Thoughts on future

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

ParabolaMDPHd

Full Member
10+ Year Member
Joined
Feb 14, 2009
Messages
16
Reaction score
0
Long time viewer, just registered however. Going into an MD/PhD program next year although not positive where but I was curious to hear some ideas on specialities for a career. I know that as a matriculating student, I have very little experience and therefore very little knowledge about the specialities, but i was wondering if you guys/gals had any ideas about what you want to get into? If so, Id like to hear why and especially how condusive research is with it? Right now I like Heme/Onc, Rad/Onc or cardio, but that is me talking directly out of my ass.
 
Long time viewer, just registered however. Going into an MD/PhD program next year although not positive where but I was curious to hear some ideas on specialities for a career. I know that as a matriculating student, I have very little experience and therefore very little knowledge about the specialities, but i was wondering if you guys/gals had any ideas about what you want to get into? If so, Id like to hear why and especially how condusive research is with it? Right now I like Heme/Onc, Rad/Onc or cardio, but that is me talking directly out of my ass.

If you are interested in continuing with a strong research-track career, then your best bets are:

Pathology (best IMHO for organizing your clinical time as you want, access to patient samples, lifestyle)
Medicine (best for pre-designed career pathways- i.e., PSTP programs, great for subspecialization if you know what field your interest lies)
Peds (similar to above)

If you are burned out and want to land a sweet, high-paying gig under the pretext of doing research because you are burned out on science and never really want to do it seriously again*:

Rads
Derm
Rad Onc
Any surgical specialty

* That's not to say you CAN'T do research- of course you can. But from personal experience you probably won't.
 
Psychiatry:

1. Encompasses some of the most interesting research questions.

2. As my MD colleagues told me upon graduation from medical school, "Good! There's a lot that needs to be researched there!" Though it was meant as a joke, it's true.

3. Easier to balance clinical and research careers.

4. Residency can be quite rigorous depending on where you go, but overall not as intense as surgical specialties or IM.

5. It's so much more enjoyable! (Okay, that's completely biased...)
 
Thanks for the reply guys. Its always good to hear what others are doing or have done. I feel that as much research as one can do, or whatever interests they feel they have, its impossible to really know until they're in the clinics and the labs, so its good to hear from people who went/ are going through it
 
* That's not to say you CAN'T do research- of course you can. But from personal experience you probably won't.

In my not so humble opinion...

From my own personal experience I've seen a bunch of people in the "research" specialties you listed who also didn't go off and do research. I've argued about this before, and I've made the same conclusion every time. Put up data that says some specialties are better than others at producing researchers or I don't think it's right to make comments like this. I've talked to people on all sides of the fence, research, clinical, ROAD specialties, the big 3 MD/PhD specialties, and it comes down to, it's all a matter of perspective and how someone sets up their own career. To say one specialty is "better" really irks me.

I've repeatedly heard my share of IM docs and Pathologists say "I wish I hadn't gone into such a CROWDED field". I've also heard twice now from IM docs "Radiology is a good field. I wish it was easier to cover my salary on my clinical work so I'd have more time for research." Another issue that keeps coming up is that many IM and Peds subspecialists scoff at their career prospects in the clinical world--i.e. with my fellowship I would make the same money doing clinical and work just as hard in Heme-Onc or Onc or Rheum or whatever. So why not stay in research?

It's good to have options. Unfortunately for the goal of producing researchers, the Radiologist or the Dermatologist might see that the 100% clinical world offers much more pay, much less stress, more vacation, etc etc etc versus the 100% research world. When you've been training beyond undergrad for 15 years and have a family, these things might just appeal to you. In the word of every PhD Radiology faculty I know "You'd have to be crazy to have a majority research career as a Radiologist". Does that mean if you're interested in Radiology/Radiology research you shouldn't pick Radiology because you'll have OPTIONS down the line? I don't think so. You might just find that making half the money for far more work while fighting to get grants well into your 40s doesn't appeal to you.

Now don't shoot the messenger. This is simply reality for any junior faculty. I think you should pick whatever specialty interests you and take the options you have available, which includes research in any specialty. If the clinical work happens to appeal to you more when you get there, there's nothing wrong with that. It may not what your MSTP director intended, but it's your life.

The funny thing is too that when it comes to Medicine, it then becomes a fellowship choice as well. All of a sudden GI and Cards are the ones that aren't "good" for research (for those of you who don't know, those are the two best paying specialties in IM). Hmmm, is it also because there's a good clinical gig down the line for those as well? Should we just not do research on those either? This is all sillyness IMO. In Pathology it's the AP is better than CP for research... I just keep hearing this stuff over and over again, and it just depends who you talk to and what they think. Since traditionally the big MD/PhD specialties are IM, Peds, and Path, their voice tends to be the loudest. The Path MSTP directors seem to pitch Path, the IM MSTP directors seem to pitch IM, but there's a bigger world out there I think everyone should strongly consider, and that doesn't just mean throwing in Psych and Neuro, but everything.

i was wondering if you guys/gals had any ideas about what you want to get into? If so, Id like to hear why and especially how condusive research is with it? Right now I like Heme/Onc, Rad/Onc or cardio, but that is me talking directly out of my ass.

