A Clinician Scientist attending answering questions

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Fencer said:
Comparing schools:
What set places apart is Mentorship. It starts from the program director (PD)all the way down to older students in the program mentoring younger students.
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How do you advise best assessing this as an applicant on the interview trail? I saw the suggested questions you posted, but when you ask those types of questions it seems like you always get positive responses. How do you read between the lines effectively?
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BrightandClear said:
How do you advise best assessing this as an applicant on the interview trail? I saw the suggested questions you posted, but when you ask those types of questions it seems like you always get positive responses. How do you read between the lines effectively?
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Reading between the lines is an art. You could try to focus by asking: tell me about the "last" meeting that you had with your program director (PD). What topics were discussed? How often do you formaly meet with your PD? Is that (topics/frequency) representative of all students?

Another way is to approach it backwards. Ask first, who do you consider your mentor or mentors? Is it only the supervising professor?

You should also read: https://www.aamc.org/initiatives/gradcompact/
My program deeply believes on this compact.
 
Fencer,

On the mentorship theme, I read the compact you posted. What are some important criteria when evaluating potential mentors? What information is important to get during the first meeting?
 
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PfNO22 said:
Fencer,

On the mentorship theme, I read the compact you posted. What are some important criteria when evaluating potential mentors? What information is important to get during the first meeting?
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There is not a single and only script, but availability of mentor is always a necessary step. You can also talk to your program director, other students in the program, and people who have been associated with the potential mentor.

Once you have selected a potential mentor for research lab or just to provide mentoring, the compact is an useful guide/script for the conversation with this person about expectations from the mentor and mentee.

We all have mentors at different stages of our careers, even as you move up, you still need mentoring for the newer roles. (I have three individuals who I respect that I talk with almost every month).
 
Hi Fencer,

I have a question. I'm currently in med school, and I want to be involved in basic/translational research. My interests are similar to yours: I'm interested in neuroscience, and at the moment at least, I'm looking to get into research in epilepsy with an electorophysiology/mathematical modeling bent. I have no idea though how feasible it is to construct a research profile during and after residency in this domain for MDs only. (my situation is also complicated by the fact that I'm an IMG - could run into visa troubles with getting funding).
 
Hi Fencer, I am a current MSTP student and pondering what life might be like as a PI. I know getting RO1-type grants is difficult and competitive in itself. What is it like to manage a grant like that? How much time/hassle is it to produce reports, budget, and keep on other aspects of management.

Also, how stressful is it to renew grants when you have people working for you who depend on your funding for their job?

Thanks. I really appreciate this thread.
 
vitalamine said:
Hi Fencer, I am a current MSTP student and pondering what life might be like as a PI. I know getting RO1-type grants is difficult and competitive in itself. What is it like to manage a grant like that? How much time/hassle is it to produce reports, budget, and keep on other aspects of management.
Also, how stressful is it to renew grants when you have people working for you who depend on your funding for their job?
Thanks. I really appreciate this thread.
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It is stressful primarily because others (in your lab) depend upon your ability to renew the grant. I suggest that you ask your PD to consider doing a panel discussion of R01 PIs (including at least one PI who just succeed on first renewal) at one of your MSTP enrichment activities. The main thing that you need to do at those stressful times is to refocus your energy on the reason (passion) for doing science while keeping the thick skin for the reviews. Tell yourself with those reviews, I did not express myself well enough to be understood. Persistence and Motivation are better predictors of long-term success doing science, but keep in mind that the sample is skew by including a lot of smart people. Intelligence and Creativity are still important.

As a side note:
Stupidity is colloquially used as an adjective to social intelligence; you can be highly intelligent -comprehending difficult concepts- and be socially stupid.
 
Hey Fencer,

I'm still an UG thinking about MD/PhD. If I'm not sure I want to be a lab PI, should I be doing an MD/Phd? Right now, I enjoy bench research and don't really see myself not doing the actual science in the future ( although I would like to teach).

Thanks.
 
There are multiple academic careers for MD/PhD graduates that are not been a single lab PI. The model for the future will include Team Science, where MD/PhD faculty play a key catalytic role by understanding the science and clinical languages and cultures. But to do that, you need to be deeply immersed in bench research as well later in clinical environment.

