I really need some advice because I am stressing myself out

[Hawkenthesky]

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[Noctámbulo]

Take a gap year. You need to 1) further explore your growing interest in pursuing an MD/PhD before making that decision and 2) gain more research experience before applying to these programs, if that's what you choose to do.

 

[Hawkenthesky]

Take a gap year. You need to 1) further explore your growing interest in pursuing an MD/PhD before making that decision and 2) gain more research experience before applying to these programs, if that's what you choose to do.

I'm pretty sure that I do want to pursue an MD/PhD, since it seems to fit the most with my research interests, but if I have no chance at getting in with the research experience I have/will get while in undergrad, then I basically want to try and figure out if my goals can mostly be accomplished with an MD, in which case I will apply to MD programs at the end of this year.

If an MD is simply not enough to do the kind of things i'm interested in, like I would need an MD/PhD, or the kind of additional training I would require if I only got the MD would basically take as much time as taking a year off and then applying to MD/PhDs, then I would wait and do a post bacc and apply next year.

If I do have a shot though (or at least could have a shot if I get high MCAT scores) at getting into MD/PhD programs if I apply this application cycle, then I will apply to the combined degree programs. [if I end up not getting in I will do a post bacc I guess and apply next year].

I've thought a LOT about whether an MD/PhD is the best fit, and I think it is. But I want to know if you or anyone else thinks my goals could be accomplished with the MD alone.

 

[eteshoe]

Your goals can be accomplished with an MD alone+residency + an intense research fellowship.

Frankly you don't have enough research experience to be super competitive for MD/PhD programs so you will need a gap yr or 2. An NIH post bacc might be an awesome opportunity for someone like you (2 yrs). Plus you will need to get some volunteering and shadowing experience. I'm not sure about how the day to day operations are but being at the NIH would give you exposure to all the things necessary to be a strong applicant.

 

[tachycore]

There are mechanisms / programs for promising residents / fellows and junior MD faculty to get an MS or even a PhD. While they are already engaged in clinical practice. In fact, these programs specifically train candidates to apply for competitive early career grants (yes, NIH). And they enjoy high success rates with getting these projects funded and developing into academic clinicians.

Heck, the ABIM even supports a separate research track for internal medicine residents. They even distinguish between basic science tracks and clinical research tracks.

If you're already committed to the combined MD/PhD idea, great. Still, combined MD/PhD (aka, MSTP) programs aren't the only path to a medical research career.

So, even if you don't think yourself a candidate now, don't write yourself off from a research career too early.

 

[Hawkenthesky]

Your goals can be accomplished with an MD alone+residency + an intense research fellowship.

Frankly you don't have enough research experience to be super competitive for MD/PhD programs so you will need a gap yr or 2. An NIH post bacc might be an awesome opportunity for someone like you (2 yrs). Plus you will need to get some volunteering and shadowing experience. I'm not sure about how the day to day operations are but being at the NIH would give you exposure to all the things necessary to be a strong applicant.

How many clinical hours (just a general number, I know it's not exact) would you recommend I get?

Also, If I return for the summer to the lab I was a lab assistant in last spring and conduct a project under the supervision of the PI, and then intern in the lab senior year, would that be enough research experience? I would have to update the schools I apply to on any work I do during my senior year as my applications would obviously be submitted this summer, but would that be enough?

 

[starfun21]

Hi, @Hawkenthesky!! Welcome 🙂 We're really excited to have you here -- the first post is so exciting!

Please allow me to quickly summarize what I've gleaned from the above to make sure I properly understand your situation (and please correct me if any of this is wrong... I apologize!). You are currently in your second semester of junior year, so you'll be applying this June. You have no clinical experience, and you have 1 semester of part-time research experience. Is all of this correct?

So as others have mentioned, whether or not MD/PhD is the right route will strongly depend on the type of research you want to do. Others may be able to more properly advise you here if you can describe the type of work you want to do to them (I am a currently applicant, so while I know that the work I want to pursue is best achieved through the dual degree, I am not as knowledgeable as others here about all fields). In general, most MD/PhD programs will be looking for someone who spends about 80 percent of their time in the lab and 20 percent in the clinic. Is this something you are interested in?

Please also keep in mind that I am only a current applicant, so I cannot represent admissions committees. I just understand the panic of a smaller institution that sometimes does not have the pre-med advising that others have, so I would love to throw in my 2 cents if you don't mind!

