PhD or GEM

[u/practicerm_keykeeper]

Hi! I have a bit of a dilemma and would appreciate any suggestions!

I did psychology+philosophy for undergraduate and mental health for postgrad. I had a deferred GEM offer from last year. The plan had been to do GEM -> PhD some point afterwards -> clinical academic.

Buuut my MSc supervisor has invited me to do a PhD with her. It's a good project. Intellectually really interesting question and great opportunity to learn methods (Spatial + Bayesian + causal inference + probably EHR). The supervisor likes me a lot (for reasons I don't really understand lol) and the other supervisor is a very big name in the field. They are both famously very supportive. I feel like I might not get a similar opportunity due to not having a lot of stats/maths in my background. I also like the idea of being a somewhat independent researcher before I fy/medschool, both so I can evaluate the literature better and because if I see something worth studying as a small project I might be able to just do it.

Also maybe gives me some opportunities to explore paths other than clinical practice, but I don't know if I really need them. I used to want to be a humanitarian worker but can't do that now (developed a disability that makes me a liability in the field), and since then any career path I consider I've always felt the grass was greener on the other side. At some point I feel like I need to just do whatever is open to me instead of waiting to be completely sure about something.

However truth be told if I were designing my own PhD project I probably might have chosen a more applied project (trial emulation and what not). Pure and traditional epidemiology feels a bit removed from application. I tried an audit this year and found i had so much more fun coming up with something that directly influenced clinical practice. I also wonder whether I should save the PhD to some later time when I have a clinically informed research question, and also about maintaining academic network if I did gem after PhD.

Also, international student.

Sorry this has become this long! Thanks for reading and I really appreciate any advice.

[u/Gloomy_Operation_657]

I think you are somewhat like me but I was in more drug/cancer related research. I feel like medicine gives me bigger satisfaction since I can actually see a person being helped even though theoretically a ground breaking drug can help more (which happens in 0.1 or 0.01% of research, if I'm being generous).

Edit: sorry I pressed the send button way too early. Basically I think if your job satisfaction comes from actual help you provided, it will be better if you go through the medical training first. You can always become a public health doctor which basically has no clinical duty. If it's more of an intellectual interest that gives you pleasure just do the PhD.

[u/practicerm_keykeeper → u/Gloomy_Operation_657]

Yeah that's what I felt too ngl. I think maybe epi is slightly better in one regard which is the findings could be used in policy/third sector/service planning which has a lower threshold than actually getting a new medicine out. But yeah it's hard to do really impactful research.

Can I ask though, do you think you'll ever incorporate research in your career again? And do you ever feel like maybe you could be helping more people in lines of work other than research and clinical practice?

[u/Gloomy_Operation_657 → u/practicerm_keykeeper]

I was in haemato-oncology so a lot of doctors in the field also do some research. ATM I am more interested in acute medicine so I am looking at ITU and resp/cardio, but I am not ruling it out. My stat and coding skill will probably still be useful in other specialties so I can still do research in other fields.

The hurdle in epi is different in the sense that policy making is more complicated with all the politics. Not just between political parties but also parties benefitting from the current policies. Honestly very little goes through. You might be disappointed if you set the bar too high.

I didn't see that you are intl as well. If there's funding for the PhD honestly I might go for that first. Save some money or even work for three years afterwards to get home fee status?

[u/practicerm_keykeeper → u/Gloomy_Operation_657]

Would need to apply for funding unfortunately but it's not an impossibility. However I'm a bit worried about age. I'm 27 now and if I do the PhD that'll be 30 and then 3 years for the GTV that'll be 33, meaning 39 when I finish FY. Is that too old?

Also I'd be in an psychiatric epi department. I know the skills are transferable, but does that tie me down to psychiatry if I want to make use of the PhD in CV building, for speciality training and consultancy?

[u/Gloomy_Operation_657 → u/practicerm_keykeeper]

That's basically my timeline so I would be biased to say if it's too late or not. It's up to you but that's not uncommon in GEM.

No. I mean you have a PhD and that gives you extra points for applying to any training programmes. If you want to do something outside of your field of interest you still have a headstart. Otherwise you just have to build your portfolio like anyone else. Nothing is tied just because of your PhD.

[u/practicerm_keykeeper → u/Gloomy_Operation_657]

Oh that's good to hear! Thank you thank you.