Any MD/PHD advised not to apply to competitive residency?

[Gotti]

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Just wondering if anyone out there was advised not to apply to a competitive residency? Or for that matter, you applied but were disappointed by the number of interviews or how you matched? I'm asking because I'm a very average medical student wanting to get into Otolaryngology and am willing to go to any program that will take me.

 

[Neuronix]

I've been told I'm "middle of the road" and not to expect too many interviews at the top places in my field, which is a bit of a blow because I thought I was doing pretty well. But, I've never seen anyone actually told not to apply. This may happen... I don't know other people's records well enough. I know some guys here who applied in Rads and Derm and got it (at lower-tier academic placs) with mediocre MD/PhD records.

 

[Gotti]

So some guy got into derm even though he was just "average?" Hurray for us average dudes unable to publish in Nature or get excellent grades in med school! I'll take an ENT spot at the last ranked place if I have to. I am just trying to avoid the shame of being the first MSTP at my school to not match.

 

[gbwillner]

Just wondering if anyone out there was advised not to apply to a competitive residency? Or for that matter, you applied but were disappointed by the number of interviews or how you matched? I'm asking because I'm a very average medical student wanting to get into Otolaryngology and am willing to go to any program that will take me.

Do you want to pursue any research in the future? Or are you totally burned out and want to only do clinical work?

 

[Neuronix]

Well I don't want to give you details about those people because I'm hardly anonymous and those people could be reading this forum, but I'll say they were less than average, both as PhDs and MDs. Dunno about Step I scores though. In your case I dunno what to say--I dunno about ENT and I dunno about you. Good luck though!

 

[Picklesali]

I've been told I'm "middle of the road" and not to expect too many interviews at the top places in my field, which is a bit of a blow because I thought I was doing pretty well. But, I've never seen anyone actually told not to apply. This may happen... I don't know other people's records well enough. I know some guys here who applied in Rads and Derm and got it (at lower-tier academic placs) with mediocre MD/PhD records.

Middle of the road?? That's okay, Neuronix, because you're #1 in my heart 😀

(So we were told by many Penn MSTPers that practically everyone in the program gets their first choice, as in the program director hears the name "Penn MSTP" aaaaand you're in! Would that be an exaggeration?)

 

[Neuronix]

That's okay, Neuronix, because you're #1 in my heart 😀

If only someone around here felt that way 😛

Would that be an exaggeration?

Yes.

 

[Brunette1981]

(So we were told by many Penn MSTPers that practically everyone in the program gets their first choice, as in the program director hears the name "Penn MSTP" aaaaand you're in! Would that be an exaggeration?)

I'm sure that is true. However, if you, just as an example, apply to 20 derm places and get convinced to apply to another 20 IM places as a backup... then you get no derm interviews, only IM (and maybe only 10 IM interviews). You would then rank the 10 IM places. Therefore, getting your #1 rank isn't exactly equivalent to your first choice (which would have been derm), is it? No one would rank a program that didn't grant them an interview in the first place.

There are no stats on people's #1 choices pre-application and their rankings after being shaped by the reality of the process, although the program admin. may have some idea based on what people say they want and what they end up doing.

 

[Gotti]

Do you want to pursue any research in the future? Or are you totally burned out and want to only do clinical work?

I actually really still want to pursue research and probably more basic research than clinical research. I just really like surgery. Medicine isn't for me because I just can't sit around that table and talk half the day. I also can't keep track of a patient's numerous problems as I have clinically diagnosed ADHD, for which I refuse to take medication.

Neuronix, you've been told that everybody over there gets there #1 choice? That's great. I'm not quite at Ivy League, but at an almost top 15 school. I don't see how ranking those 10 derm programs first would hurt you unless you didn't get a single derm interview?

 

[Neuronix]

Neuronix, you've been told that everybody over there gets there #1 choice? That's great.

They tell applicants that virtually everyone gets among their top 3 choices and many years everyone gets their first choice. Some years everyone actually does (I can think of one since I've been here). However, you have to keep brunette1981's caveats here strongly in mind.

This is how it was phrased this year:
"Another fantastic year for our MD-PhD students in the match! They're all going to GREAT programs and the vast majority got their first choice!"

So does that mean that one or two matched far down their lists or in other specialties? Cause if everyone was in their top-3 I can almost guarantee they would have said that like they have in past years. Maybe one of the graduating students will comment (I know you're reading 😛). The guy I mentioned in Rads earlier ranked farrrrr down his list.

