Uncertain: which route gives most options?

[mentoz]

hi everyone .. i'm new here, but before anyone starts redirecting me to past posts, i have done a forum search and learned a lot!

however, i'm wondering if anyone has suggestions for my specific situation .. i know quite a bit of students are trying to decide b/t an MD-only at a school they prefer over an MD/PhD somewhere else, and i am also in that boat (deciding b/t UCSF MD and UCLA MD/PhD) .. although i have wanted to go to UCSF ever since i knew i wanted to go to medical school (which doesn't mean as much as i thought it did considering that i didn't know much about medical schools 6 yrs ago), i would be happy at either school (i also loved UCLA when i went there), but i want to make a decision based on what i ultimately want to do professionally..

my concern is what should i do if i am unsure of what i want to do in the future? if i knew, making a decision would be cake, but since i don't, what is the best route to take that will give me the most options?

someone posted that being in the MD/PhD program gives one more time to consider his/her options, but i'm sure this person has no intention of considering dropping out as an option .. for me specifically, it'd be unsettling if i was in the program and decided that it wasn't right for me and dropped out .. as much as i love research (been doing it consistently for 4 yrs in Ugrad) and would like to develop the scientific habit of the mind, i wouldn't want to abuse the free tuition/stipend anymore than i have ... at the same time, i'd have a problem dropping out for exactly that reason as well ...

if in the end, i decide that i prefer working more with patients than devoting my time to research (i like basic science), then would the PhD have been a waste? or would i have become a better physician because of it (and how much better than someone who just took a year out of medical school to do research)? i guess what i'm trying to say is that if i knew i didn't want a full-time research career, i'd still pursue a research project while in medical school (i just like research, and i feel like i just have this itch in my mind that's only scratched by investigation) ..

another concern is the option of doing surgical residencies .. when interviewing at schools, many programs, though they may have no control over what you want to do, still do not seem to encourage their students to pursue surgical residencies .. the directors at 2 programs showed a great bit of discontent as much as they were proud of their students .. what i don't understand is that research experience seems to be encouraged for surgical subspecialities .. if this is true, then is the reason why MSTPs don't like this is because research experience doesn't mean you need to get a PhD? i just feel that the MD/PhD program may close some doors as it opens others for you .. but i'd like others' opinions ...

i think i wrote too much

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[oasis786]

WOW, same situation and thoughts/feelings, word for word (although there's a third school I'm considering, not just UCSF MD and UCLA MDPhD). Are you my twin?

Anyone want to offer some thoughts for us?

 

[mentoz]

haha twins? if you were a chick and from TX too, then i'll be darned ..

i'm really relieved to have "met" you! has UCLA been calling you every other day as well? they apologized for nagging me, but that doesn't release any pressure ... i'm going back to UCSF on May 1st, but UCLA wants an answer by the 15th and wants me to come back to visit .. i'm thinking about asking for an extension .. my interviewer who keeps in touch with me wants to hear my concerns, but i'm only afraid she'll give me a biased opinion ...

what's your third school? you know, i JUST received an invitation to interview from Stanford a few days ago .. goes to show that i shouldn't have applied so late ..

 

[Neuronix]

There is no easy answer to these questions. For me, if I decide research isn't right for me, I just bail out of the program or just don't do research later on in life. If I decide clinical isn't right for me, I won't do any clinical work.

For me, I feel it's as simple as that. I consider MD/PhD a great way to procrastinate making a decision. If you don't feel comfortable with this, don't do it. I don't think either program opens or closes any doors, just one is alot cheaper than the other.

 

[mentoz]

Originally posted by Neuronix
I consider MD/PhD a great way to procrastinate making a decision.

that's what i need .. do you think starting as an MD and applying later is another good way of delaying a decision (with the risk of not getting in) ..

and this isn't relevant, but .. did you ever go out with any of the MSTP applicants at Penn? when i was there, we went to Coffeehouse on one of its busier nights ... i took hilarious video clips of keith and jon (i don't know if you've seen it, but i heard it was passed around) .. Penn was a BLAST!!!! .. and was my 1st MSTP choice, along with every other MSTP applicant, but got waitlisted ..

