Taking a multi-year gap to start fresh if this cycle doesn't work out?

[whitenights]

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Hey all, MD-PhD re-applicant, currently on my gap year doing full-time research while applying this cycle. Last year, I received no IIs and chalked it up to poor writing, so I spent a great deal of time working on that ahead of this cycle. I sought feedback from my school's pre-health committee, and medical student friends. As of right now, I'm still sitting on 0 IIs and wondering if I just have a critically poor application as a whole for MD-PhD.

I feel that my stats are solid for MD-PhD (519/3.97), good amount of research (over 4,000 hours at the time of submission, primarily neuro wet-lab with some computational research as well), decent productivity (no pubs but many posters) and plenty of activities across clinical/volunteering/tutoring/teaching/hobby domains. No IAs. Being honest, I think my professor's LORs were just okay, but I should have great letters from my PIs. Broader school list this year (mix of MD-only, MSTPs, regular MD-PhD programs across the country and in terms of research funding).

I guess I'm just concerned I won't know what to change for the next time I apply. Assuming this cycle is unsuccessful, I wonder if taking 2-3 more gaps years to "start fresh" be a good idea? My current research isn't entirely related to my undergraduate research (genomics instead of neuro) so I wonder if taking the time to involve myself in this field and get some publications under my belt would be better than just chucking another batch of applications next year, to show adcoms more of a long-term commitment. I would also probably be able to source 2 more letters of recommendation from the physician-scientists I'm currently working with. Thanks!

 

[polymerization]

Something is very off with your profile if you are not receiving interviews. There's nothing to pick at here: you have maxed out on metrics and it appears you have experiences across the major categories.

Can you be more specific about your clinical experiences and nonclinical volunteering? Are you aware of the nuance in defining a "service orientation" activity and have you invested time to pursue those kinds of experiences?

You seem reflective and articulate here, so what do you think was particularly controversial about your writing last time around, and has that changed with this most recent application? If you are expressing yourself like this in essays, I would not expect the problem to be a gross lack of alignment to the question being asked. I'm sure you can make a guess.

This part is just my opinion, but if you feel strongly about MD-PhD, you could consider applying directly to PhD programs and then applying traditional MD afterward. I know part of the draw of MSTP programs is an abridged path to the PhD portion, but if you're going to spend gap years in waiting anyway, a traditional PhD program would be more productive than staying at the level of undergraduate research assistant for x number of years and then getting through a minimum 7-year MD-PhD + at least 3+ years of residency after that.

And mind you, that's assuming you get in after doing all of that research gruntwork. If you don't get in after that, I would assume you would go PhD anyway, in which case, you double down on wasting your time. It isn't truly a "waste" to work in a lab, but if you do not get in, it would not move you closer to your goal.

With your performance, you would probably be fully funded with a stipend at your (reasonable) choice of school, so there really is no downside if the time will pass anyway, you were planning to pursue PhD already, and there is nothing barring you from throwing your hands up halfway through and mastering out if you are not interested in the PhD after all.

It definitely would not be ideal to master out, and it's not as impressive as finishing, but hey, it's better than volunteering in a lab and having to pay for metered parking as a visitor to your own university to run the same projects you would otherwise be running for a modest stipend as a graduate student. It also wouldn't cost you anything you weren't already planning on paying. You were going to do research anyway.

There's a social component to it, too, like people stop asking you "when you're going to be a doctor" after a certain point. Not in a malicious way, but it's a kick in the gut when the honest answer is truly "I don't know," and people around you start collecting adult milestones. At least you would move forward life-wise, which is maybe a presumptuous thing to say, but I really did feel that way. I was very accomplished and had done a lot, and still felt looked down upon by people just trying to make regular conversation.

 

[whitenights]

Something is very off with your profile if you are not receiving interviews. There's nothing to pick at here: you have maxed out on metrics and it appears you have experiences across the major categories.

Can you be more specific about your clinical experiences and nonclinical volunteering? Are you aware of the nuance in defining a "service orientation" activity and have you invested time to pursue those kinds of experiences?

