Anyone ever hear of anyone doing this? Is it possible if you are on the MSTP grant?
1yr post doc before returning to clinics?
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Yes, know multiple people. Sometimes the reason is to spend a year in another location with SO. Other times, they're not quite ready to go back to clinic, but they want the postdoc rather than grad student level of stipend. In general, I feel it is a bad idea. Logistics make it more onerous than simply staying in grad school another year, because you should spend as little time as possible dealing with that administrative crap. Plus, this training path is long enough as is--just finish it already. Others have made a strong case that even staying in grad school for an extra year to make the difference between Nature vs. Your 2nd tier journal is a bad idea.
don't do it for a full year. only take postdoc salary if despite your best efforts, you'll end up going back nov/dec due to unforseen circumstances (ie paper not accepted in time, planning an Oct return). then, defend in november and take postdoc salary for 6 months until returning to clinic in sync. it really does nothing for your career.
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This is exactly what happened to me. For anyone who cares about my stories, I'm far enough away from that time to talk about it freely where I haven't before. So I'll explain my particular story.
From the start of my PhD I wrote a prelim defense and wrote a funded grant based on that prelim with a set of specific aims. I met those specific aims about 3 years into my 3.5 years of allotted PhD time. Two of my side projects had also borne fruit. I was ready to return to clinics.
However, my thesis committee, heavily driven by my PI, wanted MORE MORE MORE. Additionally, they had unrealistic expectations. At first the line was: "we'll let you know when you're ready to defend. BTW, why do you have thesis committee meetings so frequently? The MD/PhD program requires you to have meetings every 6 months? You're such a ridiculous stickler for the rules. They don't have to know that you didn't actually have a committee meeting."
But as the time drew near for me to return to clerkships, they expected me to keep being productive in lab until the weekend before I left the lab. They expected me, at a minimum, to write my thesis and defend during the third and fourth years of medical school. One of our MD/PhD grads from something like 15 years ago did something similar, so they felt that was reasonable. This is despite our program's policy that the thesis must be deposited before return to clerkships (semi-flexible, but still). My lab always did feel like MDs (and MD/PhDs by extension) were kind of lazy and stupid, so I should stop complaining and get to work. Besides, being an MSTP at a big name medical school was supposed to get me whatever residency I wanted (except the last two MSTPs from the neighboring labs didn't match, but I was just supposed to forget about them).
So even though I already had 4 publications (2 accepted, 2 submitted), my committee chair was insisting on having 3 publications directly related to each other. When I submitted that paper, then the rule became that I needed those 3 publications accepted. They were just stalling me, and it made me very angry. In the end, my MD/PhD program director had to come sit in on one of my thesis committee meetings to get them to agree to let me defend, which made my PI absolutely furious. The situation made me furious. In the end, I missed my return to clinics deadline by about 2 months and I vowed never to work in academics again.
So then I had 10 months to kill. I sure as heck wasn't going to keep working for that lab. So I went to another group in the location where I wanted to do residency. They seemed to like having me, I loved being there, and I had a great time. I was paid NIH post-doc minimum, which was about $14,000/year more than the MSTP stipend and with much better benefits. I event spent a couple months of it working remotely from a beach in Thailand where I was scuba diving every other day. My post-doc adviser insisted that I tell my graduate school adviser about my time with him. I'm not entirely sure what his motivations were for that, and I never should have agreed to it. The response from my graduate school advisor was: "I let you leave my lab so you could take a 10 month vacation?"
So in the end, do I regret doing a post-doc? Not at all. But, the circumstances were very different for me. The 10 months were technically a "personal leave of absence" and I can never know how much it hurt my residency applications. I was asked about it often. I didn't get the location nor the programs where I could do my research when I applied to residency, though I did match to a mid-tier academic program in a competitive specialty. So I guess that's something. Almost all the places that are strong in the kind of research that I do rejected me without an interview. The remainder just didn't rank me highly. Thus my path to clinical practice, likely in private practice, was cemented.
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I would not recommend doing a post-doc year unless it's for personal reasons (e.g. aligning with a significant other).
A talented MD/PhD in my lab, who was quite a bit older than most MD/PhDs, decided to take a postdoc year. His project was "on a roll" and he felt that if he spent an extra year, he could finish up the project and get a paper or two. Fast forward a year later, and his project had stalled, and the data still has not been published four years later. At the advice of the MD/PhD program, he stayed in the postdoc longer and shortened his third year ("You really only need 18 months") and really struggled, getting very poor grades. He matched at the home program but only after the residency director was reassured by my PI that he was actually going to be good. I doubt he could match anywhere else due to his scores, but staying home was where he wanted to be, so it worked out. If you ask him, he thinks he was foolish for staying that extra year.