Here are some links:

http://www.afmr.org/files/2009/How-to-Succeed-as-a-Clinician-AFMR-Career-Development-Workshop.pdf

http://www.ctsaweb.org/index.cfm?fuseaction=quicklink.showToolkits

http://www.slideshare.net/CTSciNet/...ce-awards-ctsa-program-what-can-it-do-for-you
 
Awesome! This is the answer I've been hoping for and praying would evolve. This is one of the many reasons I've been gunning MD/PhD, with the hopes that we who hate grant-writing can transition to more of a team model where we can share that burden with those that love grant-writing. Word.

I loved the PDF presentation, very informative and funny (e.g., Einstein's memorandum).

Any interview advice to those of us on the application trail now (besides presenting yourself well and knowing your research thoroughly)?

It looks as if I may have an advantage over most traditional MSTP applicants in that my experience may facilitate translation of my basic science research. I have extensive experience in the three major CTS disciplines: health services, clinical, and basic science. (See my MDApps profile for a better picture.) I'd have to sell it during the interview, though. Thoughts?
 
thanks fencer for your contribution! i have a few questions if you don't mind answering them. i graduated with an undergrad degree in biology but no research experience because research did not entice me back then. Recently however I've contemplated pursuing a career in research after some personal motivation. What is the industry like for PhD in medical sciences (academics or industry) if you happen to know about it. Thanks!
 
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Interview advice: know as well as you can the program that you are interviewing at. If you drop a name, know the research area of that faculty member.

Industry for PhDs: one of my PhD classmates at Wisconsin is now a CEO for a biotech company. From the time he was a student, he knew he was going into industry. He did a postdoc at the Merck Institute, worked for Dupont and eventually got involved with building up several biotech start-ups. It is a different culture than academics, but the quest for excellence is the same.
 
Fencer said:
Interview advice: know as well as you can the program that you are interviewing at. If you drop a name, know the research area of that faculty member.

Industry for PhDs: one of my PhD classmates at Wisconsin is now a CEO for a biotech company. From the time he was a student, he knew he was going into industry. He did a postdoc at the Merck Institute, worked for Dupont and eventually got involved with building up several biotech start-ups. It is a different culture than academics, but the quest for excellence is the same.
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How is job security/opportunity like for industry compared to academics? I have a primary interest in translational research and interested in working in the industry. Thanks
 
The economic pressures are the same or worse than in academia. Depending upon the size of the company, there might be opportunities in different lines. One thing is that you should be willing to change your research focus overnight as the priorities and strategic plan of biotech/industry might change abruptly.

Some larger companies could be fairly loyal, but the marketplace is very Darwinian. Industry can be a lot of fun because they are very focus on translation that leads to better care and economic results.
 
This link from AAMC shows that there is more than GPA and MCAT for medical school admissions:

https://www.aamc.org/download/261106/data/aibvol11_no6.pdf

After reading the article, MD/PhD programs have similar standards but place a higher value for LORs in relation to interviews. Why? Because LORs are the a top surrogate measure of motivation and passion to pursue a clinician scientist career.
 
I'm sorry if this question is vague, but I'd like to ask what usually happens to a senior resident or fellow as they finish their clinical training and are ready to transition into a faculty job but are lacking the papers/funding? Do they do post-docs? How long are the post-docs usually? What if after 2-3 years of finishing residency/fellowship and post-docing but still being short on funding/papers? Do junior attendings in this position continue to do more post-doc, switch to clinical research, or take on mostly clinical careers? If the person does become mostly clinical, how likely is it that he/she can still be successful in basic/translational research granted that they stay in academia? Thanks a lot!
 
echod said:
...
what usually happens to a senior resident or fellow as they finish their clinical training and are ready to transition into a faculty job but are lacking the papers/funding?

Do they do post-docs?

How long are the post-docs usually?

What if after 2-3 years of finishing residency/fellowship and post-docing but still being short on funding/papers?

Do junior attendings in this position continue to do more post-doc, switch to clinical research, or take on mostly clinical careers?

If the person does become mostly clinical, how likely is it that he/she can still be successful in basic/translational research granted that they stay in academia? ...
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These are difficult questions to answer because they are so many variables to counsel clinician-scientists doing these transitions.

