Take the guaranteed MSTP or try for MD-->MSTP?

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mulletmandan

I can has MSTP?
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I'm currently trying to make a pretty tough decision. I have been accepted to the MD program at WashU and, through some conversations with their MSTP office, I have found out that there is basically a 90% acceptance rate to the MSTP for first year medical students who reapply. I had planned on trying to take that route, but then I was recently informed that I have been accepted to the MSTP at Indiana University.

I know that WashU is an excellent school, but I'm just not sure I want to go through the hassle of paying for the first year of medical school, then reapplying, so I am tempted to take the guaranteed MSTP at IU.

What do you guys think? I really haven't altogether figured out what field I am interested in (though immunology is the most recent area of interest for me), so I don't know that choosing an institution based on a specific area of research would be a good idea at this point. Also, is choosing a place like WashU going to get me significantly better training as a physician scientist?

Essentially, I am asking for you advice on pros/cons of choosing either option. I was convinced a week ago that WashU was the way to go, but now I'm not so sure.

Thanks, everyone!

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If the only variable for you in this is getting in (and it rarely is), I would go to WashU. A LOT of schools do the "first year then apply" thing, and I never hear anyone not get in. Part of the MD/PhD prospect is that you will have made better connections with other fields and scientists than you probably would have as an MD. So the school very much matters.

Go with your gut, but don't let the fear of not getting in stop you from where you know you want to be. You will get in. Just see to it that you give them every reason to accept you (like you did to get into med school :thumbup:)
 
How confident are you that you will do well in med school? I applied to my program after my first year, and my program mentor later made a remark to the effect of "if you hadn't been doing well, you wouldn't have gotten in." That makes for a bit of risk that might be a tad uncomfortable. Also, how far in the hole will you be at WashU? My understanding is that IU is pretty nice program... is it really worth 30k(?) in debt for a shot at WashU? Your residency training and beyond is what will really make you, and I think you can get to most places from IU.

If you do with WashU, make sure you get involved with a lab there this summer, preferably one with a connection to the MSTP... those connections can go a long way.
 
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If it were my decision, I would choose WashU all the way. It's a fantastic school. It sounds like you really had your heart set on it, and that sort of thing is important in my book. If you can see yourself happy there, and there is a 90% chance, then why not? It sounds like you just need to do well in M1, which shouldn't be a problem, right? I agree with the sentiment to do some lab work there this summer. That way you won't be behind other people who do a summer rotation, and it'll cement in their minds that you are comitted to the physician scientist track.

It sounds a bit nerve wracking to not have the 100% guaruntee, but WashU is worth it in my opinion. But if you don't want to deal with the stress of reapplying, then you might as well go the easy way. Either way, good luck!
 
I have been giving this more thought, so I might as well share what I am thinking.

I come from a pretty humble background and am pretty much going to a no-name undergrad. I feel like I enjoy who I am as a person, but I am concerned that the pressure of a rather competitive school is going to turn me into someone that I don't want to become.

I really do feel very strongly about going into the field of medicine, and I want to be the best physician scientist possible, but the transformation I have seen in others put under the stress of these programs worries me that the same thing is going to happen to me. I very much want to keep loving life and being able to enjoy the small things.

That said, do you think I should take a year off?

I'm the kind of person who is very motivated, and a month ago I would have called anyone crazy who suggested taking a year off, but I feel like it would give me a chance to catch my breath before I take the plunge into a lifelong career.

So I guess my next question is this: how could taking a year off potentially be a bad thing? Would I be able to defer my acceptances to next year (I guess this depends on the school)?

I guess I just need to make a few calls to explore that possibility...

Please feel free to let me know at all if you think I'm crazy. I just don't want to end up hating something I love so much right now just because I didn't give it enough thought.
 
I have been giving this more thought, so I might as well share what I am thinking.

I come from a pretty humble background and am pretty much going to a no-name undergrad. I feel like I enjoy who I am as a person, but I am concerned that the pressure of a rather competitive school is going to turn me into someone that I don't want to become.

I really do feel very strongly about going into the field of medicine, and I want to be the best physician scientist possible, but the transformation I have seen in others put under the stress of these programs worries me that the same thing is going to happen to me. I very much want to keep loving life and being able to enjoy the small things.

That said, do you think I should take a year off?

I'm the kind of person who is very motivated, and a month ago I would have called anyone crazy who suggested taking a year off, but I feel like it would give me a chance to catch my breath before I take the plunge into a lifelong career.

