Do you tell residencies that you don't want to do research?

[ariel28]

I have about T-1 year left in the PhD phase of my MD/PhD program. As things progress, I am realizing more and more that I am unsure if I want to pursue a research career at all. (Funding woes, grant stress, publication pressures etc. make me think that it might not be the career of my dreams after all). Sometimes I still get very excited about the pursuit of science, but most of the time I wish I had just done the straight MD.

With this in mind, I really have no idea what I'm doing with my future. My Step1 score is not very competitive (only 227). Everyone always said that having the PhD would help, but if I'm not really thinking that I want to do a basic research career how can it? In my case, it doesn't look like I will have a great publication record (a couple middle author pubs, 1-2 first author in a so-so journal, and a 1st author review). Of course, I still have 3rd year grades, and LORs, Step 2 that will make up my package. Do I tell residency directors that I don't want to do research anymore? Other people in my program who feel the same way suggest that you would NEVER intimate that you've lost the research bug.

Thoughts?

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[Neuronix]

Another person PMed me a very similar question recently. Here is my reply:

I have written a lot about the "MD/PhD trap". Start there.

http://www.neuronix.org/2011/07/nrmp...tcomes-in.html

Being not interested in research won't hurt you if nobody knows about it. Community programs will have no interest in you because you are MD/PhD. Academic programs will have interest in you because you are MD/PhD. You will never convince the community or other non-academic programs that you have given up on research. Don't even try. They will laugh at you. But you can send an essay to the academic program that kills your ability to get a position or go interview at a program and kill your chances by saying you aren't interested in research anymore. Don't be this person. Say you are trying to focus on clinical training at this point in your life so you can be an excellent physician. Maybe someday you will be an excellent physician-scientist during/after fellowship. Don't downplay your strength. Because every fourth year MD-only out there who has a SUMMER (at best) of research is going to swear up and down they want to do academics in the future. They will talk about how much they love research and can't wait to become big name faculty. That is until they match at [insert big name academic residency program here] and then switch right back to private practice minded/highest paying fellowship mode which they wanted all along. Don't get beat by them. You worked too hard. Once you're in residency you can do what you want, just don't close any doors beforehand.

As for low to mid tier academics, it's a gamble. It depends on what the chair/PD is looking for. Do they want to hire MD/PhD residents who they will support to do research or do they want scut monkeys. There's no real way to find this out except maybe an away rotation. You might get a better sense of these sorts of issues when you interview, but probably not even then.

 

[debateg]

Absolutely not. Never burn bridges until you're no longer a trainee. The best time to abandon science is during fellowship (at least for medicine). By that time, you will have very desirable clinical skills that can secure you a clinical job if you want. I know a few people who also went directly from residency to hospitalist and never looked back.

Keep in mind that right now, you're probably burned out from lab which is very common considering many of your med school cohort have moved on. You also haven't done clinical rotations so you don't even know if you'd prefer lab; many MD/PhDs are itching to leave lab and then really want to go back once they hit the wards. Also once you go to third year, it's going to be at least 4-5 years before you even need to make that decision. It's really not something you have to worry about now.

The most difficult question you could be posed while interviewing is how you see your career working out once you're finished training. I think it's best to come up with a clear cut answer for this one but admit that you can never predict what opportunities may arise that will change your career path.

 

[Shifty B]

Say you are trying to focus on clinical training at this point in your life so you can be an excellent physician.

This is pretty much the perfect advice. If you want to do research then people will be really happy that you have your priorities focused on clinical training. If you don't want to do research it is the perfect way to describe what you are thinking. Maybe you'll change your mind.

 

[Etph2003]

Hello, and thanks for bringing this honesty matter up.

I am IMG, I did a MD PhD, and a post-doc and after that I did the steps.

My concern is when I apply to residency, I am afraid I will get interviews that offer me only " research track residency" and I really don't want to do that, since I do not want to do an academic career! I want to do clinics and some research during my residency... Like 20 % of my time.

I do love science, but not the scientific career. I've heard in this research residences you have to do like 90% research the 3rd year!! Honestly I think what I need now it's clinical experience, after being 5 years in the lab.

So what should I say in the interview if they offer me this? I understand it is the same application for regular and research track, is it? Is it ok if I say that it is too early for me to take that decision and I prefer s regular track?


Thanks

 

[strangeglove]

Many "research track" residencies offer the best clinical training. Some of these residencies offer a formal research track with slightly less clinical work in exchange for some extra research time. You usually don't have to commit to this prior to the match, though there are a couple of exceptions. As an MD-PhD, you will, however, be interviewed by research faculty who are specifically tasked with sussing out whether you are serious about your research interests. The Neuronix strategy would involve pulling the wool over their eyes.

