Oct 22, 2012
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I’m a 4th year med student applying for internal medicine and the physician-scientist track in hematology and oncology. This track allows residents to complete IM training in two years and move directly into fellowship, usually at the same institution (at some programs the fellowship is guaranteed obviating the need to even apply for fellowship). So, in compiling my IM rank list, I am also sort of deciding where I will be staying for fellowship and would like to understand a little better the differences between programs. The residency programs I am most considering are affiliated with the Dana Farber, MSKCC and Penn. At this point I am not sure whether I will want to specialize in liquid or solid tumors, but I do know that I want to run a lab with very translational focus. I’m curious how these programs differ in terms of breadth and quality of training opportunities (both research and clinical) and how they compare in facilitating the transition from fellow to faculty. Thanks for all your help!
 

gutonc

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I’m a 4th year med student applying for internal medicine and the physician-scientist track in hematology and oncology. This track allows residents to complete IM training in two years and move directly into fellowship, usually at the same institution (at some programs the fellowship is guaranteed obviating the need to even apply for fellowship). So, in compiling my IM rank list, I am also sort of deciding where I will be staying for fellowship and would like to understand a little better the differences between programs. The residency programs I am most considering are affiliated with the Dana Farber, MSKCC and Penn. At this point I am not sure whether I will want to specialize in liquid or solid tumors, but I do know that I want to run a lab with very translational focus. I’m curious how these programs differ in terms of breadth and quality of training opportunities (both research and clinical) and how they compare in facilitating the transition from fellow to faculty. Thanks for all your help!
I would not fret about the training (IM or Onc) at any of these places. You'll be fine. And you'll have research opportunities galore at any of the 3 as well.

If you're thinking about finding a place to make your "home" for a career, from the people I know who have trained at both of them, both Farber and MSKCC tend to have "ever fellows" that never "grow up." I was told flat out at my MSKCC interview (by both faculty and fellows) that if I wanted to be on faculty there I should train elsewhere and if I wanted to be on faculty somewhere else, it was a great place to train and the name would go far.
 

priam18

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... I know who have trained at both of them, both Farber and MSKCC tend to have "ever fellows" that never "grow up.
Could you expand on what you mean by that?
 

gutonc

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Could you expand on what you mean by that?
"Once a student/resident/fellow, always a student/resident/fellow."

Outside of the very small fraction of fellows who hit it big (a couple of Nature and NEJM first author papers and a K99 in your 2nd year of fellowship), it's hard to distinguish yourself in a place full of superstars. With 15+ fellows each year at those places, it makes it even harder to stand out.
 

threecoins

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Agree with Gutonc, staying at a place where " they saw you in diapers" is sometimes not the best thing.
Gutonc: can you please comment more on the K99 awards?
 
OP
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Oct 22, 2012
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Agree with Gutonc, staying at a place where " they saw you in diapers" is sometimes not the best thing.
Is it more common then for fellows to get their first faculty position at an institution other than where they train? At a number of the places where I have interviewed, they advertised proudly that they take a lot of their own fellows as faculty. And if MSK and Dana Farber don't hire their own, then who do they hire?

Speaking of faculty positions, can anyone comment on the Instructor position? From what I understand it is sort of like a second post-doc that allows you to continue to build a research program before you get a prof-level faculty position and the tenure clock starts ticking. But, it sounds like some programs take advantage of that position and keep you as instructor for many years (I think MSK and Dana Farber fall in that category...is anywhere else notorious for that?). How much does the salary differ from Instructor to Prof and what does it typically take to make the transition - does a K-award get you there? And at those places where they keep you at the Instructor level for many years, why don't/can't people leverage the big name of their institution and obtain tenure-track positions elsewhere?
 

gutonc

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Agree with Gutonc, staying at a place where " they saw you in diapers" is sometimes not the best thing.
Gutonc: can you please comment more on the K99 awards?
What do you want me to say? Other than I don't have one?
 

gutonc

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Enough said :)
A friend of mine is applying for one right now though and said that NCI is funding in the mid-30s for the K99/R00 which is pretty sweet. Of course, then you move on to the 8-12% range for R01s so you're pretty screwed at that point.
 
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Oct 22, 2012
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Hi

I didn't understand how to do only two years of IM?
ABIM allows residents who are designated as research track and plan a career as a physician scientist to begin fellowship training after only two years of internal medicine training. The fellowship, however, is extended by 2 years of additional research training, so overall it is actually a year longer with 1 year shorter clinical training and 2 extra years in the lab. This path is usually restricted to residents with a significant research background (MD/PhD, etc.).

http://www.abim.org/certification/policies/research-pathway-policies-requirements.aspx
 

gutonc

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ABIM allows residents who are designated as research track and plan a career as a physician scientist to begin fellowship training after only two years of internal medicine training. The fellowship, however, is extended by 2 years of additional research training, so overall it is actually a year longer with 1 year shorter clinical training and 2 extra years in the lab. This path is usually restricted to residents with a significant research background (MD/PhD, etc.).

http://www.abim.org/certification/policies/research-pathway-policies-requirements.aspx
FWIW, the pathway was actually designed to get non-PhDs into basic/translational research and is open to all applicants. But most of the people who are interested in a research career have already self-selected by that point and already have PhDs. Of the last 8 research pathway trainees that went through my program, 2 were MD-only, the rest of us had PhDs.
 
OP
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Oct 22, 2012
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FWIW, the pathway was actually designed to get non-PhDs into basic/translational research and is open to all applicants. But most of the people who are interested in a research career have already self-selected by that point and already have PhDs. Of the last 8 research pathway trainees that went through my program, 2 were MD-only, the rest of us had PhDs.
Is short-tracking usually only available to applicants admitted into the physician-scientist residency tracks, or can any resident (assuming they are sufficiently competent and convincingly committed to a career as a physician scientist) apply for fellowship starting as PGY-3? What I am asking is, is short tracking generally still an option if you match into the categorical rather than the physician scientist residency track (but without the fellowship guarantee)?