surgery anyone?

[geekgirl]

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any word on strong programs in gen surg who like md/phds?
anyone hear of people starting their own labs while in residency training (i.e. during the research years)?
any info in general?
thanks!

 

[oasis786]

Oh goodness, you said the S word. I'd be interested to hear any info on this as well...

 

[enhypnion]

any word on strong programs in gen surg who like md/phds?
anyone hear of people starting their own labs while in residency training (i.e. during the research years)?
any info in general?
thanks!

I can't answer your first question, but I can tell you that there have been a few MD PhD grads who have started labs during their residencies. And, contrary to some of the opinions you may here on this website, they have made significant contributions to their related fields. In one case, of which I know specifically, the MD PhD started his lab while in his PGY1 year (neurosurgery). He obtained funding prior to starting his residency, and worked out an agreement with the program director. I would not recommend it however. Your PGY1 year is hard enough, without the added difficulty of starting a lab. Also, this student showed remarkable promise during his MD PhD studies and had secured his own funding.

If you are looking forward to a career in surgery, search for programs that are currently involved in research you like. Then contact the program directors about your interest. You may be suprised.

Hope this helps.

 

[JKP]

I'm also interested in surgery and was thinking of doing a post-doc during my research years. Wow, I haven't heard of anyone starting up their own lab right off the bat... especially during their intern year. IMHO it would be close to impossible to do both really well... geekgirl, do you already have funding for a project and if so what would you be studying? also would you be doing basic science or clinical? Good luck!

 

[Joel Fleischman]

I'm interested in G-surgery too...
it seems like some programs are definitely more interested in others in having mud phuds.... either real HOT or real COLD.

 

[JKP]

Northern Exposure was one of my favorite shows!
Joel, how's Maggie doin' these days?
And what was the name of the mayor of that town in Alaska?

 

[beary]

it seems like some programs are definitely more interested in others in having mud phuds.... either real HOT or real COLD.

Path is like this too. I have gotten downright hostility at some programs for my research bent.

 

[Joel Fleischman]

First time anyones here's mentioned Northern Exposure reference (publicly at least) ... no Joel Fleischman is not my real name, but I think I would act just like him in said situation.
Couple of questions:

It would seem like a MD/PHD grad in residency would be ready for the post doc
level in residency... did these folks who started their own labs do post docs before hand?

do you guys know, perhas could list programs (G-surg, ent, neurosurg) that do take a liking to mudphuds....or perhaps some that really dont like them?
As for those that do like us, how does the research training factor in with the other criteria (grades, USMLE, etc et al)

 

[geekgirl]

First time anyones here's mentioned Northern Exposure reference (publicly at least) ... no Joel Fleischman is not my real name, but I think I would act just like him in said situation.
Couple of questions:

It would seem like a MD/PHD grad in residency would be ready for the post doc
level in residency... did these folks who started their own labs do post docs before hand?

do you guys know, perhas could list programs (G-surg, ent, neurosurg) that do take a liking to mudphuds....or perhaps some that really dont like them?
As for those that do like us, how does the research training factor in with the other criteria (grades, USMLE, etc et al)

these are good questions. i am facing many of them as we speak. during interviews for gen surg at the big academic places, i have gotten many different responses to my preexisting PhD.

speaking of welcoming places, all the academic powerhouses have welcomed me with open arms. so pick your geographic location and the big names will be open to you.

here are some research advice/comments:
1. you may want to go straigth through and not do research during your residency
2. you may want to use the 2 years research during residency as a postdoc experience - gain new skills, publish in a new field, combine past and future research interests, connect with a new field, find a new mentor, etc
3. you may want to use the 2 years research to prove fundability - i.e. NRSA grant, etc. this is a tricky topic because the 2 years mid-residency can not be used as foundation for a training or K type grant, since you will not be able to implement the research funding when you're back in the hopsital during your final clinical years.
4. one attending told me, with long hard gazes and much seriousness "someone in your position would be infinitely more fundable and basically welcome anywhere after your residency, but you MUST show fundability during your residency. if you ignore this advice, you do it at your PERIL" yes, he said those words - "at your peril".

so i guess where i stand right now is that likely i will do a year or two or research mid-residency. i have made it clear that i do this for my own career, as a post-doc, rather than to be someone's lab b*tch and get some publications. i HAVE publications, i just need a platform for my own career when i'm done. also, research years are a nice break in an otherwise hectic surgical residency. life years. so many MD/PhD attendings i have polled have used them for personal growth as well.

and finally, i did have some of the smaller or more flexible academic programs momentarily consider making me faculty early and thereby allowing me to implement grants during residency. but this is tricky and requires alot of pre-emptive work and may or may not be feasible.

