Rejected MSTP, accepted MD: reapply?/chances

[Hopf Fibration]

Hi all, I have a bit of a dilemma. I am an unsuccessful international MSTP applicant. However, I have an MD-only acceptance at a very good Canadian school. I'm trying to decide what to do now.

My career goal is very research-focused. My backup plan had been that I would matriculate to an MD program, and take a leave of absence mid-program for a bioinformatics or basic science PhD. I just found out from the MD program where I am holding an acceptance that their policies do not allow this. I am also not able to apply internally to their MD-PhD program. This kind of crushed me because I want research to be a very large part of my life.

My brain is telling me to play it safe and take my MD acceptance and run with it. My heart is telling me to play the MD-PhD lottery again. Part of my decision depends on whether I'd have any chance of getting into MD-PhD programs this time around.

Last application cycle I applied somewhat late (secondaries in end of September to beginning of October) and to a somewhat top-heavy list of only 12 programs. I didn't hear back from anywhere until around December. 10 pre-interview rejections, 1 pre-interview roll-over to MD, 1 MSTP interview at Baylor. Rejected/rolled over to MD-only post-interview.

My question is: would I have a much better chance if I reapplied and got everything in early? My application would not have changed except for the addition of a (non-research) MSc. Or do you all think that it was my non-citizen/PR status and lack of clinical ECs which killed my application?


My details:

Citizenship/Residency: Canadian, not US permanent resident.
Undergrad: Theoretical math degree at a top US school. Have a very strong chem/bio background though.
Master's: (Non-research) master's in mathematical statistics at a top European school.
GPA: 3.9 in undergrad. 3.8 AMCAS gpa due to some bad grades from senior year of high school.
MCAT: 38S - 14/12/12
Research: Started with 1 summer after freshman year. Then did research for the next two years until I graduated in a very well-respected lab. Both in basic science: chemical biology. No pubs.
ECs: Very good leadership ECs, excellent athletic ECs. Some, but not much volunteering. Zero shadowing.

Last cycle I applied to: AECOM, Baylor, Columbia, Dartmouth, Harvard, Mount Sinai, Northwestern, UC Davis, Chicago, Vanderbilt, WashU, Tri-I. If I were to reapply, I expand this to include all the MSTPs which accept Canadians, plus USC and UT Houston... so maybe 7 more schools total.

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[EmailWatcher]

Oh wow. You're my doppelganger! I'm another Canadian, with only an MD offer at one of our good VMT schools, after getting many rejections from just about the same set of MSTPs, with a couple MSTP interviews. My career aspiration is also research focused- my undergrad was also in math, and my research interest is in bioinf as well as the more basic science side of the things.

I'll PM you, we should chat.

I'll put some of the reasons why I'm leaning towards just accepting the MD here, in case others have an opinion about it...

1.) We can still have research focused careers, and still do some amount of research in our first two years of MD. People keep telling me this, but I think it's true. Look at Rob Mckinnon (MD, nobel prize in electrophys!) I've seen many a physician-scientist with solely an MD doing some pretty basic-science research. I think bioinf is particularly ripe for MD's, as we can actually interpret data....especially for stuff like running stats on medical databases.

2.) We can both apply to PhD programs this year (I think) and if we really don't like first year med, we can bail, do a PhD, and leave medicine behind us. We can't reapply MD/PhD if we've started med school, but my feeling is kinda "we should only decline MD if we really want a PhD-only career".

3.) Financially, we're in a lot better situation than our American counterparts doing MD-only, wanting to do research. Our tuition is ~$15k/year, a little less when you factor in the gov't student loan program and bursaries. Our MD/PhD programs also have much worse stipends...so I think if you do the math, we'll grad without a crushing load of debt. Interest on $100k is only ~$5k, after all.

4.) Let's face it- we don't know if we'd do better next time. MD only at Canadian schools is tough enough. I do think that our lack of citizenship makes a (decently big) difference, even at programs with many spots not MSTP funded. I also don't think we have much shadowing opportunity here in Canada, eh?

Just my thoughts... I'm really curious what others think as well.

 

[debateg]

I would just take the MD-only acceptance and run with it. If it's a Canadian school with very low tuition, you will graduate with much less debt, which is very important if you want to do science. It is very possible to have a career in science that develops later in training. In fact, for many people, I think this is the much better route.

At least in the US schools, once you show up in medical school, they're sort of stuck with you, and if you press the issue really hard to the right people, they often will just give up and let you do whatever you want. If you're dead set on that, you may be able to politic your way into doing what you want, especially if you manage to secure your own funding to support your research and have a mentor who is a strong advocate for you.

If you want to have continuity in research during medical school, can you do a MD/MA or MD/MS program where you only take off one year? You also can make good use of your summers off to do research. Depending on how light your first year is, you could probably get a lot of a project done during that as well.

