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MD/PhDs Matching To Radiology

Discussion in 'Radiology' started by theprizefighter, Apr 16, 2004.

  1. theprizefighter

    theprizefighter Senior Member
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    Hi, All

    Anyone know how well MD/PhDs match to radiology? Any MD/PhDs in radiology residencies right now? If so, do you think your PhD training has given you any edge over the MD only radiology residents either in the applying to residencies and actual residency performance? Thanks so much.

    theprizefighter
     
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  3. juicyfruit

    juicyfruit Junior Member
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    MD-PhDs have a huge advantage when applying for radiology residencies, especially if the research is related to radiology. But even if the PhD is unrelated, with solid boards, great letters, you will match very very well. At the top programs around 25% to 35% of those there are MD-PhDs, while they probably only comprise 5% of the total applicant pool.
     
  4. frick

    frick Senior Member
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    Related PhD, i.e., physics/engineering?
     
  5. biplane

    biplane Junior Member
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    I agree that MD/PhDs have an advantage all other things being equal. At the Penn interview day, there were probably 10-15 MD/PhDs out of 90 applicants. Less than half of the MD/PhD applicants had Ph.D.s in physics/engineering areas.

    However, I think there are a few provisos.

    1) You have to articulate why you want to do research in radiology regardless of what your Ph.D. was for.

    2) Your Ph.D. should be respectable/solid. When you are running away from a failed Ph.D. it is kind of obvious. Programs will then be less interested because you are typically going to be seen as a "research" candidate.

    3) Your clinical performance has to be as good as a non-MD/PhD applicant. Your primary role as a resident/fellow is to provide clinical services--even if you are in a research tracked residency. There are enough good applicants out there that they don't have to compromise much quality-wise.
     
  6. theprizefighter

    theprizefighter Senior Member
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    Hi, All

    Thanks for the feedback. I ask because I'm faced with the dilemma of getting an MS in a project that is directly radiology related at one school versus getting an MD/PhD in basic neuroscience, but not radiology, related at another school. Both are top ranked med schools with good clinical backgrounds so this decision is a rather tough one for me. My goal is to do academic radiology research at a top institution.

    tpf
     
  7. russellb

    russellb Senior Member
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    Would the neuroscience option allow you to become involved with a Radiology department, i.e., would neuroimaging be part of you studies? If so, then you'll certainly be in good shape to get an excellent Radiology residency.
     
  8. theprizefighter

    theprizefighter Senior Member
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    russellb,

    The MD/PhD program doesn't have any labs that I can find in which neuroimaging is a central component of their work. That doens't mean that collaborations across departments can't happen but I just haven't been able to find any. Any thoughts?

    tpf
     
  9. russellb

    russellb Senior Member
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    Have you talked to any of your potential advisors in the PhD program? One of them might be able to guide you towards a project which involves collaboration with an imaging department.
     
  10. Gradient Echo

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    At my program, 100% of MD/PhDs choosing radiology have matched at their first choice for the past 5 years.
     
  11. theprizefighter

    theprizefighter Senior Member
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    Gradient Echo,

    Do you know if the PhD of most of those students where radiology related?

    Thanks,

    tpf
     
  12. Docxter

    Docxter Senior Member
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    Yes, there are many dual degree residents in radiology :laugh: . Radiology is right up there along with Derm and Path as having many MD/PhDs. In my residency, about 30% of residents have a PhD. They are not necessarily in Biongineering or Physics. We have people with PhD's in molecular biology-chemical engineering-organic chemistry-neuroscience-computer science-electrical engineering, etc. A few other residents have had an MPH or JD or MBA.

    Having a PhD will definitely help you. However, we have had applicants doing MD/PhDs who have had less than stellar clinical skills and clinical rotation evaluations; they were all eliminated. So, your PhD will help you only if you excel clinically as well. Nobody wants someone who cannot perform clinically, but is good in the lab. If your PhD is relevant to some aspect of imaging, it'll be more beneficial. Even if you are doing molecular biology, molecular genetics, or neurobiology, if you somehow focus your research more towards molecular imaging (which is a hot and growing topic now) and collaborate on the side with someone at your school or within the radiology/nucs departments in this area , you will be at a great advantage.
     
