Academic medicine mentor thread

[Doodledog]

hello!

This may seem like an irrelevant/biased question but this came up as I was reading through the posts..

Would the mentor's age be a factor to consider?

I have a few professors that I consider to be potential mentors, whose careers and even personal lives I'd like to follow and who I get along really well with. But the problem is, they're retiring in a few years' time and I feel likely will not be that very active in their teaching careers as I see them now.

Thanks and I hope you tell me teachers/MDs never really retire.

Well, Dr. DeBakey will be 100 years old soon and is rumored to still be active in mentoring......

I really wouldn't worry too much about age. Most academic folks will go into semi-retirement and increasingly are delaying even that. Mentoring can be a great thing for many of them. If they are medical school faculty, they can be granted "emeritus" faculty status at many institutions which may give them the ability to serve on some committees, etc, but no salary.

Talk to them honestly about their plans, but in general....ignore age in this!

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[Doodledog]

Hi,

First, I really appreciate you guys doing this! I am impressed and grateful that people with such qualification and busy lives take time to help others along. I will remember that.

I am 46 years old. I did a PhD in biochemistry from the University of Bombay in 1992, then taught and did research in various fields (biotechnology, molecular evolution, environmental preservation) before going to medical school in the Caribbean. While there, I taught biochemistry at the school. I am now in the 3rd year of a Med/Peds residency and thinking about the next step.

In a perfect world, I would teach biochemistry to med school students, have time to see patients in Internal Medicine and pediatrics (inpatient and outpatient, although more of the former) and have a little time to develop some research. I have some research ideas and am also interested in literature in medicine, doctors and writing and stuff like that. I absolutely LOVE classroom teaching.

At 46, I could do a general IM (or Med/Peds) fellowship or a specialty fellowship before getting into academic medicine. However time is ticking, and I would like to get started.

So my question is:

1. Are you aware of opportunities for this sort of thing?
2. How can I find such opportunities? My residency is not in an academic program.

Thanks so much for helping.

oslerfan

I think the hardest challenge will be setting things up so that you are doing both medicine and pediatrics. The best opportunity for you will be within an academic department where you would likely do a mixture of outpatient clinics, in-patient attending and have enough non-clinic/patient care time to develop research interests. I do know of med/peds folks who have pulled this type of combination off. You may end up spending more time in either medicine or pediatrics depending on how your primary academic appointment works out. Be flexible, explain to academic departments (apply both to medicine and pedi) your interest, and it is certainly a possibility.

The biochem teaching is something I'd put on the back burner until sorting out the clinical part. Lots of basic science folks around to teach biochem and most folks will have less interest in you doing that initially. Once you are established in a medical school environment it will be much easier to try to get involved in the preclinical curriculum. I would not advise pushing that in the job application process.

In terms of finding jobs, I would focus on the medical journals that have most of the academic job offers. There are specific academic job hunting venues that I won't list here...but you can find them. Send letters of interest to places with med/peds residencies a full year in advance of looking to start work. You'll get some interest!

 

[NYFootExpert]

how do we approach them? or introduce ourselves?
What if we don't know yet what we are looking for in a mentor? Or what we want to do later?
Is it okay to ask someone to be a mentor with those 2 questions?

I would say yes. If you find that you fear that you will not be as comfortable with your mentor as you would like you can always find multiple people & befriend them before you ask any one to be your mentor.
After all a mentor can seriously affect the direction of your career so your first responsibility must be to yourself.

 

[Doodledog]

Hi Tildy,

Great thread! I had a question that I'm having a tough time finding out an answer to - do you know if it is possible do do a Ph.D. while you are in residency? I assume this will obviously take longer than a full-time Ph.D., but I didn't know if you knew if such opportunities existed. I am in a surgical subspecialty and have done a posdoctoral research fellowship, but would be interested in getting more formal research training either in bioengineering or neuroscience.

Thanks again for your time!

I have known of people who have done this with specialty fellowships, although I'm not sure it couldn't be arranged during a residency. Usually though the lab components require a block of 2+ years that would be hard to fit in within a training program. I have some substantial doubts that it is worth doing a PhD in your situation however. In general, there is a lot of interest in training surgeons in academic medicine and there are a number of programs available in terms of early career protected-time training in basic and clinical sciences that would be worth looking into. Although there might be some benefit to the PhD in terms of getting this formalized training, the economics of it would be challenging relative to a protected-time early career training grant.

What I would recommend doing is trying to narrow your interests a bit and make contacts with folks in those areas. Ask if they are willing to take you on as a post-doc (I realize you've done a post-doc already, but doing more than one isn't uncommon) and give you the equivalent training as if you were a grad student. Then decide (with your PD) if you want to do this while a resident or wait until afterwards. Regardless, I admire your interest as a surgical specialty trainee in pursuing this as we definitely need more academic research-oriented surgeons and wish you the best of luck!

 

[Doodledog]

This thread is like an answer to my prayers, here is my situation, I'm a FMG and am currently doing my internship in Internal medicine and from my early days I've always wanted to do some research in the field of Neuro chemistry, here are my questions and any advice will be gratefully received, FYI we have an excellent neuroscience research program at Champaign, IL where I'm currently doing my residency and I did try unsuccessfully to match in a neurology residency.

1. I did see a previous post where you opined that it's not advisable to do a PhD after residency, so how should I go about ?? I am curious since I don't have any research experience and if I did get in touch with someone in the Univ how can I convince them that I can be of some use to them and will they be willing to train me ? I'm more than willing to work in labs in my spare time like evenings etc. I understand that they won't hand the lab over to me on the first day but I do want to do something solid and not be a mere audience in the lab.

