that greatly values research like Derm, Plastics, NeuroSx/Neurology etc. 

 

The above posters mentioned some important alternative thoughts. Pay is the most significant one, in the end we’re talking maybe a $120,000 difference in after tax career earnings all else being constant, though not necessarily depending on your funding situation. That’s either a lot, or not a lot depending on your viewpoint. The other point about how if you do your PhD first, the research might not relate to your specialty, I think is actually not an issue. The point is to learn good science first and foremost, and that’s translatable across fields even if you take up a new field of research every 5 years. If it relates to your residency then great, but many do not, and it doesn’t matter - I encourage MD/PhDs to keep their mind wide open during their clinical training so their residency choice isn’t biased by their research, and the reverse should also apply. You could also see it as a positive, as in brining a new perspective to a new field. In the end you will probably have to do a fellowship/post-doc for an academic job and that’s where you’ll be judged for hiring purposes, not your PhD. 

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8 minutes ago, ZBL said:

Devils advocate here. 

Doing a PhD before residency will *usually* result in a higher quality PhD by virtue of the fact that most PhD trainees in residency are pushed through way too fast and end up not being able to do substantial independent research. Doing it before residency may also help improve your chances of landing a highly competitive residency or one that greatly values research like Derm, Plastics, NeuroSx/Neurology etc. 

 

The above posters mentioned some important alternative thoughts. Pay is the most significant one, in the end we’re talking maybe a $120,000 difference in after tax career earnings all else being constant, though not necessarily depending on your funding situation. That’s either a lot, or not a lot depending on your viewpoint. The other point about how if you do your PhD first, the research might not relate to your specialty, I think is actually not an issue. The point is to learn good science first and foremost, and that’s translatable across fields even if you take up a new field of research every 5 years. If it relates to your residency then great, but many do not, and it doesn’t matter - I encourage MD/PhDs to keep their mind wide open during their clinical training so their residency choice isn’t biased by their research, and the reverse should also apply. You could also see it as a positive, as in brining a new perspective to a new field. In the end you will probably have to do a fellowship/post-doc for an academic job and that’s where you’ll be judged for hiring purposes, not your PhD. 

The funding factor is the biggest difference, and that's why I'm leaning towards pursuing Phd during residency .

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4 minutes ago, End Poverty said:

The funding factor is the biggest difference, and that's why I'm leaning towards pursuing Phd during residency .

Valid, there’s no one universally correct answer. Unless someone is going for something like derm/plastics, and they know they want to do a PhD at some point, then I’d universally say to do the PhD first - yes funding is greater in residency, but the opportunity cost of not matching to derm/plastics if that’s what you want is worth far more than any funding discrepancy, so better to maximize all aspects you can control pre-CaRMS. 

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I’ll also add that doing a PhD in residency can have some issues in terms of content translation, just as it can pre-residency. For example, say you are in a cardiac surgery residency, and for your PhD you want to do health services research on valve replacement. Well what if your institution doesn’t do research in that area and the only person doing health services stuff does mental health, and all that is available in heart related stuff is cardiac physiology research? Either you do a PhD in cardiac related stuff but in a research field that is not exactly what you want to be doing, or you do research in the field you want but might not be related to your medical specialty. Same as pre-residency. Yes you can always try and build your own research path and have various mentors advising on some new area that suits your needs, but for someone just starting a PhD  without much research background while in the middle of residency that is risky to say the least. 

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2 minutes ago, ZBL said:

I’ll also add that doing a PhD in residency can have some issues in terms of content translation, just as it can pre-residency. For example, say you are in a cardiac surgery residency, and for your PhD you want to do health services research on valve replacement. Well what if your institution doesn’t do research in that area and the only person doing health services stuff does mental health, and all that is available in heart related stuff is cardiac physiology research? Either you do a PhD in cardiac related stuff but in a research field that is not exactly what you want to be doing, or you do research in the field you want but might not be related to your medical specialty. Same as pre-residency. Yes you can always try and build your own research path and have various mentors advising on some new area that suits your needs, but for someone just starting a PhD  without much research background while in the middle of residency that is risky to say the least. 

 

I don't think many people will pursue a Phd during residency unless they were already keen on research and have some form of research background. 

 

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16 minutes ago, ZBL said:

Keen on research and undergrad research background is not equivalent to capability in leading an entirely new research program

I don't know much about the riskiness of doing a Phd in residency, but I feel that it  really is dependant on the individual, and their mentors as well as how teachable they are. It does not have to be risky if you have the right attitudes, mentors, etc.  I personally know individuals in surgical specialties who finished their Phd during residency and they were quite successful, but they were VERY hardworking individuals.They also finished it in 2 years instead of 3.