So I guess my next question is this: how could taking a year off potentially be a bad thing? Would I be able to defer my acceptances to next year (I guess this depends on the school)?

I guess I just need to make a few calls to explore that possibility...

Please feel free to let me know at all if you think I'm crazy. I just don't want to end up hating something I love so much right now just because I didn't give it enough thought.

Absolutely NOT! Why would you take a year off when you already have acceptances. That's crazy talk! A lot of schools only allow deferment if you're going to be doing volunteering/research/etc. Personally, I would just go to the MSTP at IU. That's just my opinion. Either way I'm sure you'll be fine, but don't take a year off.
 
My usually advice is to go for the sure-thing MSTP, but it IS WashU, so I'm not so sure. I don't know, but I would definitely take that 90% figure with a huge grain of salt.

P.S. NO NO NO to the taking a year off. You don't do that once you're in. Defer if you have reasons for it, but DON'T GIVE UP YOUR ACCEPTANCES!
 
Absolutely NOT! Why would you take a year off when you already have acceptances. That's crazy talk! A lot of schools only allow deferment if you're going to be doing volunteering/research/etc. Personally, I would just go to the MSTP at IU. That's just my opinion. Either way I'm sure you'll be fine, but don't take a year off.
I realize that it sounds crazy to defer for a year if I've already been accepted, but I would in all likelihood work in a lab or as an adjunct at my current undergrad during the year off, so it's not like I would be doing anything that wouldn't be giving me experience in the sciences.

Like I said before, the last thing I want in a 7-8 year program is to get completely burnt out, and I fear that it will happen to me if I don't take some time to develop my life outside of the lab/classroom.

Could I get any opinions on the year off idea from current MD/PhD students?
 
I realize that it sounds crazy to defer for a year if I've already been accepted, but I would in all likelihood work in a lab or as an adjunct at my current undergrad during the year off, so it's not like I would be doing anything that wouldn't be giving me experience in the sciences.

Like I said before, the last thing I want in a 7-8 year program is to get completely burnt out, and I fear that it will happen to me if I don't take some time to develop my life outside of the lab/classroom.

Could I get any opinions on the year off idea from current MD/PhD students?

Don't do it. If you feel like doing this program will make you not love life... you should probably stop now. How this program affects you will depend on your real motivations for doing it and for your intestinal fortitude.

Taking a year off will not solve any problems. Going to the better program will prepare you better for your future career. It will put your foot in the door MORE and in a sense make your life easier. Face it- you've chosen a difficult career path filled with other intelligent, motivated people. It won't be a cakewalk like your "no-name" undergrad experience. But it is doable, and you can develop a "life" while doing it.
 
I think most MD-PhD students end up feeling burnt out near the end of their course.. it's a natural reaction to the tribulations we face. Will a year up front help assuage that? I doubt it. When you're three years into your PhD and all your former classmates are in residency, that year will be a distant memory, no more comforting than summer vacations of yore. Conversely, the sting of time seems to catch up with all of us eventually, and 15+ years from now when you're doing a postdoc post-fellowship you may very well regret it.

I'd try talking to students at different points along the MD-PhD path, if not graduates that are just now making their way into a real job at 40. I've learned a lot from their perspectives, and it's definitely made me more appreciative of my time.
 
I come from a pretty humble background and am pretty much going to a no-name undergrad. I feel like I enjoy who I am as a person, but I am concerned that the pressure of a rather competitive school is going to turn me into someone that I don't want to become.

The whole field is competitive. I don't think going to Indiana or WashU changes that fact. The only way to try to some extent to escape competitiveness is to go to a school without grades or that's P/F. As long as there's grades, there's former pre-meds, there's residency pressure, and... Even then, later in life it'll be pressure for fellowship, pressure to get grants, etc etc etc... It never ends. This is a high hour, high pressure career field. I wouldn't be concerned about where you're doing it--the pressure is the same.

I really do feel very strongly about going into the field of medicine, and I want to be the best physician scientist possible, but the transformation I have seen in others put under the stress of these programs worries me that the same thing is going to happen to me. I very much want to keep loving life and being able to enjoy the small things.

That said, do you think I should take a year off?

Your transformation is going to happen regardless of whether you take a year off now or not. The question is can you really get something accomplished that you want to get accomplished? If you really want to travel the world for a year, a year off isn't bad IMO, of course assuming you can defer and not lose your status. If you're just going to go work in a lab for a year, what's the point? You'll be working in labs plenty in the future.