 

[coldchemist]

If you're willing to take the risk, it's worth it. I don't think anyone can tell you that but yourself.

Personally, I like a challenge--but if I were faced with your situation I would probably take the safe route and go to LA. Of course, maybe Penn would come through and I would go there.

Hey, I like your life! Wanna trade?

 

[Neuronix]

Originally posted by mentoz
that's what i need .. do you think starting as an MD and applying later is another good way of delaying a decision (with the risk of not getting in) ..

Sure, knowing the risk and the added cost of delaying a year or two, it's also an excellent way to procrastinate making a decision. If you plan to do this, just make sure the school you matriculate into has a good record of taking people into their MD/PhD program from their MD program.

and this isn't relevant, but .. did you ever go out with any of the MSTP applicants at Penn?

I don't know who Keith and Jon are, what years are they? Anyhow, I hosted and went out with the applicants every week. The week you were here I went to the Friday dinner, then went to Monk's/Nodding Head and got blitzed. I hosted Ken that time if you remember him. I think we may have met. Do/Did you go the U of Houston?

It does seem like alot of people really liked Penn as a first choice this year. If you don't mind my asking, what did they tell you about your waitlist status? What tier or any additional information? If you're tier 1, there's still a good chance you could come off the waitlist, especially if you let them know how much you want to come.

Good luck with your decision!

 

[mentoz]

Yes i did go to the UofHouston!!! i'm impressed!

and yeah that friday night i think i used up a little too much of Penn's resources for alcohol, and as a result i do not remember names of places or ppl .. i went to a series of bars/clubs that night .. i remember wanting to find a salsa club, but ended up watching Russians dance to old techno? .. i also somehow ended up with the friends of my host (lost my host somewhere along the way) and managed to stagger back to my host's place at the end of the night...

yep, that night sold me


oh and i was placed on Tier One .. Skip Brass emailed me and told me that he knew that i wanted to go there and to keep in touch with him ... *shrugs* .. i remember that Friday of my interview that he said i was "in", sooo i'm not countin my chickens ..

keith and jon should be 2nd yrs now .. i guess i didn't expect you to know them, but they did put on a great show - a rendition of Tupac's Thug Mansion ... got it right here if u need a good laugh

 

[oasis786]

Originally posted by mentoz
Friday of my interview that he said i was "in",

lol, that's so sketch.

 

[mentoz]

when the director of the program AND the director of admissions both tell you privately that they will be seeing you in August, you'd think it'd be safe to get your hopes up .. but they're great guys and one of the reasons why the program is so awesome..

 

[coldchemist]

Sounds like you had a great time during your interview visit! The students at UAB were equally cool (although I didn't see any of them get tanked). How big is the Penn waitlist anyway (not that it matters since I didn't apply there)?

I had several experiences where faculty told me how impressed they were with me, or that I shouldn't have any trouble getting in. I have yet to receive an acceptance...

 

[Neuronix]

I remember exactly who you are now, as I met you at dinner and you came out to Nodding Head. I still have a list of who visited that week, so I checked out your website (part of your e-mail address) and put your name and face together. Small world. I don't remember who coordinated the bar trip that week, though I do remember we our budget of $40/person that night I've never seen a bill that big before! Still, I don't like the clubs in Philly. They're expensive and crappy. Don't come here for that scene There are some great bars though!

I have nothing against our administrators, but, I'll put it this way, they're alot happier and friendlier when the applicants are around. The students are too. Though on the up-side, it's good to see that our new recruiting tactics are working. This is the first year that we've started taking students out and showing them a good time. It's also the first year we put applicants who request it up into a hotel. We used to do nothing for the applicants, and they used to leave here thinking Philly was a hole and there was nothing to do here.