 

[QofQuimica]

If only someone around here felt that way 😛

She's only saying that because you're on the adcom. 😛

Gotti, does ENT require a transitional year? If it does, then can't you apply for categorical positions and also apply for internships plus advanced positions? If it doesn't, what about applying for post docs just in case? I noticed there were one or two people at most of the schools on doctor&geek's page who were going to post docs after graduating rather than starting residencies. It may not be your first choice, but it's better than being unemployed, right?

 

[gbwillner]

I actually really still want to pursue research and probably more basic research than clinical research. I just really like surgery. Medicine isn't for me because I just can't sit around that table and talk half the day. I also can't keep track of a patient's numerous problems as I have clinically diagnosed ADHD, for which I refuse to take medication.

Neuronix, you've been told that everybody over there gets there #1 choice? That's great. I'm not quite at Ivy League, but at an almost top 15 school. I don't see how ranking those 10 derm programs first would hurt you unless you didn't get a single derm interview?

I only ask because you can really use that to your advantage in your residency apps and interviews. Regrading competitive residencies:

1- You will most definitely match somewhere in ENT as an MD/PhD, provided your step 1 wasn't below 200 (or thereabout) and you didn't FAIL any clinical courses or Step 2.

2- You will likely be sought-after if you claim you want to do academic medicine + research. Let's face it- if these pograms need to pick between another trainee and someone who will bring in grant $ and make the institution look better, who will they take?

3- MD/PhDs aren't told NOT to apply to competitive specialties... but they may be discouraged. Not because they won't match well, but because 95% they will never do research again. Those that go into medicine, Peds, Path, Neuro tend to continue with research. If you are an admin and your students are never heard from again in science... you're doing it wrong. How many of you guys know MD/PhDs that went into Derm or Plastics? How many of them are doing research? I can't think of any I know.

4- That being said... you could do ENT and still do research. Just know that the cards will be stacked against you from the beginning.

5. MD/PhDs ALWAYS match well. Even from not-great programs. I bet 98% of all graduating MD/PhDs from all programs match to their top 3. But, as others have said, that doesn't really mean they got into a program they REALLY wanted to be at. For instance, take Rad Onc. It's super-competitive. There are only 100 or so spots in the entire country... and MD/Phds seem to really like it. One top place is MD Anderson- they are one of the biggest programs (and probably the best)- with a whopping three spots. They'll interview ~30 people TOPS yearly. There will be more that 30 MD/PhDs applying for Rad Onc in a given year. They'll probably only interview 10-15 MD/PhDs, and everyone will want to go there- but few will actually end up ranking it.

 

[Doctor&Geek]

For instance, take Rad Onc. It's super-competitive. There are only 100 or so spots in the entire country... and MD/Phds seem to really like it. One top place is MD Anderson- they are one of the biggest programs (and probably the best)- with a whopping three spots.

Not quite - I believe that have 5-6. But it is true that maybe only half of those are "reserved" for MD/PhDs.

They'll interview ~30 people TOPS yearly. There will be more that 30 MD/PhDs applying for Rad Onc in a given year. They'll probably only interview 10-15 MD/PhDs, and everyone will want to go there- but few will actually end up ranking it.

See here:
http://forums.studentdoctor.net/showthread.php?t=505911&page=2

 

[Gotti]

I only ask because you can really use that to your advantage in your residency apps and interviews. Regrading competitive residencies:

1- You will most definitely match somewhere in ENT as an MD/PhD, provided your step 1 wasn't below 200 (or thereabout) and you didn't FAIL any clinical courses or Step 2.
5. MD/PhDs ALWAYS match well. Even from not-great programs. I bet 98% of all graduating MD/PhDs from all programs match to their top 3. But, as others have said, that doesn't really mean they got into a program they REALLY wanted to be at. For instance, take Rad Onc. It's super-competitive. There are only 100 or so spots in the entire country... and MD/Phds seem to really like it. One top place is MD Anderson- they are one of the biggest programs (and probably the best)- with a whopping three spots. They'll interview ~30 people TOPS yearly. There will be more that 30 MD/PhDs applying for Rad Onc in a given year. They'll probably only interview 10-15 MD/PhDs, and everyone will want to go there- but few will actually end up ranking it.

Gbwillner, that's the most encouraging thing I've heard someone say. I really appreciate that. I've been discouraged by talking to all these regular med students tell me they scored 240s and are at the top half of the class who still only managed their last choice. I was lucky just to score low 230s.
I considered rad onc for a while because people told me they love MD/PHDs, especially since my PhD was in biophysics and biochem. But I just don't like it enough. Fortunately, I don't think many MD/PHDs want to do surgery given the rough lifestyle and the additional years.

Nobody has actually told me yet not to apply, but a fellow only looking at IM was told that he probably wouldn't get a look from prestigous places like Harvard and UCSF. I noticed that the VCU MD/PHds matched into neurosurgery and plastics at prestigous places.

