Advice for re-application

[ExcitatorySynapse]

Hello, I am interested in hearing any insight from the brilliant people on this forum re: how I ought to prepare in the probable event of my re-applying. As an international, and likely as a non-outstanding applicant, I am also contemplating just going for the MD and then trying to integrate research in my career later on, if possible. I know for certain that I want to be a physician and that I am only interested in clinically relevant work, and have had multiple MD only mentors. I would appreciate any thoughts on this scenario, as well.

Current situation:

Spoiler

T5 undergrad, 521 MCAT, 3.75 c/3.65sGPA. This cycle: 3k research hours, ~ 20 hours of shadowing (two specialities), about 50 clinical volunteering hours and 50 nonclinical hours, some research awards/university designations, and a decent # of university clubs/organizations. Applied in September. Had a couple of interviews, not expecting much. Still waiting on 14 schools, but again, not expecting much.

Additions I will have: 1 middle authorship in a good journal, submitting on the first day and altogether being better prepared.
Additions I want to have and think are feasible: 1 first author paper
Additions I am considering making: Adding roughly 250 clinical and 250 nonclinical hours each to make myself a better MD applicant.

Thank you for your time and consideration.

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[vaticrunner]

I know for certain that I want to be a physician and that I am only interested in clinically relevant work, and have had multiple MD only mentors.

It seems from this statement you should definitely consider just applying MD only. From my limited understanding of the field, there are numerous opportunities for MD's to get involved in clinically relevant work and often times you can partner with a basic scientist and leverage both of your skill sets that way.

As far as reapplication, I am probably not well equipped to provide advice on that front, but I do wish you a speedy acceptance. I think if you have a few interviews, you have a good shot at getting in this cycle. It is unfortunate that you are an international; however, I think judging by your interest in the field, you can make things work even if you don't get in this cycle. Good luck!

 

[ClimbsRox]

There is no reason to break your neck trying to get the MD/PhD if the majority of what you want to do falls under the "clinical" category. Beef up those clinical hours and apply MD if you need to. From my limited experience, the MD/PhD is designed for people who want to spend <50% of their time doing basic/translational research. If thats not you, then dont force it.

 

[ExcitatorySynapse]

When I meant that my interests were clinically relevant is that I only want to do stuff that is directly disease related and that would further therapeutics, I.e more translational. I had thought initially that I’d find molecular/cellular mechanisms underlying neurological diseases the most interesting and at this time, I *do* but I don’t know if looking forward four decades, such a focus will hold me, if that makes sense? I think it may end up being more satisfying to have my end goal be targeted therapeutics for disease. Conversely the reason why we don’t have them is because we don’t know all too much, which is a bit of dilemma....
My MD only mentors actually do a lot of basic science work but have been able to work towards diagnostics and therapeutic applications also. I suppose in an ideal reality I’d have a lab that did both.
I do think that I’d be able to accomplish such work with an MD. A PhD would probably help, though.

 

[TheJooce]

When I meant that my interests were clinically relevant is that I only want to do stuff that is directly disease related and that would further therapeutics, I.e more translational. I had thought initially that I’d find molecular/cellular mechanisms underlying neurological diseases the most interesting and at this time, I *do* but I don’t know if looking forward four decades, such a focus will hold me, if that makes sense? I think it may end up being more satisfying to have my end goal be targeted therapeutics for disease. Conversely the reason why we don’t have them is because we don’t know all too much, which is a bit of dilemma....
My MD only mentors actually do a lot of basic science work but have been able to work towards diagnostics and therapeutic applications also. I suppose in an ideal reality I’d have a lab that did both.
I do think that I’d be able to accomplish such work with an MD. A PhD would probably help, though.

I agree with you that an MD-PhD would be good for your goals—although it would probably benefit you to emphasize your interest in basic brain mechanisms with translational potential in your interviews. Perhaps unfairly, you will often be compulsively compared to the mold of a physician scientist with the 80-20 split and an NIH-funded basic science lab.

Don't be discouraged by people who immediately bin you as MD-only just because they hear the word "clinical"come out of your mouth. If there are MD-PhD folks studying public health, economics, or anthropology (and there are), then there should be folks like you who are committed to the translational.

As far as advice for next year, I would just say apply the first day and do your best to pump out that first-author paper.

 

[Tothepub]

The first-author paper would be a huge help to your application, of course.
One consideration there is how long it takes to take a paper through publication. In my subdiscipline, drafting a paper and getting it accepted in 6 months (when you would start applying) would be considered fairly fast. Peer review is unpredictable, and if reviewers want additional experiments the timeline of publication can be pushed to a year or more.

Basically what I'm getting at is to not put too much pressure on yourself to get the paper out there. Being able to talk about your lead role in the project and your plans for publication is valuable, too.