2. Secondly should I do the above or wait till my residency is over and do a year or so of fulltime research? personally I don't want to wait that long.

I am not really keen on a neurology residency anymore and would like to work in academic medicine with neurochemistry research simultaneously. I do have extensive training in Internal Medicine having trained in India and than in England and now here and have had the unique oppurtunity of having picked up a lot of stuff along the way.

Hi and thanks for the nice thoughts. I think that, since you are now coming to the end of internship, it would be a good time to explore with faculty your research interests. Be patient, be clear about your background, and carefully select one or two faculty members to approach. It is likely that they will be helpful and interested, but it is also possible they will brush you off or send you down less than useful paths or to less than ideal colleagues. So, go cautiously, but now is definitely a good time to sort this out as you will likely have a bit of time as a PGY-2 and even more time as a PGY-3. Ultimately, you would probably have to do a somewhat traditional lab-based post doc to get the training you need, but if you have some experiences as a resident, it'll make this much easier.

Good luck

 

[NotAProgDirector]

If someone only does an IM residency, but nothing else, what can you do in academia? I can see the endless possibilities to do research/tenure track if you do fellowships in cards, onc, etc. I just don't know what academic IM is like these days. I love to teach and do research, but is it even worth the effort in IM? I spoke to an IM prog director at length who spoke about interns who could care less about what happened during the year they were there, or people who used IM as only a stepping stone -- needless to say he was rather jaded after so many years.

You raise two issues. There are plenty of people who di an IM residency because they want Cards/Pulm/CC/Heme-Onc etc. It's simply a matter of history that these fields are subs of IM rather than stand alone programs (like Neuro, for example). It's easy to get frustrated if you love IM and see so many residents leaving for a subspecialty.

But that's not what you really wanted to know. If you do straight IM and want to stay in academics, there are many pathways:

1. You can get a job straight out of residency, either as a hospitalist or in outpatient GIM. Without any additional training, your job will be 100% clinical. You then have two pathways to follow:
   1. Stay 100% clinical. You work in an academic environment, with residents, etc. Sometimes you'll do uncovered work. Many academic programs need "workhorses" like this, either as hospitalists on both ocvered/uncovered services or in their GIM outpatient practices. These are often non-tenure track positions (i.e. not eligible for promotion), which is not a big deal (in general, tenure is not needed in today's academic medicine because physicians can generate their own salaries in clinical work)
   2. Find an area you're interested in. Volunteer to work on it. Do a good job. Someone will notice, and offer to "buy" 10% of your time. Leverage that, and get more of your time protected. This gets you into the Clinician/Educator (or Clinician/researcher) track towards promotion.
2. You can do a GIM fellowship, which is usually research focused. After this, you will likely be able to negotiate for an academic position with some protected time to start.

There are also a myriad of research fellowships you could do, similar to post doc's. Usually this path requires some basic research skills obtained before residency -- else you are better off with a GIM fellowship.

Please note that you can be very successful without the GIM fellowship -- it just makes it easier to get started and is a great way to build your skills. Every program's GIM fellowship is different -- you need to shop around and find the ones that will give you the skills you want.

 

[Doodledog]

I'll try to make some comments over the next few days for you. We can see what the fine folks say in the Physician Scientist forum as well - I suspect they'll have better answers that I will.

Edit: You've gotten some good advice in the physician scientist forum. I would only add that splitting all research into clinical or basic and deciding on degrees based on that is a huge oversimplification of modern biomedical research. Clinical and translational research run a large range of scientific projects and ideas. I would generally say that if you don't wish to spend any time in a lab then an MD/PhD would be an uncommon (but not unheard of) approach, and I probably wouldn't recommend it. However, that still leaves a lot of science that is done on people or using tissue samples from people that has practical applicability, but uses tools of modern hormonal, genetic and biochemical analyses and fits in with MD/PhD research.

 

[NotAProgDirector]

Thanks for all your good advice about academic medicine I specifically have a question about the administrative duties. Namely it seems that on top of research, teaching, and patient care duties academic physicians are expected to be able to make decisions that affect how their department (or even institution) delivers healthcare, processes patients, staffs the facilities etc... often times without any formal training.

To whit do you ever see anyone benefit from either formal or informal training. Do people with MBA's or MPH's (say in healthcare administration) have an easier time with these facets of their job. Would you recommend med students interested in academic medicine take an opportunity to learn about these topics, even if not formally persuing a dual degree maybe taking advantage of their ability to take classes in various adjunct schools associated with their home institution or is that sort of minimal exposure of no utility for a position you may have 5,10 or 15 years in the future?


Thank You

The more general your training is, the easier your time will be -- regardless of whether or not you are in academics. Many of my program graduates, when questioned about how our program as trained them, ask me to add more "how to run your own private practice" into our curriculum.

Directly to your point, much of the "administration" in academic medicine falls into three categories: 1) being on a committee working on a problem, 2) leading a committee / taking a leadership position, and 3) directly working with financing / budgeting (usually associated with being a division / section leader or the leader of a large "group" that has it's own budget). The first requires no real additional skills other than listening and playing well with others. If you don't have those already, you're in trouble. The second requires knowing how to be a good leader -- how to make others do what you want them to do, but think they're doing it for themselves. The third requires some financial knowhow.

Academic administration usually moves from 1 --> 2 --> 3. So, if you are really interested in academics, I'd favor anything that focuses on leadership skills as the most useful to your immediate career.

 

[Doodledog]

Hi Tildy, first of all, I enjoyed reading your posts. They've been extremely helpful. I have a question about MD-Only clinical research.

