MD/PhD scientist or MD surgeon scientists needed in plastic surgery?

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PRS mud phud
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Plastic surgery seems to always be on the cutting edge of medicine. Is it any surprise that the field is becoming attractive to research minded MD and MD/PhD students? Tissue engineering, composite allografts of the hand, face, and abdominal wall, biomaterials in wound closure, etc are really hot topics in plastic surgery and the lay press. With the recent death of Joseph Murray, we are reminded how profound the contributions are to medicine from plastic surgeons.

With that in mind, I want to target this thread toward a certain discussion. Is it just me, or are there a surprising number of MD/PhD applicants applying to plastic surgery residency this year? I met 4 at a couple interviews. Considering that was out of a pool of 30 applicants, this suggests that MD/PhD applicants are over represented in the applicant pool. Are there other MD/PhD applicants who will out themselves? If so, what attracted you to plastic surgery. For myself, it was innovative thinking and the academic nature of the plastic surgeons I worked with at a few different institutions. In particular, some with R01 funded laboratories running alongside their clinical practice.

To summarize, what drew you as a scientist into plastic surgery? This question is targeting MD/PhD applying to PRS this year, but really open to anyone with on-going interest in conducting research in plastic surgery. What research topics got you interested in plastic surgery?

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Most MD/PHD in plastics I know either do almost 100% research or 100% clinical. It's literally impossible to be academically productive in basic science (rather then "dumb" clinical papers) and run a full time clinical practice. The difficulty in funding for research and the high overhead of clinical practice really conspire against to making this work. Most of the MD-PhD's I met during interviews for plastics were burnt out on the lab and just wanted to do surgery and no more research.

The reality of of a guy like Murray is that they existed in an era where IRB's didn't exist and you were given wide latitude for human experimentation. In contrast to where advances are made now (at the cellular level), surgeons like Murray, Jim Hardy (chief at Mississppi who was putting animal hearts in humans in the 1960's), Christiaan Barnard (1st heart transplant), performed macro-scale surgical manuvers. It's a completely different skill set (surgical versus basic science) then what it takes to be a successul research now.
 
Agree with Ollie. There are a few MD/PhDs in Plastics who are both clinically active and maintaining a productive lab.

There are a bunch of MD/PhDs who have a clinical practice and kind of dabble in bench research -- usually in collaboration with a PhD-run lab.

The old guys could do it for the reasons that Ollie mentioned. Also, they made proportionately more money doing fewer cases and research rules and funding were much more generous. Get an NIH K or RO1 grant and you'd better be prepared for serious audits of your time. If you're spending 4 days a week in the OR and clinic, you'll lose your money.
 
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I'm a senior PRS resident with a PhD in Developmental Biology. I was attracted to plastics because we're the ones that deal with craniofacial anomalies, an area with very little good science being done, at least by clinicians. I hope to find a niche where I can have both a busy academic peds practice and share lab space with a dedicated PhD, at least initially, until my practice is more established and I can narrow research interests. However I do agree with Max and Ollie above. It is becoming harder and harder to be a successful surgeon scientist, particularly to compete for grants, without giving up operating.
 
I'm glad I randomly stumbled upon this topic as I am a MD/PhD student in my third year now seriously considering a few different surgical fields including plastics. I was attracted by the revolution in stem cell biology/regenerative medicine and the recent successes in transplantation of allogenic tissue derived from deceullarized cadaveric donations and artificial molds in bioreactors. This actually drew my interest to plastics as well as transplant surgery/immunology but I do like the ability to lock in my spot with the former at the start of residency rather than fighting for a few fellowship spots down the road. I also liked the idea of joining a field where there are few doctors trained or interested in thinking scientifically about applying biology to practice (e.g. surgery). Unfortunately as everyone points out here, surgeon scientists are rare for a reason. There have been models proposed of long-term partnerships between doctors and PhD biologists/engineers to facilitate the division of labor and skills needed to bring about new technology. Wonder if this is also a pipe-dream or if this is something more than a privileged few can pull off.
 
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