Relooking at interview question asked, any advice?

[madamebovary]

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I recently interviewed at an MD program and was asked by interviewer who was a professor of pharmacology on "why not straight phd or md/phd, considering my extensive research experiences."

I gave my answer that i imagine my career as splitting my time 50/50, clinical to research. Also, I told him that at the moment i'm not 100% sure exactly what my research would focus on and would like to wait till in medical school (when i have a better idea), before diving into a specific research area. But ultimately, i imagine contributing in research and incorporating scientific advancements to improve patient care.

He responded by asking a second question, don't you think by splitting it 50/50, it would be inefficient in what you want to accomplish. Wouldn't it be better to focus on phd alone?

Ultimately i responded by saying that i still want to be able to see patients and interact with them, and gave reference to volunteer experience.

But im pretty sure i didn't really answer his question. Not sure if he looked favorably in my answer. Any advice if this question is asked again. 😕

 

[SBR249]

This is speaking from the MD/PhD application route perspective, but I feel that the whole 50/50 model is just a fantasy.

Having been surrounded by physician-scientists who do indeed do both basic bench work and see patients (all as part of clinical trials) for the past year and a half, I can say that if you want to do that kind of research, spending 50% of your time in the lab just doesn't cut it. Conversely, spending 50% of your time seeing patients means that, by the time you get through all the bureaucratic red tape and paperwork, you'll be seeing at most a few patients a week, if you are lucky. Not nearly enough to be an outstanding clinician.

That's assuming you plan on doing normal things like sleep, eat, have a life, start a family, etc etc.

What I see most people doing is focusing on one side and then dabbling in the other (like seeing patients one day a week, attendings rounding one month a year, or working as a part time fellow in someone else's lab while principally being a staff clinician for the PI, etc).

That's just my anecdotal experiences but I think the reality these days if one wants to do both is closer to 80/20.

 

[ImagineThis]

I think that, as an MD-only applicant, you need to break down the question a bit more clearly.

1) Why not PhD only? You want to see patients. This is important because you are applying to be a clinician, and even if you want to do research as well, gives you a good opportunity to reflect and tout your *presumably* excellent clinical experiences which made you want to become a physician.

2) Why not MD/PhD? While you obviously like research, from the fact that you didn't apply MD/PhD, I can assume that you want to have a primarily clinical career. Even if you do want to do 50/50 (which I agree is quite difficult), the question is if you would be willing to go to 80/20 research/clinical. I presume the answer would be "no" because you didn't apply MD/PhD. So I think that, once again, your answer here is "I want to do mostly clinical medicine and, although I love research, I don't think I would want to make the clinical sacrifices that I would have to make to devote my life to a career in biomedical research". Then you can say things like maybe you will take a few years following your MD to do research, or even internally apply to the MD/PhD if you change your mind. But the purpose of this interview is to get your foot in the door of that medical school and the way to do that is to stress, above all, that you want to see patients.

 

[madamebovary]

I think that, as an MD-only applicant, you need to break down the question a bit more clearly.

1) Why not PhD only? You want to see patients. This is important because you are applying to be a clinician, and even if you want to do research as well, gives you a good opportunity to reflect and tout your *presumably* excellent clinical experiences which made you want to become a physician.

2) Why not MD/PhD? While you obviously like research, from the fact that you didn't apply MD/PhD, I can assume that you want to have a primarily clinical career. Even if you do want to do 50/50 (which I agree is quite difficult), the question is if you would be willing to go to 80/20 research/clinical. I presume the answer would be "no" because you didn't apply MD/PhD. So I think that, once again, your answer here is "I want to do mostly clinical medicine and, although I love research, I don't think I would want to make the clinical sacrifices that I would have to make to devote my life to a career in biomedical research". Then you can say things like maybe you will take a few years following your MD to do research, or even internally apply to the MD/PhD if you change your mind. But the purpose of this interview is to get your foot in the door of that medical school and the way to do that is to stress, above all, that you want to see patients.

Thank you so much Imaginethis.

 

[Fencer]

... I feel that the whole 50/50 model is just a fantasy...

I guess I am a figment of your imagination. It is very hard and an inefficient model, but fortunately, NIH (and other funding agencies) and my longitudinal clinic patients don't see it that way! 50:50 for past 15 years.

 

[SBR249]

I guess I am a figment of your imagination. It is very hard and an inefficient model, but fortunately, NIH (and other funding agencies) and my longitudinal clinic patients don't see it that way! 50:50 for past 15 years.

No need to get testy on me. I'm just speaking about my opinion derived from experience in the people that I meet and I've never met you. I even said this was anecdotal. But since I'm doing full time research at the moment, my feeling is that it's very hard to be productive while doing lots of clinical work, especially if you are at the early stages of your training. Sure if you are a PI, you may be a bit more flexible with how you get your work done, your grants written, your papers read, your data analyzed, your manuscripts edited., etc. (not to disparage the work of a PI) But if you are a resident/fellow/whatever trying to get that science/nature/cell paper, I don't really see how you can afford to spend a lot of time with patients. Unless you have the Midas touch or something when it comes to bench work.

 

[Fencer]

... if you are a resident/fellow/whatever trying to get that science/nature/cell paper, I don't really see how you can afford to spend a lot of time with patients...

No problem.... I agree. During training, you learn best by concentrating substantial blocks of time to one or the other activity. The rewards of being a clinician scientist doing bench and bedside are so much fun. The real problem as you pointed out is that physician scientists are competing with 100% researchers at the Bench and 100% clinicians at the Bedside. I still recall been chief resident protecting patients from an outstanding research attending (now member of the IOM). His clinical skills were atrophic. Doing both is possible, but hard and inefficient. Your research productivity record suffers. The future for those of you who will like to do 50:50 is Team Science.

 

[cyneuron]

The future for those of you who will like to do 50:50 is Team Science.

Well said...

I think that 60: 40 (clinical:research) is a good way to go as a clinician investigator.