 

[QofQuimica]

Many "research track" residencies offer the best clinical training. Some of these residencies offer a formal research track with slightly less clinical work in exchange for some extra research time. You usually don't have to commit to this prior to the match, though there are a couple of exceptions. As an MD-PhD, you will, however, be interviewed by research faculty who are specifically tasked with sussing out whether you are serious about your research interests. The Neuronix strategy would involve pulling the wool over their eyes.

Not necessarily. As a fourth year med student, a lot of people still don't know their a** from your elbow in terms of what they're going to be when they grow up. I think it's very fair to say that you want to get the best possible clinical training as a resident, and that you also want to keep the door open for a research career, although you understand that residency is not the proper time to be focusing on research. (I'm assuming for the sake of this argument that one is *not* applying to a research track residency, because in that case then there is certainly time for research.)

 

[dl2dp2]

While I agree with Neuronix that a regular US MD/PhD (esp. MSTP) graduate should not eliminate their research career so willy-nilly--in fact I would argue that after you determine which specialty you want to get into, and if it's a competitive one, have a research plan to discuss how you can formally transition your career into one of physician scientist. You can defer this decision and you don't want to shut any doors.

However, for the IMG poster, my sense is that unless you are a research superstar and you really have a good narrative, most residency programs will never think that you'll be a good candidate to do research anyway, so that's not gonna be taken seriously. The only real solid advice for the IMG is to apply to as many program as possible and stay consistent. If you want to be a researcher, be a researcher, but if you know 100% that you don't want to be a researcher, be honest about it.

There is a huge difference between different types of MD/PhDs. While an MSTP grad from a top program with mediocre grades and score could still have a slimmer to a decent of a shot at some of the most competitive residency programs in the country, a non-US PhD + a non-US MD will not take you very far. Unless you did very very well during your postdoc and have multiple high profile publications--in which case you'd be gunning for a different kind of market, the tenure track basic science market--you are pretty much just like any other IMG, and it's highly unlikely that you'll be offered a very competitive "research track" spot that's usually reserved for the best MSTP grads.

 

[Fencer]

I have seen non-US MD/PhDs in top 10 residencies. Get into the best US residency that you can (research track or not) and if you do very well, you will be competitive for top Fellowships/Research post-docs.

 

[dl2dp2]

I have seen non-US MD/PhDs in top 10 residencies. Get into the best US residency that you can (research track or not) and if you do very well, you will be competitive for top Fellowships/Research post-docs.

I've seen this as well. However, these people are mostly people who did really well during PhD research, and the department wants to hire them to enhance the research portfolio. This doesn't apply to IMGs who also did mediocre PhDs, or have PhDs from unknown universities outside of the US.

Your CV is evaluated as a package. There are different kinds of candidates in both US MSTP and IMGs. For instance, if your CV says you went to Karolinska for MD and did PhD at Cambridge with Nobel Laureate and published a Nature paper, and now you want to attack the problem of poststroke neuroregeneration using the same assay you invented during your PhD, and had done a number of US clinical observeships and very strong letters, you bet all the top neurology programs will fight for you. This is an "IMG" with a "non-US PhD". But this CV is a much higher profile compared to a middle tier US MSTP candidate who didn't publish any papers and only got Ps during 3rd year.

These things are really hard to talk about without looking at an individual CV and evaluate on a case by case basis.

 

[mercaptovizadeh]

Just say you want to do research. It simplifies things. Your ECs are so skewed to research, if you wanted to say you wanted to follow another track (e.g. public health, humanitarian work) you would need some powerful ECs in those domains - and powerful reasons for abandoning basic/clinical research - to explain yourself. Otherwise they will suspect that you did it just for the cash and will be running off to PP post-residency/fellowship.

 

[gbwillner]

Kinda disagree with most here.

I think you need to be honest with people. Most clinical staff at most clinical training programs couldn't give two craps if you want to research or not. Maybe the PhD helps you a little, maybe not. I know MSTPs who went into community programs, also in competitive fields. Maybe let them know you have zero interest in research? Maybe that helps? It certainly doesn't hurt. And why would they care if you did have some interest in research? You're certainly not going to do anything about it at their program. You will be 100% clinical, just like everyone else there.

If you are not sure about research, i would stay away from PSTP-type positions. You will be burning bridges early, because you need to commit to labs fairly early on before short-tracking. It will be painfully obvious to everyone you are not going that path within a year or two of training. Unless you are the coolest guy on earth, the faculty will feel like they wasted a valuable spot on you. At that point, don't expect any favors. And their word matters A LOT when you get a real job. Many of the top jobs are all about connections. You don't think future employers are going to call your faculty mentors as a reference? If you leave a bad taste in their mouth you are looking for trouble.

Going into an academic program always gives you the opportunity to do research again. But you really don't have to sell your research prowess to get into such a program, since most people at most programs don't care at all about research.

 

[Orin]

I think you need to be honest with people.

Say you are trying to focus on clinical training at this point in your life so you can be an excellent physician.