Is it necessary to have a MSCR or MPH in order to be a successful independent clinical researcher at an academic institution?

I mean, will it be difficult for a MD-Only clinical researcher to obtain grants and funding from the NIH with 2-3 years of hands-on formal training experience?

I've completed a subspecialty fellowship and currently in a research fellowship. My mentor strongly recommended that I pursue a degree from the school of public health at my institution but I'm still debating.

Thanks.

Okay, first a bit of "truth in mentoring." I do not have an MPH but do have an adjunct appointment in the school of public health and work a good bit related to public health as one of my areas of research and teaching. Having said that, it really depends on what you plan to do your research in. If you are planning to do epidemiology or significant public health interventions, an MPH would be very helpful. If your interest is more related to clinical pharmaceutical trials, an MPH is less neededl. If you are heading into a teaching track involving community outreach, an MPH would be fairly helpful, although not mandatory.

I've seen a lot of faculty pick up their MPH during their early years as an attending. Depending on the school you're at and your field, this may not be too hard to accomplish. A bit of work though. Of course, if your school doesn't have a SPH or you need to go out of town for it, then it would be a bigger deal.

If I was doing it over, I might have even considered it, but it wasn't necessary at the time for what I needed to do and I've gotten by without it. But, 10 years ago it would have been helpful.

Bottom line is that NIH won't "require" an MPH to fund clinical research from an MD, but it will be helpful if your work is epi or public policy related.

 

[Doodledog]

Hi Tildy, thanks for your reply. I have a couple more questions regarding academic medicine.

1. If I participate in a clinical research projects doing subject assessment and recruitment, on-going project which my mentors are conducting, will my name be on the paper when it is published? (does this happen routinely?)

2. Any advise on what resources I can use to improve my knowledge in research methodology, biostat..etc if I don't opt for the formal MSCR?

I have a comment tho. I sat through a meeting with junior faculty members at my institution and all they talk about was how to get promoted, # of papers they will need to publish to get a tenure position, what kind of grant they would have to have..etc. Sounds pretty stressful for someone like me who just started and want to learn and do research for now.

Thanks.

1. For a physician doing these roles, it would almost certainly be the case you would be listed as a co-author. I think it's best to clarify this up-front however. The exception is large multi-centered study where there may only be one author (or less) from each site.

2. One can take epi and biostats without getting a degree at many schools of public health. Some schools may have "certificate" programs for those who take core courses without actually getting an MPH or similar degree.

3. As far as stresses related to publishing, etc, this is all a matter of perspective I suppose. I find it somewhat LESS stressful than I would find doing patient care 50 weeks/year full-time. But, I enjoy writing papers and for the most part don't mind writing grants. It can be daunting however, for those just starting out. The key is good mentoring and patience....

 

[Doodledog]

Hi,
I just need a good advice - so far my health career has been unsatisfactory.

• First I am a Foregin medical graduate
• Flunked USMLE 1 two times, step 2 1 time & gave up
• Went on to do Masters in Public Health - GPA 3.87
• Worked as clinical study coordinator for two years

I interviewed for Epidemiologist positions, biostatitian positions - was among top three candidates but was not selected. Now waiting for more job opportunities and there are'ent any openings.

I am confused how to utilise my MBBS, MPH and study coordinator experience into something that rewards me good monetarily >60k as well as intellectully.

Any career advice will be highly appreciated -

Sorry, but I don't have a good answer for you on this one. If you haven't already, I suggest posting on the MPH forum. Unfortunately, lacking a medical license, it'll be hard to turn your MBBS into something very lucrative.

 

[Doodledog]

This summer I worked on a fascinating outcomes research project and really came to appreciate the thought process behind it and its implications on the future of health policies. I had had some coursework in epidemiology, which had led me to my summer project, but now we are learning about it here in medical school, and I'm finding myself wanting to gain more experience in epidemiology/outcomes research again.

Do you have any suggestions of how I can gain more research experience while I'm in medical school? I'm an M2 this year, so theoretically, there's no more room for research summers. My school doesn't have any research programs that are related to my interests (I have checked.), so if I did want to do additional work, I would probably have to go to another institution. I've thought about the Doris Duke Fellowship, but as an average medical student at an average medical school, I don't know if I would be a desirable candidate even though I am indeed very interested. Do you have any insights on year-off options or on research electives at other medical schools?
If I really don't have any way of fulfilling my interest in this research, how can I keep myself in the loop to gain more experience after medical school?

It's not easy to gain clinical research experience, especially in epi types of things as an MS-2-4. As you correctly pointed out, the time just isn't there to do this very well. There are two good options to consider. The first is to find out about epi type projects at your school and just ask to participate. I realize your school didn't identify anything, but I bet they don't really know all of the projects going on. Consider any other med schools in your city if this is possible OR non-medical schools that have public health groups. Maybe you'll only do a bit of things here or there, but if you start as an MS-2, you should be able to follow things along. Maybe if it's an international project you can go overseas for a rotation. Best thing is to find out who among the faculty has these type of projects going on.

The second option, and a real one, is to do your research year as an MPH. How to pull this off depends a lot on where you are and if they have a School of Public Health, etc. If this really interests you, then you might get ideas in the MPH forum or PM me.

 

[NotAProgDirector]

Hello Tildy - I'm enjoying this thread greatly. Two questions for you:

#1: Two of my courses as an undergrad were taught by academic physicians (both MDs only), and they were absolutely two of the best teachers I'd ever had - I'm curious about being an academic physician and teaching at that level. I've always enjoying teaching, and I think I'd enjoy clinical instruction also, but I see myself wanting to interact with undergraduates (pre-meds, presumably) as well. Can you talk about how an assignment like that works? How does one get a position like that? Is it very common?

