wait so if I want a residency in radiology then I should half-ass my PHD and get as many publications in clinical radiology as possible? I'm kind of confused here...everyone I met throughout the application season told me that the PhD will help you get into a top residency, so they say that you should choose a program based on where you want to live or what kind of research you want to do.
Everyone you met throughout the application season is probably full of it. You probably didn't meet a single radiology faculty member and the students you talked to were probably almost entirely first years. The advice I'm giving may not apply to IM (though I often hear that it does nowadays) or pathology, which comprises the vast majority of MD/PhD program faculty members.
The most important factors are what I already commented on above. If you have AOA and a 260 step 1 score with a first author case series from a month of fourth year research, you will likely match to a top radiology program. If you have years of outstanding radiology research (as I did), are middle of your class (as I was), and have a 220 (national average) step 1 score (mine was higher... fortunately), you will absolutely not match anywhere near the top programs. If anything you will have a difficult time matching at all, and probably take a lower to mid tier academic program in the midwest, as community programs won't look at you and competitive locations are too competitive.
I didn't say half-ass your PhD, but I will say get a respectable PhD (i.e. one publication only is fine) within Radiology as quickly as possible with safe projects and move on. It will help to get at least one clinical publication as well if you have time in fourth year. When you go to get a faculty position they will be looking much more at whether they need someone trained in your fellowship area and your fellowship research. At that point what you did in graduate school is pretty much ignored unless it is exceptionally great, bad, or still directly related to what research you're doing at that point (unlikely).
Like should I also choose a program based on whichever has easier requirements for me to complete a PhD (ie. fewer required publications/classes/etc) so that you can get more time to work on clinical publications and stuff?
Yes. Not necessarily so you have more time to work on clinical publications, it's so you can get done the MD/PhD program in 7 years and not spend more time than you have to. Life looks a lot different when you're 30-35 and still in training than it does when you're 20-25.
why is step one score at the top of this list? I'm kind of confused on why its so important, its just one test. Like would you say its more important than the importance of MCAT in the application process?
Step 1 is the major cutoff for most programs. It is on par with the importance of the MCAT, except a few things. First, you're competing with other medical students who are very bright and motivated, instead of a lot of pre-meds who were just screwing around. Second, you can't retake step 1.
As for picking a school for step 1 studying, I think schools without pre-clinical grades are best. I mean even without exams is the absolute best like Yale. That way you can ignore the extraneous nonsense that professors often test on and spend your entire first 2 years focused towards step 1. Also, it's probably good to have 6 weeks or so of dedicated study time like medical students.
I would actually be pretty pissed if say someone with a sky high step 1 and average research, clinical, etc. stole my position just because my step 1 was low...
This is exactly what could happen. If you have a lower than national average step 1 score good luck matching radiology at all as an MD/PhD. This goes back to a blog entry I called the MD/PhD trap. If you are heavy in research, community programs take no interest in you. But the academic programs require a reasonably high step 1 score. A strong research app with a weak step 1 score is a recipe for not matching at all in a specialty like radiology, and I have seen not matching due to this scenario several times in my MD/PhD program. It is also similar to match at a not research heavy (lower tier academic) program if your research is strong but your clinical performance is just ok. Those who make decisions on who to interview and who to rank highest are often 100% clinical people who care about 100% clinical indicators and have no appreciation for basic science research.
Ok so as long as your school is top 20 then its considered just as good as the other top 20's?
Looking at where I and my friends at other schools matched, I don't think school rep matters much at all for residency.
To add to that: if you know what specialty you want to do, by all means do your PhD in that specialty. That is really important to competitive residencies. Otherwise you might find yourself being beaten out by medical students who took a year out and did research in that area. If anyone who has not been through the match recently gives you advice other than what I've given you in this thread, they are incorrect. My program would disagree with me on many of these points (if only in the past), and I think they are absolutely wrong.
