OK, given the over-abundance of MD/PhDs on UH, maybe some reflections on the journey, if nothing else, to free up the “2009 applicant qualifications” thread for the rest of our colleagues to post Answer as many or as few of the following questions as you want…

1) Were you planning on, or even contemplating neurosurgery when you started?
2) How long did your PhD take?
3) If you could do it all over again, would you do MD/PhD?
4) How much do you really think your PhD will help you in the future, if at all?
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship?
6) Was your research relevant / related to neurosurgery?
7) What percentage of your PhD research plans / experiments were successful?
8) Did you continue your research during the clinical years?
9) What % of your time do you intend to spend doing research, once you get a real job?
10) Do you plan to run your own lab?
11) What would be your ideal job?
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future?
13) How important are research opportunities to you in selecting residency programs?
14) Do you think your research from now on will be more basic science, clinical, translational, or other?
15) Will your future research be in a similar field to your PhD?
16) Do you think your PhD helped your neurosurgery residency application?
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery?
18) Is your significant other, if applicable, happy you did MD/PhD?
19) Looking back, is there anything you would have done differently?
20) Other thoughts, comments, advise?

1) Were you planning on, or even contemplating neurosurgery when you started? no
2) How long did your PhD take? 3.25 y
3) What percentage of your PhD research plans / experiments were successful? 30%
4) Did you continue your research during the clinical years? yes
5) If you could do it all over again, would you do MD/PhD? yes.
6) How much do you really think your PhD will help you in the future, if at all? a lot
7) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? no (but see below)
8) What % of your time do you intend to spend doing research, once you get a real job? 30-50% depending on what subspec i choose and my local work environment
9) Do you plan to run your own lab? yes
10) What would be your ideal job? a neurosurgeon with HHMI funding
11) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? yes
12) How important are research opportunities to you in selecting residency programs? very
13) Do you think your research from now on will be more basic science, clinical, translational, or other? basic then translational
14) Do you think your PhD helped your neurosurgery residency application? overall, yes but I think it hurt for some programs
15) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? That’s a horrible reason to get a PhD. Getting a PhD is emotionally and intellectually difficult and frustrating and I believe that one should pursue a PhD because they love science… not just to get a job. I noticed that some interviewers consider the 1 year of HHMI/D. Duke research to be equivalent to a PhD. So if the research is just an means to a match, I’d just go that route.
16) Is your significant other, if applicable, happy you did MD/PhD? yes… because otherwise we wouldn’t have met
17) Other thoughts, comments, advise? enjoy your 4th year of medical school but don’t get fat during interviews

i have been a long-time observer and have really appreciated the comments and conversations on UH. i have a question about PhD and year-off programs and the production of research...there is usually a disparity between PhD students, year off students, etc on how productive they were during their research. some PhD students manage to get like 5 first author pubs (some even become senior authors) while others get 1 or 2 pubs out and a bunch of abstracts. in the end, both are PhD students or both complete the Doris Duke or HHMI programs… how do program directors weigh the publication numbers game vs the experience of getting that PhD or taking that year out? im def not sayin that some students jus bum around during their research, but im just trying to wrap my head around the fact that all labs and lab productivity is different and one’s publication record and experience are sort of dependent on the lab you’re in and don’t always equate to your ability as a scientist. i hope i was clear with my question… thanks in advance for your opinions!

1) Were you planning on, or even contemplating neurosurgery when you started?  Absolutely not.  I was hardcore medicine since birth since in my father’s mind surgeons are dumb mechanics.
2) How long did your PhD take? 5 years
3) If you could do it all over again, would you do MD/PhD? yes, but likely in a different lab
4) How much do you really think your PhD will help you in the future, if at all? Pragmatically, it will help me get into a good residency.  Hopefully, the critical thinking I refined during that time will also help become more productive in research.
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? Don’t think so.  Scope of 1 year project vs. PhD is very different.  It has nothing to do with the time it actually takes to complete but rather the problem you are trying to tackle.
6) Was your research relevant / related to neurosurgery? Not at all
7) What percentage of your PhD research plans / experiments were successful?  100% - I now know what not to do.
8) Did you continue your research during the clinical years? Yes.
9) What % of your time do you intend to spend doing research, once you get a real job? 33-50%
10) Do you plan to run your own lab? Yes, but not a wet lab.  More likely engineering lab
11) What would be your ideal job?  50-50 research/clinic at Stanford or someplace with great industry relations
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future?  At first, but if research is patient-facing, there are great opportunities to spin out into real-world advances and make much more $$.
13) How important are research opportunities to you in selecting residency programs?  Very.
14) Do you think your research from now on will be more basic science, clinical, translational, or other?  I chose translational, but don’t think that is necessary for all
15) Will your future research be in a similar field to your PhD?  Nope
16) Do you think your PhD helped your neurosurgery residency application?  Absolutely
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery?  Don’t do it to help match.  Do it because you want to do research.
18) Is your significant other, if applicable, happy you did MD/PhD?  Yes.  Great time to start a family
19) Looking back, is there anything you would have done differently?  Different lab, more translational focus, but at that time I didn’t think I wanted to practice medicine at all.
20) Other thoughts, comments, advise?