My advice has always been get out as soon as you can. There comes a point where you've learned all you can learn and the rest is just polish. Polish can come later. Choose your PI wisely based on their track record with MD/PhD students, and choose a thesis committee chairman who has been a good advocate for MD/PhD students and is not afraid to antagonize your mentor and advocate for you.
When the time comes, sit down with your PI and ask, "Have I earned a PhD?" She may start talking about all the work that is left to do, but keep on coming back to the question. At the moment she says, "Yes," schedule your defense.
A talented MD/PhD in my lab, who was quite a bit older than most MD/PhDs, decided to take a postdoc year. His project was "on a roll" and he felt that if he spent an extra year, he could finish up the project and get a paper or two. Fast forward a year later, and his project had stalled, and the data still has not been published four years later. At the advice of the MD/PhD program, he stayed in the postdoc longer and shortened his third year ("You really only need 18 months") and really struggled, getting very poor grades. He matched at the home program but only after the residency director was reassured by my PI that he was actually going to be good. I doubt he could match anywhere else due to his scores, but staying home was where he wanted to be, so it worked out. If you ask him, he thinks he was foolish for staying that extra year.
My advice has always been get out as soon as you can. There comes a point where you've learned all you can learn and the rest is just polish. Polish can come later. Choose your PI wisely based on their track record with MD/PhD students, and choose a thesis committee chairman who has been a good advocate for MD/PhD students and is not afraid to antagonize your mentor and advocate for you.
When the time comes, sit down with your PI and ask, "Have I earned a PhD?" She may start talking about all the work that is left to do, but keep on coming back to the question. At the moment she says, "Yes," schedule your defense.
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Because nobody cares about that except your PI who will use that paper to apply for their own funding. Clinical departments, especially residency program directors, don't know or care about the difference. They want to see that you have a PhD, that you published something (preferably in their area), and most importantly your class rank, step 1 scores, and that you seem like a happy-smiley enough person to keep getting beat down while you keep smiling. When you're applying for grants, fellowships, and faculty positions several years later, almost all anyone will care about is what you've done recently.
I'll say it very plainly: staying in the lab to get a "better" PhD than necessary is a waste of your time. Do not do this. If you have other reasons for considering time off before you return to clerkships, it may make sense.
And the extra years... Oh they don't seem like much when you're 22. But when you're 32, the dragging out of time, the super hard work for low salary, the virtually no control over your job options, the being treated like a child/trainee... It just gets more and more painful.
debateg's advice on picking a committee and getting ready for defense is good advice. I knew these things too. I was posting very similar things on SDN during my PhD. My story is not that dissimilar from others I know who also took that same advice. The reality is that in a PhD program, others have all the power over you, and the criteria for finishing a PhD are very subjective. Everyone comes into their MD/PhD program wanting to finish in 6-7 years. But the average is still 8 years, with many finishing in 9 years, for a reason. I should have finished in 7 years, but I didn't. It can, and with some frequency does, happen to anyone.
If it looks like your project has loose ends to tie up, and your PI is pushing you to stay longer, you can approach your PI with the deadline and discuss what needs to be tied up before publication. If there's a relatively new trainee, you can float the idea to your PI that the trainee takes over the project in exchange for co-author or second author. It's a win for everyone. You get to defends, the new person hits the ground running and gets a good publication quickly (hopefully), and your PI is reassured that someone will take over your project. Your PI may be resistant to this idea, but get the other person on board, and offer to start training the trainee in the techniques you do. Hopefully, your PI will acquiesce eventually.
Once your PI is on board, your committee should fall in line. If that does not happen, you have to start politicking, first with your chair. If your PI and your chair both agree, but there is a holdup, talk to your MD/PhD administration to exert pressure. If all else fails, you can fire members of your committee. That's not ideal, but sometimes it has to come to that. In your career, you should never burn bridges, but sometimes people are such jerks, you can get away with it.
This is all easier said than done, and best if started early. Sometimes, people get forced into terrible political situations despite doing everything right, and unfortunately, that really sours people's views towards academia. If you can, get an mentor (mentor as in someone who gives you advice, not your PI) skilled in the politics of it all who is completely outside your field and has no say in what happens to you. Those people can be great resources.
Once your PI is on board, your committee should fall in line. If that does not happen, you have to start politicking, first with your chair. If your PI and your chair both agree, but there is a holdup, talk to your MD/PhD administration to exert pressure. If all else fails, you can fire members of your committee. That's not ideal, but sometimes it has to come to that. In your career, you should never burn bridges, but sometimes people are such jerks, you can get away with it.