so, my plan:
1. do research, post-doc, build mentorship and prelim data (and hopefully stay involved in the work even when back for final clinical years). and look at this experience with an eye to return to this lab/PI as my K grant mentor
2. begin to integrate clinical and research goals. i HOPE to want to stay at my residency institution post-fellowship, so that all these connections and projects will be true career foundations.

hope this helps.
if you're interested in general surgery, there are loads of opportunities. and all the big programs will love you for your research background. there is definitely a niche for academic surgeons. i can not speak for the subspecialties.
also, seriously think of finding mentors in your field. i emailed and met with MANY MD/PhD surgeons at my own and various other institutions. and i polled them on how to manage my career and use my time most valuably. they were all willing to give me honest advice. and it has been terrifically valuable. some of them are now chairman and they're recruiting me to their programs. HARD. so all of this stuff is good.

best of luck with everything. and keep your eye on the prize, whatever the prize is for you. and as one of my mentors said, "always have a 2, a 5, and a 10 year plan. be aware that they can change at the drop of a hat, and that this changeabilty is ok. just always have some sort of plan. and be cool with it changing over time."

 

[Joel Fleischman]

geekgirl-
thanks for the the response... some good advice!
more open questions:
how do you guys think a PHder's application should be bent for surgery? ie. how should the CV be bent, how the essay should sound... how bold should I be in saying I am, or want to be, a surgeon scientitst.

 

[Ecthgar]

these are good questions. i am facing many of them as we speak. during interviews for gen surg at the big academic places, i have gotten many different responses to my preexisting PhD.

speaking of welcoming places, all the academic powerhouses have welcomed me with open arms. so pick your geographic location and the big names will be open to you.

here are some research advice/comments:
1. you may want to go straigth through and not do research during your residency
2. you may want to use the 2 years research during residency as a postdoc experience - gain new skills, publish in a new field, combine past and future research interests, connect with a new field, find a new mentor, etc
3. you may want to use the 2 years research to prove fundability - i.e. NRSA grant, etc. this is a tricky topic because the 2 years mid-residency can not be used as foundation for a training or K type grant, since you will not be able to implement the research funding when you're back in the hopsital during your final clinical years.
4. one attending told me, with long hard gazes and much seriousness "someone in your position would be infinitely more fundable and basically welcome anywhere after your residency, but you MUST show fundability during your residency. if you ignore this advice, you do it at your PERIL" yes, he said those words - "at your peril".

so i guess where i stand right now is that likely i will do a year or two or research mid-residency. i have made it clear that i do this for my own career, as a post-doc, rather than to be someone's lab b*tch and get some publications. i HAVE publications, i just need a platform for my own career when i'm done. also, research years are a nice break in an otherwise hectic surgical residency. life years. so many MD/PhD attendings i have polled have used them for personal growth as well.

and finally, i did have some of the smaller or more flexible academic programs momentarily consider making me faculty early and thereby allowing me to implement grants during residency. but this is tricky and requires alot of pre-emptive work and may or may not be feasible.

so, my plan:
1. do research, post-doc, build mentorship and prelim data (and hopefully stay involved in the work even when back for final clinical years). and look at this experience with an eye to return to this lab/PI as my K grant mentor
2. begin to integrate clinical and research goals. i HOPE to want to stay at my residency institution post-fellowship, so that all these connections and projects will be true career foundations.

hope this helps.
if you're interested in general surgery, there are loads of opportunities. and all the big programs will love you for your research background. there is definitely a niche for academic surgeons. i can not speak for the subspecialties.
also, seriously think of finding mentors in your field. i emailed and met with MANY MD/PhD surgeons at my own and various other institutions. and i polled them on how to manage my career and use my time most valuably. they were all willing to give me honest advice. and it has been terrifically valuable. some of them are now chairman and they're recruiting me to their programs. HARD. so all of this stuff is good.

best of luck with everything. and keep your eye on the prize, whatever the prize is for you. and as one of my mentors said, "always have a 2, a 5, and a 10 year plan. be aware that they can change at the drop of a hat, and that this changeabilty is ok. just always have some sort of plan. and be cool with it changing over time."

Wow......awesome post. Thanks for the advice (and keep it coming). I feel better about being a md/phd student who wants to do surgery. Please keep us up to date with how things are going with the match. Best of luck to you.

