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Do You Need an MD(DO)/PhD to do Research as a Physician?

Session 247

Dr. Maureen Leonard discusses her journey to medicine and her life as a physician-scientist. Dr. Leonard spends 70-80% of her work time doing research with “just” an MD. Find out why she thinks you don’t need to have a dual degree to do a lot of research as a physician.

A lot of students think that because they want to do research, they need to get an MD/PhD or a DO/PhD. Maureen is “just” an MD and now has a Master’s degree, too. We talk about her journey into medicine and the advice she got when doing research as an undergrad with a PhD advisor. She talks about all the things she’s done throughout her career as a premed, as a medical student, and now as a physician scientist. If you’re thinking about doing a dual degree, maybe today’s episode will change your mind.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[05:45] Her Interest in Medicine

Maureen knew she wanted to be a doctor when she was in her senior year of high school. She initially wanted to be a dancer, but it didn’t seem to be working out. She realized she likes people and science, so she decided to go down the medicine path. To make sure it’s what she really wanted to do, she did volunteer work at a neighboring hospital throughout high school. She also took a part-time job doing filing at Boston Children’s Hospital.

Her Premed Journey and First Research Projects

The hardest part of being premed for Maureen was the workload. She wanted to make sure she had a lot of experience to be ready for medical school, so she spent a fair amount of time doing research. Her major was psychobiology, which has been renamed as neuroscience. She did research projects with rats throughout her time in college. Like many people, she got her EMT license. She was shadowing and volunteering.

The hardest part was juggling so many things to try to make sure I was a well-rounded applicant.Click To Tweet

She was basically the typical premed when she was in college. She got advice from her premed advisor. Although her psychology advisor thought research would be helpful for medical school, Maureen was also interested in doing research. So she was encouraged to do both research and clinical experience.

[08:40] Research Project Tickling Rats

Her major required students to do research for their psychology degree and a thesis for their biology degree. They had a small class and Maureen’s mentor at that time did a lot of research. So she got invited to do research with her and tried it out. She ended up really liking it. She likes the ability to ask questions and design how to answer that question and watch it all unfold.

We were trying to identify what the vocalizations in rats meant.Click To Tweet

The first research she did was identifying what the vocalization in rats meant. Maureen reveals that their research suggests that rats made a 55-kilohertz ultrasonic vocalization for laughter. You can elicit this vocalization if you tickle the rats. So she spent hours a day tickling rats to be able to elicit vocalization.

They eventually did place preference studies to confirm that these vocalizations meant that they were happy. They didn’t work with cute rats but old, grumpy rats which they tickled morning, noon, and night. She obviously put this on her med school application, and it did come up during her interviews.

They didn't work with cute rats but old, grumpy rats which they tickled morning, noon, and night. Click To Tweet

[12:05] Why She Didn’t Choose the MD/PhD Path

Maureen’s psychology advisor throughout her entire college experience was very adamant that she should do MD/PhD. Of the four people they worked with, two of them went to medical school and one did the MD/PhD.

Maureen was told she should do the MD/PhD. Her advisor made it clear that she would be making a huge mistake if she didn’t apply. Her advisor thought she could do more with the MD/PhD and, since she was interested in research, it could open so many doors.

But Maureen decided not to go that route. She hoped research was going to be part of her life, but at that time, she didn’t know what she wanted to specialize in. She couldn’t imagine agreeing to a seven or nine-year program when she didn’t even know what her focus in medicine was going to be. So she took a gap year before applying and did basic science research with mice.

Why She Didn’t Pursue a PhD, Even Though She Liked Research

Part of her thought process was that in doing the PhD, you’d be delving into a specific question you have for three or four years. But she didn’t have any question yet because she didn’t know what she was going to specialize in. For her to be excited about spending so much time on a project, she knew she had to feel passionate about it. Until she knew what she wanted to specialize in medicine, she couldn’t commit to something for that long.

[17:15] Exploring Global Health Work

Maureen thought research might be a part of what she wanted to do, but she actually spent the extra time she had in medical school on global health work, rather than research. For example, in the summer that medical students have off between first year and second year, instead of doing research, she did a global health trip.

She did this out of curiosity and not knowing what she wanted her life as a doctor to look like. It was something she wanted to experience. She wanted to spend her time in medical school examining what she was interested in doing long term. She wanted to see what felt right to her.

During medical school, research stayed on the shelf. She went to internship and pediatric residency at Tufts University in Boston. She still liked global health and research. At this point, she put both back into her mix. She wanted to do both to help her make an informed decision about how to spend her time as a doctor.

In her internship year in the first year of residency, she did retrospective chart review with a pediatric gastroenterologist. She felt it was what she wanted to get into. Then in the second and third years of residency, her program allowed her to spend a month each year in Haiti. She was doing global health work related to cholera and general pediatric medicine.

[21:44] Fellowship and Research Mentorship

As a pediatric gastroenterologist, Maureen got involved in studying celiac disease and all the gut microbiome issues involved with that. She had gotten interested in studying autoimmune diseases during medical school and did a lot of reading about them. She came to understand that the gut is a very important organ in the development of autoimmune diseases.