  13. joshmir

    joshmir Senior Member
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    Docxter-

    Thanks for your post, it sounds like you were privy to some rank-list decision making, and so I wanted to ask for your thoughts.

    I am thinking of getting a PhD in molecular imaging after my intern year and re-applying, and I wanted to get your advice. You said in your post:

    "However, we have had applicants doing MD/PhDs who have had less than stellar clinical skills and clinical rotation evaluations; they were all eliminated"

    I applied this year (17 interviews) and didn't match...my 250 step I score helped me get 17 interviews, however my only applying to urban areas and below-the-mean class rank probably prevented me from matching...I have no clerkship Honors, but also no failures...just some high passes, etc. I interview allright...typical, nice, polite, joe-average candidate. Have a good letter from a well-known person in the field, good letters across the board.

    Based on your experince, do you think with a PhD I would be *still* assumed to have inadequate clinical abilities because of average grades?


    Thanks for your advice!
     
  14. theprizefighter

    theprizefighter Senior Member
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    Hello,

    I think a big problem with an MD/PhD program is that you have that big 3-4 yr discontinuity between the first two years and the clinical rotations of the 3rd and 4th year of medical school. That can really hinder how well clinical rotations go for an MD/PhD student. Also, by the time you finish your clinical rotations, the field you did your PhD in may have progressed so far that you'll be left behind. Balancing the two very well strikes me as difficult if not impossible. Anyone have thoughts on this?

    tpf
     
  15. Docxter

    Docxter Senior Member
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    Joshmir, I'm actually surprised that you didn't match, considering you went to 17 interviews. Could it be that there was something negative in your application like a bad LOR or something, bad personal statement, or that you interviewed not as well as you think you did? Looking at what you wrote, I can say that I am surprised. I don't know whether your choice of programs hurt your application as well. There is no question that for the university programs, having a PhD will help, but this entails a long committment. Are you ready to go through with it? It's going to be a couple of years of hard work with its inherent disadvantages. I was an older applicant as well who had gone through the Masters, then PhD route. Yes, I became a competitive applicant, but then I was older and had more personal responsibilities, etc, and that was the downside.

    On the other hand, there is nothing you could do about your med school grades and evaluations. Honestly, if you hadn't failed any course, it shouldn't have counted so much against you, unless you consistently got mediocre or poor evaluations. My advice would be to apply in your internship year to a broader range of programs (both geographically and in terms of quality) if that's possible, and in case you're unsuccessful in matching next year, then think about the PhD route, considering that it's a long-term kind of solution.

    Also, when in my original post I said "less than stellar", I really meant "well below average". Just to be more clear.
     
  16. joshmir

    joshmir Senior Member
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    Thanks for the reply docxter. It's always great to hear the inside scoop from someone who's on the other side.

    It's great to know that with a PhD, there is still something I can do to bolster my application. This betrays my ignorance, but would an MD who has not gotten a master's degree be able to get directly into a PhD program?

    Certainly it could have been that I didn't interview as well as i thought, but since at least a couple people flat out told me they wanted me to come to their program, I don't think I was horrible. Also, on one interview I had a chance to read through my file, and there was nothing bad. Rather, I feel that the stroke of luck that allowed me to do well on my Step I got me interviews (most of them came in early, before programs got my transcript), but my below-the-mean class rank is not what they expected, and inconsistent with those board scores. Apparently things were much more competitive this year than in previous years. I try not to think of the money I burned.

    I need to touch base with some residents I met to try to see if they can slip me a bone in reference to why I ranked low on their lists.


    Thanks again!
     
  17. MacGyver

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    Despite those difficulties, it beats the hell out of just an MD with no PHD.

    Whats the alternative? To do all the medical training first and then the PHD? Then you would be criticizing it because you've "lost touch" with all teh clinical stuff.
     
  18. theprizefighter

    theprizefighter Senior Member
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    MacGyver,

    Why does an MD/PhD beat the hell out of just and MD? If it is just to say, "Oh, look at me! I have an MD/PhD" then you're really not using a micron of mature reasoning in evaluating the value of an MD/PhD degree.

