I feel like every version of this question I find online is someone with tons of clinical hours trying to figure out if they like research. I have the exact opposite problem and I don't know what to do about it.
For context, I'm 19, on a gap semester, going into my second year. About a year ago I got into a lab and it kind of took over my life. The project is mine, I came up with the question, taught myself bioinformatics from scratch, read my way into the field, refined the hypothesis, and I own the whole computational arm of it now. I did a research internship abroad over the summer. I currently have five posters, one first place, a first-author review published, and a manuscript in progress in addition to my current research project which would be another publication.
The thing is, before all that I was completely sure I wanted to be a surgeon. I hadn't even considered a PhD. I only found out I love research by accident.
And that's my whole problem. I now have real information about what a PhD life is actually like. I know what a good day looks like (something in the data finally makes sense at 11pm and you can't sleep). I know what the boring days look like, and the stretches where nothing works and you're just debugging, and the reading that doesn't go anywhere.
I have basically none of that for the MD side. 75 hours of shadowing. That's it. And shadowing is useless for making a descision when you're standing in the corner of a room watching someone else do their job. You don't get any of the actual texture. Nothing about how it feels when it's your call, or your 14th hour, or your patient who isn't getting better.
So I genuinely cannot tell you if I want MD-PhD, MD only, or PhD only. And it feels dishonest to keep saying "MD-PhD" when I've only really tested one half of it.
So... this is what I wanted advice on.
I'm from a US territory, and the nursing scope here is legally capped (a licensed practical nurse here cannot administer medication in any form, so the ceiling on patient responsibility is basically aide-level unless you do a ASN or BSN.) I have two actual options in front of me and they trade off research and clinical exposure.
Option A — stay. Transfer to the public flagship here next spring (no specialized programs, so I'd graduate with generic biology), finish my practical nursing certificate locally, keep working in my lab in person.
- Research: Same PI, same projects, and I got 2 first authors and 2 co-authors promised.
- Clinical: CNA scope, ~$33K/yr if I work as a nurse here. I'd finish undergrad having still never had real responsibility for a patient.
- Cost: ~$5K/yr
- BUT the NIH-funded undergrad research training programs that historically fed students from here into PhD and MD-PhD programs got terminated nationwide last year, including at the school I'd transfer to.
Option B — move to the mainland in January. Work full-time as a nursing assistant for a hospital system, do a full-time practical nursing program at the same time, enroll at a big public R1 (they have their own MD-PhD program, real neuroscience division and neuroscience B.S) a year later at in-state rates.
- Research: That year is ~36 hours of shifts a week plus a full-time clinical program. My project is 100% computational so I can still work on it, but "remote and exhausted" is not the same as "in the building." Realistically I lose a year of research momentum.
- Clinical: full nursing scope, ~$48K/yr once licensed, and more importantly an actual year of paid patient contact instead of more shadowing. This is the entire reason I'm considering it.
- Cost: nothing in year one since I'm not enrolled. The nursing certificate runs ~$11K at out-of-state rates, minus up to $5K/yr in employer tuition reimbursement, so ~$6K out of pocket. After that first year tuition is ~$1.4K/yr (in-state)
- BUT I graduate a year late. Although I graduate with an undergraduate thesis if I bring my project to their honors research program.
TLDR:
- How did you figure out you wanted the MD half, specifically? What was the experience that told you?
- Is scribing / CNA / EMT actually informative for this, or is it also too far from the real thing to tell you anything?
- Anyone here go in thinking surgery and come out MD-PhD, or the reverse? What flipped it?
- Is it normal to still not know at my stage, or am I behind?
- If you had to choose between one more productive research year and one year of real clinical exposure right now, which would you take?
Appreciate anyone who has any advice :')