Starting the PhD after M1

[Vlnwi2017]

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I was just wondering what people thought about starting the PhD after M1 (I am currently just finish up M1). I am not sure if my school will even allow this but I was curious as to what people thought before I talked to administrators about feasibility etc. It seems that having the M2 stuff fresh in your mind before 3rd year rotations would be more useful than forgetting it all in four years.

 

[solitude]

I was just wondering what people thought about starting the PhD after M1 (I am currently just finish up M1). I am not sure if my school will even allow this but I was curious as to what people thought before I talked to administrators about feasibility etc. It seems that having the M2 stuff fresh in your mind before 3rd year rotations would be more useful than forgetting it all in four years.

It's not a bad idea. I wouldn't do it simply to have the M2 material prior to M3. The consensus is that most of the M2 material comes back fairly easily during M3, and the rest of it is not needed after Step I.

Is there another reason in particular that you're doing it?

FWIW, At my school there is talk of combining M1/2/3 into a 3 year program that would include both didactic coursework and clinical clerkships in a much more integrated way than is currently done (right now, we have an "intro to clinical medicine" type course that meets a couple times a week for a few hours, but it isn't a true clerkship). If the curriculum ultimately goes that way, the MSTP is likely to go to a system of doing the PhD after M1. Personally I think that that curriculum setup sounds like a terrible idea, but every 10 years a new set of deans has to make their reputation on reinventing the wheel.

 

[URHere]

I was just wondering what people thought about starting the PhD after M1 (I am currently just finish up M1).

Like any other decision, there are pros and cons. This is how I see it:

Pro:
-You don't have to worry about those pesky time limits for Steps 1-3 required by some states.
-You don't end up taking Step 1 only to have it "merge" with Step 2 a year or so into your PhD (note: this has been discussed for awhile, but there is no definite date to speak of).
- You get to enter MS3 with your store of medical knowledge still fresh in mind.

Cons:
-You waste time that could have been used for a research rotation (don't underestimate the value of that second summer and potentially MS2 year).
-You get to go through MS2 with a slew of people you don't know.
-You really don't have enough medical knowledge to apply it to your PhD in any meaningful way - it may sound idealistic, but isn't the point of MD/PhD training to provide a medical perspective on basic science research?
-Your "return to med school" date is set in stone. You can always enter 3rd year clerkships a little bit late, but you need to be present for required MS2 exams and courses from the beginning.

 

[nomogram3]

Like any other decision, there are pros and cons. This is how I see it:

Pro:
-You don't have to worry about those pesky time limits for Steps 1-3 required by some states.
-You don't end up taking Step 1 only to have it "merge" with Step 2 a year or so into your PhD (note: this has been discussed for awhile, but there is no definite date to speak of).
- You get to enter MS3 with your store of medical knowledge still fresh in mind.

Cons:
-You waste time that could have been used for a research rotation (don't underestimate the value of that second summer and potentially MS2 year).
-You get to go through MS2 with a slew of people you don't know.
-You really don't have enough medical knowledge to apply it to your PhD in any meaningful way - it may sound idealistic, but isn't the point of MD/PhD training to provide a medical perspective on basic science research?
-Your "return to med school" date is set in stone. You can always enter 3rd year clerkships a little bit late, but you need to be present for required MS2 exams and courses from the beginning.

The pros really aren't that huge. I'm in the time limit boat, and will just have to sit for Step 3 at the end of my intern year. The merging of the USMLE exams is still undecided and could present an issue but for now is not a problem. Going into MS3 with your MS2 "fund of knowledge" is pretty irrelevant, no one knows what the hell is going on when you first hit the wards as far as the day to day stuff, and you have to study like mad for the shelf exams as it is. I was pretty surprised how much stuff I retained for immediate regurgitation as an MS3 after 4 years of learning immunology. Another pro of doing this that wasn't mentioned is that when AOA elections come around you will be more recognizable if you did MS2 with the class instead of being someone no one has heard of with a lot of publications (which at my school means even if you are eligible you're not getting voted in).

I see the return to MS3 date being fixed as the biggest problem. You may be able to set a fire under your committee and get back to the College of Medicine in a timely manner, but having cold hard end dates proved to be a bigger obstacle in my experience than I thought it would. It was also nice to have Pathology under my belt during graduate school, it gave me a better perspective on autoimmune disease in particular (but if you go into a graduate program that is not as clinically relevant it may not matter much).

 

[JmanDO]

Could someone clarify what you mean by Steps 1 and 2 merging? And time limits? I live in NYC, btw.
Maybe post a reference?

 

[Shifty B]

The thing about step 1 and 2 merging has been a rumor for a long time but nothing has happened yet. The idea is that there would be one exam at the end of your medical school (end of M3 or sometime in M4) when you would take the exam. Good for regular medical students, but bad for MD/PhDs who would have to conceivably relearn any "step 1" material that was on the exam. Nothing has come of this yet.

It would be particularly bad if it happens and you are caught in the middle. That is, if you already passed the old step 1 but then the old step 2 doesn't exist by the time you would take it. Then you would have to take the new step 1 + 2 combo exam.

Personally, I think they should combine step 2 and 3. The content is extremely similar and I'm not even sure why they are separate.

The time limits refer to licensing time limits. In some states, all of your step exams have to be within a 7 or 10 year period. Once you take step 1, the clock starts ticking and you have to complete step 3 within this time limit. If you spend 4 years in a PhD, 2 years back in med school, and 1 year in your internship you would have to take it by the end of the year. However, most states have an exception where MD/PhD students can send a letter asking for additional time.

 

[solitude]

It would be particularly bad if it happens and you are caught in the middle. That is, if you already passed the old step 1 but then the old step 2 doesn't exist by the time you would take it. Then you would have to take the new step 1 + 2 combo exam.

from what I understand, the USMLE has promised that eventually when this really does happen, everybody who already took step I would be grandfathered in, so they would continue to offer Step II until all of those people were done with med school. But I agree that it seems unlikely this will happen anytime soon. If they were to roll it out, they would probably give a couple years of notice, and they certainly haven't done that yet.