Sometimes I don't think I deserve special treatment an applicant, but then I think about all those difficult years waiting for my damn crystal to grow and want whats coming to me.

 

[Brunette1981]

Neuronix, you've been told that everybody over there gets there #1 choice?

I was just trying to point out the difference between #1 CHOICE and #1 RANK - they may not be the same. The program doesn't give us any data on relative success in obtaining interviews after applying. That being said, people do seem to go to great programs so many may actually be getting their #1 choice, not just their #1 rank. But they may not.

I don't see how ranking those 10 derm programs first would hurt you unless you didn't get a single derm interview?

You can rank how you want and should do so, in order of your preferences. It absolutely can't hurt you (except maybe your ego if you get lower down your list). The only point I was making is that people applying to competitive specialities often get told to apply to less competitive backups - I know of someone who applied to both derm and psych. Therefore, when you hear the statistic that everyone got their #1 rank, it may mean they only got interviews in their backup specialty and got the top choice among that.

So it's almost impossible to say how much advantage an MD/PhD applicant has for competitive specialities without knowing # of interviews obtained vs # of applications sent out. And we definitely don't get that information.

 

[gbwillner]

I was just trying to point out the difference between #1 CHOICE and #1 RANK - they may not be the same. The program doesn't give us any data on relative success in obtaining interviews after applying. That being said, people do seem to go to great programs so many may actually be getting their #1 choice, not just their #1 rank. But they may not.

Let's not forget that after a LONG MD/PhD, many grads are no longer looking for the top US News-type program. For one, we recognize that many of these rankings are virtually meaningless (especially when it comes to residency programs where there is no stable measuring stick other than seeing things for yourself), but more importantly, as we get older other things become more relevant. People tend to stay close to home because of family constraints. Some of us would rather take the top in-state program or in-city program than some flashy program across the country. This probably artificially inflates our matching.

I do think it would be false to assume that the MD/PhD WON'T help you- it will- even in the super competitive specialties. However, as some have said, that alone may not be enough. Some PDs have specific beefs with MD/PhDs... so at some places it may hold true. I do know many "average" MSTPs that matched into Rad Onc, Plastics, ENT, etc.

I also think it's silly to talk about pre-interview "top" schools. How would you know you really like a program unless you go there and see it? If I really like MGH and apply there, but don't get an interview, and then I go and see BWH and really like it best of all the programs, wouldn't BWH be my #1?

 

[Brunette1981]

I also think it's silly to talk about pre-interview "top" schools. How would you know you really like a program unless you go there and see it? If I really like MGH and apply there, but don't get an interview, and then I go and see BWH and really like it best of all the programs, wouldn't BWH be my #1?

Sure, I'm looking at a particular area of the country myself for personal reasons - that's totally normal and valid.

I was speaking more to people who apply to backup specialties if they are also applying to a competitive speciality. So if you really like dermatology and apply there, but then only get interview invites for IM, it doesn't really matter if the IM is at MGH or BWH or Your State U if you really wanted to be a dermatologist...

Mostly, whatever people's matching priorities are in terms of program preferences, I was only trying to say we had no data about success at obtaining an interview as an MD/PhD applicant - it probably helps but no one knows how much.

 

[Gotti]

Hey guys,
I think I've been sweating this whole matching into ENT thing too much. At the end of the day, at least I finished my Phd in the field I like. And by memorizing a few facts here and there, I'll get a MD too. I look at these forums and see people sweating just about getting into certain graduate or medical programs and have to just wake up and smell the roses. Everything will work out if its meant to be.

 

[Myempire1]

I'm in a similar boat: interested in a competitive subspecialty. My step's avg for it and my grades are 50%ile. Consequently, every once in a while I am prone to anxiety-ridden hissy-fits. So, to cover my bases, I'll do continue to work hard, do a couple away rotations, apply to 45 programs, and (hopefully) interview at 20ish programs from all tiers. Hopefully it all works out.

 

[Gotti]

I have just about decided to apply to every program possible (>80) and if I don't get in after that, it wasn't meant to be and I will be done with the idea.

 

[cluelesspremed]

I only ask because you can really use that to your advantage in your residency apps and interviews. Regrading competitive residencies:

1- You will most definitely match somewhere in ENT as an MD/PhD, provided your step 1 wasn't below 200 (or thereabout) and you didn't FAIL any clinical courses or Step 2.

What if we DID fail a clinical rotation? Despite passing the NBME and having a passing overall grade, I did not pass my family practice clerkship because of a crock of an evaluation from my attending. (Our FP department has a policy that if your attending thinks you need more clinical experience in FP, they alone can fail you).