 

[geekgirl]

geekgirl-
thanks for the the response... some good advice!
more open questions:
how do you guys think a PHder's application should be bent for surgery? ie. how should the CV be bent, how the essay should sound... how bold should I be in saying I am, or want to be, a surgeon scientitst.

i spelled out that career track in both my CV and personal statement. without any mincing of words. that IS my goal - so i don't want a place that doesn't support that.

the only places i got a rejection or weight-list from were columbia and cornell. in those cases i think my HEAVY research focus and my lack of expressing a specific interest in living in NYC led to their responses. i wasn't that interested in their programs, which i guess came across. 'cause i got interviews everywhere else i applied to. ALL the biggies.

my view is that this match process will only work if we're both honest. i don't wanna end up somewhere that doesn't want to train academics. and i'm not selling anything. i am who i am. and i'm just looking for a good fit.

conversly, i AM clear during the interviews that i want good surgical training and to come out with good hands. i have a brain, now i need a strong skill set. so, i do spell that out as well.

 

[AJ2000]

Looking back on it, do you guys think it was necessary for a PhD to prove interest in academic surgery? I am sort of in a bind, trying to decide between enrolling in my institution's MSTP or if I should just do the Howard Hughes fellowship this upcoming year. Some attendings that I have talked to have said that you can prove you are proliferative by taking a year or two off and getting a few papers/presentations, others have suggested that a PhD will train you to become an independent researcher whereas the year off will not. I guess I am trying to weigh the pros/cons of each. I too am interested in staying in academia, but as we all know, training is so god damn long so I'm not sure if I want to commit the extra 3-4 years at this stage of the game.

Any input is much appreciated.

 

[JKP]

Ask yourself how much do I really enjoy doing research? (Hard to do if you haven't done any...) Do I want to do basic science research exclusively? (Then do the PhD). Am I interested more in clinical/translational research? Depends on what you eventually want to do with your career and also your personal interests. It may not be just 3-4 years extra, it could be 5-6 depending on how your project develops and the expectations of your thesis advisor and committee. Some labs may require a certain no. of publications for graduation (May vary even within the same department.) If your hypothesis turns out to be completely false and your project is a wild goose chase you may wind up with a lot of work but difficult to publish negative data (although you will have a thesis and the PhD training). Are you okay with your friends in med school being your attendings/chief residents by the time you are an intern/jr resident? Are you okay with starting your first attending job at the age of 40? You may have some advantages... you have time to date and meet the spouse of your dreams, time to start a family. Time to develop strong connections at your home and surrounding institutions. After 8-10 yrs you will know everyone (!) at your hospital/lab. Opportunity cost: You are forgoing many years of salary. However, if you are considering this path money may not be your primary motivation. Just remember it's not necessarily a race... and life happens (read this post again in ten years and you'll know what I'm talking about). I'm glad I did the PhD and probably would do it again. Try to find good mentors in your field! Good luck and I hope you are able to find your own path to a fulfilling career!

JKP

Looking back on it, do you guys think it was necessary for a PhD to prove interest in academic surgery? I am sort of in a bind, trying to decide between enrolling in my institution's MSTP or if I should just do the Howard Hughes fellowship this upcoming year. Some attendings that I have talked to have said that you can prove you are proliferative by taking a year or two off and getting a few papers/presentations, others have suggested that a PhD will train you to become an independent researcher whereas the year off will not. I guess I am trying to weigh the pros/cons of each. I too am interested in staying in academia, but as we all know, training is so god damn long so I'm not sure if I want to commit the extra 3-4 years at this stage of the game.

Any input is much appreciated.

 

[AJ2000]

JKP, I appreciate your response.

Let me ask this way, from the viewpoint of residency competitiveness, would there be a difference between someone who does a year out and has about 5-6 publications (I already have 4 and will probably get 1-2 from year off), versus someone with a PhD who might have 10-15? I mean, do they really care about how many publications you have after you have established that you are proliferative?

I do agree that for training purposes that a PhD would offer more than a year out could ever offer.

Thanks again.

Ask yourself how much do I really enjoy doing research? (Hard to do if you haven't done any...) Do I want to do basic science research exclusively? (Then do the PhD). Am I interested more in clinical/translational research? Depends on what you eventually want to do with your career and also your personal interests. It may not be just 3-4 years extra, it could be 5-6 depending on how your project develops and the expectations of your thesis advisor and committee. Some labs may require a certain no. of publications for graduation (May vary even within the same department.) If your hypothesis turns out to be completely false and your project is a wild goose chase you may wind up with a lot of work but difficult to publish negative data (although you will have a thesis and the PhD training). Are you okay with your friends in med school being your attendings/chief residents by the time you are an intern/jr resident? Are you okay with starting your first attending job at the age of 40? You may have some advantages... you have time to date and meet the spouse of your dreams, time to start a family. Time to develop strong connections at your home and surrounding institutions. After 8-10 yrs you will know everyone (!) at your hospital/lab. Opportunity cost: You are forgoing many years of salary. However, if you are considering this path money may not be your primary motivation. Just remember it's not necessarily a race... and life happens (read this post again in ten years and you'll know what I'm talking about). I'm glad I did the PhD and probably would do it again. Try to find good mentors in your field! Good luck and I hope you are able to find your own path to a fulfilling career!

