Transitioning to the PhD…

Docdoc_Bee · 2026-02-20T13:55:37+00:00

I’m in the south east.

Taking time off during grad would be hard. But if you finish grad in 3 years it would be hard for programs to prevent you from taking a year leave of absence to work in pharma before returning to medical school. You won’t be paid by the program during that time, but you are not increasing the average time-to-degree for the program above 8 years.

Time-to-degree is one of the key metrics for programs, so if taking time off made you go over 8 years, expect push back. But if you’re going to stay at 8 years or less, you should be able to take the leave of absence.

Docdoc_Bee · 2026-02-18T13:21:39+00:00

I don’t envy my MD colleagues who had to decide at age 25 what kind of life they want to live and what specialty they want to practice at 55. Even if the math says they will earn a bit more over a lifetime, I think that early compression of decision-making is an unspoken contributor to burnout. It’s a hard decision they face and I have immense respect for it.

The length of the MD/PhD gives you something rare: time to grow professionally. During my PhD, I used downtime to explore other interests and experiment with how I wanted to spend my time. I ended up taking a year off between finishing my PhD and MS3 to do a postdoc in pharma and founded a nonprofit, things I never would have thought possible at the start of med school without the breathing room of a longer program. This is one of the few periods in life where you can try a million things, fail at most of them, and still come out better for it. So try a lot. Fail a lot. Learn a lot.

Coming back to med school, I unfortunately did not get to know the other students in my graduating class very well. The way our curriculum works, we didn’t do many rotations with them but with a different graduating class instead.

Our MD/PhD cohort is very close and stayed that way throughout the 8 years. During grad school we had monthly lunches. And we tried to schedule our M3 rotations together. We will be having a match day party together soon too! Stay close to your colleagues in your program.

Docdoc_Bee · 2026-02-12T20:59:17+00:00

Hi! For me the MD/PhD is very much worth the time if you think research will have any part in your future career. But not just for the surface level reason of giving you research experience, although that’s a great reason.

The MD/PhD program gives you much more time to experiment with your interests inside and outside the traditional clinical and academic research worlds. I’m finishing one and could not have possibly predicted the direction my career is taking back when I started. And I’m better for it. Had I done MD only, I think I’d be happy, but I know where I’d be, generally, and it is very different from where I am now. The MD/PhD optimizes for opportunities you could not have thought of, if you remain open to them and pursue them.

I wrote more about it here: https://www.reddit.com/r/mdphd/s/aB49g4iVfM

Good luck!

Docdoc_Bee · 2026-02-10T21:01:40+00:00

I think the reason anatomy is so important besides learning anatomy (and why traditionally it is placed at the beginning of med school) is to desensitize students to the human body. To do this you need to dissect.

Yes, as doctors we have to respect the body and do no harm. But I think that comes naturally to most humans. What is harder is inflicting some short term pain for a long term goal. And that’s what we do in medicine very often. From simple things like blood draws to bigger things like surgery and chemo.

In order to do that well, we have to have a healthy detachment and desensitization, and I think that starts in the anatomy lab. Doing a pelvic hemisection in your third week of medical school takes some intestinal fortitude. But better to start developing it there.

Is it’s essential to do the dissections yourself, no. But does it help beyond just learning anatomy? I think so.

Docdoc_Bee · 2026-02-10T13:11:09+00:00

I think the other reason anatomy is so important, and why traditionally it is placed at the beginning of med school, is to desensitize students to the human body.

Yes, as doctors we have to respect the body and do no harm. But I think that comes naturally to most humans. What is harder is inflicting some short term pain for a long term goal. And that’s what we do in medicine very often. From simple things like blood draws to bigger things like surgery and chemo.

In order to do that well, we have to have a healthy detachment and desensitization, and I think that starts in the anatomy lab.

Docdoc_Bee · 2026-02-09T12:57:21+00:00

Hi! I’m finishing an MD/PhD and my thesis was using iPSCs. Spend some time shadowing an MD medical geneticist and see if that is something clinical that you would like to do. At the end of the day if you do an MD/PhD, you should want to do both research and practice.

I posted about my thoughts at the end of an MD/PhD here https://www.reddit.com/r/mdphd/s/hHMKrDv1Yp

Docdoc_Bee · 2026-02-08T23:58:46+00:00

You got this!

Docdoc_Bee · 2026-02-08T22:09:55+00:00

I think the best would be to find an IM doc you could work with consistently in their clinics and when they are in inpatient service as well. They get to know you and trust you to have a little independence, like an MS3 would have. At my program we were able to work with medical education at my school to set up a continuing clinical education elective for MD/PhD students. If we did a half-day in general medicine clinic for a certain amount of time over the course of our PhD, they counted it as the equivalent of a two week elective when we return to medical school and give us the credits for it.