What people for some reason never talk about is that you can always find time within your program to do outside things if you try hard enough. You can take a leave of absence later as well. Grad school often offers the opportunity to take vacation and have a good time if you push for it. It's all up to you to seize your own personal time and accomplish what you want. In an MD/PhD program you'll actually have the income to do that.

Otherwise, personally I feel that you should take the sure thing if you're serious about academic medicine. As long as there are labs you can see yourself working at at IU, I think you'll get the training and background you need to be successful in whatever you end up doing. I don't think the school prestige amounts to much at all in the long-run, and thus, I would save the $60,000 or whatever your first year is going to cost you.
 
You can always take a year off later. Once you're in a program, it is in their best interest to keep you in and happy, so they will be happy to give you a year off if it will mean that you're coming back. But taking a year off now is probably going to lose you your spots in the programs, which is not something that can be undone. It seems long and daunting now, but like they said, a year off now is only going to exacerbate that problem. I'm also kind of scared right now, and I'm filled with thoughts about how I never did a study abroad and I haven't traveled as much as I'd like and I have never taken a real vacation (stayed here and did research full time over every single undrgrad break I had), etc. But in the long run, this is what I love to do and taking time off is something that I know I will regret before the year is over. I think that you'll find your fellow MSTPers to be much more laid back than the normal MD (correct me if I'm wrong). From what I can tell, people are MUCH less worried about grades in med school, and have much more fun and downtime (less stress about $$$ probably helps a lot). Maybe we're all destined to become cynical bastards, but I don't think an extra year of research beforehand is a proven remedy. But once again, it's just my opinion, and what to I know? :)
 
I think that you'll find your fellow MSTPers to be much more laid back than the normal MD (correct me if I'm wrong). From what I can tell, people are MUCH less worried about grades in med school, and have much more fun and downtime (less stress about $$$ probably helps a lot).

I think the laidbackness of individual MD/PhD students vary widely. I think when you interview you meet a bunch of chipper first years who haven't really been stressed yet and thus seem very happy and laid back. The students you almost always meet, even in your first year of a program, are the upbeat and outgoing and tend to be poorly representative of students in 3rd year and beyond. There are also a lot of students who work very hard but downplay how much effort they put in, in an effort to look more down to earth or laid back than they really are.

I also think that MD/PhDs tend to have more responsibilities (such as taking courses on top of med school or rotation between first and second year etc) which in most cases diminishes their downtime compared to MD students. I don't see why MD/PhDs have any less stress than an MD student. There may be a perceived notion of an easier time obtaining a residency, and thus grades not mattering as much. But there's still plenty of MD students who aren't real concerned about competitive specialties.
 
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I haven't read everyone's responses, but as a long time IU student (undergrad + MBA), I wanted to tell you a bit about the culture at IU, which seems like it could be important to you.

IU, as an institution, is very flexible, very liberal arts, and very open to a student making and finding his/her own path. If you're concerned about not knowing exactly what you want to do, IU's culture is well suited to helping you find it. It's very willing to let you branch out and make your own story. When I was an undergrad here, I got three majors, three minors, and some certificates. Had I gone to Purdue (my other major option) this simply wouldn't have been possible.

Bloomington is a LOVELY town. Indianapolis is a kind of yawn city, though there's plenty of good stuff going on for those who are willing to look. The two areas have fairly different cultures. Depending on your PhD topic, you could be split between the two areas.

I know several people for St. Louis. Dated one, actually. From everything I can tell, St. Louis is not a city I'd like to live in, for various reasons. But I know little about WUSTL.

If you have any questions about Bloomington, Indianapolis, or IU, just post here or PM me.

And don't take a year off. Do, or do not. Maybe take a week or two off, instead ;)
 
Thanks for all the advice!

I'm studying for finals right now, and I think the stress of that is putting undue stress on my decision making skills. I now definitely see that taking a year off is probably not in my best interest.

So, back to my initial question.

I guess the big problem I have right now is that I don't have a specific area of interest on the PhD end of things. I really have enjoyed the research I have done, but I just haven't had enough experience in different labs to know where I would fit best. Because I don't know where I'll eventually end up, it is difficult to choose an institution on the basis of research opportunities alone.

I have looked into the backgrounds of both schools, and I have gotten the impression that I would have more of a variety of areas to choose from at WashU, but I could be totally wrong. I may just have to chat with the IU program directors to see what my options are. Money is kind of a big deal (especially considering that WashU would mean around ~$30,000 in debt, whereas I would be getting a stipend at IU), but I don't want to decide on IU just for that reason.
 