One stat that illustrates the advantage of doing a MD/PhD is that the age for first R01 is the same for MDs, MD/PhDs, and PhDs (PhDs is about one year earlier). This stat means that if MDs have to do other things between getting their MD degree and obtaining their first R01 as compared to MD/PhDs. In addition, the success rate for MD/PhDs is twice as much as MDs. During this period, you apply for K-series awards which are done as faculty working on bench or clinical research.

You can be successful doing research with perseverance, thick skin, and mentoring. There are many back ways to get there even if you took a poor turn in your career.
 
Neuronix said:
Ok, a question for you... Do you have a source for this? My belief is that statement is incorrect based on:

http://jama.ama-assn.org/content/294/11/1343.full (particularly figure 3)
http://jama.ama-assn.org/content/297/22/2496.full (figure 1)
http://jama.ama-assn.org/content/291/7/836.full (table 2)
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I attended a presentation by a NIH official/panel advisory member that showed that data. I will try to find that if it has been published. As I recall, MD/PhD graduates now account for twice the number of R-01s than MDs despite being outnumber on the faculty ranking. This person had an issue as to how the JAMA data was analyzed too.
 
Hi Fencer-

Thanks for your presence on these forums--your advice is invaluable. I have a question regarding graduate studies. How did you go about deciding a lab/field to work in? I have a strong interest in neuroscience at the moment, but I'm not sure if I've really been exposed to enough of it to be absolutely positive (most of the research I've seen in this area has been clinical or related to stroke rehabilitation--not any real "bench" neuroscience). For the past year I've been working in a biochemistry laboratory which I haven't found completely satisfying, but that may be because it's not really translational or even disease related. What was your thesis work like? How did you decide to work in that? Do you feel there are opportunities to gain enough exposure to a variety of labs to make an informed decision (this may be more program specific)?
 
Fencer said:
The economic pressures are the same or worse than in academia. Depending upon the size of the company, there might be opportunities in different lines. One thing is that you should be willing to change your research focus overnight as the priorities and strategic plan of biotech/industry might change abruptly.

Some larger companies could be fairly loyal, but the marketplace is very Darwinian. Industry can be a lot of fun because they are very focus on translation that leads to better care and economic results.
Click to expand...

That's really interesting. I always thought it's the other way around since I'm always seeing open job positions for PhDs in the industry. For someone like me without any research background, what's the most efficient way to enter the research field? My first guess would be to find some some Master's program that I can get into and start from there...
 
I'm an undergrad who's considering a MD/PhD after two years of study. Is this a little late? My major is in chemistry and I hope to go into drug design. I've been interested in research since freshman year but haven't been able to get into a lab. I almost was able to start research this past summer until medical problems placed a slight dent into my plans. It was what I experienced over the summer/am experiencing now that's making me consider a medical profession again (as a middle school student I had thought of becoming a doctor but the number of years I needed to train turned me off and I was being steered towards science-related professions seen as held by "introverts"), but I'm still interested in drug design too. I think it's all a matter of what do I want to focus on more.

What made you want to pursue a MD/PhD degree over one or the other alone?

Because I'm considering going to med school two yrs after I started college, is this to my disadvantage, even if I started getting clinical experience as soon as I could?

MD/PhD programs take around 7-8 yrs to complete then on top of that 3+ yrs of residency and if I wanted to do any subspecialty more training even more time, so it could be 10+ yrs post-college before I get a job if I took the MD/PhD route. When you were considering your post-college degree options, did you ever take time needed to start your career into consideration?
 
Neuronix,
MD/PhDs are 3% of the pool of physicians but receive 40% of K08, 15% of K23, 50% of R01 awarded to physicians.
MD/PhDs are 7.5% of Medical School Faculty and 10.5% of the MD Faculty (AAMC 2010 -
https://www.aamc.org/download/169798/data/10table7.pdf )
Part of the reason for the relative increase of success in R01s is that there is an actual decrease in the number of MDs (not MD/PhDs) submitting R01s. Why? The clinical demands for revenue have increased progressively. There is a greater emphasis on RVU production in clinical departments. If your negotiation as you take a position is primarily based on salary, you are signing up for a life of making that salary. Bridging between your first few grants will be very expensive and with much less duration, resulting in a greater probability of not doing science in the future.