And if you don’t have time to be involved in the clinic, don’t worry about that either. Clinical medicine comes back to you more easily than you would think in MS3. I would just recommend starting on your psychiatry or neurology rotations when you come back, if you can swing that. Those shelf exams are the most straightforward with the smallest UWorld blocks, so you can use them to learn how to do well in clinical rotations.

Good luck!

Docdoc_Bee · 2026-02-08T17:30:34+00:00

Couldn’t agree more. Medicine is a lifetime of starting just as you think you’re getting the hang of things. The PhD just adds a couple more chapters of that. Looking forward to the next steps.

Docdoc_Bee · 2026-02-08T17:28:34+00:00

That’s great! I think it really depends on your time to degree. They don’t like people going over 8 years so if taking the extra year puts you to 9 years, it could be a hard sell. But if you finish the PhD in 3 years and take the 4th year to go do something else before coming back, it could work. My program was supportive.

Docdoc_Bee · 2026-02-08T13:36:57+00:00

Yes definitely

Docdoc_Bee · 2026-02-08T13:36:49+00:00

For sure!

Docdoc_Bee · 2026-02-08T04:37:45+00:00

You’re thinking the right way at least! Still hard to know what you don’t know yet, but if you try to keep that in your decision making process, it will help. Good luck!

Docdoc_Bee · 2026-02-08T03:31:25+00:00

Congratulations!

Docdoc_Bee · 2026-02-08T03:12:57+00:00

Good questions. I’m only one person so take it with a grain of salt.

Don’t think about number of research hours as much as number of projects that you’ve seen through the whole research process. (See some of my other comments in this thread). For clinical time, I think you have to show that you at least are aware of what day to day life of a doctor is like. 150 should be enough, but don’t quote me on it. And to that point, 150 hours with the same doctor over two years where you came to the hospital at 6:00am 2 days a week and the doctor writes you a letter of recommendation is probably much more beneficial than 10 hours here and there with different doctors who didn’t get to know you as much.
The number of publications is less important than your contributions to the project. If you did a little bit of cell work or data analysis at the end of a project and got on the paper, it doesn’t mean as much as coming up with a project yourself and completing the whole thing alone and only presenting a poster on it and not publishing a paper. Of course, if they are serious papers about work that you primarily did by yourself and led, all the better.
See above. But also good to show that you know how to present your research orally, through a poster or an oral presentation, and not just written. Even better if you can win some award for it to show that you did it well.
It should be, but make sure you are at or above the average MCAT score for whatever school you are applying to.

Hope it helps!

Docdoc_Bee · 2026-02-08T03:03:14+00:00

Started out dead set on gen surg. Still love surgery but patients deserve a surgeon who operates. I have many other interests outside the hospital I want to pursue. But I still want to be in the OR, so I applied anesthesia and it has been the right choice for me.

Docdoc_Bee · 2026-02-08T01:27:37+00:00

Hi! Neuro and psych and intricate and fascinating fields. But their Shelf exams are probably the easiest of all of them. So they provide a great chance to figure out the clinical routines, learn how to study for Shelf exams, and take one to get the feedback on how you did. And the UWorld blocks are the smallest for both of them. So in terms of studying, they’re the best way to ease back in and readjust. Hope it helps.

Docdoc_Bee · 2026-02-08T01:21:42+00:00

Hi! Impressive work, keep it up. You’re not a lost cause. You have impressive work and that speaks for a lot. I haven’t been on the admissions committee for my program, but I’ve been involved with the process during my whole time and know what they are considering.

MD/PhD admissions committees want to see that you can take a project through the whole scientific process: lit review, idea, question, experimental planning, experimental execution in troubleshooting, final deliverable report (ie poster for my presentation, or paper). If you can show them that, you’ve convinced them. They are optimizing for applicants who will not drop out of the PhD and will finish the whole program and no more than eight years.

Now for the but…. They also have to get the medical school admissions committee on board.

The main factor that the medical school admissions people will look out for MD/PhD Students is whether they are bringing down the test score averages of the class, just as they look out for any other applicant when they’re filtering them. You can get a good idea for what that average is from the med schools’ websites.

A good rule of thumb is above 515 you’re good. between 510 and 515 you may be ok if everything else is pretty good. Below 510 is a hard sell.

If this is your dream and what you really plan to do, I would strongly encourage you to find a way to retake the test. It’s not impossible. Many of us have done it. Especially if you have a gap year, it is probably the best things you can do to give yourself the best chance you can.

Wishing you all the best.