If you choose to do the MD-only route, I would recommend that you seek out a scientific mentor now. Also, talk to the MD/PhD director about your career goals and how he/she thinks you can best accomplish them.

Good luck.

 

[Fencer]

... I have an MD-only acceptance at a very good Canadian school. I'm trying to decide what to do now. ...
...
My brain is telling me to play it safe and take my MD acceptance and run with it. My heart is telling me to play the MD-PhD lottery again. Part of my decision depends on whether I'd have any chance of getting into MD-PhD programs this time around.

Despite that your outstanding qualifications, the international component diminishes dramatically your chances for next round...

In reality, you are facing a 9-10 year MD/PhD vs a 3-year MD followed by residency/post-doc. The 9-10 is because this year will only count on your record if you pursue the MD, thus, taking a MD/PhD route now, has this extra year of re-applications.

If earning a PhD is important to you, you could later pursue a PhD/residency route. There are program with such paths.

PM me if you need...

A MD/PhD program director.

 

[Hopf Fibration]

If you want to have continuity in research during medical school, can you do a MD/MA or MD/MS program where you only take off one year? You also can make good use of your summers off to do research. Depending on how light your first year is, you could probably get a lot of a project done during that as well.

If you choose to do the MD-only route, I would recommend that you seek out a scientific mentor now. Also, talk to the MD/PhD director about your career goals and how he/she thinks you can best accomplish them.

I would not be able to do any kind of combined degree at the MD school. I am starting to look into the possibility of taking a year or two off to spend some time in a lab. There is apparently a small chance that I might get approval to do this. I'd like to do it in the US... I have no idea how visas would work for something like this though.

Good advice: I'll get in contact with the MD/PhD director there.


Right now I'm a lot more concerned with opportunities to develop my career than... I will not be graduating from med school with much debt whichever way I go.

2.) We can both apply to PhD programs this year (I think) and if we really don't like first year med, we can bail, do a PhD, and leave medicine behind us. We can't reapply MD/PhD if we've started med school, but my feeling is kinda "we should only decline MD if we really want a PhD-only career".

I don't personally feel that dropping out of med school after 1st year would be wise... I don't want to do just basic science either, and I feel that this would kind of kill any possibility of later medical training.


However... weighing all my options: Given that I'm set on a PhD, would it be dumb to turn down my offer, apply PhD-only this cycle, and then reapply for medical school in 4-6 years after I finish?

 

[byaaaaaaah23]

Despite that your outstanding qualifications, the international component diminishes dramatically your chances for next round...

I thought many (not all) programs don't care about citizenship?

Last application cycle I applied somewhat late (secondaries in end of September to beginning of October) and to a somewhat top-heavy list of only 12 programs.

Last cycle I applied to: AECOM, Baylor, Columbia, Dartmouth, Harvard, Mount Sinai, Northwestern, UC Davis, Chicago, Vanderbilt, WashU, Tri-I. If I were to reapply, I expand this to include all the MSTPs which accept Canadians, plus USC and UT Houston... so maybe 7 more schools total.

These are 3 significant problems.. which can definitely be corrected in a re-app. I honestly think you have a shot at a re-app provided you apply early and broadly (at least 20 schools). Also look at more non-MSTP schools. You already said you've been considering a PhD, so if you strike out again, you could just go that route. However, I was only an applicant this year so obviously don't take my advice over others'.

 

[miz]

I thought many (not all) programs don't care about citizenship?

This is not correct. MSTP funding can only be used to cover US citizens or permanent residents, so there are very few slots for international students.

I agree with others that graduating with relatively low debt from a top Canadian medical school is the best option and doesn't bar you at all from a research career. If I were in your shoes I would not reapply. Your statistics are great, but the successful international applicants I met were superstars, and I don't think reapplying will increase your chances enough to be worth the opportunity cost.

 

[Maebea]

OP: you probably should take the sure thing and enroll in the Canadian medical school.

NIGMS just informed MD-PhD programs that it is cutting training grant slots beginning July 1. From what I can gather, big programs are being cut 8%. Programs with fewer slots are being left alone, and a handful of smaller programs are being given a slot or two. While international students cannot be funded on MSTP grants, the cutting of these grants means that progams will need to use institutional money to make up the shortfall; this is the same money that is used to support international students. It would not be unreasonable to say that you and other international students will likely face longer odds in the coming application cycle. For that matter, domestic students will probably find admission to be somewhat tougher as programs may cut back on their admissions targets to deal with the new funding reality.

 

[ratherbefishing]

Take the MD. Do a post-doc before/after residency. As has been said, some programs will support this ad part of a PhD but you dont need the degree to do research. You'll be making twice as much as you would as a grad student and have less hoops to jump through.