Collected Words of Advice

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Doctor&Geek

Doctor&Geek

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For those who are accepted, or already are in:

1] Being proactive solves problems. Whining doesn't get you far.

2] Your potential residency director will say: what's your best publication? What will your answer be?

3] Why would the residency director care if your work has nothing to do with what they're doing?

Corollary: The more basic your research, the larger the number of specialities it can be applicable to.

4] Go to the place, no matter what the reputation, where you know you will be interested in the work and will succeed.

5] That being said, there are two types of labs you'd ideally want to join; the new faculty member who will depend totally on you to make or break him [and get on all of his papers], and the established famous guy whose work is good enough to get you in Cell/Nature/Science.

6] Scoring the mean on your exams still equals MD/PhD.

7] The smart graduate will already have grants for future research. Upon hearing this, residency directors will quickly issue letters of acceptance.

8] As uncouth as the topic is, politicking starts now.

Cynically Yours,

Jason
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Originally posted by JPaikman

7] The smart graduate will already have grants for future research. Upon hearing this, residency directors will quickly issue letters of acceptance.
Click to expand...


Actually, you got my attention there.... You bring up a good point.

I wasn't aware that a newly grad MD/PhD can get grants before doing his/her residency i.e. starting a lab. Can you clarify this (in other words, what kind of grants are these, can you take them with you wherever you go for your residency, and what does that mean in terms of doing research during your residency? Do you spend part of the time in the lab, or is it a clinical project, or do you just not do anything but have the grant 'waiting'?)

Thanks, S.
 
I'm also curious about funding, so I'm bumping this. I know there are pre-doctoral grants that can be awarded by the NIH for promising grad students/post-docs, but I wonder if that's what the op was referring to?

Also, just want some feedback about residency applications. My dream has always been to be a neurosurgeon and I think I can do that with a MD/PhD by becoming a co-PI in my career. There are alot of MD/PhDs soaking up the neurosurgery residencies and I've met quite a few leaning in that direction, and yet the MSTP directors do not like hearing that I am considering neurosurgery. In any case, my question is whether or not I'd have to do research that has definite translational potential to neurology/neurosurgery during my PhD years to be competitive? There's so much basic science going on, and programs certainly push you that way, but not much of that has imminent translational potential. There only seem to be a handful of schools that I've interviewed at that have faculty that I could really see applying to a career in neurosurgery.

Any feedback? Note that I've also considered neurology as a residency/career, and that seems appealing to me as well. I guess it depends on whether or not I really can balance research and clinical in neurosurgery.
 
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Jason-

Your advice is awesome! Thanks!!
 
nice words paikman. yes i finally make my appearance here.
 
8] As uncouth as the topic is, politicking starts now.
Jason [/B][/QUOTE]

I hate to admit it, but this is by far the most important advice given!!!
 
Originally posted by surge
Actually, you got my attention there.... You bring up a good point.

I wasn't aware that a newly grad MD/PhD can get grants before doing his/her residency i.e. starting a lab. Can you clarify this (in other words, what kind of grants are these, can you take them with you wherever you go for your residency, and what does that mean in terms of doing research during your residency? Do you spend part of the time in the lab, or is it a clinical project, or do you just not do anything but have the grant 'waiting'?)

Thanks, S.
Click to expand...

You don't even need to be a newly graduated MD/PhD. You have your PhD as soon as you finish your thesis. Apply for grant funding during your clinical years based on your PhD work.

Mostly, these funds are going to be very small [think in the $5-10K range]. What they prove is that you've

A] done research good enough to get grants
B] proven that you can WRITE grants [and have the potential to get even more]

Most of the time, funding not offered through the institution you're at is portable.

One of the students who finished our program got enough grants so that during his fellowship training at Mayo, they set him up with lab space, a technician, and startup funding from the Mayo Foundation to continue his work.

Remember, that even with PhD postdocs, grants are available for funding their postdoctoral work. Your mentors ideally should NOT provide all of the funding necessary for your postdoc stipend - you have to get via grants. Luckily, there's more money available for physician-scientists.

Yours,

Jason
 
Hey, thanks JPaikman! This is some really good advice.

..... Now all I have to do is get in :D

S.
 
Actually, what do you mean by politicking? Politicking for faculty positions?
 
Neuronix said:
I'm also curious about funding, so I'm bumping this. I know there are pre-doctoral grants that can be awarded by the NIH for promising grad students/post-docs, but I wonder if that's what the op was referring to?

Smallish grants which are offered to fund postdoctoral fellowships and small projects. The NIH has some in the 5K-10K range.