If you do end up wanting to apply MD/PhD (woooo!), I will say that I would strongly recommend you take a gap year. Your research and clinical experiences will be huge red flags that I quite honestly am not sure that any admissions committees will be able to get over, as these are two of the most essential components of the application (and cannot be accommodated for by even a stellar GPA/MCAT). Please keep in mind that none of this reflects on your potential as a person or future physician scientist, if this is the route you choose to take. But at this time, I think it will be important to develop your skills further. Allow me to explain some of the thoughts behind that on both the research and clinical end.

I know you are planning to do more research this summer and next school year, but the only thing you will be able to put on your AMCAS that will matter is the research you have already done. So you will have only 1 part time semester. Yes, you can update programs, but it is very likely that your application will be discarded at almost all institutions I can think of before you are ever able to do that. They need to know what you already done and see tangible results of that (not necessarily publications, but that you have done sustained, independent work and that you have learned a lot from it). As part of the application, in fact, you will need to write a 10,000 character essay of your research experience. Can you do that from a part-time semester?

I want to clarify again that this in no means says that you will not be a good physician scientist. I am sure you could be an excellent one!! It takes a curious mind and some serious thought to pursue the dual degree, and I love that you are asking these questions. Thanks so much for coming here and being so open with us. Your GPA also indicates that you are very capable. I just worry strongly that programs will not give you a chance due to the low number of research hours/time. Most applicants have a full 2 years of experience already completed by the time they apply. I really cannot say I have ever heard of anyone being successful with 1 semester. Schools will say that you are just not experienced enough; research is the single most important part of your application. Keep in mind also that you will need a strong letter of recommendation from your research advisor for all of your MD/PhD applications. This is hard to secure after 1 semester.

Schools will also notice ASAP that you have no clinical hours on your application. Even if you add them very quickly now before applying, they will notice that they all occurred right before the application cycle, and you are very unlikely to get past the MD side. They might consider that "box-checking" and question your commitment to the MD side as well. The number generally thrown around these forums is that 100 hours of clinical experience (volunteering, shadowing, or other) is the standard. I understand that your school and location may not have allowed these opportunities to come easy to you, and I'm very sorry about that -- it's a tough situation to be in!! But schools will likely just tell you that you need to take some time after graduation, find an area where you can get more plugged in, and gain the experience that will convince them that you are sure of pursuing the dual degree and that you will not drop out of a 7-8 year program because you did not know what it would be like.

If you were to take at least 1-2 years and get more clinical/research experience, I think you have the potential to be a very strong candidate. I would still suggest getting clinical experience now so that you are not cramming it all in last minute and it is a more sustained activity. But look into joining a lab more permanently, or perhaps pursuing programs through the NIH or other institutes after graduation. This will let you know if you really like research and how much of it you could see yourself doing, and it will show schools that you have an idea of these things, too.

With that all being said, everything will of course ultimately be your decision. If you do decide to apply this year, I would strongly encourage you to apply smart and to apply early. These are all lessons that I've learned throughout my time applying this cycle, and I'd love to share it with you. 🙂 By applying smart, I mean that you'll want to look into schools very carefully and see what opportunities they have. What research areas do they excel in? What is the program structure? What are you looking for in a program, and why School X? You will need to apply VERY broadly, so to many schools of varying levels of "competitiveness." I would highly suggest non-MSTPs at this point. Applying early is SO important. If you are the first in the door, you are the best application they have seen! It just gives them more time to look at you and to consider giving you an interview when the program has many slots left. Whenever you apply, give yourself every advantage you can. But again, please do seriously consider taking time to get more experience.

I hope this helps. Best of luck!

 

[URHere]

How many clinical hours (just a general number, I know it's not exact) would you recommend I get?

Also, If I return for the summer to the lab I was a lab assistant in last spring and conduct a project under the supervision of the PI, and then intern in the lab senior year, would that be enough research experience? I would have to update the schools I apply to on any work I do during my senior year as my applications would obviously be submitted this summer, but would that be enough?

MD/PhD applicants generally need fewer clinical hours than MD-only applicants -100-200 is fine. Some shadowing is nice but not entirely necessary.