#2: I read your front-page article about making time for humanitarian work overseas as an academic physician. I'm curious as to whether it's realistic for an academic physician to conduct research primarily (or only) in the field of global health. I've found that I dislike basic research, and am rather indifferent to clinical research, but love the work I'm doing now (studying chronic disease in a developing country, as well as the efficacy of a proposed humanitarian intervention).

To sum up, I suppose that my ideal job would be splitting time between caring for patients in a hospital setting, teaching and mentoring undergraduates, and performing global health research in developing countries. How realistic do you suppose this job description would be?

Thank you!

Tildy appears a bit busy at the moment, so I'll take a swing at this one.

#1 - By "undergrad", I assume you are talking about college education. Confusion arises because medical school is often called "undergraduate medical education". Anyway, getting involved with college level classes is difficult but not impossible. You would need to be at a site with a college, of course. Problem is, you will be a very expensive resource (MD) to use to teach a college course. Often, the way this happens is "protecting" part of your salary -- via research grants, or administrative positions -- and then using some of that time to teach an undergrad course. It's unlikely that you'll be paid for this (or at least not paid much) so it's something that you'd do for the love of it.

#2 - This is definitely do-able, but also somewhat difficult (depending on your job location). It's unlikely that you'll be hired into such a position -- you'll need to make it work for yourself. You could always sign up for Doctors without Borders or something similar -- but that's usually a 2+ year commitment full time. Once you do something like that, it's much easier to maintain the contacts / resources in a foreign country and continue your work part time. It is very hard to do work part time in a foreign country and actually have a positive impact there -- needs are often persistant and your intermittent presence could actually harm rather than benefit. Much depends on your field -- for example, a surgeon performing elective procedures (let's say fixing cleft lips) could pre-arrange for a bunch of patients to be ready, arrive with supplies, and fix a bunch of kids. But in Primary Care, showing up for a few weeks and leaving may not help at all. But there are great exceptions -- Paul Farmer for instance.

Some institutions are famous for this. Yale has a large international program, for example. But don't expect to be hired right into a job where you spend 2 months a year internationally -- you'll likely need to prove yourself first.

Although you might not like "research", what you describe is basically clinical research and is often funded by NGO's and other philanthropic groups. Get yourself a nice grant from them, and you'll be able to do whatever you want!

 

[michaelrack]

Re MD's teaching at colleges:
This is a popular option for docs with licensure problems or who have not completed residency, often teaching at the community college level. I knew a doc who left residency, and after working at starbuck's for a while got a job as an instructor at a local community college in the anatomy program.

 

[Doodledog]

Lets see...

First, I am just back from a trip related to my work to a place isolated enough not to have wireless access .

In terms of the teaching college, this is, as noted, possible, but for someone who is a practicing physician not common. It simply is hard to make this work in terms of time or finances. It does happen with those who have fewer or no patient care responsibilities, but to teach a full class to undergrads as an active practicing physician would be a challenge.

What I do is to give occasional guest lectures related to my interests at both local universities AND when I go as a "Guest scholar" to various places. I do about 5-10 of these/year for undergrads and enjoy learning about what goes on there. These lectures are set-up as part of a regularly scheduled class. So, I might give a (slightly off-topic for the class ) talk on something as part of an undergrad intro biology class, although usually I do this with more advanced undergrad classes. Not the same as teaching a whole semester, but it usually goes well.

With regard to international work, this is a big topic and question that I can't do justice to here. It is possible, but it depends entirely on your career and pathway. Funding is not easy for this but it certainly is becoming increasingly common.

 

[Doodledog]

First - thanks for answering these questions! One more - in terms of research students (MD/PhD or PhD), what kind of discression should be used when talking to a faculty member other than your primary research mentor about your lab work, your PI and how things work their lab, or more general personal and career advice?

A lot of discretion should be used. It is certainly okay to talk to other faculty members about your research - that is expected and appropriate as a way to get more feedback. But when it gets to things that might be sensitive, be very cautious. You may not know the internal politics, etc of that department/group and you could be in the middle of something. As far as career advice, again, this is fine to talk about, but be a bit careful not to imply, especially early on, that you are unhappy with your current mentor or the career path. As you head towards the "next stage" (e.g. postdoc), it is more reasonable to discuss career plans with a variety of faculty.

 

[Doodledog]

I would love to shadow a doctor and get that mentor experience but I've been out of school for quite some time now and I don't know how to go about doing this. Also I've tried volunteering in hospitals and they just make me file. That is not the kind of volunteering I had in mind.

Does anyone have advice/tips in how I can get better exposure to doctors and how they work and to help in anyway that I can?

In general, the best thing is to start by sending emails out to docs you might want to shadow or have mentor you. If they are academic docs, you can usually find their email address available at the med school website. If in private practice you may be able to search for it. If you can't find it, then go ahead and call the office and leave a message clearly explaining the purpose of the call.

It is best to try a range of doctors and types of practice. Also, don't be discouraged if some folks don't reply, etc. If you have any direct contacts - friends, etc, see if they can help you make the contacts.

As far as hospital experience, this can be difficult, but if you aren't getting good experiences, then don't look for that type of experience. Instead look to places like nursing homes where they may be more receptive to volunteers.

Be persistent but back off in any of these contacts when you meet real resistance. There are other places to try. Always send a thank you note if you do any shadowing and if a doc says "no" still send a note thanking them for their time and asking if they know anyone you can shadow.

Good luck.