Quite honestly, Penn has two tiers of waitlist. The tier two waitlist is pretty much a rejection, and while nobody on SDN has been admitting to getting it, I know some applicants who have. If you want, if you tell them you really want to come here in a letter, e-mail, something, it will count for alot. What happens is that they don't even start checking their waitlist until around May 15th. By that time, most applicants are committed somewhere, and so last year they dug deep into their waitlist. My speculation is that this combined with a low retention of the first accepted students scared them a bit and led them to the greater investment in recruiting and the institution of the MD/PhD Early Decision Program here (the first).

That all being said, I would write to them and tell them you're waiting until they make their decision and you will definately come if accepted, but know that this may keep you in limbo until the end of May or even June. If you're alright with that, I'm sure they'd love to hear from you. Penn basically only accepts the number of people they have spots for in their first pass, so spots will DEFINATELY be opening. Showing love for them gets you alot of brownie points.

I'm not sure of their tier 1 vs. tier 2 waitlist breakdown, but the numbers I've heard are that we interview about 100, and we accept about 40 total each year. We only accept around 20 in the first pass and they play games where they favor those off the waitlist who have shown interest... So, I feel like anyone who interviews and gets a tier 1 or better has an excellent chance of coming. The hurdle is just getting the interview and not getting a tier 2 waitlist.

Anyways, good luck!
Eric

 

[mentoz]

Originally posted by coldchemist
Sounds like you had a great time during your interview visit! The students at UAB were equally cool (although I didn't see any of them get tanked). How big is the Penn waitlist anyway (not that it matters since I didn't apply there)?

I had several experiences where faculty told me how impressed they were with me, or that I shouldn't have any trouble getting in. I have yet to receive an acceptance...

you know the coolest MD/PhD students i have ever met (i mean i've met some of the coolest individuals at some programs, but perhaps not the entire group as a whole) was at UCLA .. those guys rocked! there was not one person i couldn't see myself being friends with .. everyone was active, funny, friendly, outgoing ... i knew that if i went there, it would only be good times ..

i didn't get to meet many MD/PhDs at UCSF, but the one that i did meet sort of rubbed me the wrong way ... he asked me if i was going into the MD/PhD program or the regular MD and when i said regular, he blew me off with this "forget you then" attitude ..

the other cats at UCSF were great though .. student diversity/unity is pretty significant to me .. as well as the fun factor .. maybe it's just california, but the students there seem more happy than the students i met elsewhere ... who are you waiting to hear from if you don't mind? maybe we've interviewed at the same places ...

 

[coldchemist]

Mostly mid-to-low tier schools. UAB was the highest ranking of them all. Georgetown, Maryland, BU, Jefferson, UConn, Penn State, and Pittsburgh. Pitt was MD only, though. Considering you were waitlisted at a school as good as Penn, I'm guessing you probably didn't apply to too many of these schools.

Who knows, though...Neuronix applied to Maryland and look where he's going!

 

[mentoz]

i applied to most programs in the top 20 and the others were schools in TX .. i figured that if i ended up at low tier school, i'd rather it be in TX where everything's cheaper!
i pretty much considered all the top tier schools as my reach schools, but turns out they were more receptive to me than i thought they'd be ..

i have heard that Pitt has the happiest students .. did you see that there?