This is all easier said than done, and best if started early. Sometimes, people get forced into terrible political situations despite doing everything right, and unfortunately, that really sours people's views towards academia. If you can, get an mentor (mentor as in someone who gives you advice, not your PI) skilled in the politics of it all who is completely outside your field and has no say in what happens to you. Those people can be great resources.
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This is the reason for me. I have been very productive in my PhD (4 first author pubs already, a couple more in review) and am ready to submit my thesis for a 3.5yr PhD (PI and committee have already signed off). I agree with all the other posters that an additional year of research is not particularly beneficial, however, my wife and I want to match together and that is much more important to me than getting finished quicker.
So I am trying to figure out how to post-pone my return to clinics by 1 year. And obviously I need to be getting paid, and ideally would like to maximize how much I am getting paid, hence my original question. My PhD supervisor is a great guy and I know if I ask him about doing a post-doc he will try to make anything work.
Basically, I figured I have these options: 1) postpone submitting my thesis by a year to stay 'in the program' so to speak. 2) Stay in the same lab as my PhD for a 1 year post-doc, and continue working on things that I already have going 3) do a 1 year post doc elsewhere
I didn't know if this was legal in terms of MSTP programs, being on 'leave of absence' from medical school for a PhD, and/or would be questioned by Residency directors during interviews. From everyone's responses, it looks like it would be okay and has been done before, which is good.
Thanks everyone for your insight it is helpful.
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It's legal for the MSTP. It's not legal if you're on a grant like the F30 - you'd forfeit the remainder of your grant. Talk to your MSTP director, but that's a fairly commonplace reason to delay for a few months - whether as grad student or post doc depends on PI's funds (ie may not be feasible with sequestration). Be sure you leave on great terms with your PI, whatever your decision - they write the most important residency rec. No residency director is going to care that you delayed to couples match, but ask the MSTP director what it'll look like on your applications (I'm sure LOA will raise an eyebrow or two and ideally will be promptly explained as a postdoc).
You will have to do all the new employee annoying stuff, e.g. orientation, getting all your tax forms in order to be a new employee, learning about health insurance options, retirement funds, getting a PPD, etc. Your student loans will likely go into repayment. You also will probably not qualify for your student health insurance and will have to enroll in a university employee plan. That means a bunch of paperwork, and you may have to find a new doctor to see for a year, transfer records, etc. If your health benefits as a student are good and much worse as an employee and you have an expensive medical need, it be worth it to stick around as a graduate student. That's the only reason that I see to stick around, unless your PI can absolutely not afford to pay you as a postdoc.
Make sure the MD/PhD program is 100% behind this idea. Make sure the MD program is also 100% on board, and they explain to you how the process of transitioning from post-doc to MD is different from PhD to MD (it should be identical). You don't want to prepare to return back and find that the MD program wants you to do something crazy like retake Step 1 or take Step 2 now. At any decent program, it should be a non-issue, but I have heard horror stories about not so well run places.
I wouldn't worry about taking a leave of absence for this. My dean recommends that all MD/PhDs check "yes" in the box asking about leave of absence from medical school in ERAS and say, "I spent four years in lab working on a PhD +/- and one year as a postdoc." No program director will care about that.
Make sure the MD/PhD program is 100% behind this idea. Make sure the MD program is also 100% on board, and they explain to you how the process of transitioning from post-doc to MD is different from PhD to MD (it should be identical). You don't want to prepare to return back and find that the MD program wants you to do something crazy like retake Step 1 or take Step 2 now. At any decent program, it should be a non-issue, but I have heard horror stories about not so well run places.
I wouldn't worry about taking a leave of absence for this. My dean recommends that all MD/PhDs check "yes" in the box asking about leave of absence from medical school in ERAS and say, "I spent four years in lab working on a PhD +/- and one year as a postdoc." No program director will care about that.
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I think you should just match and have your wife match the year after you. The couples match is not guaranteed. I'm not sure you have any better chance of staying together if you match in separate years. I think you should just try to match now in a location that has a lot of programs.
I was on an F30 and the grant was suspended while I was away on "personal leave of absence" and resumed when I returned.
I did very little of this.
You do have a six month grace period if you haven't used it before. My undergrad loan payment is quite small, but YMMV.
Opposite for me. The post-doc benefits were much better. Those benefits were far better than what I have now as a resident.
This is true. Dot i's, cross t's.
I was on an F30 and the grant was suspended while I was away on "personal leave of absence" and resumed when I returned.
I did very little of this.
You do have a six month grace period if you haven't used it before. My undergrad loan payment is quite small, but YMMV.