I may just have to chat with the IU program directors to see what my options are.

Remember they're going to do their best to sell their program to you. Can you second look at WashU as well? I gave my opinion, but I want you to make the right decision for yourself. The only way to do that would be to revisit and talk to the admins at both schools I think.

You will certainly have options at both schools. There just may be more options and bigger name labs at WashU. But, there's big name labs even at small schools and there's great training to be had in many a small lab. It always makes the decision that much more complicated, especially when you don't really know what you want to do for PhD.
 
It always makes the decision that much more complicated, especially when you don't really know what you want to do for PhD.

Yeah, no kidding. Thanks for your input on my situation, Neuronix. I'm not entirely concerned about going to a smaller school (I did that for undergrad and things worked out fine for me), but it's more that I realize that having a good PI can really make or break the PhD part of things, and it's tough to make a decision that will affect my life for the next 7-8 years. I'm just going to have to do a final bit of research on both of the schools, and I may talk with a few students with whom I have been in contact at both schools (they are 3-4 year students, so I think they should have a good idea about the program).

If anyone here is an MSTP at either WashU or IU, I'd love your input (either here or via PM).

Thanks again, everyone. This is a really tough decision and I appreciate your opinions.
 
I would go with the guarantee. You don't know how you'll do in your first year classes, or what could happen along the way. You may end up regretting it if you don't get into WashU's MSTP program. Also, you don't know if they'll have the same acceptance rate next year (especially with the increase in applicant numbers). If they can guarantee that they can accept you, why didn't they just accept you without funding the first year?

I would go to IU if I were you. It is an MSTP program, so you can't go wrong.
 
FWIW, I really think that in general-- at least within the realm of medicine-- the schools with MSTPs are all considered within the same tier. There are maybe sub-gradations within that tier, but I think residency program directors realize that MSTP schools are in the upper echelon of medical schools and compare them essentially equal.

Further, I personally think that given a good step 1 and an away rotation where you want to go, what school you went to has no meaning whatsoever. But I would at least say no one is going to question you with "oh so why did you end up going to Indiana." Indiana is a well respected, major academic center. I would not make the deicision based on that worry alone. Other factors are probably more up in the air and personal.
 
You can always take a year off later. Once you're in a program, it is in their best interest to keep you in and happy, so they will be happy to give you a year off if it will mean that you're coming back.

This may be very program dependent and is certainly not as simple as you make it seem. Certainly at my MSTP, no one is going to let you just "take a year off" unless there is an actual reason. Even then, it needs to be either a legitimate personal reason or you need to show good evidence of how what you are doing in the year off is going to improve your training. However, your 4th year can essentially be a year off if you want it to be.

But taking a year off now is probably going to lose you your spots in the programs, which is not something that can be undone.

Not necissarly true at all. I know many friends who, once they were accepted, asked the program director if they could defer. It can't hurt to ask (ie they so no and you show up on day 1), but many of them are actually very open to this if you can show good rational. Further, and this is just my speculation, MSTPs are hurting for money this year and may love to have someone defer and save paying them until thier endowment/funding improves.

I think that you'll find your fellow MSTPers to be much more laid back than the normal MD (correct me if I'm wrong). From what I can tell, people are MUCH less worried about grades in med school, and have much more fun and downtime (less stress about $$$ probably helps a lot).

Sorry I don't mean to seem like I am trying to rip your ideas, but I would have to disagree with this as well. I think MSTP students in every way are just a small sample of medical students as a whole. You have the entire range in one MSTP class from super gunner to way too laid back for their own good, just like in the large MS only class. At least that has been my experience in a fairly large program.
 
This may be very program dependent and is certainly not as simple as you make it seem. Certainly at my MSTP, no one is going to let you just "take a year off" unless there is an actual reason. Even then, it needs to be either a legitimate personal reason or you need to show good evidence of how what you are doing in the year off is going to improve your training. However, your 4th year can essentially be a year off if you want it to be.



Not necissarly true at all. I know many friends who, once they were accepted, asked the program director if they could defer. It can't hurt to ask (ie they so no and you show up on day 1), but many of them are actually very open to this if you can show good rational. Further, and this is just my speculation, MSTPs are hurting for money this year and may love to have someone defer and save paying them until thier endowment/funding improves.