 

[ExcitatorySynapse]

@TheJooce I am genuinely interested in mechanisms, because they’re really cool and what make biology so neat, but I am not sure if it’s where I want to go, long term. I’ve been learning about and been involved in more translational work of late, and it’s actually fairly interesting with lots of room to grow. I appreciate the feedback!
@Tothepub Thank you for your feedback. That’s actually my dilemma - my current work is more computational and other students (with stronger backgrounds than me, granted) were apparently able to do publishable work in less time than I have. So, I think if I focus most of my efforts on this, it could happen. And I also think that these skills could be highly valuable going forward, so I am sincerely interested in mastering them. However, if I have no chance in my re-application for MD/PhDs, then I may as well spend that extra time on MD only stuff (which I’m apparently way behind at, according to the folks at the WAMC forum). I’m not sure what I should do. I feel like I can only begin my career, either way, after my MD or dual degrees, and I don’t want to put it off in a futile hope.

 

[moggat]

I was a successful re-applicant, so I can give a bit of advice, but I think your #1 biggest hurdle is going to be being an international student. If you're not a US citizen or permanent resident, I would seriously research every program in the US and only apply to those that accept and matriculate international students. If you're curious and can't find out--email them. It's a total waste of time and money to apply to schools that won't even read your application.

As for stats:
Your MCAT is strong, and your GPA and research hours are average. 20 hours of shadowing is on the low side, but you also haven't shadowed any MD/PhDs which I think is more concerning if you aren't able to articulate clearly why you want to be a physician scientist (emphasis on the scientist) and not just a physician.

I think that, if you're really passionate about MD/PhD (which from your answers here, I'm not convinced) you need to have a really strong narrative as to WHY and how it's going to shape your life. As a re-applicant, you're starting 500 ft below everyone else on the race to the top of the mountain, so you need to clearly demonstrate to the people reading your application that you know what you're getting into and why. I'd suggest shadowing a physician-scientist and doing some soul searching.

As for timing and papers, you're on the right track. Apply early, get your middle author paper out, and if the first author paper happens, great but don't kill yourself to get it done. Focus on being a well-rounded, thoughtful, and interesting applicant. I think adding clinical and non-clinical hours may help with that, but make sure they're not just "box checking" activities, but something that actually means something to you.

Otherwise, good luck!

Hello, I am interested in hearing any insight from the brilliant people on this forum re: how I ought to prepare in the probable event of my re-applying. As an international, and likely as a non-outstanding applicant, I am also contemplating just going for the MD and then trying to integrate research in my career later on, if possible. I know for certain that I want to be a physician and that I am only interested in clinically relevant work, and have had multiple MD only mentors. I would appreciate any thoughts on this scenario, as well.

Current situation:

Spoiler

T5 undergrad, 521 MCAT, 3.75 c/3.65sGPA. This cycle: 3k research hours, ~ 20 hours of shadowing (two specialities), about 50 clinical volunteering hours and 50 nonclinical hours, some research awards/university designations, and a decent # of university clubs/organizations. Applied in September. Had a couple of interviews, not expecting much. Still waiting on 14 schools, but again, not expecting much.

Additions I will have: 1 middle authorship in a good journal, submitting on the first day and altogether being better prepared.
Additions I want to have and think are feasible: 1 first author paper
Additions I am considering making: Adding roughly 250 clinical and 250 nonclinical hours each to make myself a better MD applicant.

 

[ExcitatorySynapse]

I was a successful re-applicant, so I can give a bit of advice, but I think your #1 biggest hurdle is going to be being an international student. If you're not a US citizen or permanent resident, I would seriously research every program in the US and only apply to those that accept and matriculate international students. If you're curious and can't find out--email them. It's a total waste of time and money to apply to schools that won't even read your application.

As for stats:
Your MCAT is strong, and your GPA and research hours are average. 20 hours of shadowing is on the low side, but you also haven't shadowed any MD/PhDs which I think is more concerning if you aren't able to articulate clearly why you want to be a physician scientist (emphasis on the scientist) and not just a physician.

I think that, if you're really passionate about MD/PhD (which from your answers here, I'm not convinced) you need to have a really strong narrative as to WHY and how it's going to shape your life. As a re-applicant, you're starting 500 ft below everyone else on the race to the top of the mountain, so you need to clearly demonstrate to the people reading your application that you know what you're getting into and why. I'd suggest shadowing a physician-scientist and doing some soul searching.

As for timing and papers, you're on the right track. Apply early, get your middle author paper out, and if the first author paper happens, great but don't kill yourself to get it done. Focus on being a well-rounded, thoughtful, and interesting applicant. I think adding clinical and non-clinical hours may help with that, but make sure they're not just "box checking" activities, but something that actually means something to you.

Otherwise, good luck!

