Undergrad Question RE: choosing specialties

[Y88]

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I'm not sure if this question has been addressed before, but in general do MD/PhD applicants have a better idea of exactly what specialty they will go into? I hear a lot that medical students don't really know what specialty they will choose until they go through rotations and whatnot (experiences after they actually get into med school). Does this case hold true for MSTP students too?

Since prospective MSTP students have a lot of research experience as undergrads, I assume they have a pretty good idea of what field they want to do research in (or am I wrong about that?) before they undergo the program. When interviewing and suppose the students have to explain why they decided on the MSTP route, do they usually speak of a particular research field that they area interested in? It would just seem odd to me if an interviewer asked a student the 'why' question, and the student replied with, 'I just love biomedical research in general.' However, I can see MD applicants saying 'I just love helping people in general.'

Can anyone speak from personal experience? I just want to get a general idea of how MSTP students differ from MD's when it comes to choosing specialties.

 

[mudphudwannabe]

I think it depends on the person - I think a fair number of MD/PhD applicants either don't know exactly what type of research they would like to do, or end up doing something different than they set out to do when grad school rolls around. On the other hand, many people at least have a general idea of what they would like to do coming in, but probably only a few really know exactly what research they want to do when they apply.

Using myself as an example - my undergrad research consisted of fairly run-of-the-mill cancer biology -- 100% bench work. But, I am now doing 100% computational biology in grad school. I fully intended to make the "switch" to computational work when I applied to MD/PhD programs, but I didn't really know exactly what I wanted to do as far as what biological problems I wanted to address, what computational tools I wanted to learn, etc.

Now, for the sake of interviews, you will probably be asked about both your previous research, and your future directions. I think it's totally ok to say "I'm not sure" when asked about what you'd like to do for your PhD research, but you should definitely follow that up with a couple of possibilities you'd like to explore. Being too vague or wishy-washy might come off as not being truly committed to research. You might be asked why you don't want to continue in your current area of research - you should probably think about some non-offensive, positive way to say that (especially if your interviewer is connected with that field of research).

 

[Brunette1981]

I think most people don't know exactly what sort of research they want to do as grad students beginning in undergrad. And doubly so for clinical medicine, since at least you've done research before.

I did a particular technique as an undergrad (chemical synthesis) and continued it in grad school but on a different disease and I expanded to do more biology. So, you may have a general idea of what physical activities in lab (running gels, protein prep, animal work, chemistry, etc) appeal to you and select a lab (and thereby a problem to approach) in that way. I imagine that is common.

Is the question how to answer what you want to go into or if you will change your mind about what clinical speciality you want to pursue?

If it's the latter, as far as deciding on a clinical field, I think you have to do it to know if you want to go into it. MSTPs tend to exert some pressure on students to enter more traditional fields (IM, Peds, Path) but people go into all sorts of things and not everyone continues to be heavily research involved. Mostly the decision comes from finding a good fit when you do a clinical rotation, which you confirm with subsequent rotations. Possibly MSTP students give more thought to selecting a speciality that could include research but the trends in match results seem to suggest the "desirable" fields for MSTPs are pretty similar to straight-MDs. Partially, this is because these fields tend to offer better lifestyles and money (although this is less true in academics) and partially it's hard to remain immune from the prestige factor of what the straight-MDs want (eg, it's really fun to say that you matched in derm...) Personally, I am planning to dual apply in IM (cards-bound, hopefully) and anesthesiology because I like a mix of procedures and clinical time and I like pharmacology/drug design. But everyone tells me I'm nuts.

If it's the former, I think it's ok to say you don't know and I wouldn't outright lie, but I wouldn't announce to interviewers you have always wanted to do surgery or obgyn. It's not looked upon favorably. And (see above) as an undergrad with no clinical experience, you don't really know what you are talking about anyway IMO.

 

[Y88]

I think most people don't know exactly what sort of research they want to do as grad students beginning in undergrad. And doubly so for clinical medicine, since at least you've done research before.

I did a particular technique as an undergrad (chemical synthesis) and continued it in grad school but on a different disease and I expanded to do more biology. So, you may have a general idea of what physical activities in lab (running gels, protein prep, animal work, chemistry, etc) appeal to you and select a lab (and thereby a problem to approach) in that way. I imagine that is common.

Is the question how to answer what you want to go into or if you will change your mind about what clinical speciality you want to pursue?

If it's the latter, as far as deciding on a clinical field, I think you have to do it to know if you want to go into it. MSTPs tend to exert some pressure on students to enter more traditional fields (IM, Peds, Path) but people go into all sorts of things and not everyone continues to be heavily research involved. Mostly the decision comes from finding a good fit when you do a clinical rotation, which you confirm with subsequent rotations. Possibly MSTP students give more thought to selecting a speciality that could include research but the trends in match results seem to suggest the "desirable" fields for MSTPs are pretty similar to straight-MDs. Partially, this is because these fields tend to offer better lifestyles and money (although this is less true in academics) and partially it's hard to remain immune from the prestige factor of what the straight-MDs want (eg, it's really fun to say that you matched in derm...) Personally, I am planning to dual apply in IM (cards-bound, hopefully) and anesthesiology because I like a mix of procedures and clinical time and I like pharmacology/drug design. But everyone tells me I'm nuts.