uditnarayan - 03 March 2009 05:07 PM

i have been a long-time observer and have really appreciated the comments and conversations on UH. i have a question about PhD and year-off programs and the production of research...there is usually a disparity between PhD students, year off students, etc on how productive they were during their research. some PhD students manage to get like 5 first author pubs (some even become senior authors) while others get 1 or 2 pubs out and a bunch of abstracts. in the end, both are PhD students or both complete the Doris Duke or HHMI programs… how do program directors weigh the publication numbers game vs the experience of getting that PhD or taking that year out? im def not sayin that some students jus bum around during their research, but im just trying to wrap my head around the fact that all labs and lab productivity is different and one’s publication record and experience are sort of dependent on the lab you’re in and don’t always equate to your ability as a scientist. i hope i was clear with my question… thanks in advance for your opinions!

I think you are correct.  Of course research is so variable so you cannot determine the value of a scientist by the letters after one’s name or #s of publications. I know Ex-Dorris Duke fellows who were more productive durint their single year than MSTP students. I am sure that there are many ex-Dorris Duke/HHMI fellows who are superior scientists than myself and other mudphuds. I’m not a program director, but would guess their research assessment is derived from many factors including research LORs, # and impact of pubs, degrees, and many other things I am too young to recognize.

In response to the question about number of publications in a phd vs. research year.  I think the types of projects people do in a PhD are very different than the type people do in a research year.  Research year projects are more likely to be related to neurosurgery and people tend to do projects that have more clinical relevance and work in labs that publish smaller chunks of work more frequently.  They also tend to work on more “sure thing” type projects.  Many MD/PhD’s choose labs that publish large chunks of work much less frequently and tend to have risky projects as well as more secure ones.  Also, # of publications alone doesn’t tell very much about productivity.  The amount of work that goes into a science, nature, or cell paper (as well as certain other top basic science journals) is very different than the amount of work that can go into some smaller journals and some more clinical journals - ie years with 10 authors working vs. months with a few authors.  That being said, while some programs/interviewers recognize the difference, some clearly just count number of publications.  Everything above is obviously a generalization but thought it was worth pointing out that PhD vs. research year is not just a difference in number of years.  People work hard in both, but the approach is often very different.