    Is an MD/PhD better becuase it allows you to integrate basic science and clinical medicine? On paper, that what it is supposed to so but in practice most MD/PhDs I know choose one or the other. Either they do mostly bench science or just clinical. What, then, I wonder is the point of getting the combined degree when a PhD is clearly the best route for bench science and MD is obviously the best way to go for clinical medicine? Is a MD/PhD better for getting a good residency? Supposedely it is but we have just seen on this thread Joshmir not matching despite an MD/PhD and killer board scores. And what about all the regular MD only people who get superb residency matches anyway? Finally we come to the issue of the money. MD/PhD programs pay for med school. True. However, in the 3-4 years of getting a PhD one could make 500-800k in clinical practice and easily make up any finacial benefits of a MD/PhD program. Again: Why is an MD/PhD better? The answers don't seem as obvious when you look at the issue in depth.

    theprizefighter
     
  19. MacGyver

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    Because academic residency programs are highly interested in research, and a PhD is "gold standard" research training. All things being equal, an MD/PhD will always have the edge over a regular MD.

    No, it has nothing to do with the title and EVERYTHIGN to do with the experience/training gained BEHIND the title.

    thats part of it, but not relevant to residency programs per se. Whats relevant to residency programs is research experience, and MD/PhDs have more research experience than MD-only candidates 95% of the time.

    Even if that were true, which I'm not sure that it is, there's still a benefit gained from studying both even if you dont do both in your career.

    Because PHDs cant do invasive procedures on humans, and MDs are not trained to be scientists.

    There's no SUPPOSEDLY about it. Having an MD/PhD is CLEARLY better than not having it.

    Uhh.. you need to read his posts again. He does not have a PHD, he is thinking about pursuing it to boost his chances at reapplication.

    Do you really want to go there? Most MD/PhD programs have 90%+ match rates at THEIR FIRST CHOICE. Thats not top 3 choices, thats #1 choice. Even the regular MD program at Harvard cant boost that kind of match performance.

    Money has nothing to do with it. Its all about experience and training, which I've already addressed above.
     
  20. theprizefighter

    theprizefighter Senior Member
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    "Whats relevant to residency programs is research experience" - MacGyver

    - That statement is such a gross oversimplification and of coure it's not true. What is truely relevant to residency programs, both academic and non-academic, is CLINICAL COMPETANCE. I've talked to at least 5 different residency directors from Family Practice to Radiology who have stressed this. If you don't have kick ass clinical competance under your belt equal to or superior to that of regular MD applicants then the PhD won't be worth a damn to residency programs.

    "a PhD is "gold standard" research training."

    - Depends on what you are talking about. A PhD is great for basic science or bench research training but is not as effective for clinical research. An M.S. in clinical research, for instance with a fellowship is waaaaaaay better for someone interested in clinical resesarch, not to mention more time efficient, than a PhD in some basic discipline.

    "MDs are not trained to be scientists"

    Apparantly you've never head of courses in evidence based medicine, HHMI-NIH yearlong research fellowships, research track residencies, or the new Cleveland Clinic Program.

    I'd dissect every statement in your post but I don't have as much time to waste as you evidently do.

    theprizefighter
     
  21. MacGyver

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    1. You misquoted me. I said that research experience is one thing thats relevant, not the only thing.

    2. Clinical competence is independent of MD/PhD status. Like I said, all things being equal, an MD/PHD has a much better shot of landing the residency than the MD-only. Are you really going to sit there and argue otherwise? The data is clear on that.

    Clinical research is very superficial relative to transitional research that MD/PhDs work in. Academic residency programs seek out MD/PHDs for their strong research skills in BOTH areas.

    :laugh:

    EBM is research training? Yeah right.

    HHMI-NIH? Thats only 1 or 2 years long. Certainly not comparable to a PHD

    yearlong research fellowships? See above

    Research track residencies? Irrelevant to the question at hand. We're talking about desirability of MD/PhDs vs MDs for residency slots, not fellowships or beyond.

    Cleveland Clinic Program? Yeah, its only a year extra training in research. Not the same as a PHD. Also, they only take 40 people a year or so.

    You are just a lowly premed. Please learn some things about how the system works before you spout off your nonsense.

    MD/PHD, ALL THINGS BEING EQUAL, IS ALWAYS BETTER THAN AN MD-ONLY

    Thats the bottom line. You can spin these "what if" scenarios all day long, but my statement above stands.
     