As for research, you won't in any way be ready to apply MD/PhD this summer. To have a realistic chance, you ideally need at least 2 years of research where you have a mostly independent role (planning your own projects, carrying them out, troubleshooting, performing data analysis, presenting data, etc). Full time is ideal (gap year style), but otherwise you should expect to be putting in at least 20 hours/week if you want to have any hope of doing something meaningful. This experience should be acquired before you submit your applications if you want programs to seriously consider you for MD/PhD.

 

[Hawkenthesky]

Hi, @Hawkenthesky!! Welcome 🙂 We're really excited to have you here -- the first post is so exciting!

Please allow me to quickly summarize what I've gleaned from the above to make sure I properly understand your situation (and please correct me if any of this is wrong... I apologize!). You are currently in your second semester of junior year, so you'll be applying this June. You have no clinical experience, and you have 1 semester of part-time research experience. Is all of this correct?

Thanks for your response starfun21! I definitely realize that my lack of research and clinical hours are a huge hindrance to my application. I didn't seriously realize until late in my sophomore year that I had quite a strong interest in the clinical applications of research and in medicine itself, and unfortunately I recognize that leaves me quite behind my peers in terms of preparation for medical school and MD/PhD programs. And as for research, when I went into college I had my whole "plan" where I was going to do research the summer following my sophomore year, during/after my junior year and then throughout my senior year. Going abroad messed up this plan, but the program offered at my school was too good to pass up and I didn't really know enough about the application timeline for med school or MD/PhD programs last year to realize that I was falling behind in prep.

I am pretty certain that the research I am interested in doing does require a medical perspective, and would be best suited to an MD/PhD. I am interested in pursuing a PhD in either human genetics or neuroscience (although I am leaning heavily toward neuroscience), and pursuing research that focuses on the underlying genetic and neurological mechanisms of neurodegenerative diseases. When I worked in the lab last year I primarily provided assistance for a project focusing on vagal control of GI function and the prevalence of GI disorders in females vs. males, and if I get the grant to return to the lab this summer I will be doing my own project on gastric dysmotility in Parkinson's.

If I am being honest the main source of my stress is probably the fact that I am unprepared for what is now my *tentatively* intended course of study post-undergrad. Like most of you I am typically a planner and a self-reliant, independent, over-achiever, and the fact that I have miscalculated is throwing me off. One year isn't that much time, but it's stressful to think that it means one more year before finally starting my career. After reading these responses and having conversations with some other users, I'm almost positive that I will have to take a year off

 

[starfun21]

Thanks for your response starfun21! I definitely realize that my lack of research and clinical hours are a huge hindrance to my application. I didn't seriously realize until late in my sophomore year that I had quite a strong interest in the clinical applications of research and in medicine itself, and unfortunately I recognize that leaves me quite behind my peers in terms of preparation for medical school and MD/PhD programs. And as for research, when I went into college I had my whole "plan" where I was going to do research the summer following my sophomore year, during/after my junior year and then throughout my senior year. This plan got messed up by going abroad, but the program offered at my school was too good to pass up and I didn't really know enough about the application timeline for med school or MD/PhD programs last year to realize that I was falling behind in prep.

I am pretty certain that the research I am interested in doing does require a medical perspective, and would be best suited to an MD/PhD. I am interested in pursuing a PhD in either human genetics or neuroscience (although I am leaning heavily toward neuroscience), and pursuing research that focuses on the underlying genetic and neurological mechanisms of neurodegenerative diseases. The lab I worked in mainly focused on vagal control of GI function and the prevalence of GI disorders in females vs. males, and if I get the grant to return to the lab this summer I will be doing a project on gastric dysmotility in Parkinson's.

If I am being honest the main source of my stress is probably the fact that I am unprepared for what is now my *tentatively* intended course of study post-undergrad. Like most of you I am typically a planner and a self-reliant, independent, over-achiever, and the fact that I have miscalculated is throwing me off. One year isn't that much time, but it's stressful to think that it means one more year before finally starting my career. After reading these responses and having conversations with some other users, I'm almost positive that I will have to take a year off

Ahh, yes, I understand!! It is so hard to have planned something or thought about it so much and then to have some curveballs thrown in at the last minute, and mainly due to things that you just weren't aware of. I've definitely been in that position, and it is a helpless feeling. So sorry about that. And not knowing exactly where to go after undergrad is so stressful. I can imagine that it's bringing about a lot of anxiety!