You seem reflective and articulate here, so what do you think was particularly controversial about your writing last time around, and has that changed with this most recent application? If you are expressing yourself like this in essays, I would not expect the problem to be a gross lack of alignment to the question being asked. I'm sure you can make a guess.

This part is just my opinion, but if you feel strongly about MD-PhD, you could consider applying directly to PhD programs and then applying traditional MD afterward. I know part of the draw of MSTP programs is an abridged path to the PhD portion, but if you're going to spend gap years in waiting anyway, a traditional PhD program would be more productive than staying at the level of undergraduate research assistant for x number of years and then getting through a minimum 7-year MD-PhD + at least 3+ years of residency after that.

And mind you, that's assuming you get in after doing all of that research gruntwork. If you don't get in after that I would assume you would go PhD anyway, in which case, you double down on wasting your time. It isn't truly a "waste" to work in a lab, but if you do not get in, it would not move you closer to your goal.

With your performance, you would probably be fully funded with a stipend at your (reasonable) choice of school, so there really is no downside if the time will pass anyway, you were planning to pursue PhD already, and there is nothing barring you from throwing your hands up halfway through and mastering out if you are not interested. Even mastering out would benefit your application, inadvertently.

On top of getting fresh LORs from your major professor and committee/mentors, you could reconnect with the pre-health professions office and maybe be taken a little more seriously as a PhD—you won't be brushed off as casually as an undergrad might be. I think, even if they are totally unhelpful, the proximity can help you at your home program, at least.

Thanks so much for your advice. In terms of clinical activities, I will admit this is likely a weak part of my application as I have 500 hours solely as an EMT, so all of my clinical involvement is condensed in a single activity (although, I've heard this matters less for MD-PhD admissions). For community service, I have about 450 hours split between a local education outreach program (Whether this was teaching/tutoring or community service my pre-health committee advised the latter and I marked it as so) and volunteering at a senior living facility (in a non-clinical manner).

In terms of last application's writing, it was bad. Poor personal statement/why medicine that leaned too heavily on details from experiences rather than what I took away from them, and I don't think I could quite articulate why I needed both the PhD and the MD. I also had much less research experience (especially in leading projects) so that didn't help. Since then, I've had my essays read by my school's writing center and pre-health committee, and overall just feel much more confident in what I wrote.

I hesitate towards going straight into a PhD because PhD admissions are a different beast entirely separate from MD-PhD admissions, and I would likely need another year to prepare for that, get LORs ready, etc, and it would push back my applications a bit more than I would like (given the regular PhD timeline instead of the abridged PhD portion of the MD-PhD). I'm not so sure mastering out would be good either, wouldn't it look poorly on me that I couldn't handle the rigor of a PhD? I'm already being paid for research at a good institution so I'm fortunate for that, and wouldn't mind staying another year or two.

 

[polymerization]

Thanks so much for your advice. In terms of clinical activities, I will admit this is likely a weak part of my application as I have 500 hours solely as an EMT, so all of my clinical involvement is condensed in a single activity (although, I've heard this matters less for MD-PhD admissions). For community service, I have about 450 hours split between a local education outreach program (Whether this was teaching/tutoring or community service my pre-health committee advised the latter and I marked it as so) and volunteering at a senior living facility (in a non-clinical manner).

In terms of last application's writing, it was bad. Poor personal statement/why medicine that leaned too heavily on details from experiences rather than what I took away from them, and I don't think I could quite articulate why I needed both the PhD and the MD. I also had much less research experience (especially in leading projects) so that didn't help. Since then, I've had my essays read by my school's writing center and pre-health committee, and overall just feel much more confident in what I wrote.

I hesitate towards going straight into a PhD because PhD admissions are a different beast entirely separate from MD-PhD admissions, and I would likely need another year to prepare for that, get LORs ready, etc, and it would push back my applications a bit more than I would like (given the regular PhD timeline instead of the abridged PhD portion of the MD-PhD). I'm not so sure mastering out would be good either, wouldn't it look poorly on me that I couldn't handle the rigor of a PhD? I'm already being paid for research at a good institution so I'm fortunate for that, and wouldn't mind staying another year or two.