1) Were you planning on, or even contemplating neurosurgery when you started? A possibility, but neurology etc not rulled out.
2) How long did your PhD take? 4 years
3) If you could do it all over again, would you do MD/PhD? Yes
4) How much do you really think your PhD will help you in the future, if at all? PhD provided important insights and experience in a “protected” environment, when the stakes are lower if you completely screw up. When I’m a faculty member trying to balance research and clinic, I expect my years of training will be invaluable.
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? I don’t think so. Nevertheless, very useful for those who want to try out resaerch without committing to a PhD.
6) Was your research relevant / related to neurosurgery? Yes - neuroregeneration.
7) What percentage of your PhD research plans / experiments were successful? 20% - though did get some publications from things that went wildly wrong in ways no one expected.
8) Did you continue your research during the clinical years? Yes, though progress painfully slow.
9) What % of your time do you intend to spend doing research, once you get a real job? ~50%
10) Do you plan to run your own lab? Yes, but if it seems I would be more productive as a collaborator, coordinator, organizer, that would be OK as well, so long as I can continue to be intellectually directing the research.
11) What would be your ideal job? Head of translational neurosurgery research, overseeing projects that have basic science and clinical components
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? Yes. I really don’t see any way around it. I don’t currently foresee that I will get rich off of some product I invent. I would rather remain unfettered by commercial interests, employing the best strategies and collaborations for the task at hand, even if it is different this week than last week.
13) How important are research opportunities to you in selecting residency programs? Very, but not at the expense of operative experience, or if it meaned training in a malignant atmosphere. Geography also weighs heavily, for the sake of my wife. Programs with the strongest research in my field ended up being ranked 1, 4, 7, 10, and 11.
14) Do you think your research from now on will be more basic science, clinical, translational, or other? Basic science as pertaining to the development of translational applications.
15) Will your future research be in a similar field to your PhD? Yes
16) Do you think your PhD helped your neurosurgery residency application? Yes, without question.
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? Similar to someone applying to neurosurgery: Only do it if you know you would not be happy any other way. It is painful and difficult, but if that is what makes you want to get out of bed in the morning, then go for it!
18) Is your significant other, if applicable, happy you did MD/PhD? Depends on the day - certainly not a fan of me coming home smelling like mice, and would not object if I decided that I wanted to just do nsg and earn a decent income. Nevertheless, very supportive of my goals and would not be happy if I settled for anything less.
19) Looking back, is there anything you would have done differently? No. I was fortunate to have a good lab, and work in a relevant field.
20) Other thoughts, comments, advise? Carefully research the lab before joining. Ensure productivity and secure funding. Even if you are brilliant, you will be more productive as part of well equipped lab than if you are scrambling to pull together equipment and reagents for something no one in the lab has ever done before. Know the literature pertaining to your work better than your PI. Make realistic plans and budget for them to take 3 times as long as expected, even while working overtime. Seek the insights, opinions and critiques of as many experts as possible regarding your experimental plans - this may save lots of wasted time and effort.

1) Were you planning on, or even contemplating neurosurgery when you started?  No
2) How long did your PhD take? 1.5 years
3) If you could do it all over again, would you do MD/PhD? Yes
4) How much do you really think your PhD will help you in the future, if at all? A ton
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? I did a year of postdoctoral work in med school and I would say there is no comparison between a PhD and a year of research.
6) Was your research relevant / related to neurosurgery? Not at all
7) What percentage of your PhD research plans / experiments were successful? 90%
8) Did you continue your research during the clinical years? yes
9) What % of your time do you intend to spend doing research, once you get a real job? 60%
10) Do you plan to run your own lab? yes
11) What would be your ideal job? HHMI funded Neurosurgeon
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? No
13) How important are research opportunities to you in selecting residency programs? Most important
14) Do you think your research from now on will be more basic science, clinical, translational, or other? all basic
15) Will your future research be in a similar field to your PhD? yes
16) Do you think your PhD helped your neurosurgery residency application? that’s all anyone talked to me about in the interviews
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? Stay in touch from the periphery with the NSG dept. Remember you are an asset to them if you print a new skill set to the table.
18) Is your significant other, if applicable, happy you did MD/PhD? We will see.
19) Looking back, is there anything you would have done differently? Nope; no regrets.
20) Other thoughts, comments, advise? The dual degree is a huge commitement of time and personal juice. Do it for the right reasons; by that i mean make sure you really love it!

1) Were you planning on, or even contemplating neurosurgery when you started? Yes, spent 2 years in Neurosurgery before starting my MD/PhD
2) How long did your PhD take? 4 years
3) If you could do it all over again, would you do MD/PhD? Yes
4) How much do you really think your PhD will help you in the future, if at all? I did clinical/translational work. I think it will be not only relevant, but very useful in the future.
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? Not comparable.
6) Was your research relevant / related to neurosurgery? Neuroimaging, though more neurology application. Working to change that now.
7) What percentage of your PhD research plans / experiments were successful? I agree with the above post, you learn from it all.
8) Did you continue your research during the clinical years? Yes
9) What % of your time do you intend to spend doing research, once you get a real job? 30%
10) Do you plan to run your own lab? Possibly
11) What would be your ideal job? Academic Neurosurgery Position with research infrastructure and support.
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? Not necessarily
13) How important are research opportunities to you in selecting residency programs? Important
14) Do you think your research from now on will be more basic science, clinical, translational, or other? Translational
15) Will your future research be in a similar field to your PhD? Yes
16) Do you think your PhD helped your neurosurgery residency application? Yes, somewhat
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? Bad idea. Like above, it is only worth doing if you love research. Otherwise, it is much too painful to do just for some help on your application. Many other things that you can do to improve you candidacy.
18) Is your significant other, if applicable, happy you did MD/PhD? As an MD/PhD, I think everyone just wants you to finally finish…
19) Looking back, is there anything you would have done differently? Not really
20) Other thoughts, comments, advise?

