1 year to go ... was it supposed to be this tough?

[gstrub]

MD-PhDs would be wise to learn some humility & political savy before they start clinics. Even if everyone else on the wards is an idiot compared to you, they know how to care for patients far better than you. Furthermore, they are what stands between you and Honors.

I hope the motive for this...advice...is that you met some terrible MD/PhD students. I'm not sure how you conclude that spending time doing research makes anyone less humble or politically savvy...I would say the opposite is more likely to be true. I was suggesting that often times MD/PhD students' schedules become disconnected with the MD program, and by not allowing flexibility (say by allowing a MD/PhD student to move a rotation to M4 so that they might complete an AI before an interview), those disconnects put some students at a disadvantage when it comes time to match.

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[Neuronix]

and by not allowing flexibility (say by allowing a MD/PhD student to move a rotation to M4 so that they might complete an AI before an interview), those disconnects put some students at a disadvantage when it comes time to match.

We are allowed to do this, and I think most students here do it. Unfortunately it puts you at a disadvantage for two reasons.

1) If you need more honors core clerkship grades, there's a missed opportunity there. I know I've been accused more than once in this thread of being too grade-focused, but in the real world I'm being constantly reminded that core clerkship grades and Step I score are the most important factors for competitive residencies.

2) If you need to take Step 2CK early to attempt to make up for a sub-par Step 1 score, you should really take all your clerkships before Step 2 CK. One piece of advice I received from the group of students who didn't match was not take Step 2CK without full preparation including all the core clerkships. I've been assured that taking the advice: "oh you'll be ok for Step 2 without OB/GYN" was a mistake.

For these reasons I came back to clinics pretty early for my school. Even with coming back early it can be hard to get the time to figure out what specialty I want and get the LORs I need.

 

[QofQuimica]

2) If you need to take Step 2CK early to attempt to make up for a sub-par Step 1 score, you should really take all your clerkships before Step 2 CK. One piece of advice I received from the group of students who didn't match was not take Step 2CK without full preparation including all the core clerkships. I've been assured that taking the advice: "oh you'll be ok for Step 2 without OB/GYN" was a mistake.

This is going somewhat off topic, but for the record, I would strongly advise against taking CK without OB/gyn. Whoever said you could do that has no idea what they're talking about, because OB/gyn is a major subject covered on the test. You can get away with not having done rotations like FM, geriatrics, EM, or neurology, although I think these rotations would all be helpful to some extent. But you better have all the core rotations done and down pat (surgery, peds, psych, OB/gyn, and especially IM). Don't even think of taking CK without finishing your rotations in these five core specialties.

 

[nomogram3]

While I agree that MD-PhD students need to have flexibility in the scheduling of clerkships and electives, I do not support the idea that they should be treated as if they are masters of the universe. The attitude that MD-PhDs are somehow better than MDs & thus deserve special treatment is dead wrong. (They need special treatment in order to ameliorate conflicts caused by the structure of their training, not because they are enrolled in an institution's "highest degree program".) Hitting the wards with an attitude that everyone else should be in awe of your mighty PhD degree is the surest way to earn the animus of everyone on the floor, from the chief of service down to the nursing staff. I have seen this happen many times over the years.

MD-PhDs would be wise to learn some humility & political savy before they start clinics. Even if everyone else on the wards is an idiot compared to you, they know how to care for patients far better than you. Furthermore, they are what stands between you and Honors.

Apparently you've seen me on the wards with my He-Man white coat and stethoscope. An MD/PhD is the highest degree an institution awards (I'm sorry if I'm leaving out the MD/PhD/JD student, he's probably out there somewhere) and sometimes the clerkship structures have to be bent to accommodate us. The NIH has a fair chunk of change riding on Mud-Phud education because of the outstanding research that physician-scientists do. In my experience, MD/PhDs are more mature and better managers of their time when they hit the floors. Does this mean you can behave arrogantly on the floors...no. Does "everyone else on the wards" know how to take care of patients far better than you...no. If you behave professionally, take good care of your patients (therefore being humble) you can avoid too much ***** kissing during the clinical years (medical student political savvy) and get good letters and honors grades.