 

[hockebob]

mentoz,

i was going to say that in your particular situation maybe going md-only at a place like UCSF would the best solution... 'cause if you decided that you really wanted to do research later you could always apply for one of the "payback med school tuition" fellowships at NIH, but maybe md/phd wouldn't be so bad (it seems so weird to say that). you definitely wouldn't have to worry about tuition (and get a fat stipend to boot!), so the quality of life might be higher than in an md-only program. also, the residency opportunities may be greater for you coming out of an mstp than "just" an md program (although that isn't necessarily the case... particularly for those surgical residencies you were talking about). although, ultimately, surgery is a research-heavy specialty... i've also found that mstp directors tend to have an ambivalent attitude towards it. i guess i could think of two reasons for this: 1) the type of research involved is, on the whole, more experiential and, thus, less "scientific" in a way (although that is certainly not always the case) and 2) surgery is time-consuming and, perhaps, interferes with the scientist aspect of being a physician scientist. however, when i was interviewing at uw-madison, there was an anesthesiologist there who was doing research on the neurological impact of surgery, so perhaps surgery is just one of those fields that requires real innovation for the application of basic science research (and thus is well-suited for an md/phd).

just my thoughts,
- aaron

ps - i, personally, think you should go to penn if you get off the waitlist (what an opportunity!), not that that probably carries much weight... in any event, congrats!

 

[Neuronix]

Note that the NIH payback fellowships only pay up to $70,000 and may not exist when you're done. With the debtload of greater than $200,000 that many students face, it's helpful, but the route is still very costly.

Originally posted by hockebob
although, ultimately, surgery is a research-heavy specialty... i've also found that mstp directors tend to have an ambivalent attitude towards it.

Anyhow, I think I'll derail the thread and talk about this because I find it interesting. I found that most MSTP directors were more than ambivalent about the idea... They disliked it completely. After I matriculated here, I learned that the reason I was on the waitlist, was told to come back for a second interview, and was such a controversial admit was because I told them I wanted definately to be a surgeon. I would advise anyone applying now not to even bring surgery up, as it will likely hurt your application. At some interviews the mere hint of surgery brought up a protracted discussion about this topic. Many see it as a disturbing trend that more and more MD/PhDs are going away from Peds, Path, and IM, and going for surgical subspecialties or high-paying clinical specialties (derm and rads for example). On the flip side, MD/PhDs are very sought after by academic surgical subspecialty residencies. It's interesting to me that the two PDs are so out of sync.

You hit the nail on the head about why MSTP PDs fear MD/PhDs going into surgery. They don't think enough (any?) surgeons are doing basic science research. They seem to think this about alot of specialties that aren't known for research. The ideal is some IM or Path specialty where you do little clinical work in some really specialized area that you do your research on. Surgery has a reputation of being empirical and too time consuming for research. I'd imagine that it is true that the vast majority of MD/PhDs who do surgery residencies don't end up doing basic science research. Nevertheless, there are some people who do it. I'm getting turned off from the idea though of being an average surgeon who only does one or two procedures so that I can keep up my lab. Even to me now, with surgeon-researcher mentors, the prospects for me doing basic science and doing surgery aren't great. The barriers are high to begin with, they're worse in surgery.

Now, some of the specialties may not be known for research, but are ripe for more clinician-researchers, at least in my mind. Why not ENT? Why not emergency medicine? Etc... Anesthesia is one of those why nots as well. You can do a shift a week and go back to the lab. If there's no complications, you could theoretically sit around and read papers in the down time. Also, some of the surgical subspecialties are better known for research than others--like Ophthomology.

Knowing these things about surgery, why is it that MD/PhDs are so highly prized by the residency programs? There's still plenty of money to do research in surgery. Most force you to take time out to do research, however I hear that you still have alot of clinical duty. Also, I think all residency programs want researchers, unless they're very community-oriented. Research is what brings prestige and revenue to the institution. So what if one residency or career is more research-oriented than another? That's not important from the residency director's perspective. They want the brightest research and medicine oriented residents so their surgery programs look more prestigious by hopefully paying off in productive academic faculty down the road.

Anyhow, I was so set on surgery before, but now I'm not sure what the heck I'm going to do. I'm finding out that I happen to like my free time. I'm a person first, and a doctor second. Strange concept in our society... I guess I'll never win that nobel prize.

 

[oasis786]

That was an awesome post, Eric.

