MD/PhD in EM

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jd989898

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I'm an MD/PhD student, and after a lot of shadowing and considering all of my options, I've decided I want to become an EM physician. I have not started the PhD portion of my program yet (the lab I plan to join does immunology research.) This is unfortunate, as I know the field of EM will make it especially difficult to establish a career with a basic science research component. My clinical interests just don't seem to match up with my research interests. What I'm wondering is if residency program directors will question my motives/judgement with a PhD in immunology. Most MD/PhDs go into IM, path, peds, neuro, etc. Having a background in basic science research can't HURT my residency prospects, can it?

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Unlikely to hurt at most programs, but some people are weird and will have their biases when looking at your application. EM isn't a bastion of basic science research but I think that says more about the people typically attracted to EM than EM itself. I wouldn't be surprised if the wide breadth of clinical scenarios and forgiving schedule leave a lot of opportunity for basic science research.
 
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Unlikely to hurt at most programs, but some people are weird and will have their biases when looking at your application. EM isn't a bastion of basic science research but I think that says more about the people typically attracted to EM than EM itself. I wouldn't be surprised if the wide breadth of clinical scenarios and forgiving schedule leave a lot of opportunity for basic science research.

Thanks for the reply. If I could go back in time and I knew I wanted EM, I wouldn't have done MD/PhD in the first place.. I know doing basic science research with a career in EM will be like swimming against a current, so I'm willing to give up a career in research for medicine if it becomes unrealistic. I'm beginning to wonder if this warrants dropping my PhD altogether which would be an enormous headache and would carry its own negatives I'm sure :/
 
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If you go to residency with MD/PhD, you will be dead on target to be "the research guy". We used to have a regular poster who is MD/PhD. I also know of at least 4 current or former EM docs with both degrees. However, 3 of them (of which I know) had the PhD before going to med school (ie, did not do a dual degree program).
 
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I disagree. EM is the best field out there for someone with an interest in something else. Whatever that something else is, EM is the best match for it.

Heck, I ran a full-time business for five years while being a full-time emergency doctor. EM allows you to have outside interests because the total hours worked are some of the lowest in the house of medicine and 3/4 of those hours are outside of banker's hours.

If your goal is really to practice EM AND have a meaningful research career, I absolutely think they can be combined. But don't be surprised if your interests are very different 10 years from now. You may lose that interest in research. You may lose the interest in EM. You may find yourself doing something totally different. But as your interests change I know of no better specialty that allows you to make a gradual transition to doing something else with your life.
 
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Thanks for the reply. If I could go back in time and I knew I wanted EM, I wouldn't have done MD/PhD in the first place.. I know doing basic science research with a career in EM will be like swimming against a current, so I'm willing to give up a career in research for medicine if it becomes unrealistic. I'm beginning to wonder if this warrants dropping my PhD altogether which would be an enormous headache and would carry its own negatives I'm sure :/

Its funny you should say that, because if I could go back in time, I would have gotten and MD/PhD. My research interest has enough of a basic sciences component that it would have been helpful. One of my residency classmates is an MD/PhD, but no longer does research in his PhD field. I know a couple of other practicing Emergency Physicians who do a lot of bench research, one with a PhD, one without. Thats not even counting all the toxicologists. It happens.
 
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Just do it, if the PhD is right for you.
There are several residencies with interest in research &a existing research programs -- Cincinnati, BW, MGH,... -- and more that have the space and faculty to encourage research. Having the PhD gives you a huge advantage for getting grants later. And yes, do what you want now. Your clinical research interests will reveal themselves with time. For better or worse, it's often difficult for a mudphud to get away from the basic sciences for training purposes.
 
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Yes, PDs and interviewers will question you. And ideally you will have an answer that lets you handle them easily and put them at ease. By the time you've defended and presented umpteen posters & conferences & committee meetings & journal clubs, the interview process will look like cocktail party conversation by comparison.
 
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My thought: consider dropping the phd if you aren't really sure about doing research. The lost years of income FAR outweigh any payment for tuition. Many MD/Phd dont end up doing any research even if they were sure prior to residency. If you are already wavering.....


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EM is everything. You can relate pretty much any aspect of medicine to EM. Your PhD will only help you. Granted you may not use it once you're done so it all depends on if you want to give up 4+ years. I know I wouldn't!
 
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The PhD will probably help your application.

On the other hand, Step 1 grade inflation over the next 4-5 years will probably hurt your application. I knew a few people who killed Step 1, but by the time they finished their PhD, their awesome score had become an average score.
 
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The big thing is the loss in time. You don't need the super strong science background to do clinical research. I don't see how it would hurt you, people's interests change. I think your skills would be an asset to programs, especially if get down IRB approval stuff/securing grant money/etc.

But FYI, they are doing basic science type EM research at northwell...only place.


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