 

[Doodledog]

Hello Tildy,
I have been a SDN member for over a year but always been browsing the dental section (since I am an international dentist)since I am a prospective dental student and just today i stumbled upon this thread.
My questions are differnet from the other students because I see that most of the students visitng this thread are medical students.
I am a fresh graduate from another country and I am having a hard time finding a mentore where I live. I do not know of any dentists who will be willing to help me simply because they do not know the international student requrements. I did go to some dentists but they dont know how they can help me.

I have tried calling universities to see if I can get any research position as I know that it looks very good on my CV but as you may already know that schools rarely let an ousider do research at their labs unless they are a student.

I feel like I am alone in this country and really dont know who to approach with my problem. I am studdying for my nbde part I (it is a requirement to get admission) and was hoping to volunteer (appx 6 hrs a week) so I could get a recommendation letter.
Last time I volunteered at an office and when I asked if I could get a recommendation letter the dentist asked me to write one myself and said that he would sign it. (it didnt work out too well for me as I dont know the difference between an excellent rec letter and a mediocre one)....

Any advice as to what I should do?
I know I jumped around in the above paragraph but I think my situation is very complex to type here.
Do you have any suggestions?

Help will be appreciated.

Hi - I don't know too much about finding Dental mentors in your circumstance but will post this. You could also PM the dental mods. In a general sense, you should consider whether you are looking for a dental related research position - e.g. bone metabolism, or any particular research. Consider how much time you have for this research as well and whether it would need to be paid.

 

[Doodledog]

Tildy - thanks so much for all the time you've put into this thread. I've got tons of questions, but I'll start with just one. You mentioned the NIH loan repayment program - could you tell me some more about how that works extramurally? I'm still early on in this process - I'll be starting med school in the fall - but I'd love to hear more, since I'm interested in academic medicine, but I'm also interested in being able to pay off my loans. I looked the program up online, but it was hard to get a feel for how the program really works. Is it ultra competitive? Do you know of any other ways that newly-minted academic doctors use to aleviate their debt?

Thanks a bunch.

The LRP is moderately competitive. It is focused on clinical research but the definition of "clinical" is very broad and includes things that many would consider lab-based. As long as there is some "human" connection, it will generally be okay. It is designed for applicants completing their clinical training (residency or fellowship) or even newly minted attendings. As such, one has to have a reasonable background in research, an established mentor and a plan of research. Remember, however, that the LRP does not PAY FOR you or your research - it is not a salary. It is only to help you pay back the loans.

The process for applying isn't too bad. Essays, letters or rec, etc. Not as bad as many programs. You do need to present your research plan. The financial aspects if chosen are complicated - better to look those up than have me try to explain the details and get it wrong.

Otherwise, outside of the usual frugal living, some "early" attendings will try to do extra clinical moonlighting to make money to pay off loans. Others will try to give CME lectures or do consulting. These actually don't pay very well usually and are a lot of work. The better opportunities come later in ones career.

 

[Doodledog]

I am a recent graduate of a top level MD program. I realized over third and fourth year that I am not sure if clinical medicine is for me. Not sure if I'll ever do a residency. I love science and learning and I decided I want to be a full time researcher. My plan right now is to do a couple of post doctoral research years and potentially get a PhD. I know I may never break the bank, but is it possible to make a decent career as a researcher following this path? I figure after a few post doc years I could try to break into biotech. Also I have been told by some that the PhD is not necessary to become a quality researcher because of my M.D. Curious for your opinion. Thanks.

In general, I would not seek out a PhD at this point. You can probably get the training you need in basic or clinical science with the MD degree even without a residency. I would also try to keep your mind open to the possibility of going back in the future for a residency. I've seen this done before - something might appeal to you or you might just decide that you want to do some patient care.

good luck.

 

[Doodledog]

Hi Tildy,

Sorry if this isn't posted correctly, but I had a related question to your reply. I am very interested in a clinically oriented academic medicine career, and am thinking ahead to trying to obtain competitive 1-year fellowships in med school, as well as trying to get into the LRP. I've been admitted for this coming fall at 2 great med schools, but in the past few months my research has come to the point where a first-author publication is certain, but I am still knee-deep in it, and unlikely to finish before med school starts in the fall. My question is, would having this publication on my CV (a basic sciences/genetics project) give me that extra "edge" in applying for programs such as the LRP/Doris Duke/Cloisters in the future? As well as for jobs, fellowships, etc., as they come up?

Thanks!

I wouldn't delay my admission to med school if you've been accepted already just to try to finish up that project. The med schools would probably (well, one of them ) grant a deferment, but I don't think the extra year is worth it. You'll get plenty of chances later to get 1st author publications. If you start med school in the fall, presumably you'll still be on the manuscript and can talk about it and take some significant credit for it.

 

[Doodledog]

I'm pre-med. I started out studying psychology with no real professional goal in mind. I gravitated toward studying neuroscience. Initially, I assumed research and a PhD was THE path for someone like me. But I like the well-rounded and formal structure of MD training, and I especially like the ostensibly greater career flexibility.

However, since I arrived at the pre-med mentality relatively late in my undergraduate career, my GPA/resume isn't exactly a shoe-in for MD admission. And an MD/PhD (though perhaps ideal) seems even more of a reach (even though I am probably more interested in basic [neuro] science research than most pre-med's).

Academic medicine seems like a good career destination for me, since I'm very interdisciplinary minded (also like policy, education, research, science, etc.). Recently, I realized that there are some DO/PhD programs in existence. I was curious if a DO/PhD route might put me in good contention for an AOA residency in neurosurgery. However, I'm wondering if I would be limited since most academic hospitals are allopathic.

My question is, can you elaborate on and distinguish between the definite and de facto limitations of a DO/PhD and an AOA residency?