 

[coldchemist]

Originally posted by mentoz
i applied to most programs in the top 20 and the others were schools in TX .. i figured that if i ended up at low tier school, i'd rather it be in TX where everything's cheaper!
i pretty much considered all the top tier schools as my reach schools, but turns out they were more receptive to me than i thought they'd be ..

i have heard that Pitt has the happiest students .. did you see that there?

Oops...forgot to follow up on this thread. The students at Pitt definitely seemed to be happy (remember, this was for MD-only). Everybody I've spoken to, not just med students, absolutely loves the city.

 

[Neuronix]

I know lots of people who don't like Pittsburgh. I guess it's nice if you like suburbia or the country surrounding Pittsburgh. But, as a city, it's pretty blah. I couldn't have seen myself being happy there, which is good since I got the rejection letter postmarked the day after I interviewed

 

[ImmunoANT]

Originally posted by Neuronix
I know lots of people who don't like Pittsburgh. I guess it's nice if you like suburbia or the country surrounding Pittsburgh. But, as a city, it's pretty blah. I couldn't have seen myself being happy there, which is good since I got the rejection letter postmarked the day after I interviewed

hah, that's even better than me. they only offered me MD interview and they did so 1 week before the interview date. What's the point???

 

[coldchemist]

Originally posted by Neuronix
I know lots of people who don't like Pittsburgh. I guess it's nice if you like suburbia or the country surrounding Pittsburgh. But, as a city, it's pretty blah. I couldn't have seen myself being happy there, which is good since I got the rejection letter postmarked the day after I interviewed

Ouch! That sucks...but I think you've been vindicated since then.

 

[Vader]

That is too bad about your interaction with the UCSF MSTP student... I wonder who it is? (I am a student in the program).

If you are uncertain about the MD/PhD route, then I would not go this route. However, I suspect you have quite a bit going for you if you have been admitted to excellent MSTPs like UCLA.

There was at least one student in my med school class that chose UCSF MD over UCLA and other MSTPs. He ultimately chose to do the MD and is taking a year off for research. You might consider this option if you are not sure about doing a full PhD, but may still want to get some research experience during medical school. I know another former student (and now neurosurgical resident) who took a year off for research under a Howard Hughes fellowship and got a Nature cover article a couple of months ago. So it is entirely possibly to go the MD + research route.

I would be happy to answer any questions about UCSF (or UCLA since I went there for undergrad).

 

[mentoz]

Hi guys ..


so it's been over a month .. after more introspection and more information, i'm again at the same place i was over a month ago


i'm very close to choosing UCSF MD b/c of the environment and the people and the daily experience, knowing i'll be in a load of debt and giving up the PhD for less intensive research experience (at this point i'm not sure if i want to go through the application process again) ...

however my friend asked me last night if i wanted to do research in the future .. surely i said yes, but i told my friend i wasn't sure if it would be minimal, half-time, 80%, or full-time b/c it all depends on my clinical experience (i'm betting someone will bring up the correlation b/t really good research and the amt of time spent in the lab) .. the fact that i even said yes prompted him to say that a PhD will always help, even if i'll do minimal research in the future .. this is very true. whether it's worth it to pursue the MD/PhD (which i realize in no way harms anyone unless they are unhappy where they are or they need those 4-5 years for something more important to them, whatever that is) is up to me, i know ... if only i had gotten into UCSF MD/PhD maybe this would be easier since i know i'll be happy in SF for however long and i could merely not do research in the future if i realize that i like something else more .. i guess i am choosing what i think makes me happy pertaining to how i'll be living and learning in the next few years over going for that PhD .. being unlike my MSTP friends who would go anywhere to earn their PhD, placing it over the opportunity to live someplace they'd prefer, makes me feel embarassed that i am not as dedicated ..

i'm amazed at the commitment you guys have made .. especially to 8-10 years of being wherever you are now ... was it ever hard for you?