Interested in RadOnc and Holman

[Ty Row]

Hi guys, I'm a a third year medical student considering various specialty options right now, and RadOnc is high on the list. My underlying interest is immunology research. The Holman Pathway sounds like an ideal way to pursue both interests in a unified training program. I looked at previous threads on Holman, and wanted to renew the conversation regarding some of the questions that came up. First, do programs adhere to the promise they make up front with regards to protected research time? For example, if you are cleared to initiate an 18-month research program, does that trump other departmental interests? Or can you get broadsided later on with ad hoc clinical and call responsibilities to fill in scheduling gaps because they "need" your help. Second, if you've completed Holman, how do you feel about the experience with respect to achieving your research goals and getting prepared to submit a starter grant? If things didn't go according to plan, I would be interested to hear your thoughts as well. Finally, can you pursue your Holman research at another institution? There are some great RadOnc programs that don't have the type of cellular immunology labs doing what I'd like to do.

More about me - MD/PhD student interested in academic medicine. Zero of my MSTP colleagues in recent years have gone into Radiation Oncology, so I'm looking to make friends or find mentors here who are willing to discuss RadOnc. Thanks!!

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[Gfunk6]

First, do programs adhere to the promise they make up front with regards to protected research time? For example, if you are cleared to initiate an 18-month research program, does that trump other departmental interests? Or can you get broadsided later on with ad hoc clinical and call responsibilities to fill in scheduling gaps because they "need" your help.

Generally speaking, programs adhere to the minimum 18 month guideline. If there is serious doubt about this time commitment then programs would not/should not let you pursue Holman in the first place.

With that said, there are extenuating circumstances like births, deaths, prolonged sickness, etc. and you may have to "take one" for the team in such scenarios. Of course, you could be a hard ass about it and squeal to the ABR that your program is not fulfilling their end of the bargain. However, the bridges you burn by doing this would probably not be worth it.

Second, if you've completed Holman, how do you feel about the experience with respect to achieving your research goals and getting prepared to submit a starter grant? If things didn't go according to plan, I would be interested to hear your thoughts as well.

I did Holman and IMO was reasonably successful in achieving all of my research goals. I had a nice first author paper in a respected journal and a good starting point for an early Phase I clinical trial. By "starter grant" I assume you mean a grant to start your career as junior faculty and not grants that you can obtain during the Holman itself. I believe I was prepared to write a starter grant if I so desired. However, it makes sense to sign with an academic program first, identify what resources are available and THEN write the grant. If you sign in Jan of you PGY-5 you should have a good six months to mull it over, which is plenty of time.

Finally, can you pursue your Holman research at another institution?

Technically, yes. However it would be ideal if an institutional affiliation previously existed. For instance if you are at Harvard and want to do Holman at MIT or UCSF --> UC Berkeley, I don't think it would be a hard sell. However, in the absence of an affiliation it would be difficult. First of all, it's not at all clear how your sponsoring institution would directly benefit. Also you would have to make a highly compelling argument that what you want to do is absolutely out of the question in your sponsoring institution. Given that Holman-friendly programs tend to be research powerhouses, this will be difficult to justify.

 

[Ty Row]

Thanks for the detailed reply, Gfunk. When you were interviewing as an MS4, did you know that Holman was your plan, and were faculty generally upfront and willing to talk about this pathway? If I were ranking Radonc programs, it would definitely be important to know that some of them are able to guarantee (or nearly guarantee) protected research time. That said, I do realize that the primary objective for residency directors is to find a physician who will successfully master all the clinical skills and devote their time to patient care, so hopefully I won't come across as too lopsided on this. Another option that has been going through my mind is heme/onc via a PSTP. Their program websites seem to have more details than what I've found so far in researching Radonc, which is why I'm asking all these questions. Anyone else who did Radonc/Holman care to comment? Thanks for sharing.

 

[Gfunk6]

I was upfront about Holman when I was applying. However, prior to your interview you should do your homework. If a given program is not willing to put residents in lab, then you may be damaging your chances of matching by harping on the subject.

 

[kimplera]

Ditto Gfunk's upfront approach. I told basically all programs I was very interested in Holman. I think the reason you have so few details on residency websites is that other than a couple large institutions most programs have only had 1 Holman resident.

Feel free to PM me if you want to chat.

 

[NIHNewInnovator]

... - MD/PhD student interested in academic medicine. Zero of my MSTP colleagues in recent years have gone into Radiation Oncology, so I'm looking to make friends or find mentors here who are willing to discuss RadOnc. Thanks!!