Opposite for me. The post-doc benefits were much better. Those benefits were far better than what I have now as a resident.
This is true. Dot i's, cross t's.
That's awesome. At my institution, I was told that a postdoc wasn't an option for me because of my grant. I didn't push it or explore the option much. Perhaps it's different if you stay at the same institution rather than leaving and going elsewhere.
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I really don't think broad generalizations like this are appropriate. I consciously took an extra year in the lab for the very purpose of getting a "better" PhD. I actually had to argue with my advisor to let me stay. And this was one of the best decisions I have made. I knew at the time that I could take one year while at my academic-prime, and accomplish more than any other year in my future academic career. I was publishing on average every 10 weeks. I won several highly prestigious national and international awards (and about 20k in honorariums), and at the end of the day, based on the degree of recruitment pressure, I more or less had my pick from the top academic orthopaedic programs in the country (and I matched at my #1). This sure as hell wasn't because of my step I (average for ortho), GPA (less than average for ortho) or even the PhD per se. It was because of busting my A$5 in the lab, culminating in that extra year. I assure you that it was anything but a "waste" of my time.
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That's a very unusual story. I will be curious whether you stay in a research-based academic career, and if you do, whether that extra time you spent in graduate school will help you obtain grants, faculty positions, or be promoted.
There is of course no way for us to know whether you'd have matched as well without the extra year.
There is of course no way for us to know whether you'd have matched as well without the extra year.
???
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The couples match is not guaranteed. But it does have a 90-95% success rate. My point was that if you match to an area that has a lot of programs, she has a good chance of matching to one of those programs. However, it does depend on her specialty. If it's FP/IM/pediatrics and she's a decent medical student it probably won't be an issue. If she's going for a very competitive specialty, who knows what will happen, and the couples match might be a good idea.
As you can tell, I'm just against spending extra time in training when you don't have to. Our training is too long as it is. But, if you have a good reason to spend extra time or want to spend extra time, that's your choice.
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Wait the year and synch with your wife. Prolonging the PhD from 4-5 is not that big a deal especially if you are productive. Respect the work life balance, it is silly to be apart from your SO for the year because of thinking it'll hurt your match potential. The pressure on her to match where you are will suck and with the time demands of intern year its not easy to co-ordinate calls and visits. You guys will have to forever be negotiating both your carriers in terms if training and job locations, so now is a good time to start thinking like a team. Also being able to spend 4th year together will be awesome with all the free time. If your worst case scenario fear is that couples matching with her will have you end up at a subpar program, then are you truly willing to spend your entire residencies living apart, then how about fellowship?
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Got ya. Yeah I agree with you, but it's more important to me to delay for a year so I can stay with her another year, and to guarantee us being in the same city for residency, than it is to finish one year earlier.
Like I said, was just trying to get a feel about how common this is and the details surrounding doing it. But from everyones' post it sounds like it should be okay.
FWIW, I will be staying in the same lab as my PhD, so won't have to deal with new admin stuff. Also, my PI is a great guy and basically just lets me do what I want, so it should be an enjoyable year.
Agree with you 100%. Actually, we aren't worried at all about subpar programs both because I'm sure we will each be fairly competative, and honestly that stuff isn't incredibly important to us, plus we aren't really trying to be in NE or California...
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My only advice is that, if you stay, to make sure that the year counts for something. I got questions about my one year postdoc at every residency interview last winter. PDs wanted to know whether I was a slacker who took a 8-10 month vacation. I had papers, patents, and participation in a clinical trial to show for my postdoc; that seemed to satisfy my interviewers. Like many of the posters above me, I should warn you that the postdoc year can be a double-edged sword, so think carefully before going for it, and be sure to have an ambitious but reasonable set of goals for that year.
Interesting point. Thanks. Hopefully this won't be an issue because I have plenty of 'spill over' to finish up from my PhD, but good to know.
When you were able to demonstrate that you were productive, did that allay PD concerns? Or did they still not love the idea of another year away from medicine?
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What "year away from medicine" are you talking about? I assumed you were talking about doing this at the end of PhD, before going back to clinical rotations. In that case, there's no year away from medicine. If you're talking about graduating from the MSTP program completely and then taking a year "off" to let your SO catch up, that's a completely different discussion.
Apparently agp4 did a 1 year post doc after defending his PhD thesis but before returning to clinical rotations. He/she didn't say why, but I am trying to do the same to match up with SO...
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That's what I thought.
