Let me declare my interest here, I did do one at the end of my basic surgical training and before my higher surgical training. In those days (the early noughties) it was impossible to get a registrar job in general surgery without an MD or a PhD. (In the UK medical doctors graduate MBChB, bachelor of medicine and bachelor of surgery, unlike the states it is not a post graduate course and “Dr” is a courtesy title.)
So should a trainee in 2015 take 2 or 3 years out to do research and a higher degree? You need to read and think over the following questions;
1. Do you work well alone?
This is crucial, the answer is that you probably don’t. Most of us medical professionals work well in teams, that is the nature of our job. Research means quite a lot time spent working alone, only you are responsible for completing the work. Your supervisor cares a bit, they will pressure you but ultimately it comes down to you.
2. Can you cope with a drop in salary?
You are likely to suffer a drop in salary when you embark on research. Although most research jobs come with a salary, it usually is less than a banded, full time registrar post.
3. Are you someone who sees things through?
One colleague of mine referred to doing research as a sword of Damocles hanging over your head. Certainly there is a sense of dread when you contemplate the consequences of not finishing your thesis. You have to see this process through to the award of your MD or PhD. I was not very good at seeing things through, for example I frequently lose interest in wrapping Christmas gifts after the 30th one or find I run out of enthusiasm for gardening after an hour or two.
However, the discipline required to complete and submit your thesis is character building. If you are already good at completing boring tasks then you will be at an advantage during your research.
4. Are you considering a career as an academic?
I was not and am not going to be an academic surgeon, at least not any more than all surgeons need to be academic. I will not be pursuing a university position with the ultimate aim of being Professor KBW. If you are, you definitely need to do a higher degree. But, research isn’t just for those who want to spend every waking minute at work, or thinking about work, or wondering how they can do even more work. Ordinary surgeons can get a lot out of research too, it is crucial that we are involved with science and progress.
5. Are you prepared to spend an additional 2 to 3 years as a trainee?
I feel that this shouldn’t really be a consideration, but then I have had 3 years of maternity leave and am training part time. Time has lost its meaning to me in many ways, I’m enjoying the journey as opposed to rushing to the destination.
6. I am not on the academic foundation program, I feel it is too late for me?
There are some people who enter medical school aged 18 and know that they are going to be a neurosurgeon who does research into obscure receptors in the amygdala, they are in the minority. The truth is you can do research at any point, as long as you are approved by your training scheme for time out.
7. Should I do an MD or a PhD?
I don’t think it matters. It is more than simply a decision of 2 years MD versus 3 years PhD. The opportunities open to you will affect this decision, as will the type of project.
Nobody looks down their nose at an MD, nor is a PhD significantly better. It depends what you do with it. An MD that results in 4 papers and multiple international presentations and a prize is worth more than a PhD that got 2 publications and a poster.
8. Do you want to be competitive at consultant interview?
I assume you want to be in a position of picking and choosing jobs when you reach the end of your training.
You don’t want to be forced to locum in an obscure dump because everyone else you are competing with has a PhD. It is often hard to find time to publish quality research papers when working in the NHS and many people find that research allows them to get all the necessary publications.
Saying that, there is nothing worse on your CV than an unfinished project and far worse than not having done an MD/PhD is having done 2 or 3 years of research in a laboratory and not getting your thesis.
Some people think that having a higher degree makes them better, smarter and uniquely qualified to comment on others research which of course it doesn’t.
My view of it is that it is the equivalent getting a tattoo of your boyfriends name to prove you love him. It hurts, it costs you time and money but in the long run it toughens you up and proves something to yourself and your employers and colleagues.
At the end of it you will have those letters after your name, which mean you get you the consultant job interview you want. It gives you much more than that though; it teaches you how to write grant applications, papers, plan posters, “do science”, understand statistics, how to make projects happen, how to follow through, thesis writing, working with scientists (that is a whole other world), travel, communication skills…I would recommend it, even though it was not the best time of my career in terms of enjoyment.
Speak to your local professor of surgery, your medical school and your colleagues. There are frequently jobs advertised in the BMJ careers for PhD’s and MD’s.
Listen to Auntie KBW though, do not start something that you aren’t going to finish and make sure you turn up in jeans and a T-shirt on the first day in the lab or they will kill you.