Sorry I don't mean to seem like I am trying to rip your ideas, but I would have to disagree with this as well. I think MSTP students in every way are just a small sample of medical students as a whole. You have the entire range in one MSTP class from super gunner to way too laid back for their own good, just like in the large MS only class. At least that has been my experience in a fairly large program.

Agree on all points. My program requires good rationale for taking off time. You can't just do it because you're tired and want a break. So not all programs are flexible with this. Also, your last point is exactly true - MSTPs have their gunners and their slackers, just like the "regular" med school.
 
Addendum to latest blog entry relevant to this thread.

If desired I could have stayed in my old lab for a year and negotiated a light and fun schedule. I had my own grant, so I was paying for myself. My old PI is rather mad I didn't do this. I'm very glad I did join another lab because I'm learning another part of my field I couldn't learn where I did my PhD.
 
I think that if you're serious about being a physician scientist, then you should go to IU. If you're not completely sure, then go to WashU.

Basically this is a bird in the hand versus two in the bush. Why gamble with your dream when you can achieve it? Unless it's not really your dream, and then gamble away...

I don't really think that paying a year of tuition at WashU and then braving the MSTP reapplication could possibly be worth the risk... I also don't believe that going to WashU will put you in that much better of a position in any case.
 
FWIW, I really think that in general-- at least within the realm of medicine-- the schools with MSTPs are all considered within the same tier. There are maybe sub-gradations within that tier, but I think residency program directors realize that MSTP schools are in the upper echelon of medical schools and compare them essentially equal.

Further, I personally think that given a good step 1 and an away rotation where you want to go, what school you went to has no meaning whatsoever. But I would at least say no one is going to question you with "oh so why did you end up going to Indiana." Indiana is a well respected, major academic center. I would not make the deicision based on that worry alone. Other factors are probably more up in the air and personal.

I couldn't disagree more on these two points. First off, knowing several program directors and having been through this process, I think that it DOES matter, at least somewhat, where you go. We've talked about a "golden ticket" for residency before, but it applies much more so from "top-tier" programs. Everybody knows WashU is a top 5 school. I bet most people don't even know Indiana has an MSTP. It may hard to compare the programs directly in terms of where people go for residency because in general, these two populations of students may have different ambitions. But telling a PD that you went to WashU will impress them for sure. I'm obviously not saying that Indiana MSTP is not impressive, but that Washu is more so.

Secondly, Away rotations are a double edged sword. They can hurt you as well as help you, and should not be used to get your foot in somewhere. This is actually a specialty-specific thing, but in my specialty you will be warned over and over again NOT to do this for that reason. An away rotation should be used to see if you fit in somewhere, not as an audition. And regarding stepI scores... as I hear they are going to do away with a score and go pass/fail on it, making it meaningless (it already is, BTW, since there is no correlation between resident performance and Step I score), which may mean that where you went for school will be that much more important in the future.
 
as I hear they are going to do away with a score and go pass/fail on it, making it meaningless (it already is, BTW, since there is no correlation between resident performance and Step I score), which may mean that where you went for school will be that much more important in the future.

They've been talking about that for a long time with no action. Hard to say if that will ever happen. If anything, now Step II scores are getting more important than when I started and they added the damn cs part. So if anything it just seems to be getting more competitive and burdensome, not the other way around.

Step I score is certainly not meaningless when it comes to getting a residency, at least in Radiology. In fact, that score means a heck of a lot.
 
Step I score is certainly not meaningless when it comes to getting a residency, at least in Radiology. In fact, that score means a heck of a lot.

Definitely true today... I was really thinking about 4 years from now. In most residencies Step scores are critical, but never THE most important thing (maybe 3rd or so). In other residencies (NOT radiology :() it's just an initial screening tool- you need to be above X number.
 
I couldn't disagree more on these two points. First off, knowing several program directors and having been through this process, I think that it DOES matter, at least somewhat, where you go. We've talked about a "golden ticket" for residency before, but it applies much more so from "top-tier" programs. Everybody knows WashU is a top 5 school. I bet most people don't even know Indiana has an MSTP. It may hard to compare the programs directly in terms of where people go for residency because in general, these two populations of students may have different ambitions. But telling a PD that you went to WashU will impress them for sure. I'm obviously not saying that Indiana MSTP is not impressive, but that Washu is more so.