There are obviously lots of mix-n-match options. Since AOA residency matching occurs before ACGME, after my DO/PhD I could for for AOA neurosurgery, and if I don't get matched, pursue an ACGME residency in psychiatry or neurology (which seems pretty attainable, though ACGME neurosurgery as a DO seems impossible).

Intuitively, being confined to academic medicine at only osteopathic schools/hospitals seems unattractive -- though this is not based on first-hand experience or knowledge.

I know my question is pretty vague and I recognize psychiatry and DO issues are not your specialities, but any information or leads are greatly appreciated.

Thank you!

Sorry for not seeing this for a while. I'll pass completely on the neurosurgery issue and perhaps comment a bit about the issue of doing academics as a DO (or DO/PhD).

I really don't see a problem in terms of the grant process in doing this. I know several DO's in academic positions in allopathic medical schools. There are a lot of routes to do this. You could end up doing a residency in pedi/medicine/neuro, etc and then specializing and doing academics for example. I personally would just move towards the med school (MD or DO) that you can get into and works for you and see what happens. If academics is your future, where you go to medical school will not limit it.

 

[Doodledog]

I know it's been a while since anybody has posted here, but I hope Tildy or aPD are still around to help me out. I'm currently an M1 at a mid/low tier university-affiliated school (though I will be in a non-university affiliated site after M1). I have always been extremely interested in social-science/policy research related to medicine, and want to have an academic medicine career focusing in health policy and outcomes research. However, the few people I've met who have had extremely successful careers as physician-researchers in the social sciences came from tremendous research powerhouses and have generally been a hell of a lot smarter than me.

I was wondering what would be the best way to be competitive in doing this research, since it is a relatively uncommon research pursuit, especially coming from a non-powerhouse school? I only know of a handful of schools (Harvard, UMich, etc.) that have strong social science research at their med schools. Do I have to aim to match into residency in such a program? I'm not sure of what I'd want to do yet, but I'm leaning anesthesia or IM/critical care right now - competitive, but not extremely so.

FYI, I did a year of health outcomes research before med school, one (low) authorship in a Annals of IM paper pending and likely one to two more papers (one probably with second authorship) in the next year. Thanks for any advice you may have.

First of all, outcomes research is an increasingly important and widespread area of research. Although there is no doubt it is most widely done in some of the larger academic centers, it is actually fairly widespread. Certainly many folks with this interest have gotten MPH or PhD's in this area. An alternative however, is to do exactly what you suggest. That is, wait until fellowship or late in residency and then look for an appropriate mentor. You don't have to do your residency at a major research center, but I would be looking to see what programs have people with that interest.

Good luck

 

[Doodledog]

Hi Tildy,

Great thread. As someone said earlier, I wish I had come upon it before.

I an a foreign graduate and will be starting a residency in Internal Medicine next year, to go on to subspecialty training later. I eventually want to lead my own lab doing translational research in critical care.

I wanted to ask you, how easy or difficult is it, in your opinion, for non-US citizens to go about this path, who do not have a PhD? I hear the NIH has scarce grants for non-US citizens, and while I hope to publish starting from residency itself, I wanted to know if you have seen non-US citizen M.D.'s in your academic institution eventually running their own labs, getting tenure and the obstacles involved in the process. Thanks!

Yes, it definitely is possible and not all that uncommon. The key will be getting into a fellowship in an academic center and getting good mentoring. If you can get a head start during residency that will help.

Good luck

 

[Doodledog]

Hi Tildy, thanks again for all the useful advice.

I have a question that's been plaguing me for a while now, so I thought that you might be able to help answer it. When I graduate, I'll owe Uncle Sam over $250,000, plus another $20-25k/year in interest. By the time I finish my residency, that number will have grown by a pretty substantial amount. I'd like to continue and do a research fellowship or a PhD, but for every year that I'm not paying off my loans, I'm accumulating more and more debt.
I realize that, in signing up for an academic career, I'm accepting the fact that I won't be earning as much money as the primary care doctors. What do young researchers usually do to pay off their med school loans? I'm thinking that I might have to spend a couple of years working in private practice (ugh...); do you know of any other good ways? Maybe doing a residency with the military or some other public sector?

Most folks with an MD and residencies in IM or pediatrics will do a clinical fellowship (e.g. cardiology, GI, etc in adult medicine or their equivalent in pediatrics) and do research then. At the end of the fellowship they (and this can be true for surgeons and surgical specialists as well) they may be eligible for the NIH loan repayment program which isn't perfect/complete or a guarantee, but can be helpful. If not, they'll need to start their career doing enough academic clinical work (sometimes doing some moonlighting) to cover their needs while building up their research. It's not an easy haul with a big debt. Those who have done things like anesthesiology or pathology will follow a similar track, sometimes doing fellowships, often not.

In my experience, few with a big debt would do private practice and then go back into academics. Hard to give up the salary.

 

[Doodledog]

Dear Tildy,
A very happy new year. Thank you for answering our questions.
My questions are:

1) Is it possible for a physician-scientist(predominant scientist) to have a position/spot with such life-style at ivy league places where you can expect evenings free and weekends off? I intend to spend time with family and concentrate on personal hobbies(reading literature/writing/traveling etc etc like others do).

2) If possible, what are the likely designations/configurations of such positions? How is the typical day for such people?

thank you in advance. I apologize for the long post.
thanks
regards

Assuming you are referring to a faculty position, not a training level position, then the answer is that it is difficult to have such a lifestyle initially as a faculty member. Most primary research faculty positions require a fair amount of weekend and evening work. Not necessarily every weekend or every night, but some. Note that a portion of this work can often be done at home - especially with the ability to do literature searches and the like from home.