Try to hang in there as best as you can. My suggestion at this point would just be to look up post-grad opportunities like mad! Make pro/con lists if you'd like, send some emails, take some notes.... whatever best helps you figure out options. Cast a wide net and explore everything; you can always narrow it down later, but it's hard to create opportunities out of thin air. You should have a while though, so please don't panic just yet -- if you know you'll take a gap year or two, the major decision for now is made! You can worry about exactly what you'll do over time and as you go into senior year. I am sure some plans will fall into place for you and everything will be OK in the end. Keep on chugging along!

 

[eteshoe]

Thanks for your response starfun21! I definitely realize that my lack of research and clinical hours are a huge hindrance to my application. I didn't seriously realize until late in my sophomore year that I had quite a strong interest in the clinical applications of research and in medicine itself, and unfortunately I recognize that leaves me quite behind my peers in terms of preparation for medical school and MD/PhD programs. And as for research, when I went into college I had my whole "plan" where I was going to do research the summer following my sophomore year, during/after my junior year and then throughout my senior year. Going abroad messed up this plan, but the program offered at my school was too good to pass up and I didn't really know enough about the application timeline for med school or MD/PhD programs last year to realize that I was falling behind in prep.

I am pretty certain that the research I am interested in doing does require a medical perspective, and would be best suited to an MD/PhD. I am interested in pursuing a PhD in either human genetics or neuroscience (although I am leaning heavily toward neuroscience), and pursuing research that focuses on the underlying genetic and neurological mechanisms of neurodegenerative diseases. When I worked in the lab last year I primarily provided assistance for a project focusing on vagal control of GI function and the prevalence of GI disorders in females vs. males, and if I get the grant to return to the lab this summer I will be doing my own project on gastric dysmotility in Parkinson's.

If I am being honest the main source of my stress is probably the fact that I am unprepared for what is now my *tentatively* intended course of study post-undergrad. Like most of you I am typically a planner and a self-reliant, independent, over-achiever, and the fact that I have miscalculated is throwing me off. One year isn't that much time, but it's stressful to think that it means one more year before finally starting my career. After reading these responses and having conversations with some other users, I'm almost positive that I will have to take a year off

Hey there. There's been some good advice given already but I thought I'd tell you a bit about my path. I didn't realize until around my junior year that I wanted to seriously pursue this type of path. I was a Chemical Engineering/Biochemistry double major. I was also (still am) a serious planner. I got a pretty solid offer for an engineering job and worked for a bit (~2 yrs) after college but eventually realized I wasn't being intellectually fulfilled. I decided to go back and get an MS (2 yrs) with the intent of doing some graduate research and seeing if the path was something I could actually achieve. I ended up having an awesome PI who really helped solidify my career goals and here I am going into my 2nd year of my PhD.

What I aim to achieve with this post is telling you that you don't need to stress yourself out to get into an MD/PhD program. Not everyone on this path had it planned from the very beginning. Take the time to really make yourself a strong applicant for these programs. Your GPA is very good and if you can get a high MCAT, more research experience, volunteering & shadowing experience, etc - you should do very well. You're young and this path is long - a couple yrs is not going to hurt your chances.

 

[tachycore]

@Hawkenthesky

What is your end game? Where do you see yourself after the MD/PhD? What about after that? Even at my current stage (fellow), I am still being asked these questions.

If your goal is simply to open a lab and not be involved with patients, then maybe the entire MD route isn't the best fit. On the other hand, MD's have a better perspective of what will translate from bench to bedside, what other clinicians will more readily adopt. These MD/PhD's maintain some patient exposure.

Then, there's a rating penalty of being an MD/PhD on clinical rotations.

I have always been extra supportive of MD/PhD's who rotate through my services. But in clinical rotations I've been in, MOST attendings and housestaff frown on MD/PhD's as space cadets, dangerous to have on wards. Yes, they are aware of the time spent in labs, etc. But that hasn't stopped attendings from commenting to me, "Oh, that student's an MD/PhD? No wonder [s/he's bad] ..." I've always argued the reverse. Because one is an MD/PhD, s/he should know the fundamentals and science behind medicine better than an MD student.

But now that I reflect, that may explain why the MD/PhD students that I've known get pushed to considerably less competitive medical specialties.

 

[soporific]

If you want to finish earlier, you can just pursue the MD and do a postdoc after fellowship along with perhaps HHMI or other 1-year research opportunities during medical school. The debt is a problem, but there are loan repayment programs through the NIH for certain fields. Also, the time you save should enable you to make up for it by working.