Into The Rabbit Hole

Wow.  So I just spent a few hours researching the possibility of getting my MD/PhD through the MSTP (Medical Scientist Training Program) at CU.

This means I would be earning both my Medical Degree and my PhD at the same time, in one fell swoop.  It’s something to consider!

I was speaking with two of the doctors within my department over brownies today.  I had told both of them (two very opinionated, vociferous fellows) that I was tossing around the idea.  The biggest pleaser: tuition is paid through grant monies AND I get a stipend.  It’s a modest stipend, about $10K less that what I earn now.  But… I wouldn’t be working.   I wouldn’t be working through my MD anyway… The whole point of these MSTP’s are to attracted physician scientists, because apparently this is a program that has been lacking qualified applicants.  So, the not accruing $300K worth of debt I would otherwise accrue should I go the MD program alone seems somewhat tantalizing.

There are rumors that the more research you do after you earn your degree (and therefore the less clinical work– ie, seeing patients), the less money you earn.   All this time I have been banking on the whole “Good psychiatrists can average ~$400K a year” thoughts… which is interesting, because I wonder just how many psychiatrists actually earn that kind of money.  I believe the MD/PhD graduates show somewhere on the scale between $80-300K yearly, and that, too, is relatively flexible depending on where I’m employed.  Ultimately, though, I’m really not following my dreams based upon the amount of money I earn.

Clinical stuff is something to consider as well.  I believe I have something within me that helps people, and to deny future patients the opportunity to see me clinically may be a greater deprivation than I initially posited.  Clinical, especially in private practice, is where the money is at.  So, could I earn my degree, performing extraordinarily valuable research in chemical neurobiology in the field of neuroscience, and also ultimately earn a name for myself well enough to have my own private practice?  Could I actually only spend half of my time in research and half practicing?  I believe from what I just read, I could, should I choose to do so.

My mission, ultimately, is to change the world of psychiatry.  I want to come up with the reasons for behavior.  I want to be able to diagnose (accurately) via neuroimaging and blood tests.  I want to be able to find real solutions to mental illness– real pharmaceuticals or otherwise effective treatment for bipolar, schizophrenia, depression, OCD, anxiety, autism, ADHD, etc.  As of yet, the medical field really doesn’t know a damn thing about how the treatments (which often aren’t effective) work at all.

So, will I have the most bang for my buck being a really great counseling psychiatrist, helping one individual at a time, doing minor research on the side, earning more money, yet having significant debt to pay off, or would it be better to do research, come out with only the debt from my undergraduate courses, and make less yearly?  The question is yet to be answered.

Then there’s my age.  I am older than most college seniors.  I started six years late.  I have debt outside of student loans, albeit less than $10K.  I don’t own my own home (yet), but I still have a mortgage to pay.  I could buy the house I’m in, but…  Ultimately how much debt am I getting myself into?  Will the ends justify the means?  When will I get to settle down and stop working so hard?  And what if I were to make babies?  (Had to throw the question in there, simply because I’m a woman, and that’s what women are expected to do, eventually.  Not saying I’m gonna.  Hold onto your britches, mom.)

Jesus, these are all so many grown up thoughts and grown up decisions.  When I finally earn my bachelor’s degree, and then finish my pre-reqs for med school, will I have high enough grades to get into med school?  And what about the MCAT?  Am I going to score well enough on it to ensure acceptance into the ONE school of medicine I plan on applying for?  Obviously, in my mind and heart, it’s a no-brainer: yes.  There is no question in my mind that I’ll be going to the school of medicine here in Colorado, and it doesn’t seem to phase me that I’ll have to do well on my MCATs (and if I want to do the MD/PhD program, also do well on my GREs) in order to be accepted to the programs I’m applying for.

I feel like time is running out for me to get the education I want.  I am eager, but at the same time, I’m exhausted.  I know I’m going to keep plugging away, because that’s just what I’m going to do, and I’m a very tenacious lady.   When one of the doctors said to me today, “How old are you, Ash?” I answered (27) and he said, “When will you be done with your undergrad?” and I said, “Hopefully by the end of 2009, and he said, “Well, I’d strongly suggest you DO go the route of MSTP [because you’ll have less time to pay off the debts of medical school, and you’re getting older!]”  Okay, so he didn’t say that part in brackets, but I know what he was thinking.  I AM getting older, and it DOES seem as though time is running out.   Eventually, I’ll get to my career…

And it’s exactly that mode of thinking that gets me all panicked and in a tizzy.  It’s that impatient Time Is Running Out attitude that freaks me the frack out.  Ultimately time isn’t running out, really.  I have all the time in the world, and as This is my plan, This is my attack, This is the One Goal that I will achieve before I die, or I will die working towards achieving.  It’s just that I recognize that this is the one life I have for the moment, and I want to make sure that when working with such life-altering decisions, I’m making the right choices.   I can look back at so many past decisions I’ve made with my education, and I recognize the mistakes… the stuff I could’ve done better.

I’ve been reminded, even today, that I don’t have to make a decision now.  In fact, it would be silly to be dead set on deciding to do the MD/PhD route without having done any research yet in my undergraduate career.  Who knows?  Maybe I’ll hate research.  I’m guessing, though, that I won’t, as it’s something I’m incredibly passionate about and have put much thought into How I’ll Change The World.  Research is a good avenue to do such things.  And to be using that line: What if Medical School isn’t something I like?  Ha!  Then I’d be really out of luck.  All this time and energy spent on something that I would turn out not liking.   That’s such a random unlikely possibility that I’ve never even considered it– not even when I was just typing it out.  Of course I’ll LOVE medical school.  I’ve put major thought into all of this.  (can ya tell?)

Anyway, the thing is that there are a lot of options out there for me.  I want to make lots of money, yes, but more importantly I want to do what I love– and I want to make a difference.  If I could solve even one of our chemical mental afflictions, that would be plenty of an effect on the world as we know it.  Lofty goals, yes.  But have you met me? I realize I don’t have to make any decisions just this moment, but I must ultimately THINK about what it is I might do.   Not thinking about it is what led me to take 30 extra credits of electives than were necessary for my undergraduate degree.  Of course, I’ll know a hell of a lot more about astronomy than any other applicant.  (Don’t get me started on the other things I’m doing to secure my success as an applicant, I’m blowing those other fish right out of the water! *wink*)

So, this all being said, any advice out there for me???

xoxoxox