Research and surgery?

[Jorje286]

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Hi everyone,

I know that some MD/PHD graduates end up practicing both research and medicine, with most of their time being devoted to research.

I am interested in cognitive neuroscience research and I also would like to do brain surgery. Is that a realistic goal? Furthermore, will that career goal enhance or diminish your chances of acceptance into MD/PHD programs?

 

[Neuronix]

Neurosurg and Neurosci were my interests when I started medical school. I have since gotten off of the neurosurgery track, and instead shifted over to neuroradiology. I figured out once I got to clinics than an 80hour/wk lifestyle just wasn't for me. I like having hobbies and interests outside of school and medicine. I'm miserable without 8 hours of sleep a night.

That all being said, you probably don't want to say you want to be a neurosurgeon someday, even if you are going to be one. Most program directors are IM subspecialists or pathologists, and they will say the usual sorts of things like "Surgeons don't have time for research" or "Surgeons don't do quality research". In general, they want you to head into the big 3 specialties: IM, peds, and path. Neurology tends to be okay with PDs as well. As such, as a direct answer to your question, saying you want to be a neurosurgeon will probably put you at a disadvantage. Of course, that's a general statement. Some interviewers probably don't care what you say you want to be someday (probably because they changed their minds several times too). Other interviewers might be sympathetic to it.

All I'd say is, don't put neurosurgery on your secondaries and only bring it up as a possibility after all others in your interviews. I remember a few interviews where I mentioned neurosurgery even as a possibility and the conversation shifted to surgeons and research for the next 15 minutes so maybe it's better not to bring up surgery at all. I mean, life changes too much. You really don't know what specialty you want right now. So I don't think you're being dishonest with everyone.

Good luck!

 

[Jorje286]

Thanks Neuronix! That's kind of what I expected.

Do you think psychiatry/cognitive neuroscience is a good choice? (as a true career goal and something to talk about in interviews). I know that psychiatrists tend to have more free time than others even in residency, and so they have the potential to conduct more research. Also, I guess psychiatry and cognitive neuroscience fall very well together, and definitey one helps the other.

 

[Neuronix]

I think psychiatry has a difficult time earning the respect of many physicians. That being said, physician-scientists in that area are in demand, because there's really very little basic science research being conducted on diseases of the mind (how do you even model it?).

Honestly, if you want to study the brain, you have alot of ways to do it.
Neurology
Psychiatry
ENT (peripherally/senses)
Neuroradiology
Neuropathology
Neurosurgery
Child or adult in any of these. Also, you get alot of neuro work in things like pediatric genetics.

I guess my point is, don't worry about it so much now. There's alot of options and you'll figure out which one is best for you in those 7-8 years you're in the MD/PhD program.

 

[Vader]

There is a comeback of psychosurgery in the treatment of behavioral disorders such as OCD, depression and others. Deep brain stimulation, performed by neurosurgeons, is being applied to psychiatric disorders for which critical foci within the brain have been identified.

The current issue of Neuron has some great review articles on this and other topics in neurological and psychiatric disease.

See Wichmann and DeLong 2006 Neuron 52:197-204 for a review on deep brain stimulation for neurologic and neuropsychiatric disorders.

 

[enhypnion]

Hi everyone,

I know that some MD/PHD graduates end up practicing both research and medicine, with most of their time being devoted to research.

I am interested in cognitive neuroscience research and I also would like to do brain surgery. Is that a realistic goal? Furthermore, will that career goal enhance or diminish your chances of acceptance into MD/PHD programs?

I agree with the other threads, in that you should also look into other Clinical Specialties before you settle on Neurosurgery. Of all the MD PhD's that I started with who wanted to do Neurosurgery only one actually went into Neurosurgery after graduation. Most decide to go into Neurology or Radiology. The problem lies in finding the balance between your surgical practice and your research interest. I once had a veteran Neurosurgeon (who had retired from neurosurgery to pursue her research interest), tell me that the only way this could be done realistically is to have a very focused practice in an area of elective surgery such as Functional Neurosurgery or less surgically intensive practice such as Image guided radiosurgery. And I think she is right. I know several neurosurgery MD PhD's who do basic science tumor research and have a full Neurosurgical practice, they seem to have a very difficult time balancing their practice and research work, not to mention their personnal life. Divorce rates are high in this field and clinical researchs seem to be clumped on the wrong side of the bell curve. This is of course not evidence that you cannot do good research and have a good clincal practice, but it should help you understand that it will be a very rocky road. That being said, there is a huge interest in recruiting MD PhD to the Neurosciences. Very few MD PhD take the long road of Neurosurgery and so those few who do decide to apply to Neurosurgery are often rewarded by having their applications viewed with slightly more interest than their MD only peers at the more academically oriented training programs. Bottom line, seek out and investigate the other career options. Once you are sure you can only be happy in Neurosurgery, find an MD PhD mentor in Neurosurgery (you can start by doing this or similar program during the summer before your M2 year http://www.aans.org/otheresearch/med_student_research.asp) and let them help you find the best way to pursue your interest.