Subspecialty Struggle

[gundelfingen]

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Hallo! I know my questions might be dumb.
First thank you everybody, I am in med school now. School is unique, it's in El Paso with P/F. I am learning Spanish now. (already speak fluent French and German)
Background:
Born in China (US PR), PhD from UT Austin in orchem, 9 pubs, 1 year API analysis in pharma, 1 year associate lab supervisor in pharma development for anti-cancer drug. Artiste dissolu, play fancy piano and sing fancy but couldn't go to music school due to Asian parents... My goal is to become physician scientist to conduct clinical trials and connect scientists to medicine
Difficulties:
Met my mentor in neurosurgery office, strongly recommended me to do surgery instead of research. I found neurosurgery is also really my favorite, especially glioblastoma. I really like different types of malignant brain tumors. I enjoy watching resection. However, neurosurgery is ultra competitive and even I get in I'll stay away from pharma development. I am struggling between 2 paths:
1) IM+oncology
2) neurosurgery
Question:
when is the deadline to determine between 1) and 2) What's your recommendation?
If choose 1) what should I do including research in my med school? Step 2 score to be competitive? Also other fellowship I can consider beyond oncology for research in pharma?
if choose 2) what should I do including research in my med school? Step 2 score to be competitive?
Do 1) and 2) have overlapping research can cover both?
I have 3 summers to do research, so which directions should I go?
I am humbly consulting your general opinions. (just be concise, I don't want to waste your time)

 

[NotAProgDirector]

There's only one medical school in El Paso, so you're talking about PLFSOM.

For Neurosurgery, it's incredibly competitive. Some combination of top scores on USMLE, outstanding clinical evals and grades (if PLFSOM has clinical grades other than PF), research, and support / experience in an academic neurosurgery program is critical. Per my quick review of their clinical sites, they do not have a NS residency. This will make your application to NS much more difficult, and you'll need to reach out to other TX sites to see if they can mentor you, and perhaps do rotations there, Their 2024 match list has 2 NS matches, the 2025 has none. If this is what you want to pursue, you need to reach out to those prior grads and get the scoop from them. You need to decide whether you're willing to do 1 or more research years. And whether you're ready for a 7 year residency which is very grueling. You mention a NS mentor, but if they are not connected to an academic program they may be of limited value.

And from your description, I assume you're a US citizen. If not and you need a visa, it gets even more difficult.

IM + Oncology, on the other hand, is much less competitive. If you're interested in research, you could apply to places with an ABIM research pathway. These are designed to train docs who plan to be 70%+ research ultimately. IM + HemeOnc is usually 6 years (although you could do IM + just Onc in 5 years, it's often useful to do both Heme and Onc, else you can't take Heme call. Some big academic places will have separate Heme and Onc call, but some will not). The research pathway is longer, but less IM - 2 years of IM, 2 years of clinical HO fellowship, and 3 years of research. You trade an IM year for 2 years of research. Although it appears longer, if that last year is research and you get hired by your institution, you can be hired as faculty for your last year (with a faculty salary).

 

[purpledoc1]

I am struggling between 2 paths:
1) IM+oncology
2) neurosurgery
Question:
when is the deadline to determine between 1) and 2) What's your recommendation?
If choose 1) what should I do including research in my med school? Step 2 score to be competitive? Also other fellowship I can consider beyond oncology for research in pharma?
if choose 2) what should I do including research in my med school? Step 2 score to be competitive?
Do 1) and 2) have overlapping research can cover both?
I have 3 summers to do research, so which directions should I go?
I am humbly consulting your general opinions. (just be concise, I don't want to waste your time)

Why are you interested in oncology? Easy crossover bet. pharma and the clinical setting? It might be easier to just do IM + pharma research, or even peds + pharma research.

I would try to choose as early as possible after 2nd year. Research (of any type, but of course neuro is best) is almost a must for neurosurgery these days. It sounds like your background is pretty competitive already. Important to find a mentor in the specific field that you're interested in. It doesn't have to be exactly what you want to do--neurosurgery or pharm research is enough.

Step 2 I would say over 230 at the bare minimum (for neurosurgery), dep. on the program of course.

To make your questions more streamlined, IMHO:
1) Neuro--if you are at all interested and can stand the field, you are probably going to love it. Most people hate it.
2) Try to choose as soon as possible after 2nd year (so that people don't say that you don't know what you're talking about). Gen surg rotation is fine and counts for all intenstive purposes as exposure to the field. Of course there isn't really a deadline, but the mentor thing is really important. Keep an ear out at all times. Most of the time, a lucky phone call is needed even for competitive applicants.
3) Peds neuro is a very interesting and quickly developing field. That's my recommendation for fellowships. 😀
4) I would really try not to choose something overlapping. It looks wishy-washy. PDs do not like this.

Idk what I think about heme + onc. It's a dying field, and although there are many passionate docs, there may not be as much demand in the future (as technology develops further).

Good luck with whatever you choose. Remember, you got in; you can do this! The future is what you make of it.

 

[NotAProgDirector]

Step 2 I would say over 230 at the bare minimum (for neurosurgery), dep. on the program of course.

Can't say I'd recommend a score in the 230's.

Idk what I think about heme + onc. It's a dying field, and although there are many passionate docs, there may not be as much demand in the future (as technology develops further).

What? I don't think cancer is going away any time soon.

 

[LucidSplash]

What? I don't think cancer is going away any time soon.

No, but the funding for research is.