Also, just want some feedback about residency applications. My dream has always been to be a neurosurgeon and I think I can do that with a MD/PhD by becoming a co-PI in my career. There are alot of MD/PhDs soaking up the neurosurgery residencies and I've met quite a few leaning in that direction, and yet the MSTP directors do not like hearing that I am considering neurosurgery. In any case, my question is whether or not I'd have to do research that has definite translational potential to neurology/neurosurgery during my PhD years to be competitive? There's so much basic science going on, and programs certainly push you that way, but not much of that has imminent translational potential. There only seem to be a handful of schools that I've interviewed at that have faculty that I could really see applying to a career in neurosurgery.

A good question; large numbers of MD/PhDs do indeed enter into neurosurgerical residencies, and residency directors do indeed want them.

To answer your question let me give you a few examples at my school:

a] young neurosurgeon does a wide variety of neurosurgery, but basic research is focused on association of late-stage gene expression of cytomegalovirus and a variety of cancers, including the brain. Not absolutely translationally related to his surgical work, but is important and related to the field.

b] md/phd student wanting to go into neurosurgery, but research focuses on the effects of sugar metabolism on gene expression. His project has more to do with diabetes, but it may branch off into Alzheimers. The fact that there is a tenous relationship between the two does not concern him.

c] md/phd student works with papillomavirus as a model. Research can be applicable to dermatology, oncology, infectious diseases, or oncological surgery, even though none of the work is clinical in nature, or directly mentions clinical implications.

Couple points:

Your PhD research can relate only tangentially to your residency. Simple stuff to convince residency directors, such as using a glioma cell line in your published work, can convince them that your work has relation to their field. When you write your essay for school is when you spin your research to the residency director.

Remember also that your PhD work is when you learn to think as a scientist, not select the sub-sub-field you're going to go into for a career [although that sometimes does happen]. Questions about its translational potential are indeed relevant, but probably not as important as you think it is in your PhD years. Residency directors are going to be more impressed by your 1st author Cell/Nature/Science than your 5th authorship in some clinical trial.

Finally, you will have to do at least a year of research work during your residency [usually year 5 or 6]; let that time decide what kind of research you want to do in the future, and learn clinical research if necessary.

Yours,

Jason
 
FenderB2004 said:
Actually, what do you mean by politicking? Politicking for faculty positions?

You'd think that being in a lab or in science is more ideal or better than on Capitol Hill.

You'd be dead wrong.

Yours,

Jason
 
Thanks for digging this up! This is excellent advice!

Do you have anything to update or add?
 
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So what exactly do you guys mean whe you say "politicking"?
 
Doctor&Geek said:
Believe it or not, I wrote this five and a half years ago.
Click to expand...
Time for a new update? I can include this link in the sticky so you can find it easier in another five years. ;)

Neuro, come on, let's hear your dissenting ideas. This isn't like you to hold back. :laugh:

Gosh - I'm old.
Click to expand...
:rolleyes: :p
 
bump.

no elaboration from neuronix et al.?

i, as well, am curious to know what you guys meant by politiking.
 
I second the former bump also.:confused:
 
I believe that by "politicking" they mean getting to know the right people. The point being that who you know matters even at the grad/med student level, and even in a "pure" field like science.
 
Ok, ok, since you're all asking for it... Keep in mind I'm interested in a non-traditional area. I've never wanted to go into one of the big three (IM, Peds, and Path), and I settled on Radiology instead of surgery. I think some of D&G's advice makes more sense for those big three specialties. For example, because they are so broad you can probably do almost any research and have it count. They aren't very competitive, outside of the top programs, so you'll probably get an excellent spot regardless. The bits I disagree with:

Doctor&Geek said:
3] Why would the residency director care if your work has nothing to do with what they're doing?

Corollary: The more basic your research, the larger the number of specialities it can be applicable to.
Click to expand...

They absolutely do care, and doing graduate work that is heavily related to your PhD is quite helpful for landing a top residency in my field (if you aren't 260+, AOA anyways). I hear this over and over again. Spinning your research depends how close you are. Every molecular biology PhD is trying to claim "Oh, but now I can do molecular imaging!" Nobody's biting, everyone makes that claim and everyone knows it's kind of silly.

5] That being said, there are two types of labs you'd ideally want to join; the new faculty member who will depend totally on you to make or break him [and get on all of his papers], and the established famous guy whose work is good enough to get you in Cell/Nature/Science.
Click to expand...

Not sure I agree with this. Not only is that a very small percentage of potential PIs around here, but you do want to be in the lab where you can be interested, productive, and happy. That's ideal to me.

I just don't see all these guys with their papers in Cell and Nature and Science that you keep talking about at any stage of the game. My whole field pretty much doesn't publish in those journals.

6] Scoring the mean on your exams still equals MD/PhD.
Click to expand...

True. Everyone keeps telling me now that doesn't mean you'll get the residency you want, however. Still, just to be clear, what really counts is Step I and your clinic grades. I can never do well on those ridiculous shelfs and you don't get any time to study when you're in clinics (if you like sleep anyways), so it's just a setup for failure--at least for me anyways.