Hmm... I thought MD-PhD was more forgiving of so-so EC profiles because so much effort gets put into research. And you still went out and got respectable clinical experience beyond what many others in your position would do, especially in sight of just one gap year while also doing research. I could nitpick whether your nonclinical volunteering is the maximally legible flavor of service orientation, but in context it would not make sense to diagnose it as the root cause of a zero-interview cycle.

I guess it could be your writing, if you think it was really that bad, but I'm still skeptical. Would you update everyone as the cycle progresses? If the problem is your writing, I guess you are already testing that theory by having had your writing vetted this time around.

And yes, that's fair. It is not ideal at all in any case. I am operating from a place of minimizing risk while the main bottleneck of your career is sorted out. It's not just that you're waiting and time is passing, it's that the cost of that elapsed time is not obvious while it's happening and there is tremendous downside, i.e., unless you are not in a position where you don't have to worry too much about expenses or even earning a living in the broader sense. But for most of us, what you have to do to be competitive for medicine is usually only worth it if you make it. So I'm trying to optimize for optionality if for whatever reason medical school does not work out while keeping in context that, at some point, you're going to need to be able to have a place to live, a car to drive, and enough latitude to engage in dating and being a 20-something. You can't really do that making $16 an hour, even if you are OK with that arrangement for now.

Of course, hopefully things work out and you won't have to choose. Good luck!

 

[Mr.Smile12]

OP: Welcome to the forums.

It's too bad you just discovered us after a failed application rather than before you started. We have a separate subforum for Physician Scientists where the MD/PhD folks hang out. We keep separate track of applicants there and have a couple of MSTP directors who moderate. We even hold some WAMC critiques there. We track MSTP rejections and interviews.

To that end, we have no clue where you have applied. If you have applied to a mix of MSTP's and MD programs and still have no bites after 2 cycles, something is fundamentally wrong with your assumptions about your profile's competitiveness (it could be your writing, but it could be something else). A publication is not required for MD/PhD consideration as it is often a factor that is outside the applicant's control.

I don't know why you didn't talk with your PI's about possibly applying Ph.D., because some faculty I know can act rather weird about training a lab assistant only to have them go into becoming an MD rather than a PhD. That weirdness can often be detected in the LOR (in other words, "something else").

The posts don't give me a clear reason why you need both degrees to do what you envision as a physician scientist. I am under the impression that only having 500 hours of EMT doesn't show me how that is going to connect the dots with your neurocomputational research, or whatever clinical area you want. (Short answer: I think you need more clinical exposure, especially to know why you must have both degrees to back up your improved statements.)

You don't need an extra year to prepare a Ph.D. application, but you must do your homework on the Ph.D. departments and mentors you want to do research in. You also need to decide whether that research is where your strengths lie vs. patient care/interaction. It's perfectly fine if you wind up in a Ph.D. program if that is what you are happiest doing (we can discuss the post-PhD. challenges later if you are serious about postdocs). But frankly, if you don't think you can handle the rigor of a Ph.D. program, you certainly won't handle the pace of an MD preclinical education. I applied for Ph.D. programs in the fall of my MD and MSTP application cycle, and I chose a Ph.D. program in the spring of the cycle instead of staying on an MD waitlist. No regrets about that, and in retrospect, that was probably a better choice for me to take.

 

[whitenights]

OP: Welcome to the forums.

It's too bad you just discovered us after a failed application rather than before you started. We have a separate subforum for Physician Scientists where the MD/PhD folks hang out. We keep separate track of applicants there and have a couple of MSTP directors who moderate. We even hold some WAMC critiques there. We track MSTP rejections and interviews.

To that end, we have no clue where you have applied. If you have applied to a mix of MSTP's and MD programs and still have no bites after 2 cycles, something is fundamentally wrong with your assumptions about your profile's competitiveness (it could be your writing, but it could be something else). A publication is not required for MD/PhD consideration as it is often a factor that is outside the applicant's control.