Since you don't really leave M2 with appreciable clinical skills anyway (MD or MD/PhD), it's not like you have anything to lose by being gone an extra year before starting clinicals. You'll definitely have to justify the year but not because you're going to lose (non-existent) clinical skills/knowledge, but because they're going to want to know you weren't just dicking around for a year on some PIs dime.
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Gutonc is exactly right. I didn't feel any more or less prepared for 3rd year because of the year of post-doc between grad school and med school.
Since you asked, I did the year of postdoc for a couple of reasons - (i.) there were a few projects in the lab that I really wanted to finish (which is kind of a fool's errand - there will always be incomplete projects to finish) , and (ii.) the time crunch between defense and reentry into the clinic would have meant that 3rd year rotations were going to bleed into 4th year, and I didn't want to short-change my medical education. The third reason was a personal one - a family member was diagnosed with a terminal illness and I was able to fly back and forth to spend time with her in between chemotherapy cycles. That was an unexpected silver lining to the postdoc year; I wouldn't have had the flexibility to do that during the 3rd year of med school.
I thought the postdoc year was very useful. My mentor, for better or worse, decided to actually treat me like a postdoc which meant long hours and impossible deadlines. It was a good growing experience and I felt like a more complete researcher because of it.
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From what the older students have been saying it seems that what you do during your PhD doesn't "matter" at all as long as you "get the degree". Our program directors tell us to "learn as much as you can", "accomplish as much as you can", etc..but it seems like its better to just get in a lab and get out ASAP because you're going to have to "start over" and publish more papers once you start your research years during your residency.
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Winning summary.
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Yes and no. I think a lot of people put stock in papers and grants, etc., which I think is less important that knowing how to put together a study and write about it. If you walk out of grad school and don't know how to do the basic components of research (experiment design, basic lab technique, writing and presenting), you're really going to put yourself into a difficult position later in your career. I'm sure you know this already, but just in case, the PhD shouldn't feel like a race.
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Yeah, but this really isn't as hard as people make it out to be, especially if you've already come into the program with a Master's and you've done a thesis and you're doing your PhD in the same field so you already know the techniques and you already know how people in your field think about problems. Furthermore, if you want to continue being a researcher, this is a lifelong learning process and its not like you're supposed to get all the knowledge/skills you'll ever need in your MD/PhD program when you're in your twenties.
What I meant by my original comment was, don't spend your time trying to get grants (your MD/PhD directors might make you do this because they want you to get experience writing these) or Nature papers (especially if your mentor isn't the type of person that publishes in these journals) or to get more projects done than the bare minimum. Instead of applying for F30's, help your PI write his grants. Instead of gunning for a Nature paper, split your work into 2 first-author projects that can be published in Journal of Neurosci.
You're going to have to start over again during your residency/postdoc and how "good" your PhD is won't help you get into residency anyway. As long as you have a PhD, you're considered equal to an MD student that took a year off to do an HHMI fellowship.
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I would agree with this
I would not agree with this.
In general I do agree with the general principle that one shouldn't delay returning to the wards. It makes much more sense, IMO, to extend your first postdoc (e.g. during your fellowship). One can add only so many additional research years to training before it becomes a serious drag on the rest of your life.
However, don't fool yourself that having a "good" PhD doesn't matter. A strong publication record during your PhD absolutely *does* help you get into a top-tier residency AND a top-tier fellowship. It also helps with getting the initial career development awards (F32, foundation awards) that then lead to future grants (K, R, etc). I speak from personal experience, from the perspective of a funded junior faculty member in an internal medicine subspecialty doing 75% research.
I would also say that a PhD from a strong institution far exceeds the value of a one-year HHMI fellowship in the eyes of residency and fellowship directors.
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My experience has been that step 1 score and clinical grades are much more important. A "good" PhD requires only a publication or two. An outstanding PhD might turn a few heads, but the residency program directors who make the decisions are not research types. However, every program and specialty is different. In less competitive specialties, stats may not matter as much. In more competitive specialties, you won't even get in the door at academic programs if you don't meet cutoffs.
Very specialty specific. Heavily research oriented fellowships tend not to be that competitive anyway depending on the fellowship.
In your specialty maybe. I thought I had an excellent PhD, but I don't think it got noticed much when I applied to residency. I was beat out for many programs both at the interview and match stage by others who did not have PhDs. I saw others in other specialties who felt the same way.
Nobody is saying you should get a PhD that is poor in quality. Publishing one solid paper or several papers in field journals is reasonable and can often be achievable in a reasonable amount of time. The incremental value beyond that is low for a heavy time investment. Your clinical grades and step scores become far more important once you have a baseline reasonable PhD. This gets you the big name residency that gets you the big name fellowship where you will have to produce to get the faculty position you want.