BUT, I surely don't know much about the topic because I only did research work for one year prior to medicine and I did it in the area of health inequity, and from speaking to mentors a lot of them encouraged me to pursue Phd in my residency and none of them told me that it was risky doing it in residency, but I should explore this further. 

 

 

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2 hours ago, ZBL said:

I’ll also add that doing a PhD in residency can have some issues in terms of content translation, just as it can pre-residency. For example, say you are in a cardiac surgery residency, and for your PhD you want to do health services research on valve replacement. Well what if your institution doesn’t do research in that area and the only person doing health services stuff does mental health, and all that is available in heart related stuff is cardiac physiology research? Either you do a PhD in cardiac related stuff but in a research field that is not exactly what you want to be doing, or you do research in the field you want but might not be related to your medical specialty. Same as pre-residency. Yes you can always try and build your own research path and have various mentors advising on some new area that suits your needs, but for someone just starting a PhD  without much research background while in the middle of residency that is risky to say the least. 

I know quite a few of the surgical residents in Toronto pursue their PhD during residency at other institutions (many in the States, including Harvard, Stanford, Hopkins, etc.) so my impression was that this isn't that big of a deal. I'm sure it's easier to do your PhD at the same institution as your residency since you have the connections already, but it seems like those who want to pursue grad studies elsewhere or in a topic not offered locally are able to do it without much difficulty.

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2 hours ago, End Poverty said:

I don't know much about the riskiness of doing a Phd in residency, but I feel that it  really is dependant on the individual, and their mentors as well as how teachable they are. It does not have to be risky if you have the right attitudes, mentors, etc.  I personally know individuals in surgical specialties who finished their Phd during residency and they were quite successful, but they were VERY hardworking individuals.They also finished it in 2 years instead of 3.

BUT, I surely don't know much about the topic because I only did research work for one year prior to medicine and I did it in the area of health inequity, and from speaking to mentors a lot of them encouraged me to pursue Phd in my residency and none of them told me that it was risky doing it in residency, but I should explore this further. 

 

 

Anyone “finishing” a PhD in 2 years, let alone 3 years does not deserve the degree. 

 

Again, I’m just playing devils advocate, but there is not and should not be a single correct answer to whether to do a PhD before or after residency. 

 

Someone below mentioned going elsewhere like to the US for your phd during residency - yes you can, but with that comes cost that near negates any financial advantage of doing your PhD in residency. 

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12 minutes ago, 1D7 said:

I'm curious, how do these surgical residents maintain their surgical skills? Take call while doing their PhD? Have built in surgical rotations in their research year(s)? Bite the bullet of being out of an OR for years?

Most often they will take call during their PhD. Most surgical residents doing a PhD are doing it because they have to for job related reasons rather than actually wanting to do research down the road, so the PhD ends up being rushed, and filled with call. In the end if all it is is a means to a job then it is what it is, but it’s not what I’d recommend for surgical residents wanting a career with a significant amount of research, which on its own is hard in surgery. 

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On 11/14/2018 at 9:12 AM, 1D7 said:

I'm curious, how do these surgical residents maintain their surgical skills? Take call while doing their PhD? Have built in surgical rotations in their research year(s)? Bite the bullet of being out of an OR for years?

If you do a PhD or Masters during your surgical residency at your home institution, you usually can take some sort of call or be in the OR once a week to keep your skills. This is one of the disadvantages of doing a PhD elsewhere. 

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On 11/13/2018 at 11:20 PM, End Poverty said:

The funding factor is the biggest difference, and that's why I'm leaning towards pursuing Phd during residency .

Just curious, what is the current funding situation for MD/PhD's in Canada? In the past I thought they did not pay medical school tuition and received something like 22k a year in stipends throughout their entire program? If that still is the case then I don't think doing a PhD in residency has too much added financial advantage. 

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1 hour ago, Edict said:

Just curious, what is the current funding situation for MD/PhD's in Canada? In the past I thought they did not pay medical school tuition and received something like 22k a year in stipends throughout their entire program? If that still is the case then I don't think doing a PhD in residency has too much added financial advantage. 

At the Albertan schools, you get paid 20K per year and you do not pay for med school tuition. I'm sure that there are some scholarships that you apply to that would help you get more funding, but I haven't looked into it in great detail.

If you choose to do it in residency it is: 60+k/year.

It's almost a 40K difference per year.  

In general, from my prospective, although funding is the biggest difference, I don't think that finances should be the biggest determinant about when you choose to do a degree. Do it when you feel most comfortable about doing it.

 

 

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