IM PSTP Residency as an MD student

[camnewton1]

I am a current MD student at a strong research oriented medical school, who's tentatively interest in pursuing a career as a physician scientist. Recently, I've been looking into PSTP training programs in Internal Medicine, and they seem like great programs with strong records of enabling trainees to attain independent (K awards) grants and transition to faculty positions.

I had two questions regarding these IM PSTP residency programs. 1) taking a look at "top" MSTP program match lists where available, it seems that the vast majority of MD-PhD graduates do not end up in IM PSTP trainings. Is this largely due to personal preference, or due to the small number of spots at PSTP residencies in general, or limitations in the way match lists are reported online? My gut tells me it's some combination of the three, but it's hard to get a sense of why this ends up being the case.

2) As an MD only student, I am curious if I will be in a position to be competitive applicant to these PSTP residency training programs by the time I'm a rising 4th year. It seems like some programs (ie UCLA) are more "friendly" in terms of taking MD only students with significant research experience from things like HHMI, NIH MSRP, etc. I anticipate taking a year of for research through a competitive fellowship, and I also anticipate having at least 2 first author basic/translation publications in strong field specific journals with strong letters of recommendation from PI. Would this be enough to be competitive for IM PSTP residencies?

Thanks in advance!

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[Lucca]

I can't really answer two, but I have a tiny bit of insight into 1 based on our own PSTP residencies. IM is not the only path with a PSTP track by the way, many different specialties do, although the "short-tracks" in Peds and IM are probably the most sterotyped across the nation. It's more about 1 and 3 than the middle reason you give, was my impression.

I imagine for a lot of people they end up choosing to do categorical because:

A) they are not interested in being a PI anymore / career goals changed and dont feel they will benefit from a PSTP/short or integrated track as much as categorical or whatever the default is in the specialty.

B) they ranked categorical IM at a highly coveted academic medical center higher on their ROL compared to PSTPs elsewhere.

C) they ranked PSTP and categorical IM at a certain place because of a strong location preference and ended up in categorical rather than a PSTP elsewhere they may have matched.

There's also specialties that seem like a default physician scientist track...namely Path. Which does have its own PSTPs, but also I've never met an MSTP going into Path because they are really excited to do private practice path (a famously bad job market for some time), rather because they want the fastest possible track to full-time basic science possible and Path at academic medical centers has many convenient pros to it for people interested in basic science.

 

[SurfingDoctor]

I will say I know the person who runs the PSTP in our department of Pediatrics and know several people who have gone through the training. While they certainly have more MD-PhD than MD only, there's probably a but of self-selection there. Many MDs who have little to no research experience aren't interested or have no idea what it even means to be a physician-scientist while at least MD-PhD have some sense of what that entails. I think though if you talked to the director of the program early on, you could be placed on that pathway. I'm not sure there's really a bias of one degree versus the other, mostly again just self-selection.

As far as taking an year off to get research to get a competitive fellowship, and maybe I'm just naive to your specific field of interest, but fellowship will often give you the opportunity to get additional research training and if you're on a T32, you can have extra dedicated research time. Therefore, I would probably seek out fellowships with T32 if you're interested in research. That was my path as a MD only physician-scientist.