 

[Doodledog]

Hey Tildy,

Echoing what pretty much everyone else has said, you are an angel in disguise. Thank you so much for ALL your EXTREMELY helpful answers!!! I also realized this thread has not been updated in a while, so hopefully you're still here

I've read/skimmed through all the questions and answers so far in this thread, and some of the questions/answers touch BRIEFLY on a question I've been dying to ask, but I do not believe it has been directly addressed so I'll ask it here:

I noticed there has been sort of a conflict of views concerning whether or not to pursue research during medical school. From what I understand, the best time to do any sort of research is the summer after M1 year. Afterward, the time a medical student has for research seems to be almost nonexistent, unless he/she decides to take a year off.

However, it is constantly stressed that in order to pursue/obtain a successful career in academic medicine, one HAS to have a significant research background. Even when applying to residency programs, a 'significant research background' is necessary to get into the most competitive programs at research heavy institutions. Therefore, where is a medical student supposed to get this 'significant research background' if the only chance they really have is the summer after M1 year? What other suggestions do you have to obtain this background during the course of a medical student's 4 years?

I remember reading in one post someone strongly suggesting NOT to do research during medical school, and doing it later on (in residency, and definitely in fellowship). However, again, how are students supposed to be competitive for a residency that allows them to do research if they don't have time to do research? Should they try to do research during med school anyways, MAKING time for research? Or maybe do research that is less complicated, such as clinical work (correct me if I am wrong, but it seems a LOT less complicated than basic science research)?

A bit about me:
I am a M0 about to enter medical school in August who is EXTREMELY interested in research and academic medicine. Specifically, I want to eventually go into Heme/Onc and do research concerning cancer, immunology, or both (tumor vaccines? ).

I am in an MD-only program, but I could potentially apply into the MD/PhD program--I just don't know if it is worth the extra 4 years if I want to specialize in Heme/Onc (which, from what I've read, seems to provide enough research/specialty experience anyways).

The plan I've sort of figured out is: 1) Med School --> 2) Internal Medicine Residency at a RESEARCH-favorable/competitive academic institution (which, in order to obtain, probably requires an applicant with good research background. Is it possible to do research during the IM residency??) --> 3) Heme/Onc Fellowship (that will most likely contain research, and most definitely seems to require a research background in order to be a competitive applicant) --> more research experience? apply for faculty positions? (this part I haven't figured out yet)

The ultimate question still remains: Where should I get this 'significant research background'?? Should I spend medical school focusing on becoming a great physician first, then do research in residency? (and hopefully research after M1 year, and maybe as an elective during M4 year?) Should I just take a year off to do research?? Should I try to get as many research opportunities as possible during med school? What am I supposed to do during medical school to prepare??

I have a year of undergraduate research and two summers of research internships under my belt, so I definitely have research experience and know I really want to go into academic medicine. Unfortunately, none of the past research stints I've had have 1. resulted in papers and 2. been related to heme/onc at all, but they HAVE included using animal models and cell culture studies, techniques I will most likely see over and over. Still, I doubt residencies, and definitely not fellowships, will care too much about things I did 4 years ago (before medical school) when it comes to my research experience...

Any advice would be MUCH appreciated! Thanks again!

Greetings. I had generally decided to let this thread die, but I think there may be some value in bringing it back and posting a few answers. In any case, my apologies to those, including you who posted a while back. I will try to answer a few of these queries.

You are right that it makes no sense to say to someone "get research training in med school so you can do a residency in a research institution and then get a research oriented fellowship." There are a couple of possibilities in resolving this conundrum. First, short of an MD/PhD, one can do a research year. Many schools have that option and most would allow it. This can be helpful in deciding if basic science is a route one wants to go. Typically this year is done between second and third years, but it could be done after third year as well.

Doing a research summer after first year is another possibility, especially if one can do some follow-up during the next few years. This is a difficult option (the long-term research) in most med schools. Still it is an option.

Finally, consider that even research-oriented residency programs, especially in IM and Pediatrics, are well-aware of this problem and often don't really expect that much research out of applicants. After all, they are selecting doctors who fundamentally will take care of patients, NOT do research during residency. Any real effort in research may be considered plenty at most places. In other highly competitive fields, a research year may now be needed at some institutions, but even then, this wouldn't be everywhere.

Remember that fellowships (again I'm mostly speaking of IM and pediatrics) are not really obtained for the most part based on residency research, but based on an overall evaluation of the candidate. Some research and a lot of interest will go far, along with an otherwise good academic background and residency performance.

 

[Doodledog]

Interesting thread. You all discussed how it's like for the physician researcher, but I didn't see anything about the physician educator.

Can you comment on the clinical track that most institutions have where you're responsible for patient care, education of med students and residents, and maybe some admin work with less emphasis on research? How does promotion work, pay, lifestyle, etc.?

The clinician educator track is alive and well at virtually all if not all academic institutions. If anything, I think it is growing stronger all the time. Why? Well even the biggest and fanciest of academic institutions needs to see patients to pay the bills. They'd like to do that with academic faculty for lots of reasons, and so they want to make them reasonably happy.

Unfortunately, sometimes that do make them happy and sometimes they don't. Often the salary, working conditions and overall headaches of being a clinician in a research environment are less than ideal. Still, for many people, the benefits - salary paid, no administration issues, malpractice coverage and teaching opportunities are worth the lower pay and other issues.

Promotion is always an issue as academic centers really don't know how to deal with the clinician educator. In reality, often it doesn't matter as the concept of tenure has relatively little meaning for a clinician educator. Still, there is a lot of variability in who gets promoted, what it means to be on a clinical track vs a research track, etc.

