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- Aug 21, 2005
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Why did you suddenly jump to productivity, as if to imply that that was the reason programs have been less interested in MD/PhDs lately? I applied with 10 publications, honors in 7/10 clerkships/electives/AI (including the specialty of interest to which I applied - med-peds), strong LORs, step 1 of 250+, step 2 of 270+. No AOA - which MD/PhDs in my class did not receive for reasons that can only be described as political. I struggled to get interviews at top institutions, and when I interviewed was under the distinct impression that they were far less interested in my research and career goals in science than in what volunteering or leadership project (or lack thereof) I had done. Oh, and AOA seemed to be very important in their minds.
My situation is by no means unique. Last year, a colleague with many publications (including 1st author PNAS, for what it's worth), an NRSA F30, honors in IM/peds/neuro clerkships, step 1 of 250-260 (so far as I know), etc. but again no AOA, did not so much as get interviewed by MGH or UCSF for IM residency, and ended up at his 2nd choice from programs that invited him to interview.
My MD/PhD colleagues this year applying to ortho and radiology with comparable publication records (and with F30 grants, which I didn't have), board scores, clinical clerkships, etc. did not so much as get interviews at many top places. Even places at which they did away rotations. Again, was their lack of AOA the reason?
On the other hand, my other MD/PhD colleague applying to IM several years ago got into BWH for IM. She wasn't AOA, her board score was below 240, she didn't get honors in IM. She did do several months of research post-PhD in a very well connected lab, got a 15th author position on a Nature Medicine paper (take that for what it's worth), and had this very well connected PI (who had been recruited from BWH several years prior) make phone calls to BWH people on her behalf.
Do not be quick to cast the blame on the applicants' supposed deficiencies. You speak for one residency selection committee and one specialty. Many of us senior MSTP students have had the opportunity to observe across the past several years and over a variety of specialties that many excellent MD/PhD applicants are getting weeded out at the pre-interview stage because they lack political connections, because they lack the extracurriculars that MD-only colleagues have, because of a perceived blemish in their clinical performance (e.g. lack of AOA - as if that was somehow non-redundant with the clinical rotation grades!), because they lack that 7th author Science paper from big-name-PI's lab, etc. Just saying.
I don't think generalizations can be made from Med-Peds as it is a unique beast. Same can be said for ortho and radiology as they've never really been super MD/PhD friendly specialties.
I'm guessing by "top" programs you are really referring to UCSF, BWH, MGH, and Hopkins. If you look at those program's current IM intern rosters it is pretty clear that MD/PhDs are well represented. Ditto for the match lists above even though they tell only a fraction of the story.
Those of us who've been around awhile all have anecdotal stories of MD and MD/PhD colleagues who landed slots at those "top" places with less impressive apps then what we are seeing get rejected today, but that is likely due to increased competition across the board. My point to the younger folks is to make your MD/PhD count, because a productive PhD will continue to set you apart and even if you don't wind up at one of the aforementioned it may help unlock doors at many of the other well-regarded programs not obsessed over as much on SDN.