1. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ
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    I've already asked questions like this on the research forums, but it would help to get some input from the other side, i.e people who have been through the IM match process/residency.

    How much does a basic science PhD actually help towards matching into the top IM programs (and especially east coast programs MGH, BW, JHU, Duke, Penn, etc.)? What sort of things can it compensate for, i.e. if you have a good 250+ board score, great recommendations, and a good number of clinical and pre-clinical honors grades and a PhD, can this compensate for lack of AOA?

    In other words, can a PhD compensate for some sort of deficiency such as lack of AOA, lower Step 1, not as many clinical honors grades, or is it more of an added credential that can boost you above the competition, given the med school credentials are roughly equal?
     
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  3. OneFish TwoFish

    OneFish TwoFish Small fish, big pond
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    You are considered extremely desireable by IM programs, even if your clinical skills are weak - alot is forgiven. No need for AOA, etc.

    I came from Penn - the match list is eye popping:

    http://www.med.upenn.edu/mstp/matchlist.shtml

    An average md/phd is as competitive as the best-in-class MD
     
  4. grendelsdragon

    grendelsdragon Synesthetic
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    First, the reasoning here seems flawed. A PhD in addition to MD ostensibly adds 4-8 years to your training. Does it make sense to take this route in order to compensate a priori for anticipated poor performance in medical school? Additionally, looking at MD/PhD match lists suffers from major selection bias. These students tend to be amongst the most motivated and talented people going into medical school in the first place. Brigham and MGH scoops up these applicants because these are academically oriented programs, and nothing attests to a good trajectory in academics than successful original research (reflected by publications and competitive funding).

    As you are already probably aware, being successful in research takes a lot of dedication, hard work and some measure of luck--a process with inherent pitfalls for someone who is not intrinsically drawn to science for the love of it. NO ONE should advocate this path for resume padding. A student can always plod through medical school without intrinsic passion (simply do the work-- P=MD). The same cannot be said for a PhD in the basic sciences.

    Let's take for example the scenario of someone who has already taken the traditional MD path and performed poorly. Does it make sense to switch paths into a PhD program to bolster his/her chances at getting into a more competitive residency program? What's the motive? If the eventual objective is private practice, the candidate loses 4-8 years (sometimes more) of earning potential as a physician. If the objective is academic medicine, there are no easy answers but the candidate has to carefully weigh the benefits of doing a productive postdoc after residency versus doing a PhD (in which case a postdoc is STILL likely necessary after residency).

    The path to success in science tends to be difficult and often convoluted. There are of course golden people who find such success effortlessly, but most of us have to sweat it out. It's hard to advocate this livelihood simply for the objective of getting into a better clinical residency. If the goal is to become a better basic scientist, then you should not be concentrating on the questions in your OP. Your questions would be geared towards how to choose the best research focus, mentor, lab, graduate training program, etc.
     
  5. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ
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    You're assuming a whole lot here that isn't true. I'm already in an MD/PhD program and am starting my PhD this fall and I know who the mentor is and what department it will be. I didn't go MD/PhD to secure a better residency - I did it because I'm interested in basic science research, first and foremost, and I didn't want to be saddled with debt after med school that would limit my career options from doing research, international medicine, academics, etc. So far, I'm not regretting my decision at all. Sure, medical school itself has been difficult, but that would be the case MD-only as well, and so far the summer lab rotations have been welcome respite from medical school. Perhaps I'll be more cynical about the PhD a few years in, but for now I'm not regretting my decision.

    This question was put because I'm trying to determine the importance of clinical grades in courses other than the IM clerkship and AI (e.g. Ob/Gyn or Psych) for an MD/PhD aspiring to match into a top academic IM program and hopefully after that a fellowship. In other words, I was trying to get some responses as to how much emphasis is put on these grades (and on AOA as well) in the context of a very good board score and a PhD.

    Note: you might have also noticed that I'm interested in IM and a rather non-competitive fellowship (ID/heme-onc/rheum - not GI, A&I or cardio), rather than the lifestyle ENT, derm, ophtho, rads, etc. specialties. That might have clued you in that my primary interest here is neither money nor prestige, but simply matching into the best possible residency that will provide the foundation for a fellowship and an academic position.
     
  6. grendelsdragon

    grendelsdragon Synesthetic
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    I'm sorry for my misunderstanding. I interpret career questions of this sort as a call for advice on a course of action (as in "should I get a PhD if it would bolster my credentials?"). I usually do not assume career questions are hypothetical points over which you can do nothing, as is the case here. It is simply a waste of time to mull over such things. Is there anything that can be said that would change your actions? For example, if people reply "a PhD makes you more competitive", then will you rest on your laurels and be falsely reassured for poor clinical performance? Or if people reply "forget BWH/MGH/JHU if you don't AOA irrespective of whether you have a PhD", will you suddenly give up on those programs?

    Overall, suitability for competitive programs is very individualized, based on a combination of clinical performance (grades and AOA), letters of recommendation/connections, standardized tests, personality, prior achievements and potential for academia. The process is somewhat idiosyncratic and not totally consistent. Certainly a PhD bolsters the academic portion of a candidate's resume, but whether it makes up for deficiencies in other parts of the application is a waste of time to dwell upon. You should try your best to do well in your PhD years (yes, a Science or Nature paper can work wonders) and honor as many clinical clerkships as you can (especially Medicine). At the end of the day, put your assets together into a positive and competitive application (never dwell upon weaknesses) and shoot the moon. There is no formula here (as in, PhD = AOA), and anyone who offers such advice should be viewed suspiciously. No one can adequately assess your competitiveness until all your cards are on the table, so keep plugging away.

    P.S. Not everyone at BWH/MGH/JHU/Penn/Duke is AOA. Do you need someone to tell you that you have a shot? OK, you have a shot.

    P.P.S. Please don't think that I do not promote academic medicine. I love basic science and am a strong advocate for academics. I just like to give an honest appraisal of the pros and cons for this lifestyle.

    Good luck!
     

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