NR3A,
You are not a finish product as you do your PhD. You are learning how to think and approach scientific questions. Biochemistry or Molecular Biology, for example, can be applied to the entire broad field of Medicine or Surgery. There is not a single specialty that these two disciplines are not touching in one way or another... even health care outcomes (polymorphisms of disease). Do what you are most interest on at the present time.

triplerox,
A Master's is a good way to start research, even if you are going to pursue a MD/PhD. Don't do it if it will take you longer than 2 years. Apply to MD/PhDs programs after your first year of the Master's. PM me if you have specific questions.

Agneau91,
It is not too late. If you have the academic credentials (ie: GPA and MCAT), what we measure in the interviews is your motivation and passion for science. It is important to get some posters and very helpful if you get a publication. At the interview, you must be able to describe clearly your research and your role acquiring and interpreting data. Regarding time, this career takes a lot of time. It took me 17 years after high school to get my first Assistant Professor job. It should feel that you can not do anything else but this. At the present time, I enjoy every minute of it. Good luck!
 
Thanks Fencer, I'm currently looking up Masters program at the undergrad college I went to. They offer a 1yr masters with comprehensive exam or 2yr with thesis. I'm guessing I should go the thesis route? How exactly does a master program work? Is it just like undergrad all over again with more advanced classes or are you assigned to a lab to work in as well.
 
Often, you are also able to improve your GPA (as compared to UG). A one year Master's will not help you enough because there is very little to show for when you are applying to MD/PhD. You will have one year under your belt with some research when you apply during the summer between your first and second year.
 
Fencer said:
Often, you are also able to improve your GPA (as compared to UG). A one year Master's will not help you enough because there is very little to show for when you are applying to MD/PhD. You will have one year under your belt with some research when you apply during the summer between your first and second year.
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I see. I think that's what I'll most likely do. Good thing is my school offers year round admission so I can still make it for the winter quarter start as opposed to waiting until the fall of next year. I guess it's time to kill some GREs!
 
This is for a cousin who is a non-traditional student. She is much older and interested in MD-PhD with a career in clinical research. She is not interested in money. She thinks if she applies to the MD-PhD program, they won't accept her because of her age since an MD-PhD takes forever. So she plans to apply to the MD program and then after she is accepted she plans to apply for the PhD. Do you agree with her decision? What do you suggest for her?
 
oblong said:
This is for a cousin who is a non-traditional student. She is much older and interested in MD-PhD with a career in clinical research. She is not interested in money. She thinks if she applies to the MD-PhD program, they won't accept her because of her age since an MD-PhD takes forever. So she plans to apply to the MD program and then after she is accepted she plans to apply for the PhD. Do you agree with her decision? What do you suggest for her?
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While I'm not a clinician scientist yet, I've been conducting clinical and basic science research since 2006 and am a fellow nontrad vying for an MD/PhD seat. Most of the MD/PhD programs simultaneously consider you for both degrees or, if rejected, allow you to switch from the MD/PhD program to the regular MD path. The nontraditional aspect shouldn't affect her candidacy. If anything, it shows dedication, especially if she has a demonstrated research background. Why pay full tuition the first year if you’re planning on a career in research? In fact, some schools have fewer seats available for in-house applicants (e.g., Wash U St Louis), putting you at a disadvantage against those applying for first-year MD/PhD seats.

That said, an MD-PhD is not as advantageous to conduct clinical research as it is in pursuing the basic sciences, public health, epidemiology, et cetera. Fencer, correct me if I'm wrong, but I believe that the vast majority of clinical research is carried out by MD and MD-master's faculty rather than MD/PhD faculty.

IMHO, if med school loan debt is a deterrent, I’d say apply broadly to MD/PhD, half MSTP (which are NIH-supported and fully funded) and half non-NIH (variable tuition and stipend funding opportunities). On the other hand, an MD/PhD isn’t necessary in the clinical realm. So if she doesn’t mind taking on that initial debt and applying for the plethora of loan forgiveness programs available to Principal Investigators upon graduation, I’d say apply to MD-only or MD-master’s programs, focusing on the type of clinical research she wants to conduct (e.g., Vandy has an MSCI: Master of Science in Clinical Investigation; and most schools have an MPH: Master of Public Health).
 