Hey, thank you for taking the time to give me feedback, @moggat
Just to address some of your comments -
1) I tried to screen via MSAR but in retrospect, I should’ve just called schools and have used that extra time/money to apply to Canadian school. I really regret that now.
2) I did shadow 1 MD/PhD, a neurologist who does work that interests me. I’m thinking of adding more. 1 of my direct mentors who wrote me a letter is also an MD/Phd, and another mentor is an MD physician scientist.
3) I think I have a clear vision of what I want to do - I want to be a physician who spends half a day a week at the clinic, occasionally collaborated with colleagues on clinical trials, and spend the majority of my time doing clinically relevant research. This research can happen in industry or within academia. I know from my heart that I want to do this whether I get an MD or an MD/PhD. I’ve wanted this for a long time. I am, however, deeply cynical about this process/academia now, and I don’t want to emotionally invest myself (again) in a pursuit that may be fruitless.
4) I’m adding activités just in case I go MD only, but it’s good to know that it’ll be helpful for MD/PhD also. I have been advised by multiple people to focus on MD only and then pivot towards research later. The challenge there is just the enormous debt - if I could get into a Canadian med school, then that would be a much easier pill to swallow. One of the scientists I have the most respect for is ‘only an MD’ who did a PDF, so that isn’t a limiting factor.
Anyway, thank you again!

 

[Maebea]

You can use this spreadsheet to determine which programs accept applications from international students: https://aamc-orange.global.ssl.fast..._info_prospective_applicants_table_092116.pdf

Of the 31 programs that indicate they will accept international applicants, 11 said "On a case by case basis". I am not sure exactly what that means, but my hunch is that these would be low-yield options for international students.

Once you develop an initial list of programs that accept international students, contact the programs and ask them how many international students are currently enrolled in their program, whether there is a limit on the number of international students they can take annually, and whether international students receive full funding. This may help you to refine your list further.

 

[Fencer]

These policies were from 2016, and things change... it is a start. I believe that we are in the process of collecting an update on this list, but it won't be available until mid-October or so.

 

[ExcitatorySynapse]

You can use this spreadsheet to determine which programs accept applications from international students: https://aamc-orange.global.ssl.fast..._info_prospective_applicants_table_092116.pdf

Of the 31 programs that indicate they will accept international applicants, 11 said "On a case by case basis". I am not sure exactly what that means, but my hunch is that these would be low-yield options for international students.

Once you develop an initial list of programs that accept international students, contact the programs and ask them how many international students are currently enrolled in their program, whether there is a limit on the number of international students they can take annually, and whether international students receive full funding. This may help you to refine your list further.

I actually used this list and checked on the websites to confirm, but in retrospect, I should’ve called and emailed everyone to get the details that you suggested. There are also, I believe, 1-2 programs not listed on there that do consider internationals, as I know people who interviewed at those institutions (TJ, NYMC). Some, like my alma mater, say that they do accept on that list, MSAR, and the website, and admitted over the phone that they generally don’t take any foreign students. It is definitely best to confirm directly.
Regardless, in my conversations with successful international applicants, most told me that they had multiple peer reviewed publications. That is not something I think I can do with the time available to me. No amount of list refinement will make up for such deficiencies.

 

[lovebiochem]

^^ I did exactly that and tried to email/call programs about the number of internationals they accepted/willing to accept this cycle etc. All I got was silence in emails and "We are not certain at this point of the cycle" in phone calls

 

[ExcitatorySynapse]

^^ I did exactly that and tried to email/call programs about the number of internationals they accepted/willing to accept this cycle etc. All I got was silence in emails and "We are not certain at this point of the cycle" in phone calls

That is unfortunate to hear, especially when many institutions, I think, have pretty clear limitations.
SLU was upfront with me about their weird funding situation via email, which I appreciated. Maybe someone could compile a database of which schools *do* extend invitations to internationals by surveying students. I think that would be a very valuable resource.

 

[ExcitatorySynapse]

I’m bumping this thread because I’ve taken the time to reflect on everything. I am more clear now that I want to be a physician scientist who works on translational research and does maybe 20% clinical. I think that there are research skills that I need to further develop via a PhD to be successful in the particular area I like. I’ve also found that my hospital volunteering commitment interferes with my research job because of weird hours and that I’d much prefer doing the latter.

The issue I’m having is that I don’t know if a reapplication to MD/PhD (if necessary) will result in a better outcome than last time. The middle author paper is not in my hands and depends on when my PI wants to submit. The current work, I was told that it’s possible but no solid plans since the lab is in flux.

I made many application errors, in retrospect, last time. I applied really late, my essays probably weren’t that great, and I messed up in my interviews because I didn’t really talk about myself as much I should have. Still, I don’t think I will have a CV anywhere as impressive as some of the other international applicants I’ve spoken with.

I don’t want to delay my career any further. I won’t be young forever and I have to support my parents, and I think a reapplication to MD/PhD is risky. I would greatly appreciate any insight on this topic.
Thanks!