Politicking is what you might expect. Letters of recommendation mean a lot in this game. Nobody seems to care about the potential for abuse here. The better they are and the bigger the person writing them, the better off you are for getting residency/job/grant/etc. I mean for top residencies they just expect them. Bad letters or your PI not writing you a letter looks awful. But it's not just that. You never know what scientist is going to review your grant or your paper someday. You want everyone to have a favorable impression of you, as it just may make your life go smoother... At least that's the advice I give. I think I'm possibly the worst at this. If I was really politicking like everyone tells me I should, I wouldn't make these long opinionated posts (much of which clash with the advice say my MD/PhD director would give... so make up your own mind), say unabashed things about my school (trying to convince some people NOT to come here, beaucse I know they would be happier elsewhere for example), and then make it so easy for people to figure out who I am.
 
For ultra-competitive specialties (e.g. Rad-Onc) doing a PhD that is directly relevant is extremely helpful. Also, realize that you will get pigeonholed by every residency program you interview at based on what you did your PhD in - e.g. if you did some work on molecular basis of breast cancer signaling all program directors will automatically assume that you want to do heme-onc and will look at you funny, if god forbid, you profess an interest in GI and then you will have furiously defend and explain yourself as to why in the world you would want to make tons of money and have a great lifestyle, I mean you want to cure colon cancer, when by all accounts you should OBVIOUSLY want to do heme-onc BECAUSE THAT'S WHAT YOUR PHD IS IN.
 
Oh yeah, and grades do unfortunately matter if you want to a competitive specialty or go to the best places for non-competitive specialties. The PhD opens some doors but is not a golden ticket unless you have Science/Nature/Cell caliber pubs.
 
greg12345 said:
you will get pigeonholed by every residency program you interview at based on what you did your PhD in
Click to expand...

It seems to me like no matter what you do your research on this could happen. Then if you step so far back that it's so broad and general, then you'll get the criticism "well how is this relevant to medicine?" :laugh:

I work on cerebral energetics by MRI, so I could easily go into neuro if I really wanted to do more traditional medicine stuff. I collaborate on MSK projects, so rheum and ortho would also be application options. I just don't really see the pigeonholing aspect as much of a negative... Are people really going to hold it against you so much if you want to transition into something else anyways?
 
greg12345 said:
Oh yeah, and grades do unfortunately matter if you want to a competitive specialty or go to the best places for non-competitive specialties. The PhD opens some doors but is not a golden ticket unless you have Science/Nature/Cell caliber pubs.
Click to expand...


How do residencies deal with applicants from med schools that are P/F? The match lists seem to be really strong from these schools, but do residencies disproportionately weigh the PhD accomplishments? Do most of these schools secretly rank under the table?
 
solitude said:
How do residencies deal with applicants from med schools that are P/F? The match lists seem to be really strong from these schools, but do residencies disproportionately weigh the PhD accomplishments? Do most of these schools secretly rank under the table?
Click to expand...

Bump. This is a good question...
 
D&G, who are the people at UAB who are the established famous guys?

I know Max Cooper is, but he's stopped accepting students. David Sweat at Neurobio is quite good.

Who else in your opinion runs a Nature/Cell/Science quality lab?
 
solitude said:
How do residencies deal with applicants from med schools that are P/F? The match lists seem to be really strong from these schools, but do residencies disproportionately weigh the PhD accomplishments? Do most of these schools secretly rank under the table?
Click to expand...

"residencies" are a heterogeneous group and cannot be lumped together like that. Some programs in some specialties will look at your PhD accomplishments more than your MD ones, others will not. In my experience in pathology, I was given a lot of preference for my PhD accomplishments from many programs, while others seemed to care less.

I am willing to bet few if any residency programs give a crap if your school is P/F. More importantly: do you have a class rank? What was your Step 1 score? Yeah, it is important to do well in the rotation you would like to pursue for a career. Is your program P/F in the clinics as well? Because if you are just talking about the basic science years- no one will care for sure.

At the end of your Dean's letter, the Dean will say ONE of the following: You were a fair student, you were a good student, you were an excellent student, or you were an outstanding student. That's really all that matters from med school- if you were "fair", that means you were at the bottom of your class in some way and that hurts your application, while being "outstanding" means you were at the top and probably AOA.

Where you went to med school also matters- going to a top program gives you more clout than going to a "lower tier" place.
 
Eliot Lefkowitz at UAB is awesome if you're interested in microbio..
 
solitude said:
How do residencies deal with applicants from med schools that are P/F? The match lists seem to be really strong from these schools, but do residencies disproportionately weigh the PhD accomplishments? Do most of these schools secretly rank under the table?
Click to expand...

Step I pretty much sums up your performance for the first two years. I don't think our clinical grades are P/F, at least not strictly. Someone recently bragged to me about getting honors in OBGYN...
 
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