Secondly, Away rotations are a double edged sword. They can hurt you as well as help you, and should not be used to get your foot in somewhere. This is actually a specialty-specific thing, but in my specialty you will be warned over and over again NOT to do this for that reason. An away rotation should be used to see if you fit in somewhere, not as an audition. And regarding stepI scores... as I hear they are going to do away with a score and go pass/fail on it, making it meaningless (it already is, BTW, since there is no correlation between resident performance and Step I score), which may mean that where you went for school will be that much more important in the future.


I suppose what people say and do are different things, but I was basing my thoughts on 1. a few residency directors talks I have heard and 2. on this paper which came out this year:

Green M et al. Selection Criteria for Residency: Results of a
National Program Directors Survey. Academic Medicine, Vol. 84, No. 3 / March 2009.

Their final results synthesized showed:

Category/ Rank of importance to Res Dir/ Significantly Different from ranks

Grades in required clerkships 1 2–14
........................................................................................................................................................................................................
USMLE Step 1 score 2 5–14
........................................................................................................................................................................................................
Grades in senior electives in specialty 3 6–14
........................................................................................................................................................................................................
Number of honors grades 4 6–14
........................................................................................................................................................................................................
USMLE Step 2 score 5 7–14
........................................................................................................................................................................................................
USMLE Step 2 Clinical Skills pass 6 8–14
........................................................................................................................................................................................................
Class rank 7 10–14
........................................................................................................................................................................................................
Membership in Alpha Omega Alpha 8 10–14
........................................................................................................................................................................................................
Medical school reputation 9 11–14
........................................................................................................................................................................................................
Medical school academic awards 10 12–14
........................................................................................................................................................................................................
Grades in other senior electives 11 14
........................................................................................................................................................................................................
Grades in preclinical courses 12 14
........................................................................................................................................................................................................
Published medical school research 13 N/A
........................................................................................................................................................................................................
Research experience while in medical school 14 N/A


I would love to hear thoughts on this data
 
Too bad for us that research experience is at the bottom... ;)

I agree though that name does help, particularly in the academic world. I would bet a nickel that if one did a survey of academically-oriented programs, name and research accomplishments are larger factors for MD/PhD students applying for residency. First because of the types of residencies MD/PhD students tend to apply to. Second because of how residency selection committees asses MD/PhD students (i.e. the expectation is that they will have been productive in their PhD, produced publications, etc). Residency selection committees at the more academically-oriented programs may be slightly more forgiving about clinical grades and other measurements that bear on the clinical side of things. Of course, all these things are still very important, so it's not like one can just dismiss getting good clinical grades, etc. There is no golden ticket.

Unless you happened to have won the Nobel prize, cured cancer, already have 2 RO1 grants, or accomplished something on that level. ;)
 
I suppose what people say and do are different things, but I was basing my thoughts on 1. a few residency directors talks I have heard and 2. on this paper which came out this year:



I would love to hear thoughts on this data

I've seen that list and it is probably true assuming all other factors are the same for all individuals, which is ridiculous. Secondly, those were the only options to choose from.

I'll tell you two things that are more important than step scores for ANY program and was not listed.
1. Are you a douchebag?
2. How much do you want to come here?

If you are a tool on your interview, it doesn't matter if you're AOA with a 280 Step I. There was an MSTP who interviewed here last year from Cornell who really wanted to come here. He was so full of himself no one could stand him. He got blackballed. That's it. I good friend of mine was AOA with a 263 Step I and interviewed at ~20 places for derm. On his third interview he got drunk with the residents and was "inappropriate" with a female resident. That program called all the other programs he was applying to. Guess what happened? He scrambled into Rads, because they didn't know anything about him.
Bottom line, as you get further into the real world and meet real people, your interpersonal skills will make a huge difference- more than probably any other factor. Secondly, if you show enough interest in a program, and know how to brown-nose properly, you can go pretty far. Yes, you will have interviews with many faculty members who will "rank" you, but really it comes down to the PD much of the time, and if they like you, it doesn't matter if you had to re-take the CS.

Why else even have an interview? If it's all based on your rank and grades and scores, why not tell you your rank before you even come to visit the place? Because they want to know if they like you and vice versa, and that trumps any number you can have.
 
I realize that it sounds crazy to defer for a year if I've already been accepted, but I would in all likelihood work in a lab or as an adjunct at my current undergrad during the year off, so it's not like I would be doing anything that wouldn't be giving me experience in the sciences.

Like I said before, the last thing I want in a 7-8 year program is to get completely burnt out, and I fear that it will happen to me if I don't take some time to develop my life outside of the lab/classroom.