 

[gonogo]

I think most MD/PhD students have culture shock when they go back to the wards as MS3s. By the time you're done with the PhD, you've achieved a lot of maturity as a researcher. You've published papers, gone through the whole peer review process, presented at national conferences, etc.. moreover, you're pretty much considered an "expert" on what you did your thesis on, the guy to go to in the lab when someone needs to do an experiment you're good at. So it's definitely hard to go from there to an MS3, who's the lowest on the hierarchy on the floor. Another big problem I found was the age factor. When you return as an MS3 you're much older than you're peers, so this automatically sets you a little bit as an outsider. Then, because of your achievements during you're PhD, you may inevitably feel more entitled than the rest. No doubt this is wrong, but it happens. On top of all this, no matter how successful you were as a PhD or how much knowledge you have, no one will really appreciate this on the ward.
So in conclusion, it's definitely tough to go back to MS3, and I think it's something most MD/PhDs have gone through.

 

[RxnMan]

I think most MD/PhD students have culture shock when they go back to the wards as MS3s. By the time you're done with the PhD, you've achieved a lot of maturity as a researcher. You've published papers, gone through the whole peer review process, presented at national conferences, etc.. moreover, you're pretty much considered an "expert" on what you did your thesis on, the guy to go to in the lab when someone needs to do an experiment you're good at. So it's definitely hard to go from there to an MS3, who's the lowest on the hierarchy on the floor. Another big problem I found was the age factor. When you return as an MS3 you're much older than you're peers, so this automatically sets you a little bit as an outsider. Then, because of your achievements during you're PhD, you may inevitably feel more entitled than the rest. No doubt this is wrong, but it happens. On top of all this, no matter how successful you were as a PhD or how much knowledge you have, no one will really appreciate this on the ward.
So in conclusion, it's definitely tough to go back to MS3, and I think it's something most MD/PhDs have gone through.

This is pretty much what any non-trad MD student goes through.

 

[Neuronix]

Don't even think of taking CK without finishing your rotations in these five core specialties.

The only rotations that make sense to push back at my school are Psychiatry, OB/GYN, or Peds. This is what students commonly do. None of these can be omitted for Step 2 CK. So those students have to come back to clinics sooner than everyone else. What happens is though that students don't realize their interest in a specialty that wants Step 2 or don't realize how competitive their specialty is until it's too late. So then they're stuck either not taking Step 2 or taking Step 2 without being prepared. It's a setup for not matching that's special to MD/PhDs.

Again, the point of this thread is to junior students... THINK ABOUT THIS STUFF ASAP.

I personally only could pull this off because I took my leave of absence (post-doc) and thus had the flexibility to come back when I needed. Or else I would have had a lot of PhD overhanging into clerkships, which is also common and seems like a nightmare!

 

[QofQuimica]

This is pretty much what any non-trad MD student goes through.

That was my reaction too. I'm laughing to myself going, older than my peers? Ha! How about going through third year being older than most of my residents and even several of my attendings? How about going to med school as a first year student when under other circumstances, I might have come here as junior faculty?

 

[calvinNhobbes]

How about going through third year being older than most of my residents and even several of my attendings?

Even weirder is when your resident or attending is an old classmate from your original class!

 

[RxnMan]

That was my reaction too. I'm laughing to myself going, older than my peers? Ha! How about going through third year being older than most of my residents and even several of my attendings? How about going to med school as a first year student when under other circumstances, I might have come here as junior faculty?

Exactly. While there may be some stress to transition to clinics as an older student, it's not anything unique or special.

 

[smq123]

Even weirder is when your resident or attending is an old classmate from your original class!

I was rotating with a med student whose former anatomy lab partner during MS1 (who also happened to be his ex-girlfriend - they broke up during MS2) was later his chief resident when he was doing his med student clerkship in OB.

 

[QofQuimica]

Even weirder is when your resident or attending is an old classmate from your original class!

Has that actually happened to you? I keep waiting for the day when I have a resident or attending who was a former *student* of mine. My first groups of freshmen gen chem students would already be residents now if they went straight to med school out of college.

 

[calvinNhobbes]

Has that actually happened to you?

Yep, two of the medicine chief residents and the a pysch chief were my former classmates. I also knew several residents in radiology, cards/GI fellows, gen surg, derm, etc. Not to mention several MD/PhDs from classes above me that I knew who were senior residents.

Some of the junior residents remembered I was their TA for a couple classes.