When the journey to becoming a consultant takes at least ten years, it’s understandable that most students are eager to clamber to the top of the ladder as quickly as possible. Consequently, the thought of taking at least another three years away from medicine to do a PhD is far from enticing (unless you intend on a career in medical research or academia).
What’s the benefit then, in undertaking a PhD if you still intend on a career in clinical medicine? Is there a need for medically trained clinicians to undertake the rigorous training of a scientific researcher?
When I completed my Honours research project halfway into my medical degree, I fell in love with it enough to defer my degree and complete a PhD. I watched my fellow medical students graduate and begin working as ‘real doctors’ whilst I pottered around the lab growing colon crypts in a test tube and analysing human tissue samples on an intricate and temperamental instrument known as the Mass Spectrometer.
This scenario is rare but becoming less so in Australia, with more and more students taking the so-called ‘MD-PhD’ training route which is a formalised combined degree in the United States. Alternatively, those who seek to be a Dr-Dr can also undertake a PhD after entry into specialist training. Ultimately, this blog aims to address two questions: 1) Is a PhD worth it? 2) When is the best time to do it?
1) Is a PhD worth it?
There is no doubt that undertaking a PhD is beneficial, but it’s not for everyone. A PhD equips you with the skills of being a fully-fledged independent researcher; you get to design your own project, establish new methods, present and publish results, and (if you’re lucky) write your own ethics applications and grants. The experience of making completely novel discoveries and publishing them is incredibly rewarding, and the entire PhD experience challenges you to think in a way that is completely different to clinical medicine. Having a PhD is also in some ways a ‘golden ticket’ that will give you a step ahead into many highly competitive specialities, or will help you secure a job in large metropolitan tertiary hospitals. It also opens many career doors by giving you options to vary your workload to include a combination of clinical work, research and teaching. Having said that, a PhD is also three years out of your life with very little pay, and for those who don’t desire a career involving research to any extent (e.g. if you want to be a garden-variety GP) then doing a PhD in molecular biology is probably not going to help your career enormously…
2) When is the best time to do it?
Doing a PhD early (e.g. prior to completing the MBBS) is easier financially as you are less likely to have a mortgage and three screaming kids to feed. It also gives you more time to build your research portfolio and having the PhD will help you in getting to the specialty you want. On the other hand, doing a PhD later (after specialising) means that you can be certain the topic of your PhD is in your area of specialty, and you are qualified to work in clinical medicine whilst PhD-ing. Like all good debating topics, there is no correct answer, and this depends very much on personal circumstances.
If you are interested in a PhD, speak to one of the conjoint clinician-academics at your medical school as they most likely would have completed one at some point in their career.
The thought process I went through in deciding to defer medicine to undertake a PhD halfway through the degree was not an easy one; I was doing well in medicine and also had a lot of friends (many from high school) going through with me in the course. At the same time, I was tempted by the fact I had a great relationship with my research supervisor, and had started working on a project I truly loved and was well-familiar with the literature (all advantages for going into a PhD). Ultimately I made up my mind after talking to many faculty and hospital staff members, discussing with family and weighing up the pros vs cons.
Although there were periods during the PhD that were difficult (all research is unpredictable) coming out of the PhD I have no regrets in undertaking this detour. Going back into clinical medicine has been surprisingly much easier than I originally thought it would be. Although lacking somewhat in clinical knowledge (which comes back fairly quickly with study and practice) I have gained a whole suite of written and oral communication, teamwork and self-directed learning skills from the PhD which have been really handy in the wards in ways that are difficult to put down on paper.
My future ambitions are to be a clinician-researcher. However, anyone with an interest in academia or is contemplating a specialty that requires some research understanding should consider a PhD at some point in their training.