Could I get any opinions on the year off idea from current MD/PhD students?

Just wanted to voice a little support for the year off - I deferred a year before starting my MSTP, and now that I'm graduating I can say it was one of the best decisions I ever made. I moved to a fun city on the west coast, worked in an interesting but laid back lab and got my head screwed on after some low grade college burnout. Definitely helped me stay motivated in MS1 and 2, since by the end of my year off I knew I wanted to have a real academic career. Find a prospective lab likely to take you for a year and then get a feeling for how your potential program director would react. Mine didn't blink, just made me promise not to reapply to other programs. Life is short, and you don't get too many breaks.

FWIW: As far as Wash U vs. IU, I'd look at it this way. You have an extra year to prove your commitment to research and go to the better known program. I have a hard time believing that IU MSTPs are that much more laid back- med school and grad school can be extremely stressful no matter where you are. imho, at this stage, you should be keeping as many doors open as possibly.

good luck!
 
I've seen that list and it is probably true assuming all other factors are the same for all individuals, which is ridiculous. Secondly, those were the only options to choose from.

I'll tell you two things that are more important than step scores for ANY program and was not listed.
1. Are you a douchebag?
2. How much do you want to come here?

If you are a tool on your interview, it doesn't matter if you're AOA with a 280 Step I. There was an MSTP who interviewed here last year from Cornell who really wanted to come here. He was so full of himself no one could stand him. He got blackballed. That's it. I good friend of mine was AOA with a 263 Step I and interviewed at ~20 places for derm. On his third interview he got drunk with the residents and was "inappropriate" with a female resident. That program called all the other programs he was applying to. Guess what happened? He scrambled into Rads, because they didn't know anything about him.
Bottom line, as you get further into the real world and meet real people, your interpersonal skills will make a huge difference- more than probably any other factor. Secondly, if you show enough interest in a program, and know how to brown-nose properly, you can go pretty far. Yes, you will have interviews with many faculty members who will "rank" you, but really it comes down to the PD much of the time, and if they like you, it doesn't matter if you had to re-take the CS.

Why else even have an interview? If it's all based on your rank and grades and scores, why not tell you your rank before you even come to visit the place? Because they want to know if they like you and vice versa, and that trumps any number you can have.


I totally agree with you. Moreover, my impression is that the further along you go in medicine, the more important knowing someone big in the field who can write you a letter/ make a phone call begins to trump anything else. That is why I am thinking an away rotation could be such a big factor-- that you have a chance to make a personal connection with the people who are actually going to be reviewing your app-- which as you said is more important than the more traditional "objective" measures alone.

Anyway, regardless of whether or not an away rotation helps more than hurts or vice-versa, my impression and gut feeling is that for residency and especially fellowship, working with big names in the field or working with people who have friends at whatever program you want to go shoots to at or near the top of that list published in the study.

Obviously that study was only asking about the more objective factors, of which I would argue medical school reputation is one. I recognize the argument that med school rep correlates with big name people and therefore negates my first argument; but as a factor in and of itself I do feel that its importance is appropriately weighted in that survey. If you knew you wanted to go into Rad-Onc as a third year at Indian U, you could spend time doing an away rotation at MD Anderson and end up with an LOR from someone there. Do you disagree with this approach?
 
That is why I am thinking an away rotation could be such a big factor-- that you have a chance to make a personal connection with the people who are actually going to be reviewing your app-- which as you said is more important than the more traditional "objective" measures alone.

Anyway, regardless of whether or not an away rotation helps more than hurts or vice-versa, my impression and gut feeling is that for residency and especially fellowship, working with big names in the field or working with people who have friends at whatever program you want to go shoots to at or near the top of that list published in the study.

Obviously that study was only asking about the more objective factors, of which I would argue medical school reputation is one. I recognize the argument that med school rep correlates with big name people and therefore negates my first argument; but as a factor in and of itself I do feel that its importance is appropriately weighted in that survey. If you knew you wanted to go into Rad-Onc as a third year at Indian U, you could spend time doing an away rotation at MD Anderson and end up with an LOR from someone there. Do you disagree with this approach?

My PI was a mentor to the PD at Cornell- you'd be crazy to think it didn't make a difference- So I totally agree with you there.