1) Were you planning on, or even contemplating neurosurgery when you started? I performed my first brain surgery on a rat (3rd ventricular cannulation) when I was 19 and was hooked.
2) How long did your PhD take? 3.5 yrs
3) If you could do it all over again, would you do MD/PhD? Yes
4) How much do you really think your PhD will help you in the future, if at all? Massively. The science was fulfilling, but some of the most useful things I learned are on the practical side of things: presentation skills, grantsmanship, scientific diplomacy, leadership, collaboration, etc…
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? I don’t think so. The PhD is a marathon, not a sprint. The objectives and midset are completely different. If you don’t finish your project during your HH year you’re still a prestigious HH scholar. If you don’t finish your projects during a dissertation you DO NOT get your PhD no matter how many years you’ve been working on it (although you may get a masters).
6) Was your research relevant / related to neurosurgery? Yes, it was a deliberate choice
7) What percentage of your PhD research plans / experiments were successful? Many of the most exciting discoveries in science have come out of “failed” experiments or seredipitously so I think this is not the right way to look at things. If you get your PhD that’s 100% success!
8) Did you continue your research during the clinical years? Only as much as I needed to please the manuscript reviewers. I spent a lot of time brainstorming and writing though… and I did a postdoc afterwards.
9) What % of your time do you intend to spend doing research, once you get a real job? Hard to say. 25-75%??? (this includes participation in clinical trials)
10) Do you plan to run your own lab? Yes
11) What would be your ideal job? Academic neurosurgery leadership
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? You certainly have to love it to get paid less for doing more. However, with successful translation there will be financial rewards. It is not immoral to involve private money/industry to bring promising ideas to the clinic, in fact it is pretty much mandatory. For example, the estimated cost for bringing a new drug to market from development to clinical trials is $200-800 million dollars. Obviously, your department or University won’t give you that much… neither would the NIH (that would be upwards of 2.5% of the entire NIH budget!). If you are not comfortable personally profiting from your translational successes you can always roll it back into your research. Win-win.
13) How important are research opportunities to you in selecting residency programs? Important to an extent… however, beyond basic infrastructure and funding, successful research is what you make of it. For me it was more important to find the right departmental atmosphere in a decent geographical locale (as per UH advice from current residents).  I wasn’t willing to sell my soul for a malignant high end program or spend 7 years in a city I hated.
14) Do you think your research from now on will be more basic science, clinical, translational, or other? Hopefully all of the above. Also interested in tinkering with instrumentation and imaging.
15) Will your future research be in a similar field to your PhD? Yes, but the basic aspect will be more focused on specific diseases and pre-clinical models rather than hardcore molecular stuff.
16) Do you think your PhD helped your neurosurgery residency application? No doubt. I was feeling a little too comfortable in my MSTP shoes back then and didn’t take Step 1 very seriously. To be sure, a monumental error. While many programs still screened me out numerically, a couple dozen other excellent programs valued my research accomplishments enough to save my application from the trash (for which I am grateful).
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? My personal experience suggests a PhD can indeed save a less than stellar application. However, if you don’t love it, you will probably hate it… and if you hate it you probably won’t finish (or at least be miserable for 3-6 years). Better to spend a few extra weeks studying hard for Step 1 so you can destroy it rather than a few years trying to pad your CV with a half-hearted doctorate.
18) Is your significant other, if applicable, happy you did MD/PhD? currently accepting applications for this position (j/k)
19) Looking back, is there anything you would have done differently? Everything that has occurred in the past was necessary in order for me to be where I am today, the failures AND successes. I have been very fortunate. I think finding my passion early and identifying early and enduring mentors were critical. There were additional benefits from being MSTP including programmatic activities, waiving med biochem, and waiving 4th year of med school.
20) Other thoughts, comments, advise? People typically regret NOT doing things rather than regret things they have done. Don’t forget to enjoy the journey.