Full disclosure: Assuming I match into it, I'm going into Rads. All MD/PhDs applying for something this competitive need to apply to a backup on the side, which typically ends up being IM or Path. What irks me is you never know who failed to match into their specialty of choice because match lists never show that sort of thing. Fail to match into anything becomes "post-doc". Fortunately I *THINK* this is rare. But it's something to be considered.

How condusive is it to research? I dunno. It's a hard question to answer. I got my PhD in a Radiology department, and there are many around the country doing such research. There's a lot of research residencies, including a national application pathway (Holman pathway). So the research obviously exists.
 
Last edited:
Long time viewer, just registered however. Going into an MD/PhD program next year although not positive where but I was curious to hear some ideas on specialities for a career. I know that as a matriculating student, I have very little experience and therefore very little knowledge about the specialities, but i was wondering if you guys/gals had any ideas about what you want to get into? If so, Id like to hear why and especially how condusive research is with it? Right now I like Heme/Onc, Rad/Onc or cardio, but that is me talking directly out of my ass.

I again agree completely with Neuronix.

What you'll find is that this is a situation where there are a million options and every individual seems to think that his/her's is best. The reality is that you have to think about your own career goals, what specialty you want to do, and how best to carve out the pathway that will be best for you and those around you.

For choosing a clinical specialty, you should go into each of your rotations with an open mind and put on the hat that each specialty wears. Take clinical electives in things you are interested in, and those you think you will never do again. The choice of clinical specialty, if you intend on having at least part of your career be in the clinical world, should probably be based on how much you see yourself doing what a person in that area actually does. This often means looking at what your attendings do (for models of academic careers, at least). Be sure to observe how they spend their time. How they balance clinical, research, teaching, administrative activities. Also, think about if you like the types of patient you see (or don't see, in the case of path, rads). Having mentors is also important, particularly in your clinical area of interest. Talk to lots of people and take each opinion with a grain of salt. Ultimately, it is your decision.

Hope this helps and good luck in your MD/PhD program! 😀
 
In my not so humble opinion...

To say one specialty is "better" really irks me.

Dude, is there anything that doesn't irk you???

As I said, research CAN be done in any field. I never disagreed with anything you said for the most part. But to say that all fields are equal in pursuing research, especially during residency, is asinine.
Many IM programs have a built-in research curriculum that A)short-tracks residency B)gives you guaranteed fellowship and stipend C) funding for projects and essentially fast-tracks you to junior faculty and start-up lab funding. Path residency gives you TONS of opportunities for research. From first hand experience every interesting case can be a case report, and a large proportion of the faculty run labs and are begging for your help on projects. You can do them concurrently during residency. You have more time and resources, plus support. There are also a few fast-track programs. If you do AP or CP only you have 1 or 1.5 years of research time built in. You can easily get a job in any department FOR YOUR RESEARCH and be given minimal or non-important clinical work to to justify your existence.
If you are in a surgical specialty you have to stop your residency to do research or be in fellowship. You will not have the kind of support you would in those other fields You will later get job, for the most part, in SPITE of your research, because you will be expected to be in the OR X amount of time per week to justify your expensive salary. Just look at the number of MSTPs and research faculty at your institution on the medicine and path departments and compare them to the numbers in the other departments.
Of course there are exceptions to everything. Of course you will see MSTPs who quit research in medicine and path. But there are significantly more of them there for a reason, and it's not all because of hearsay.
 
In general I agree with GBW that some fields are better than others for basic research, but getting research done during pathology residency, at least where I am, does not happen. Yes, you can do case reports and crappy immunostaining projects, but that is not going to get you a K08 or a research-based job. You have to take additional time (read: postdoc or research fellowship) if you want to get a research-based job, as in any field.
 
In general I agree with GBW that some fields are better than others for basic research, but getting research done during pathology residency, at least where I am, does not happen. Yes, you can do case reports and crappy immunostaining projects, but that is not going to get you a K08 or a research-based job. You have to take additional time (read: postdoc or research fellowship) if you want to get a research-based job, as in any field.

Unless, of course, you are AP or CP only, in which case you have tons of time for research. Most research-oreineted folks will go this route.
 
Rad-Onc or path is the way to go and I would have done either in a second if I was even remotely interested in them from a clinical standpoint. Don't be foolish enough to fall in love with a specialty like IM where you work like a dog and get paid like crap as well.
 
Rad-Onc or path is the way to go and I would have done either in a second if I was even remotely interested in them from a clinical standpoint. Don't be foolish enough to fall in love with a specialty like IM where you work like a dog and get paid like crap as well.

After IM residency, what subspecialty areas would be more conducive to research? I would think endocrinology or infectious disease might be, but I'm not in IM. I can say clinically, the ID fellows look overworked where I am, but I'm not sure if they get a chunk of time off for research whereas the endocrine fellows may have the clinical work stretched over the fellowship.
 
Top