About away electives- in some fields you really have to do them, and Rad-Onc is one of those fields. Some programs, I'm told, will only consider applicants who did a rotation there. This is due, in part, to the fact that programs will only take 1-2 residents per year, and it is so competitive that all applicants are probably outstanding on paper. In the end, they decide who they take based on who the like the most, and that's basically it. I have several friends finishing Rad onc residency right now, and they all told me the same thing. Other fields are totally different. In medicine, peds, or path, away electives are unnecessary. In path, where you do things very differently than in the other clinical services, away electives can definitely hurt you. You are not there to learn- you are there to show off.

Also don't forget that this was a survey, and there is always a difference between what people do and what they say or think they do. Recruiting from a top-notch place makes the programs look better, regardless of the quality of the resident, because they can draw residents from top-notch places. Sound weird and circular in reasoning? Don't discount it.
 
Thank you all so much for your advice. Seriously, this has been really helpful.

I am really leaning toward WashU at this point. I feel like I would be happy there even if I didn't make it into the MSTP.

Back to the question of deferring for a year. I contacted the program director and he mentioned that they have had a few people defer their MD acceptance to do research and reapply to the MSTP.

Here's why I am considering it:
-If I took a year off, I could gain experience in the lab while simultaneously having some time to develop and define myself outside of academia.
-If I did get into the MSTP, I wouldn't have to fork over the cash for the first year of medical school.
-A year of working in a lab would really confirm to me that research is the way I want to spend my life. Granted, my past experience in the lab has already somewhat told me this, but it would still be reassuring.

I don't know. Would the cons outweigh the pros? Would a year off cause me to significantly lose my pace?

If you would recommend the year off, where should I look for a year-long research job? Spacedman, where did you look?
 
Just wanted to put in another vote for taking the sure thing (IU) over the never-may-be (Wash U). When I say that, I am assuming you're sure that you want both degrees. But like someone else already said, the main reason it might make more sense to pick Wash U is if you're still not totally sure that you want to do MD/PhD. The year of MD-only will buy you a little time to think it over some more.

As for taking the year off, I don't think it matters much one way or the other. You're basically asking if you should take a year off to do research before you spend another 3-4 years doing research sandwiched between four years of medical school. If you're looking to have more time to spend doing research, why don't you just go to med school now and then do a research fellowship when you get out? The pay would be a heck of a lot better.
 
If you would recommend the year off, where should I look for a year-long research job? Spacedman, where did you look?

if there's something you have a serious interest in learning about, look for labs in that field. after identifying labs, i'd write to find out if they can accommodate a tech. answering ads was much lower yield for me - i wrote to labs doing clinical psych/pharm in the SF bay area, south america, canada, UK, and israel. i ended up in SF, my apt was a block from the pacific, and i even (accidentally, almost) got a high impact pub out of it. a bit painful moving back to the east coast after a year like that, but it was totally worth it.
 
I contacted the program director and he mentioned that they have had a few people defer their MD acceptance to do research and reapply to the MSTP.

Does this mean you're guaranteed a spot in the med school a year later, even if you don't get into the MSTP? If that's the case, taking a year off doesn't sound like a bad idea, especially if you can get away with not paying for first year (and make some money in the meantime).

Also, I'm assuming the people who deferred in the past to do research were successful MSTP applicants, and weren't at a disadvantage compared to students who went through the first year and applied internally, right?

My one concern is how much time you'll really have to develop and define yourself outside the lab. Even if you don't wind up in a particularly hardcore lab (no 80 hr weeks), you'll probably want to have an impressive body of work to justify your year off when you re-apply to the MSTP, which may add more pressure. I don't know if this will help with the whole trying not to get burnt out thing.

In terms of finding a job, I know NIH has a Year-Off Training Program specifically for Grad/Med students (http://www.training.nih.gov/student/pre-irta/previewinterim.asp). Not sure if this is what you were looking for, but congrats on your acceptances and GL w/ your decisions!
 
Does this mean you're guaranteed a spot in the med school a year later, even if you don't get into the MSTP?

Yes.

This is why I wasn't entirely sure why someone said "don't give up your acceptances" earlier. Granted, I would have to commit to WashU, but if I'm planning on doing that anyway, I don't see any harm in deferring (unless, of course, I was unable to get a solid lab position, which could be a concern).

The program administrator at WashU said that a year-long research experience should strengthen an application, which I'm sure means that it will as long as I work hard and get a good LOR.

I can see where you're coming from when you express doubt that a research experience would help with the burnout, but I feel like it would at the very least be something different outside of the classroom, and my past summer lab experiences have been a blast despite the fact that I was trying to work hard to build my app.
 
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