JKP

 

[Joel Fleischman]

Interesting question comparing MSTP and Howard Huges et al.
I think the answer goes beyond the numbers game...
Doing HH per se is pretty impressive. It will show that you have the capability to publish. You know how things work in the lab. You are able to apply theory to practice and interpret results. As a PHD student, you will be required to come up with a broader hypothesis that typically must be answered over multiple papers. In my program 3 papers was the gold standard, I got by with two cuz my first was a doozy. Furthermore, a PhD is pedigogically more rigorous. You will need to defend your self and your work in a more rigorous setting. You will need to explain exaclty why you are doing an experiment, EXACTLY what it will prove, and what you can extrapolate from the data.
As a biased oppinion I have seen poorly trained resarchers (MD's and PhD's) make claims based on results that neither refute or confirm their hypothesis.

To put it another way,
at one time, I felt a bit like i was going to get interviews at a programs that without the PHD I would have not even bothered applying. But I realized, that these "high tier" programs are interested in academics...so you have to think of it in terms of who is best prepared to fill that posistion.

however if you have four papers pre-medical school, doing a one year HH and producing a good paper(s) will likely be sufficicent to prove your academic credentials. I take it your probably took some time off between college and med school, so no one will fault you for not wanting to add on more time... particularly if you want to do surgery.

 

[AJ2000]

Joel:

Just to clarify, I did not take time off after college, and the 4 papers I have are from my first two years of medical school - 2 clinical (surgical) papers and 2 basic science papers.

Interesting question comparing MSTP and Howard Huges et al.
I think the answer goes beyond the numbers game...
Doing HH per se is pretty impressive. It will show that you have the capability to publish. You know how things work in the lab. You are able to apply theory to practice and interpret results. As a PHD student, you will be required to come up with a broader hypothesis that typically must be answered over multiple papers. In my program 3 papers was the gold standard, I got by with two cuz my first was a doozy. Furthermore, a PhD is pedigogically more rigorous. You will need to defend your self and your work in a more rigorous setting. You will need to explain exaclty why you are doing an experiment, EXACTLY what it will prove, and what you can extrapolate from the data.
As a biased oppinion I have seen poorly trained resarchers (MD's and PhD's) make claims based on results that neither refute or confirm their hypothesis.

To put it another way,
at one time, I felt a bit like i was going to get interviews at a programs that without the PHD I would have not even bothered applying. But I realized, that these "high tier" programs are interested in academics...so you have to think of it in terms of who is best prepared to fill that posistion.

however if you have four papers pre-medical school, doing a one year HH and producing a good paper(s) will likely be sufficicent to prove your academic credentials. I take it your probably took some time off between college and med school, so no one will fault you for not wanting to add on more time... particularly if you want to do surgery.

 

[Joel Fleischman]

In that case, it definitely sounds like you've got skills .... and it mignt be a great chance to flush them out. Chances are if youre good at this stuff - you probably like it and want to do it 'all the way' One option could be that you could spin one of your published basic science papers into a PhD project that you can expand further. Talk to your research advisors and see what they say.

Joel:

Just to clarify, I did not take time off after college, and the 4 papers I have are from my first two years of medical school - 2 clinical (surgical) papers and 2 basic science papers.

 

[mytirf]

In that case, it definitely sounds like you've got skills .... and it mignt be a great chance to flush them out. Chances are if youre good at this stuff - you probably like it and want to do it 'all the way' One option could be that you could spin one of your published basic science papers into a PhD project that you can expand further. Talk to your research advisors and see what they say.

I agree that is you have already published you might understand the process, but I have to say that the PhD really is geared to more than just publishing papers, BTW 10-15 seems a bit extreme to me. Anyhow, what the goal of the PhD should be is to train one to think. That is to plan, devise and carry out meaningful experiments. I mean really anyone can do clone, purify proteins and even do basic logical experiments, but it really takes some training to determine what the right experiment is to do or identify a scientific problem in the first place. Also I really don't think one can gain these skills in one year. I hate to say it, but everyone that I have encountered who did just one year, even if their were very successfull still don't have that scientific intution that comes from sitting at your bench in year 2,3 or 4 and saying "**** what the hell do I do next??" I think the struggle that comes with completing a PhD is truly invaluable, because it says, "Wow, I can figure this out on my own". Anyhow that is just my opinion, I certainly agree with the other posts, that if you really love science and research then the PhD is for you. Anyway just my two cents

-V