I don't know why you didn't talk with your PI's about possibly applying Ph.D., because some faculty I know can act rather weird about training a lab assistant only to have them go into becoming an MD rather than a PhD. That weirdness can often be detected in the LOR (in other words, "something else").

The posts don't give me a clear reason why you need both degrees to do what you envision as a physician scientist. I am under the impression that only having 500 hours of EMT doesn't show me how that is going to connect the dots with your neurocomputational research, or whatever clinical area you want. (Short answer: I think you need more clinical exposure, especially to know why you must have both degrees to back up your improved statements.)

You don't need an extra year to prepare a Ph.D. application, but you must do your homework on the Ph.D. departments and mentors you want to do research in. You also need to decide whether that research is where your strengths lie vs. patient care/interaction. It's perfectly fine if you wind up in a Ph.D. program if that is what you are happiest doing (we can discuss the post-PhD. challenges later if you are serious about postdocs). But frankly, if you don't think you can handle the rigor of a Ph.D. program, you certainly won't handle the pace of an MD preclinical education. I applied for Ph.D. programs in the fall of my MD and MSTP application cycle, and I chose a Ph.D. program in the spring of the cycle instead of staying on an MD waitlist. No regrets about that, and in retrospect, that was probably a better choice for me to take.

Thank you so much for your advice, although I am not entirely new here (mainly lurked around last cycle before I made this account haha). When I was first joining my undergraduate research labs, I didn't shy away from mentioning my MD aspirations (and later, MD-PhD when I began to learn more about those programs), so if they would've had issues with that I feel like I wouldn't have been let into their respective labs. If any underlying weirdness made it into my LORs, I suppose it's ultimately out of my control.

Clinical exposure is definitely something I want to add more of, especially with regards to the fact that all of my experience is in a single role. Given a lot of my research is in neurodegeneration, I wonder if working in a senior living facility, or similar institution, would be a good way to tie together these loose threads. I've volunteered in one such place before, but the role wasn't clinical.

It's funny you mention that regarding PhD admissions, homework is something one of my current labmates stresses very heavily as he prepares for PhD reapplications himself. I suppose my "extra year" claim was made thinking of my current gap year research position, which I hadn't started at the time of applying (but did mention it as a future activity), and which I think I need a bit more time in my role before I can ask for one. I believe a LOR from my current PI would be a substantial boost to PhD admissions in that regard (and obviously MD-PhD applications as well).

Apologies if these thoughts are jumbled, it's a bit early where I am.

 

[whitenights]

Hmm... I thought MD-PhD was more forgiving of so-so EC profiles because so much effort gets put into research. And you still went out and got respectable clinical experience beyond what many others in your position would do, especially in sight of just one gap year while also doing research. I could nitpick whether your nonclinical volunteering is the maximally legible flavor of service orientation, but in context it would not make sense to diagnose it as the root cause of a zero-interview cycle.

I guess it could be your writing, if you think it was really that bad, but I'm still skeptical. Would you update everyone as the cycle progresses? If the problem is your writing, I guess you are already testing that theory by having had your writing vetted this time around.

And yes, that's fair. It is not ideal at all in any case. I am operating from a place of minimizing risk while the main bottleneck of your career is sorted out. It's not just that you're waiting and time is passing, it's that the cost of that elapsed time is not obvious while it's happening and there is tremendous downside, i.e., unless you are not in a position where you don't have to worry too much about expenses or even earning a living in the broader sense. But for most of us, what you have to do to be competitive for medicine is usually only worth it if you make it. So I'm trying to optimize for optionality if for whatever reason medical school does not work out while keeping in context that, at some point, you're going to need to be able to have a place to live, a car to drive, and enough latitude to engage in dating and being a 20-something. You can't really do that making $16 an hour, even if you are OK with that arrangement for now.

Of course, hopefully things work out and you won't have to choose. Good luck!

Thank you! Hopefully things improve throughout the rest of September and October. Of course, pushing back applications by a few years does hurt in terms of trajectory, but I don't feel too rushed, given the rising age of MD-PhD matriculants overall, if that makes sense. I would still be a young applicant even two or three years from now.