  22. bosky

    bosky Member
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    Well said, MacGyver, Prize fighter seems to have issues with MD/PhD programs? It has to be said, though, that about half of MD/PhD's don't actually do REAL PhD's, more like extended masters degrees (in my personal experience N ~ 12). Labs are sometimes afraid to give them the traditional pressures because they don't want to discourage future people (especially since their salaries are often fully funded!).

    I speak from experience when I say I don't think the time and tears are worth the competitive edge. It can be a very hard path...pyschologically... when the lab is going bad for months on end and your original classmates match, graduate and/or finish residencies. Some of my original classmates are attendings now and think I've wasted years of my life (they don't understand). You should do it because you think you want to be a scientist.

    There is a huge gap between basic science and clinical science that requires people with dual training. Think about all the neuroprotective drugs that worked great in animal models, but were dismal in clinical trials. The people who designed the animal models didn't have a clue how valid they were to human disease (or "doctored" them for success) and the clinicians didn't have time to understand the basic science. Many senior scientists have now written that it is a big mistake to underestimate the need for dialog between these two groups and MD/PhD's are best equiped to facilitate that.

    The advantages for MD/PhD's over MD radiology applicants should be obvious. Really, it is silly to think otherwise - besides the above, some MD/PhD's interview with faculty that are research colleagues and/or have referenced their first-author papers! Further, it's not inconcievable that MD/PhD's who did well (i.e. significant pubs and a grant) can sometimes be competitive for nonclinical assistant professor positions in the same departments they are applying to for residency spots! This is exactly what my advisor did.

    Re: returning to medical school after being out 4-5 years - Most people at my program actually did better than the medical students fresh from 2nd year classes because they were more mature, worked independently and actually knew how to problem-solve (something the first 2 years are not too good at teaching). We had one freak who did poorly, but he still got his first choice in a non-living specialty if you know what I mean....
     
  23. bosky

    bosky Member
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    This thread appears dead, but if you're interested, there's an interesting and highly relevant article that just appeared in DIAGNOSTIC IMAGING May 2004 "Residency reforms foster radiology science careers".
     
  24. peehdee

    peehdee don't have one
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    I was just wondering if you guys think that a dual doctorate should have the PhD first or the MD first.

    I think traditionally the highest academic degree is supposed to go last right?

    e.g., Matsu Nami, MS, PhD or Joel Dee, BS, MS

    So in the case of a person with a PhD and an and MD or DO or DVM or any other professional degree what is the courtesy? I know that a lot of the dual PhD MD put the MD first prolly bc they went thru the MD/PhD program and are not putting the PhD last not necessarily because it is a higher degree. But what if you received the degrees in separate settings and not the combined program.

    Any thoughts?
     
  25. peehdee

    peehdee don't have one
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    where and how do we get this? can it be read online? need subscription? do you have a URL?

    thanks
     
  26. Docxter

    Docxter Senior Member
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    You can'y say whether a PhD or MD is the "higher" degree. They're sort of independent. Also, not all people with these two degrees have necessarily done a combined MD/PhD program. These programs are significantly shorter than getting a PhD and an MD independently. Some have gone the traditional master's then PhD program and then gone to or finished medical school.

    Almost all of those who did a combined MD-PhD program put "MD, PhD" after their name. Some of those who got the PhD independently or before their MD, put "PhD, MD" after their name. Bottom line is that it doesn't really matter that much.
     
  27. Logos'

    Logos' Member
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    ...
     
    #26 Logos', May 2, 2004
    Last edited: Mar 6, 2010
  28. bosky

    bosky Member
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    Diagnostic Imaging:
    I don't work for them, but you would have to register on their website (it's a trade journal!, but lately has had some good articles in it). Google diagnosticimaging. FYI - Here's the summary available to anyone...

    Residency reforms foster radiology science careers
    James Brice
    Some of the top academic radiology programs in the U.S. are implementing reforms to enable research-oriented residents like Awobuluyi to get ahead in their academic careers. The precise measures vary from institution to institution, ranging from the designation of two residency slots exclusively for academic residents at Washington University in St. Louis to a mandated two-year fellowship and three-year residency for all radiology residents in the Duke University program. At the University ...
    May 01, 2004

    Degree order:
    The PhD is the highest degree and I think people look ridiculous when they order them differently. Of course I would never say that to an attending, but the one I know who does that is super-arrogant and out of touch with people's perceptions (aren't they all!).