I am an MSTP grad, didn't do Holman. Did get 5 yrs 80% research/20% clinic as faculty in MD Anderson's Physician Scientist program, plus lab funds. That was in addition to a modest start-up package. It's competitive and open to all specialties. You can apply right out of residency and up to 3 yrs into practice. Many of the other large academic centers have similar programs (e.g. UCLA's Star program).

 

[mdphdgirl]

Thanks for the detailed reply, Gfunk. When you were interviewing as an MS4, did you know that Holman was your plan, and were faculty generally upfront and willing to talk about this pathway? If I were ranking Radonc programs, it would definitely be important to know that some of them are able to guarantee (or nearly guarantee) protected research time. That said, I do realize that the primary objective for residency directors is to find a physician who will successfully master all the clinical skills and devote their time to patient care, so hopefully I won't come across as too lopsided on this.

Keep in mind that you don't necessarily have to do a Holman to have protected research time. Some of the bigger programs, especially those trying to encourage research, will have research time built in for every resident. Although Holman will give you more research time and the guarantee will be stronger, don't forget that there are other ways to get research time than through the structured program. I would suggest that you want to find out from the programs themselves what they offer, express interest in getting dedicated research time regardless of the specific format, and mention that the Holman seems particularly appealing to you. I also tried to emphasize that I wanted to try to integrate research as much as possible throughout the 4 years, and that I hoped to end up with a K grant that I could take to my academic appointment. It seems to have worked out well for me but your mileage may vary.

 

[Gfunk6]

Keep in mind that you don't necessarily have to do a Holman to have protected research time. Some of the bigger programs, especially those trying to encourage research, will have research time built in for every resident.

Excellent point. Programs such as Harvard and U Chicago offer one contiguous year of dedicated research time which you can spend in lab if so desired.

One additional, albeit heretical, option would be to do a post-doc if you are genuinely interested in research. There are a couple of them that are specifically geared towards Radiation Oncologists where you can still see/treat patients while in lab. Wake Forest, for instance, offers a Translational Rad Onc Research Post-Doc which can be done in two years if the candidate has a PhD.

 

[thomascarpenter]

I am currently a holman patway resident at one of the top research places.
In general i would recommend holman if you have a strong basic science interest and reasonably clear research focus, mostly because you can get your research career started as early as possible (given that MD/PhD grads don't have alot of time to mess around)

PM me if you have any specfic questions.

 

[Mandelin Rain]

I did Holman and IMO was reasonably successful in achieving all of my research goals. I had a nice first author paper in a respected journal and a good starting point for an early Phase I clinical trial. By "starter grant" I assume you mean a grant to start your career as junior faculty and not grants that you can obtain during the Holman itself. I believe I was prepared to write a starter grant if I so desired. However, it makes sense to sign with an academic program first, identify what resources are available and THEN write the grant. If you sign in Jan of you PGY-5 you should have a good six months to mull it over, which is plenty of time.

This is a very good piece of advice. Similarly, if penning a Phase I during residency, have in mind the philosophy and direction of your targeted institution. It is painful leaving your trial behind due to lack of interest/resources/etc...

 

[Photon Finish]

I also am currently in the Holman Program and thus far it seems to be going smoothly. I did not inquire regarding the the Holman pathway on my interviews, and if I was in a program with a significant amount of protected research time I am not positive I would have applied. For me, the pathway is great, though, as my program did not have dedicated research time built into it, so this pathway allowed more "guaranteed time." I would be happy to answer any specific questions you may have.

 

[Charles_Carmichael]

An editorial regarding the Holman Pathway in the latest issue of the Red Journal:

http://www.sciencedirect.com/scienc...d8ce3b02ac88fb95cc69718434df0673&searchtype=a

 

[Neuronix]

I'm a graduating MD/PhD who was pretty upfront about research interest, background, and desire to do Holman during the past admissions season. I found that many of the big name Holman pathway programs chose not to interview me. When interviewing, I found talking about Holman to be pretty unpopular, even at some of the programs that support Holman residents (i.e. one a year or one every few years). As the season progressed, I thought it would be more to my advantage to downplay Holman and talk about it as more of a possibility than an actual desire. In fact, even though I only applied to big name academic places, the majority of programs that invited me did not support Holman.

In the end, the Holman pathway seems to me to be a program supported by a small minority of rad onc programs. I tried to contact the ABR when I was applying to ask what programs would support Holman residents, and they would give me no information. I remain fairly disappointed about my experience.