Her reading during medical school and her experience in internship and residency helped her identify where her research interest was. Applying for fellowships, she looked into different programs that had either mucosal immunology or some sort of autoimmune group within their GI group. This is how she landed at Massachusetts General Hospital—they had a mucosal immunology and biology research center.

I chose a place that had many opportunities in the area that I was interested in and my mentor was doing exactly what I wanted to do.Click To Tweet

When she was applying for fellowship, Maureen was reading all of her mentor’s research which she found very interesting. She didn’t reach out to him until he moved to Massachusetts General Hospital. So he sort of became her virtual mentor at that time.

[Related episode: What Is Pediatric Gastroenterology? (Another Interview with Dr. Leonard!)]

[25:10] She’s “Just” an MD and Does Research Most Days

Maureen says that 70% to 80% of her week is dedicated towards research, which means three and a half to four days a week. She sees patients one day a week.

Since she was focusing on research, she applied for a Master’s degree in clinical and translational investigation. She had some training in statistics and clinical trial design. But because in pediatric gastroenterology they had two years to focus on research, that’s what she did. Maureen gained a lot of experience during those two years. She wrote papers and had a mentor who gives her a lot of opportunities. So she has been able to become a translational investigator.

Because of her training as an MD, she’s able to obtain clinical samples from patients and then collaborate with the lab guys. She does some work on her own, too, and answers questions which she finds clinically interesting.

Options for Doing Research as a Physician with “Just” an MD

Maureen feels that “just” having her MD hasn’t held her back. Because she did specialty training where she had time to focus on research, she had an advantage. At this point, Maureen can see that she can continue down this academic physician-scientist path. It was her plan in the first place, and she loves doing it. She likes that she gets to see patients, do research, and collaborate with so many people. She likes that every day is different.

On the other hand, she has the opportunity to make a change and become a full-time clinician if she chooses. She thinks the Master’s degree has helped her, as well. Maureen can go to a pharmaceutical or a device-manufacturing industry and be a medical director. She can also become a translational scientist at a startup up company in Boston.

As a physician who has focused on research, I think I have a lot of different opportunities now.Click To Tweet

[29:10] What It Would’ve Been Like If She Did MD/PhD

Maureen thinks that if she did the MD/PhD route, it would look similar, and she would look a little bit older.

The balance of research and clinical medicine works for her because everything she does is based on celiac disease and gluten-related disorders. So she’s able to see patients one day a week. Then she gets to do the research. She adds that all the patients she sees could possibly be research subjects or inspire research questions. She’s extremely focused, which allows her to see patients and do research.

If you do MD/PhD, you still have to decide where to focus the majority of your time.Click To Tweet

Additionally, Maureen doesn’t want to lose any of her skills, so she does an extra half day every other week doing procedures. She could do less clinic and do more research. But she doesn’t want to give up seeing patients because she likes it and they help her with all of her research.

[Related episode: Bench to the Bedside: Interview with a PhD/MD Student]

Balance Between Clinical and Research as a Physician

So if you go the MD/PhD route, you still have to make choices on how much time you want to spend being a clinician or being a scientist. For Maureen, she couldn’t see herself doing less clinical work than she’s doing now.

Maureen has gotten to where she is now, not because of the letters after her name. She has just followed her interests. She has also been very intentional with the life and the practice and the setting she wanted to create for herself.

If you have passion for a certain research project, it doesn't matter what letters are after your name.Click To Tweet

[32:22] NIH Loan Repayment Program for Physicians Doing Research

Maureen currently has an award from the NIH and a grant from NIH. Because she does more than 50% research, she is eligible to apply for the NIH Loan Repayment Program. As long as you are doing more than 50% research and you have a research project in line with the NIH, you can write a grant and be awarded up to $35,000 a year for two years. That money goes straight to your loans. They also pay some federal taxes on that.

Just this past week, Maureen received her third and fourth year of that award. This means the NIH has put over $140,000 straight to her loans. It’s basically free money. Maureen stresses how helpful this is.

By working at a major academic center, you are not making the same salary that one could make in another state doing more clinical work.Click To Tweet

More NIH Research Grants

The NIH is also paying a fair amount of Maureen’s salary through a mentored research grant called an NRSA for F (Individual Research Fellowships) grant. She didn’t initially know about all these grants. This is a mentored grant, so she has this grant for three years. She has already completed the first year of the grant.

She’s now beginning to apply for the next NIH grant. It’s a K award, a five-year grant that pays 75% of your salary. Sometimes, you may even need to do a little bit less clinical work to really focus during that mentored career award.

In order to be awarded a mentored grant, you need a mentor who’s going to oversee all of your work and support you with the rest of the salary the NIH isn’t covering. So basically, she’s not an independent researcher at this point in the NIH’s eyes. Rather she’s a mentored grantee. So in these grant titles, the K means you’re developing your own independent projects, and the R is an independent investigator award.