    I respect anyone for doing it, but their is some stigma to not going MDPhD or getting the MD first, then PhD during your residency/fellowship. If get your PhD first, then go to medical school, it may be considered a negative since you "abandoned" research (or got a "failed" PhD). People also know that these people often didn't get into medical school the first time around, did a PhD to increase the competitiveness of their application, then went to medical school. These people are not considered high in research-potential despite the PhD unless they have demonstrated it again in medical school.

    "Fake" PhDs:
    I agree time is not the perfect predictor, but publications are also misleading sometimes. Hell, I sometimes wonder at Harvard whether any undergraduate that is willing to work can "luck" into a penultimate authorship on some Nature or Science publication! We had someone, without any prior research (like a masters), get a PhD in 2 years with 3 papers, but he sure as hell didn't have to create anything of his own, he just did projects that his advisor and other people in the lab had designed for him. That person did not learn how to understand a problem, design a hypothesis and experiments to test it, etc.. That's a glorified masters.

    A lot of graduate students/postdocs resent MD/PhDs because they often witness this type of MD/PhD training (it often applies to MD fellows as well!). I find that it creates a barrier to collaborating with them (reluctance) until they realize you are not like that. I guess once you're further along, maybe away from where you trained, and have money, they no longer care if you got a "real" degree or not.

    I think we agree that it can be hard to tell on paper whether someone has the right training, but it is more likely to be present in someone that has a PhD?
     
  29. skarim

    skarim Junior Member
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    brief anecdote :

    i went to yale as an undergraduate and worked in a lab there. so did another undergraduate in the same lab.
    i went with 1 postdoc, he went with another.

    (10 months later)

    I wrote a (crappy) thesis, he wrote a thesis (with his 2nd author Science paper as appendix A)

    so people, can, and do get pretty lucky sometimes.
     
  30. peehdee

    peehdee don't have one
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    I respect anyone for doing it, but their is some stigma to not going MDPhD or getting the MD first, then PhD during your residency/fellowship. If get your PhD first, then go to medical school, it may be considered a negative since you "abandoned" research (or got a "failed" PhD). People also know that these people often didn't get into medical school the first time around, did a PhD to increase the competitiveness of their application, then went to medical school. These people are not considered high in research-potential despite the PhD unless they have demonstrated it again in medical school.

    --
    What did you mean by this? Are you saying most people who didn't decide to go to medical school at age 20 are at a disadvantage if they have a PhD already? What is the 'view' of the field on that? I mean surely they don't think, 'oh you couldn't get into medical school so you got a PhD'.. Do they ask, 'did you apply to medical school before getting your PhD?' or something? Because what I seem to be getting is that, if you did other things before going into medical school (not just PhD), people think, 'oh he/she couldn't get in so he did other things to pad his/her credentials'. If anyone did apply before is that record available to someone? i.e. do they ask you, 'did you apply to medical school before doing X?' (Btw, I'm not one of those, just curious). And my personal view is, if someone was willing to spend all that time to get a PhD (or some other stuff) to increase their chances of getting into medical school, cheers. Medical school shouldn't be just for 'gunners', the ones that knew at age 10 that they wanted to be a physician. What do you all think?
     
  31. bosky

    bosky Member
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    Sorry, I have been on vacation and then a meeting.

    I could be talking out of my a$$, but those are my perceptions of the process. I think some schools also keep records of who applied when so that when you apply to residency they may know that you applied to their medical school 5 years ago, etc...
     
  32. bsfreefalllt

    bsfreefalllt New Member

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    TPF,

    Sounds like you have put in a lot of time thinking about the MD/PhD. Many of the insights and concerns are very valid ones. In fact, I thought about the same ones before I started my MD/PhD. I am currently finishing the 3rd yr rotations and am applying to go into Radiology. My PhD was in molecular and cell biology. My plan is to be a clinician first and foremost, but I also plan on doing some research.