Any thoughts on what I should do? How this will affect me? This aside, I high passed or passed every other 3rd year clerkship, scored a 222 on step 1, and am the average joe in every sense (and 8 months into my PhD now after completing 3rd year)

Any advice/suggestions/honest input would be appreciated (either here or via PM) b/c i'm still freaking out about that one eval/clerkship...

 

[Rocket3004]

Question: when you guys cumulatively refer to "average MD/PhD students" (if there even was such a term 😉 ), do you mean PhD-wise i.e. "weak" publications (and I use the term fairly lightly), or MD/class rank/board scores/etc. ?

What do you think about raking the following students (say if you were a residency director at an academic institition):

MD/PhD student, average-above average rank/board scores etc. fairly good reserach

MD student: strong-very strong rank/board scores, good research (say 1 year off from school committed to research)

 

[Neuronix]

Question: when you guys cumulatively refer to "average MD/PhD students" (if there even was such a term 😉 ), do you mean PhD-wise i.e. "weak" publications (and I use the term fairly lightly), or MD/class rank/board scores/etc. ?

I'm referring to class ranking in the middle from MD and a PhD with a couple publications, none in big name journals.

What do you think about raking the following students (say if you were a residency director at an academic institition):

This question is impossible to answer imo. It's going to depend on the residency, the specific program, just how different the numbers are, etc...

 

[Hurricane]

I can't see why one would discourage someone from applying to competitive specialty because they have an MD/PhD. It can only help. A PhD certainly isn't going to hurt you.

How much it helps depends on the specialty. In my field (psychiatry) they are hungry for people who want to do serious research, and it's a field that hasn't traditionally had a lot of MD/PhDs (compared to IM, Peds, etc.). So the PhD boosted me more than it would in a specialty with a lot of MD/PhDs like Rad Onc. Dunno about ENT specifically.

As far as getting #1 - FWIW my year we all did get our #1, and that includes us getting interviews at all the places we applied.

 

[gbwillner]

What if we DID fail a clinical rotation? Despite passing the NBME and having a passing overall grade, I did not pass my family practice clerkship because of a crock of an evaluation from my attending. (Our FP department has a policy that if your attending thinks you need more clinical experience in FP, they alone can fail you).

Any thoughts on what I should do? How this will affect me? This aside, I high passed or passed every other 3rd year clerkship, scored a 222 on step 1, and am the average joe in every sense (and 8 months into my PhD now after completing 3rd year)

Any advice/suggestions/honest input would be appreciated (either here or via PM) b/c i'm still freaking out about that one eval/clerkship...

Hmmm.... Problem is, I don't really know anyone who's been in your boat. I guess my advise will be to go ahead and try anyway- And be really ready to explain that F. I would do my best to change that grade if I were you- maybe you can do an extra elective with another attending or something or just bitch and moan until they fix it.

 

[Gotti]

Hey! I also failed my family medicine rotation, but am looking at near honors to honors (school still deciding) for my other rotations including medicine and surgery. I actually failed the shelf because I had to do a few experiments that month to answer thesis committee criticisms. My evals have been good to great though. I can't believe the course director failed you on subjective bullshi-. Didn't you ask enough questions you already know the answer to to make yourself look interested? Didn't you mention that FM has so little research and covers such a wide diversity of topics that the field is wide open to new innovations in the practice? That was a really difficult exam and schools that emphasize Internal Medicine over FM usually leave you 4 weeks to essentially take a final exam for the year. If an MSTP takes it too early, he is really screwed since he just came out of hibernation after years off. Don't worry though, some schools don't even have FM as a 3rd year rotation. So I'm going to brush it under the rug as some lame elective I took in the countryside.

Anyway, we have to remember that we sacrificed years of the prime of our lives in the name of research and completed a tough project and will probably not benefit financially from it even as practicing doctors. Even if we do no research in the future, we will at least contribute our scientific inquiry to the clinical practice. We deserve that residency!

I will be furious if that FM rotation comes back to haunt me particularly since I was only 3 points off passing the shelf. How did you get your school to let you do 3rd year before your research? That's some sweet action! You didn't forget all your basic knowledge at all.

Other guy already in residency where everyone got their #1, you're not from Harvard or UCSF or something like that, are you? My school is only top 15-20, one time top 10. But then, I noticed everyone at Virginia Commonwealth got Neurosurgery or Plastic Surgery. A few people at my school though didn't publish and got only their #3-#5 choice, albeit in the field they like, but one guy had to scramble (complete weirdo). I guess they are below average because they didn't publish. Here's to all of us average MD/Phds who waited out our projects to publication!! Hip, hip, hurray!