If it's the former, I think it's ok to say you don't know and I wouldn't outright lie, but I wouldn't announce to interviewers you have always wanted to do surgery or obgyn. It's not looked upon favorably. And (see above) as an undergrad with no clinical experience, you don't really know what you are talking about anyway IMO.

Right, so the last paragraph you stated was what I was trying to get at. It's pretty much impossible for pre-med students to know what clinical specialty they want to go into. It's not possible for them to have enough experience to choose that specialty before even getting into med-school. However, MSTP students, with their research experience, have at least a better idea of what research entails and thus are able to decide easier what they plan to do. Is there logic in what I just stated?

When being interviewed, if you are asked how you will tie the PhD to MD aspect of your career is it assumed that you are going to do research in the field you specialize in (clinically)? What I'm wondering is, if you don't do research in the area you specialize in clinically, what is the point of the dual degree? Shouldn't the purpose of the dual degree be to integrate the skills learned from each degree into one field? Am I missing something here? I'm just trying to figure out whether the mindset of MSTP students is different than traditional MD's when it comes to choosing specialties.

 

[Y88]

I think it depends on the person - I think a fair number of MD/PhD applicants either don't know exactly what type of research they would like to do, or end up doing something different than they set out to do when grad school rolls around. On the other hand, many people at least have a general idea of what they would like to do coming in, but probably only a few really know exactly what research they want to do when they apply.

Using myself as an example - my undergrad research consisted of fairly run-of-the-mill cancer biology -- 100% bench work. But, I am now doing 100% computational biology in grad school. I fully intended to make the "switch" to computational work when I applied to MD/PhD programs, but I didn't really know exactly what I wanted to do as far as what biological problems I wanted to address, what computational tools I wanted to learn, etc.

Now, for the sake of interviews, you will probably be asked about both your previous research, and your future directions. I think it's totally ok to say "I'm not sure" when asked about what you'd like to do for your PhD research, but you should definitely follow that up with a couple of possibilities you'd like to explore. Being too vague or wishy-washy might come off as not being truly committed to research. You might be asked why you don't want to continue in your current area of research - you should probably think about some non-offensive, positive way to say that (especially if your interviewer is connected with that field of research).

From what you've said about switching research focuses, I then assume that most if not all MSTP students decide to obtain the PhD portion of the dual degree because they like research in general. What if someone really loves doing research not just in a particular field, but also the way the research is done in that field? For example, I talked with an MD/PhD in psychiatry (he's doing fMRI studies on depressed adolescents) and he said that he could never go into molecular biology research whether it had to do with cancer or other diseases because of how boring molecular biology research was in general. Thus, he had a good idea of what specialty he wanted to go into before even experiencing medical school and ended up doing what he planned to do.

Take traditional PhD's as another example. I'm pretty sure most applicants know what field they want to go into and therefore apply to the program of interest to them. Say one student loves neuroscience and decides to obtain his PhD in that field. I don't think a student would love neuroscience and then decide to obtain a PhD in say, chemistry. However, it seems to me that MSTP applicants don't have a passion for a particular area of research yet decide to obtain their PhD's and may end up doing research in a completely different area than in their undergrad years.

I guess a better question to ask you guys is: do you feel that your reasons for obtaining PhD's were really justified? Is it false logic to compare the reasons a PhD applicant gives to the ones an MD/PhD applicant gives (like comparing apples to oranges)?

 

[Neuronix]

For example, I talked with an MD/PhD in psychiatry (he's doing fMRI studies on depressed adolescents) and he said that he could never go into molecular biology research whether it had to do with cancer or other diseases because of how boring molecular biology research was in general. Thus, he had a good idea of what specialty he wanted to go into before even experiencing medical school and ended up doing what he planned to do.

So he could have gone into Radiology or Neurology as well. The problem with picking a specialty is there's tremendous overlap between the specialties. Maybe you like doing research on depressed teens but you don't like chatting with them and handing them the same pills all day long. Or maybe you do brain research but you really decide you want to be doing surgery. An emerging area of research is fMRI in neurosurgical planning for example.

Sure, you can have a good idea coming in, but it's 7 years of life or so before you really have to decide. So why should you know?

I guess a better question to ask you guys is: do you feel that your reasons for obtaining PhD's were really justified? Is it false logic to compare the reasons a PhD applicant gives to the ones an MD/PhD applicant gives (like comparing apples to oranges)?

PhDs have to decide in a way. They have to apply for a specific graduate program. MD/PhDs don't have to decide for a few more years and its expected their interests might develop during the medical school cirriculum. So you don't really have to decide, nobody is really forcing you to decide, and so it's just looser than it would be for a PhD student, who is essentially going to go straight into a specific curriculum and a lab.

 

[Y88]

That makes sense, thanks! So in essence, considering those who do end up dividing their time between clinical work and research, do most somehow integrate the two in pursuit of a primary goal? Or are there many cases where a person does clinical work in a totally different area than his/her research?

 

[Neuronix]

This is a complicated question with no simple answer. Of course it benefits you if your clinical work and research work are closely related. Does it always happen? No. People make it work anyways in various ways. But this is something you have to worry about much, much later.