She wants to maximize her probability of acceptance, given her age. And thinks MD-PhD programs might discriminate since two degrees take forever.
 
Deutsch Arzt said:
. . . The nontraditional [read as age] aspect shouldn't affect her candidacy. If anything, it shows dedication, especially if she has a demonstrated research background. Why pay full tuition the first year if you're planning on a career in research? In fact, some schools have fewer seats available for in-house applicants (e.g., Wash U St Louis), putting you at a disadvantage against those applying for first-year MD/PhD seats. . . .
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I understand. As I stated above, I don't really see age as an issue from the admission committee's perspective—to a point. Perhaps they'd be reluctant if she's >40y/o. But from what I've heard from my PIs and my colleagues sitting on the committee, I think one's age affects the applicant's decision to apply more than the committee's decision to accept. So long as she's willing to commit to the degree, can show it through prior work, and expresses it in the statement and interview, they should be more than willing to accept her.

I'm curious to see what Fencer will say. I hope this helps, though. I really want to see your cousin apply MD-PhD if that's what she really wants. Good luck.
 
Age might be perceived as a minor issue by some MD/PhD programs, but it depends heavily on the applicant. The MD/PhD program is typically about 4 years longer than regular MD, and the extra years of the applicant might be perceived to impact negatively on the life-expectancy as a clinician scientist. If you are talking late 20s (vs 22-24), the effect is none to minimal; late 30s, the effect is getting there... etc. Keep in mind that after earning MD/PhD, then you have another 4-7 years of residency and/or postdoctoral training. You pretty much have to add 12-15 years to age at MD/PhD enrollment for 1st real job. You will be more likely to be accepted into MD or PhD than a dual degree program after age 40.

It is interesting to note that the median age for first NIH R-01 for MDs is the same as MD/PhDs suggesting that the years saved after the MD are followed by what some people call the "purgatory" or "redemption" phase to then become a clinician scientist. Median age for PhDs is only ONE year younger.

Now, back to your question... As indicated above, most schools will consider you a dual applicant, with decisions made independently by each of the programs (MD vs MD/PhD). In general, MD/PhD program will be more competitive than the MD program, but I suspect there might be exceptions. Applying to both programs only marginally affects your chances for admission.
 
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Actually she will be in her fifties when she applies. But she was in a coma for about 30 years!! So she behaves like she's still in her 20's LOL and she also looks like she is in her 20s with teenagers still hitting on her.
 
oblong said:
Actually she will be in her fifties when she applies. But she was in a coma for about 30 years!! So she behaves like she's still in her 20's LOL and she also looks like she is in her 20s with teenagers still hitting on her.
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Wow, that's so interesting! I'd definitely work that into her PS. Good luck.
 
PfNO22 said:
That is suprisingly cynical.
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How is that "surprisingly" cynical? That woman overcame an obstacle that most people don't even survive, which has obviously influenced her decision to apply to medical school. The PS is all about explaining "Why medicine?" with expectations of autobiography.
 
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That is an amazing story... I still believe that she has a better chance of being admitted into a program in this order: higher chance for PhD > MD > MD/PhD. Please keep in mind that MD/PhD enrollees are supported with stipends and payment of tuition/fees thru the 7-8 years of their program. That level of financial support is based upon the expectation that graduates will pursue Clinician-Scientist careers for several decades. I hope that she pursues an advance degree.
 
Fencer, Neuronix,

How did you choose the program you attended?

One of my last interviewers asked me point-blank what I was looking for in a program beyond research, what kind of decision maker I was, and what my top 5 choices were. I hadn't thought about it much yet since I don't like to count my chickens, but I think that was a mistake. What were your dealbreakers? How would you differentiate between two really different programs which both have good research?
 
I PM'd you a series of questions that I'd like your advice on...thank you.
 
Fencer,

Would you have any different advice to give to a PhD to MD/DO then what you have already stated, considering their slightly different approach to becoming a physician scientist?
 