I think, for those in the med school/residency level, it is worthwhile spending time carefully talking to folks in this track at institutions/cities you might want to go to. I know that many clinicians are finding the lack of need to run a private practice very appealing as is the chance to do the education aspect. So, do some homework and see if there is a place that can make it happen. It is a lot easier generally to go from academics to private practice than the other way around (although one CAN got the other way), so look into both.

 

[Doodledog]

Tildy,

Thank you so much for this thread. It has answered so many of my questions.


A little background: I'm a non-traditional student who comes from a radically different career. I did a post-bac and then applied for med school, so I have almost no research experience (I did do a little during post-bac, but not much and don't have any posters/publications).

However, I do know that I want to do research as part of my practice (whether it is clinical, translation, epi, not sure yet). So my question is, how much is not having a lot of research experience hurt me prior to attending Medical school? Is it possible to make it up during med school (summer for example) and residency - so I can show my interest?

And a second, related, question would be: Now that I am accepted and have quit my old job, I have some free time, and after a vacation, I am willing to work for free at a lab for 3-4 months prior to my matriculation into medical school next year. I am very sure that will lead to at least a poster somewhere. Would this be useful for residencies, or does it not count if it's done before med school? What else can I do if I want to be an academic physician?

First question - not at all a problem.

Second question is a bit trickier. I am not fond of "free labor". I think students and the like should get paid for what they do. However, there are exceptions and you might be one. The reason to do some "volunteer" research is NOT to gain favor for residency, there isn't enough time to do enough, but IS to learn more about research and how you feel about it.
Good luck!

 

[lowbudget]

I found this AAMC report while doing a web search regarding Clinical Faculty jobs (employed, obviously) and thought I would share it with the thread.

Clinical Faculty Satisfaction with the Academic Medicine Workplace
https://services.aamc.org/publicati...rsion162.pdf&prd_id=301&prv_id=373&pdf_id=162

Most satisfied: Dermatology, general internal medicine, general pediatrics, & family medicine.
Least satsified: Anesthesiology, general surgery, & surgery subspecialties.

 

[PaperMaker]

Is it still possible to join academic medicine if you had a low GPA (3.3) during undergrad but have a few publications/posters from that period and during a post-graduate years?

 

[Doodledog]

Is it still possible to join academic medicine if you had a low GPA (3.3) during undergrad but have a few publications/posters from that period and during a post-graduate years?

yes

 

[PsychResearch]

Hi!I have a mentor although I don't always feel like I do. One mistake that I probably made was not to meet with my mentor to discuss my goals. I sort of went with the flow, at times, expecting too much from them.

I do have a meeting this week with my mentor. I'm thinking to lay out the deadlines that I have in mine for completing several milestone. E.g., get paper 1 ready for publication by the end of January; propose dissertation in March; write up thesis for publication after dissertation proposal. I also want to ask about what I need to do to get a post doc at the end of my degree.

I previously said that I wanted to graduate, sort of to give the message that I'm motivated and have no time to sit and not work on my proposal, and I think the mentor understood that's my end goal. I want to make it clear that I don't want to graduate just to graduate. My intentions is to work on enough quality publications and whatever is needed to get a post doc. Also, if I don't get a post doc elsewhere, I would like to do it here.

What would be the best way to lay out the above goals and get across the above so the mentor understands what I want. Thank you!

 

[Neuronix]

When SDN closed the mentor forum we moved many of the threads out to their respective forums in the hopes that the content would not be lost. This thread is closed, but if you wish to PM any of the contributors or myself with questions, the responses can be added here, with or without your SDN screenname.

All the posters in this thread with the moderator or advisor tags have had their identities verified by SDN and so are current students, residents, and faculty as displayed.

 

[Neuronix]

I was wondering if you could comment on the best ways for a medical student to gain mentoring to prepare them for a career in academic medicine (particularly interested in Radonc if that matters). I decided not to pursue an MDPhD but I'm concerned now that i won't get the proper amount of mentoring, etc, to approach the field as both a well-trained researcher and clinician/educator (especially because of the heavy emphasis on research in Radiation Oncology).

Is it reasonable/necessary to pursue combined residency/PhD training programs, would a HHMI or Doris Duke be satisfactory? I'm really not sure of the best route.

Thanks

I'm not faculty, but I just matched in rad onc recently and I did my PhD in related work so I feel like I can comment. I think you need to do a few things to prepare yourself to match well in radonc.

1) Start making connections early. Is there a rad onc interest group at your school? Get involved with it. Start it if not. Invite faculty members to talk about the awesomeness of rad onc. If there is not a rad onc department at your med school, don't despair, just skip this step and/or try to find local rad oncs to substitute.

2) Start doing research in rad onc early. Summer between M1 and M2 isn't a bad idea. A year out for research is not necessary, but puts you in contention for the top positions if the rest of your app is strong.

3) Most importantly, do very well in medical school. AOA and a high step 1 score are your best bet. Rad onc is almost at derm levels of competition at this point. The average step 1 will probably be 240+ by the time you apply (it was 239 at last check). You don't need AOA, but get as high grades as you can.

The most important factors for your success will be:
1) step 1
2) clinical grades
3) LORs
4) Research experience

Then of course we can talk about ERAS and interviews much later. Match to a strong academic program, keep doing research, and wayyyyy down the line you can ALWAYS pick up an academic position. Most of these positions are mostly clinical, but if you're willing to train longer (research fellowships after residency are available), make less, have less location flexibility, and have a less stable position, you can pick up a mostly research position someday. (That applies to MD or MD/PhD of course).