Grant Writing to Fund Your Research

Although the funding environment is very difficult, Maureen has worked very hard and been lucky. She has gotten several grants but applied to many more than she received. Say, out of fifteen, she only got three. So a lot of time is spent on writing, and it’s difficult.

Maureen is realistic and she loves what she does. She wants to keep doing this. So she’s always writing more grants, and she’s going to continue to do that. And as long as she has funding, she’s going to stay in research, whether that be on the academic path or through the pharmaceutical industry. She basically feels good about her options.

I am happy that I really love being a clinician and that I can see myself staying in research, too.Click To Tweet

[38:10] The Nuts and Bolts of Writing Grants

Maureen explains that writing grants varies. Some grants will ask for letters of intent. You can write a two- or three-paged letter about what you want to do. Then they’ll invite you to write a full grant. For others, no letter is needed, and you just need to write a full grant. In a grant, you’re writing your summary of the research you want to do.

In a grant, you're writing your summary of the research you want to do.Click To Tweet

Usually in the first page, you write about what you’re exactly going to do. Then you write another five to six pages about why you’re going after those research aims and how you’re going to do it. You also include your file sketch that contains about five pages of your background and your contributions to science. They want to see your publications and awards. You may also provide bio sketches for anybody supporting you in this grant. That can be your mentor, anybody you’re working with, or anybody who’s going to train you if you need to learn certain techniques to complete the research.

You need to provide letters of recommendation from one to four people, and you have to give details on your budget: How much you’re going to spend, where, and when. And you need to provide a timeline for when you’re going to do all of this. In general, Maureen does pilot funding. A pilot grant might be 20-30 pages in total. Her NRSA grant was closer to 60 pages because a lot of documents needed to be included.

Writing a grant can take a long time… It can take months to ask around for feedback. The more people you can send it to, the more feedback you can get, the better. She usually gives herself a couple of months.

[41:42] Recommended Classes for Premeds to Become Better Researchers

Maureen recommends trying to take some basic statistics courses as a premed. She doesn’t do statistics frequently, so she gets help with it. But taking those courses has helped her understand how to plan a study and what kind of analysis she can do.

She thinks it’s great to have a better understanding of how research works. Clinical trial design is a good class to take as well. Ultimately, try to read research in the area you’re interested in, and look into what people are doing. For premed students interested in research, check out PubMed or Google Scholar—just start searching keywords.

Deciding Between MD/PhD and “Just” MD

If you’re trying to decide on whether a single degree or dual degree is right for you, Maureen says you can really accomplish all your goals with an MD. If you find that you need the PhD for some reason, that’s always an option to do after your MD. There are also other degrees like a Master’s that might help you if you need or want more training.

Maureen thinks it’s certainly possible to have a career focused on research with just an MD. Her mentor has a very productive lab, and he’s just an MD. So it’s definitely possible. Either way, you’re going to have to determine how you’re going to spend your time. There are only so many hours in a week.

It's certainly possible to have a career focused on research with just an MD.Click To Tweet

[Related episode: MD/PhD Medical School Program Director Shares What You Need to Know]

[44:55] Time Management as a Physician Who Does Research

Maureen says it’s hard to figure out how to manage your time when you’re doing research and being a clinician. There are always more grants to write. There are always papers to write or a chapter to write. So she’s had to really actively try to manage her time and take time off. She’s still working on this.

Maureen is always trying to prioritize which grants make the most sense to apply for and what papers must be written. She has been able to manage her time a little bit better recently. But in research, you can always keep writing and reading more, so you have to draw some lines in the sand for yourself.

In research, you can always keep writing and reading more, so you have to draw some lines in the sand for yourself.Click To Tweet

[Related episode: Time Management for a NASCAR-Driving Medical Student]

Advice for Premed Students

Maureen wants to tell premeds out there: It’s so worth it. She gets to manage her time the way she wants right now. The premed years when you’re trying to reach your goals are the hardest years. But she loves her job and the balance she has now. She loves doing procedures and seeing patients. She loves being able to answer questions she finds so interesting. So it’s totally worth it. Keep it up.

Maureen wants to tell premeds out there: It's so worth it.Click To Tweet

[46:55] Final Thoughts

As Maureen has said, you don’t need to have a dual degree to do research as a physician. If you want to do research as a physician, you can do research. You don’t need a PhD to do it. Not having a PhD doesn’t hold you back.

Dr. Leonard is at one of the top academic medical and research institutions in the country. She has”just” an MD, and her mentor has “just” an MD, and they’re out there doing amazing things. They’re doing a ton of research and are successful at it. They have not been held back by not having PhD’s.

If you’re that student who loves research and can’t see yourself doing anything else, go ahead and get that PhD. But if that’s not quite you, or you’re still unsure like Maureen was, now you know that you don’t have to.

If you want to do research as a physician, you can do research. You don't need a PhD to do it. Not having a PhD doesn't hold you back.Click To Tweet

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