MD/PhD--> Residency--> Fellowship--> Postdoc?

[ratherberocking]

To get a faculty position, I know most PhDs do about 2 - 3 postdocs. How about for MD/PhDs? Is a fellowship counted as a postdoc? Or, does one do a fellowship and then a postdoc? Thanks!

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[gstrub]

No one in their right mind would accept a post-doc position after residency and then fellowship. You would go right to a faculty position if that was your aim. Post-doc positions are for straight PhD's or for MD/PhDs who don't do clinical residencies.

A post-doc salary: 30-40k
A fellowship trained MD/PhD can earn 10X that.

Hope this helps,
G

 

[Neuronix]

Is a fellowship counted as a postdoc?

Basically this. A fellowship is for MDs but can be 80% research. You have to keep practicing medicine at least occasionally if you want to keep practicing in the future. A post-doc can be equated to a fellowship in pay. Post-doc salaries continually go up after your last graduate degree. I've looked at a few sites comparing post-doc and fellow salaries, and the fellow makes about 10k more. i.e. A PGY-6 makes about 10k more than a 6th year post-doc.

Though MD/PhDs won't spend as much time as a PhD doing research before getting a real job. Departments are more willing to hire MD/PhDs given they are expected to handle some clinical load (more than many want to!) and can be forced to do more clinical work (or out) if they're not successful getting grants in the timeframe allowed. Tenure track actually involves large sums of money that can be entirely wasted on new faculty. MD/PhD jobs are low risk for a department. They still get clinical work out of you and there's no such thing as tenure in clinical departments. Thus, a couple years as a research fellow is more than what I've seen MD/PhDs do before moving to assistant faculty. It's a real issue then trying to balance research/clinical, get grants, etc... But that's the life.

 

[Vader]

Actually, there are quite a few MD/PhDs doing postdoctoral fellowships after their clinical training is complete (i.e. after residency +/- fellowship). Ideally, you would obtain research experience and grant funding (i.e. K award) before finishing fellowship. Many clinical fellowships offer sufficient time to do this. However, if you change research interests or are unsuccessful at publishing sufficient work & obtaining your grant, you may have to spend additional time doing research to ultimately secure a job.

The salary pay scale has to do with your postgraduate level (PGY). If you do a post-doc after finishing clinical training, your pay will be at the next higher level on the scale plus an agreed upon amount with your department for clinical effort. A K award raises the minimum salary to ~90k and guarantees you 75% protected research time, plus some additional benefits. Ultimately, you want to obtain a tenure-track faculty position, with which part of your salary will come from the department/institution and some will come from the grants you obtain (i.e. R01's).

 

[Neuronix]

Actually, there are quite a few MD/PhDs doing postdoctoral fellowships after their clinical training is complete (i.e. after residency +/- fellowship).

I think we just need to define what is a "post-doc" versus what is a research "fellowship". My working definition has always been that a fellowship contains at least some clinical component, while a post-doc is strictly research. But not everyone may be using that definition.

Ultimately, you want to obtain a tenure-track faculty position, with which part of your salary will come from the department/institution and some will come from the grants you obtain (i.e. R01's).

Does tenure-track even exist any more? I guess I have seen some tenure track spots with a 10% salary guarantee. Is anyone giving tenure track spots that are more than just tenure in name? I mean I'd love to see it, but if the salary isn't covered by grants, the department I'm working in now just pays you the salary your grants cover plus whatever clinical salary (50% clinical time = 50% salary).

 

[Vader]

I think we just need to define what is a "post-doc" versus what is a research "fellowship". My working definition has always been that a fellowship contains at least some clinical component, while a post-doc is strictly research. But not everyone may be using that definition.

Does tenure-track even exist any more? I guess I have seen some tenure track spots with a 10% salary guarantee. Is anyone giving tenure track spots that are more than just tenure in name? I mean I'd love to see it, but if the salary isn't covered by grants, the department I'm working in now just pays you the salary your grants cover plus whatever clinical salary (50% clinical time = 50% salary).

I think of "post-doc" as referring to a post-doctoral research fellowship, which can apply to anyone who has completed a doctoral degree, and needn't follow immediately after completion of that degree. A clinical fellowship may combine clinical training (which often leads to board certification in that specialty) and research. I think the term "research fellowship" is perhaps a bit more ambiguous. I've seen it used to refer to folks who have obtained their doctorate and have started their independent laboratories under the aegis of a research fellows program. So I guess we're really talking about the same thing, using different terminology. 🙂

How do you define tenure? I guess if a dept will only guarantee 10% of your salary, this in effect is not tenure since no one in their right mind would find it acceptable to stay in such a position. If, however, a department guarantees that they will retain you for a much higher percentage should you lose grant funding, then in effect you have tenure, right?

What a murky world for which we receive no formal education... 👎

 

[Neuronix]

If, however, a department guarantees that they will retain you for a much higher percentage should you lose grant funding, then in effect you have tenure, right?

Agreed on all points. I just wonder if these jobs still exist? I haven't seen them being offered at all in my field. Can you get this sort of position in some specialties? Does it pay about the same as a PhD would get paid?

I'm not sure I like talking about tenure anymore. In clinical departments what does it mean? For me tenure is like that word "academics". Academics means something different for just about everyone I talk to. Tenure seems to be similar. Anything from "It doesn't exist" to all sorts of variations on what tenure offers and who it's offered to.

 

[NGN47]

In clinical departments what does it mean? For me tenure is like that word "academics". Academics means something different for just about everyone I talk to. Tenure seems to be similar. Anything from "It doesn't exist" to all sorts of variations on what tenure offers and who it's offered to.

Good question. I always think of having tenure as having a permanent position with what some call "hard money" (guaranteed from the institution, just for being a professor there and probably some kind of teaching load) as opposed to "soft money" (out of grants). I don't know what this means in a clinical department though.

 

[NGN47]

To get a faculty position, I know most PhDs do about 2 - 3 postdocs. How about for MD/PhDs? Is a fellowship counted as a postdoc? Or, does one do a fellowship and then a postdoc? Thanks!

Many fellowships have built-in research time, and some residencies do as well. How much research time, how protected it is, etc., is dependent on the program and the field. I do know that some people do extended fellowships with additional research time on top of what was initially planned. I think it depends on what you hope to accomplish, and of course, the nature of whatever you are working on, as well as a bit of randomness thrown in as always!

 

[ratherberocking]

Thanks everyone for your responses!

 

[ClarinetGeek]

I agree with the following posts. From what I have seen at my institution, the language tends to follow as such:

In the context of a clinical department, there are fellows, and some chose to have protected research time extending from 1 year to several years. Some of these individuals are MD and some are MD/PhDs. For those that spend several years, they work on getting K08's and breaking off being independment PI's. In the lab, these individual are typically called a fellow; however, the term post-doc is occassional used. My research program currently has one MD and one MD/PhD transitioning from fellows to associate to tenure track positions with their own labs. The terminology gets admittedly fuzzy as you progress down that road. Both of them now have their own post-docs, techs, and undergrads.

Post-doc is generally a term reserved for PhDs.

I have yet to see an MD-PhD do a research post-doc without some level of clinical responisbility (aka not fellows). Realize this is just what I have seen and I understand that does occur.

I don't know if the above helps answer your question, but this is just what I have directly observed as an MSTP student. As a result, I think as a MD/PhD the optimal track is: Residency --> Fellow --> Faculty. No post-doc added on but realizing that the fellowship is extended to include the neccessary clinical training plus enough protected research time to establish yourself as an independent scientist such that you can develop your lab. In otherwords, the fellowship is both a clinical fellowship and "post-doc" in one.