    -Anyone know how well MD/PhDs match to radiology? Any MD/PhDs in radiology residencies right now? If so, do you think your PhD training has given you any edge over the MD only radiology residents either in the applying to residencies and actual residency performance?-

    At my school which graduates 3-4 MDPhDs a year many have went into radiology and been successful getting residencies (mayo, emory, miami, vanderbilt). Speaking with them about interviewing most found that programs were fighting to get them. I think one of the most important things that you gain from doing a PhD is maturity. Doing seminars, interacting with collaborators, going to conferences, completing a project...all of these experiences give you professional maturity that I have found to be head and shoulders above your 3rd yr colleagues. The experiences teach you how to have tact and interact with intelligent individuals in a professional manner.

    -Do you know if the PhD of most of those students where radiology related?-
    I would venture to say that the majority are not. I don't see hardly any MD/PhDs pursuing a phd in engineering or physics which is what the prototypical radiology research has focused on. Instead, you have the opportunity to study the biology of disease and take this knowledge to apply the techniques of radiology to approach disease states in novel ways. I think that is the future of radiology imaging research in particular molecular imaging.

    I think a big problem with an MD/PhD program is that you have that big 3-4 yr discontinuity between the first two years and the clinical rotations of the 3rd and 4th year of medical school. That can really hinder how well clinical rotations go for an MD/PhD student. Also, by the time you finish your clinical rotations, the field you did your PhD in may have progressed so far that you'll be left behind. Balancing the two very well strikes me as difficult if not impossible. Anyone have thoughts on this?

    The discontinuity is not as much of a problem as you may think. Success in 3rd and 4th yr depends more on your personality, work ethic, ability to interact professionally with your team members. It also helps if you're good at taking the standardized tests. Don't misinterpret. My first rotation was internal medicine and I felt like I was way behind the other 3rd years. I mean, I had forgotten antibiotics, hypertensives, etc. I had to review a lot of basic concepts as I went through the first 3 months and it really took me three months to feel that I was up to speed. But, the fact is all 3rd years have to adjust to the clinics. You're not as far behind as you think, and if you work hard and jump into it you catch up quickly. To your advantage, I found that I was refreshed and gungho to start the clinics. I was tired of being in the lab and the excitement of starting in the clinics sustained me through the hard first 3 months. I jumped into it, studied hard and made junior AOA.
    Don't worry about your phd topic. You will be out of date within 6 months of leaving the lab, but the reality is you'll probably never research your topic again. Getting a PhD is about learning how to approach a problem scientifically. It is training to do research. It's not training to know everything in the world about 1 or 2 proteins. It's the process not the results that matter.

    On paper, that what it is supposed to so but in practice most MD/PhDs I know choose one or the other. Either they do mostly bench science or just clinical.

    Doing the MD/pHD opens doors for you. If you know for sure that you just want to do bench work, get a phd. If you don't, then getting a MD/phd is totally worth it. In today's grant environment, you have to have a disease based research goal. The MD training gives you unique perspectives that PhDs can never get. Plus, I felt more comfortable knowing that the if I didn't like the pressure of grants having a MDPhD would give me the backup of doing clinical practice. Plus, there are more grants you are eligible for and promotion as well as hiring into faculty positions appears to be much easier with the dual degree.


    One other note, having a PhD legitimizes your ability to do research. You can do that going through the MD route followed by research training after or during residency, but I feel that the MDPhD is the most efficient way.


    hope this helps. good luck.
    B
     
  33. cbc

    cbc Senior Member
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    You are an idiot. Everyone puts John Smith, MD, MS; or MD, MPH; or MD, MBA; or MD, JD; or MD, PharmD; or MD, DDS. Does that mean all these degrees, including the masters, are higher than MD? I say you're an idiot, because you've got to be an idiot to imply MS or DDS is "higher" than MD since they come after the MD.


     
  34. theprizefighter

    theprizefighter Senior Member
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    Hi, All

    To revive discussion on this thread I ask the following questions: What measures, if any, do academic radiology residency programs take to attract MD/PhDs to their programs?
     
  35. Neuronix

    Neuronix Total nerd
    Administrator Physician PhD Faculty SDN Advisor 10+ Year Member

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    As a second year MD/PhD student, I did a rotation this past summer in basic radiology research here at Penn and everyone I've talked to, both on the clinical and research sides, has already started talking to me about recruiting me to Penn's radiology residency program.

    Obviously, I still need to do well on boards and clinics. Still, I thought this might contribute to the discussion at hand.
     

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