Any MD/PhD in plastic surgery?

[Gotti]

Sorry this is a repost from the MD/PHd forum, but I couldn't get good answers there.
Any MD/PhD out there go into Plastic surgery? I love the clinical practice of plastic surgery as well as academic plastic surgery and cannot imagine doing anything else. I have no concern about money or time involved and have long placed family as a secondary consideration, even non-factor. How much did your Phd help you to get into integrated plastics? Or were you top of your class anyway (I am going to try really hard to not let this post descend into a "what are my chances" deal)?

Unfortunately, I only found out how much I loved this stuff in the last 6-8 months and my PhD was therefore not in plastic surgery, but in something very basic involving molecular genetics, biochemistry, and biophysics.

I'd love any insight into this topic from anyone about what it has been like as an MD/PhD in this field and would also appreciate any advice as to how I can improve my resume at this point besides studying harder on my clinical rotations (almost over).

Please don't write things like most MD/PhDs end up in private practice not doing any research because I feel this always comes back to money which I already stated is a non-factor for me.

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[Moravian]

My PhD didn't seem to help me get into a combined/integrated program in that I ended up doing the five years of general surgery. For me, this happened because of a couple of different reasons.

1. I didn't know I wanted to be surgeon until the 3rd year of medical school. I thought I wanted to be an oncologist and basically do research for my entire career. I did not do very well on Step I and didn't really care. For internal medicine, my doctorate in molecular genetics would carry me. Big Oops.

2. I did better on Step II, but it's really hard to recover from a bad Step I. I was not AOA and not even close to the top of my class.

3. I had one interview from a program that had an expressed interest in my PhD. The other places could care less. I got the distinct feeling that they wanted to train surgeons, not researchers.

Your situation may be (and hopefully is) different. If you have good scores, good letters, did well on your rotations, your graduate degree should enhance your application but it is definitely not as important as the first three things I mentioned. During your interviews, I would stress that you're interested in the clinical aspects and hope that your graduate training will allow you to be productive in translational research.

I think having the PhD helped a little more in the second round in that I was a proven clinical entity in that I didn't fade away into a surgical research lab somewhere. But those pesky Step scores still dogged me and thankfully I did extremely well on the ABSITE all five years of residency. Again, I think my ABSITE scores, letters, and other things were more important than the graduate degree.

Lastly, I'd like to comment on your comments about money. I didn't come from a "money" background and have been poor most of my life (well, maybe poor is stretching it a bit, but you get the idea). In school I felt that same way you do now about how money isn't the end all be all. I must still feel that way because I turned down jobs paying significantly more in order to stay in academics. That being said, I am still very well paid and I spent a lot of time in salary negotiation before signing with my current employer. The reasons for this are because of things you might not be thinking about now, things like retirement, paying of loans, sending kids to school, and being fairly compensated for your expertise. Don't let your altruism get in the way of being paid what you should be.

I have a lot of friends that are combined degreed in varied fields of medicine. Many of them have gotten out of academics, many of those for money reasons. Some did not get good mentorship and support for writing grants and doing research and were expected to generate clinical income on par with their peers. Research was considered a secondary endeavor. Still others managed to get grants that covered part of their salary and were still required to generate the requisite clinical revenue. Try getting in some lab time to generate data for a grant renewal when you're carrying a full patient load. In both cases they felt that after the Dean's tax, department expenses, university politics, etc., that it just wasn't worth it anymore.

Some are still hanging in there, but it's in places where they have good support and the clinical load is reasonable.

This is not to jade you in any way, it's just that the realities sometimes get in the way of our good intentions.

Best of luck to you.