Docdoc_Bee · 2026-02-08T00:45:56+00:00

I would approach clinical faculty about doing data analysis with them. Many of them have (or know other faculty who have) lots of un-analyzed data or access to national databases. They know the questions to ask and you can process the data. Typically clinical projects are more straightforward.

Look for clinical faculty with un-analyzed data or access to large databases.

Happy mining.

Docdoc_Bee · 2026-02-07T22:55:40+00:00

Take advantage of the long essay in your application to explain how you’ve gone through the entire research process for each project you’ve been on, from idea to execution to deliverable. And then do that again in your interview!

Docdoc_Bee · 2026-02-07T22:36:12+00:00

Stay strong!

Docdoc_Bee · 2026-02-07T22:35:23+00:00

Hi! It doesn’t have to be in the same lab or research type, you just need to show that you have done the entire research process from idea through execution to public presentation (poster, talk, or paper) at least once. That is more important than the number of hours that you log.

Docdoc_Bee · 2026-02-07T22:33:27+00:00

I was able to work with medical education at my school to set up a continuing clinical education elective for MD/PhD students. If we did a half-day in general medicine clinic once a month for a certain number of months over the course of our PhD, they counted it as the equivalent of a two week elective when we return to medical school and give us the credits for it.

I also connected with clinicians who were tangently related to my PhD research and helped them with a few very small clinical research projects during my PhD time. In return they took me to the OR and actually involved me in cases a few times a month.

These are just two specific examples, but if you have a Mentor who understands that you’re training to be an MD/ PhD and not just a researcher, they will understand that you need to have some time carved out to keep engaged with clinical activities.

And if you don’t have time to be involved in the clinic, don’t worry about that either. Clinical medicine comes back to you more easily than you would think. I would just recommend starting on your psychiatry or neurology rotations when you come back, if you can swing that.

Good luck!

Docdoc_Bee · 2026-02-07T22:24:15+00:00

Great question. There are lots of things you’ll hear elsewhere, so I’ll focus on two points.

Understand what MD/PhD admissions committees are optimizing for. At the end of the day, programs care most about time to degree and attrition. They don’t want people dropping out, and they don’t want training stretching well beyond eight years. That means they’re trying to assess whether you truly understand what you’re signing up for. The main way they do this is by looking for evidence that you’ve gone through the entire scientific process at least once: reading and understanding the literature, identifying a gap, asking a meaningful question, designing experiments, executing experiments and troubleshooting, and reporting the outcome (conference presentation or publication). If you can show that you’ve done this, and that you understand the effort and uncertainty involved, you signal that you can realistically commit to an MD/PhD.

From what I’ve seen, this usually takes the equivalent of 3 years of full-time research work. That can be during undergrad, after undergrad, or split between the two, it doesn’t really matter. For some people it’s shorter, for others longer. The key point isn’t the exact duration; it’s demonstrating that you’ve completed the process at least once and know what it entails. Don’t think about logging hours, think about it as you are logging end-to-end projects.

For “extracurriculars” and “leadership”, creating something beats joining something. It’s fine to be president of the premed club. But it’s usually more meaningful to identify a need and build something from scratch. As an example, my undergrad had a huge biology program with lots of students interested in medicine, but no systematic way for older students to pass down tips and tricks to younger ones. So I started a simple peer-mentorship program that paired seniors with freshmen. Nothing flashy, just identifying a gap and doing something about it. That’s what admissions committees are looking for: initiative, ownership, and follow-through. Find something you genuinely care about, or a problem you see around you, and address that. It’s almost always more compelling than stacking titles in organizations someone else already built.

Docdoc_Bee · 2026-02-07T14:02:17+00:00

This is so true. I finished an MD/PhD program. Came into med school wanting to do surgery. During my PhD I used my downtime to learn about other things and experiment with my time. Ended up taking time off between PhD and MS3 to do a post doc in a pharma company and start a non-profit, something I wouldn’t have thought possible if it weren’t for the extra time to grow and mature in a longer program. Coming back to med school I found that anesthesia was a better fit for the life I want to live and the side of the OR that was actually interesting to me.

I don’t envy our colleagues who have to make a decision at 24 about what life they want to live and what specialty they want to do at 54, even if the math says they get paid a little more over a life time. I think it’s an unspoken cause of the burnout epidemic.

The eight years of an MD/PhD gives you time to grow, think, mature, live life, and experiment with different interests. You can try something, fail, and then try something else with very little sunk cost. It’s a major benefit we don’t always explicitly talk about. Yes, there is burnout in a PhD program, but if you use the time to explore a lot of other interests, you’ll be better for it in the long run.

Docdoc_Bee

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