Graduated PhD to MD/DO is one of the paths to become Physician Scientist. The small problem is that MD/DO school does not provide infrastructure thru the 4 years to academically support (i.e.: enrichment activities and mentoring) a Physician Scientist career, or the economic support (except within few MD/PhD programs). One thing that I will strongly suggest is to consider whether there is an active MD/PhD or DO/PhD program at the institutions that you get accepted for MD/DO and ask the program directors of those programs as to whether you can participate in those Enrichment activities. Those who respond "yes" should be ranked ahead on your list if your purpose is to become a clinician scientist. If they (PDs) see you often enough, they will help you with the mentoring.
 
Hey Fencer, I've been rejected from nearly all the MSTPs on my list, but starting landing MD interviews. Any advice or views on doing a PhD or master's during residency or fellowship? I saw that UCLA has an awesome PhD program for their fellows (i.e., the STAR program). If accepted to an MD program, I intend to try to do as much research during the summer and M4 elective years as possible. Although these options exist at the program that seems most interested in me, it's a very non-research oriented school...
 
ChemMed said:
Fencer,

Would you have any different advice to give to a PhD to MD/DO then what you have already stated, considering their slightly different approach to becoming a physician scientist?
Click to expand...

Fencer said:
Graduated PhD to MD/DO is one of the paths to become Physician Scientist. The small problem is that MD/DO school does not provide infrastructure thru the 4 years to academically support (i.e.: enrichment activities and mentoring) a Physician Scientist career, or the economic support (except within few MD/PhD programs). One thing that I will strongly suggest is to consider whether there is an active MD/PhD or DO/PhD program at the institutions that you get accepted for MD/DO and ask the program directors of those programs as to whether you can participate in those Enrichment activities. Those who respond "yes" should be ranked ahead on your list if your purpose is to become a clinician scientist. If they (PDs) see you often enough, they will help you with the mentoring.
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Hi Fencer, thanks for donating time to this thread!

I am a non-trad MD/PhD, I'll be defending my PhD (neuroscience, after 4 years) in the spring and starting at "A" med school next fall. I am drawn to neurology/neurosurgery for residency.

I am already becoming indecisive in terms of which school to go to. I am in a position now where i have been accepted and already been offered a full ride to stay at the same school i'm getting my PhD.
As you suggest above i already have a relationship with the MSTP program on campus and will be able to participate in some Enrichment activities while i am at UTSW. I have also been accepted at Baylor as well, waiting to hear back from Vanderbilt, WashU and UChicago. I believe i will also receive financial assistance from 2 of these schools as well based on feedback on my interview days.

These are all very good schools IMHO. What advice could you give me in terms of picking where to go for my MD?
should i focus on graduating debt-free? (i have zero debt as of today and i am also living rent free currently and will live rent free if i stay here)
Quality of training?
Family ties/location of school?
Match lists?
Protected research time in the curriculum?
Perceived quality of neuroscience publications from that school?

Thanks in advance
 
Deutsch Arzt said:
Hey Fencer, I've been rejected from nearly all the MSTPs on my list, but starting landing MD interviews. Any advice or views on doing a PhD or master's during residency or fellowship? I saw that UCLA has an awesome PhD program for their fellows (i.e., the STAR program). If accepted to an MD program, I intend to try to do as much research during the summer and M4 elective years as possible. Although these options exist at the program that seems most interested in me, it's a very non-research oriented school...
Click to expand...

Perseverance and love for doing science are among the best predictors for success as a clinician scientist. There are research residency programs that offer PhDs or MS in clinical investigation. At this point, check out the medical schools that have CTSAs. They are in the process of creating programs like these ones. Realistically, during medical school, you only have 1 summer (between MS1 and MS2) to do sustained bench research. It obviously depends on their curriculum. Unfortunately, your MCAT what kept you from getting into MSTP, but if you are truly interested in a career as a Clinician Scientist, this is only another bump on the road. You will get there. Good luck!

For other applicants, apply broadly to MSTP and mid-size or larger MD/PhD programs (any program with over 3 students per year). Every program is looking for something different, but all are trying to identify the most promising Clinician Scientists of the future.
 
Thanks for the PM Fencer!
 
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