1) Were you planning on, or even contemplating neurosurgery when you started? Yes
2) How long did your PhD take? 2 years, 3 months and 28 days
3) If you could do it all over again, would you do MD/PhD? Yes
4) How much do you really think your PhD will help you in the future, if at all? very much
5) Could you have obtained comparable benefit from, say, a 1 year Howard Hughes fellowship? No, I hadn’t even begun answering anything in 1 yr.  Also think it gave me better insight into the world of research so I can become a good PI.
6) Was your research relevant / related to neurosurgery? No but I could make it seem like a foundation for certain neurosurgical applications (especially on interviews)
7) What percentage of your PhD research plans / experiments were successful? 1st year: 40%, 2nd year: 80%
8) Did you continue your research during the clinical years? Kinda, if helping write a RO1 counts
9) What % of your time do you intend to spend doing research, once you get a real job? depends on phase of career
10) Do you plan to run your own lab? Yes, I don’t like working for others in research environment.  Don’t mind collaborating.
11) What would be your ideal job? academic neurosurgeon at respected medical center, 1RO1
12) Do you expect (or will you be willing) to make less $$$ because of your research involvement in the future? Wouldn’t mind making less money if I was happy
13) How important are research opportunities to you in selecting residency programs? very important
14) Do you think your research from now on will be more basic science, clinical, translational, or other? translational ideally
15) Will your future research be in a similar field to your PhD? yes but now applied to neurosurgery
16) Do you think your PhD helped your neurosurgery residency application? YES, because people do think it’s a big deal.  They also assume you were even a superior undergrad student to get into a MSTP.
17) What would you say to someone who is planning to do MD/PhD to help them match in neurosurgery? NOT GOOD IDEA.  I always had a research bent that dated back to highschool (science fair dork, Intel ISEF).  The PhD can be miserable.  There are more efficient ways to match, and some of the best researchers I know just have a MD.
18) Is your significant other, if applicable, happy you did MD/PhD? N/A, but I found dating is easier during medical school years, more social events and more attractive people.
19) Looking back, is there anything you would have done differently? NO, but I will find out on March 16th and 19th
20) Other thoughts, comments, advise? Still think the clinical years are by far the best.  I really look forward to doing research that can directly impact a patient’s life rather than a mouse’s life.  If I had to chose I would give up the research.

Here are my thoughts that may amplify what others have said:

1) The only reason you should do a PhD is because that is what you want to do.  Don’t do it to try and help your chances in the match - if this is your only motivation it will result in disaster.  Do it because you want the unique research experience.  It is not necessary for an academic career (although it helps greatly) nor will it preclude you from private practice.

2) For pure academics, the most important factor for a PhD is your dissertation director.  You are much better off having a well-known director at a “lesser” academic school than you are having an unknown director at a much more prestigious institution.  The MD side of course complicates this a bit.

3) The exact focus of your research really doesn’t matter that much.  As my director said, “the goal of a PhD is to learn how to learn.” That is probably a bit fanciful, but the truth is that the really important skills are things like how to set up a research program, the strategy to obtain research funding, how to write proposals, basic research techniques, etc.  These abstract skills are really what separates the PhD from other types of research experiences that are available.

serious nerd question: did you get preliminary data during your PhD for a later K08 or whatever early-career grant? or are you planning on this during your research years in residency?

did you rank any programs with 1 year of research?

Seems like many people’s advice is to do a PhD because that’s what you want to do-not for any other reasons such as it improving your chances of successful match. I want to know what this advice is based on-is it based on experienced?-who have you actually spoken to that has had a disaster because they went into a PhD for other reasons...? Or better yet, who after completing a PhD would ever admit that they went into it for “impure” reasons and I quote “impure” because reasons are personal and don’t belong within the realm of objectivity as we commonly think of objective (24 hrs/day)-they belong in the objective realm of subjective truth.

ranklist09 - 06 March 2009 10:46 AM

Seems like many people’s advice is to do a PhD because that’s what you want to do-not for any other reasons such as it improving your chances of successful match. I want to know what this advice is based on-is it based on experienced?-who have you actually spoken to that has had a disaster because they went into a PhD for other reasons...? Or better yet, who after completing a PhD would ever admit that they went into it for “impure” reasons and I quote “impure” because reasons are personal and don’t belong within the realm of objectivity as we commonly think of objective (24 hrs/day)-they belong in the objective realm of subjective truth.

I think “disaster” is not accurate. Again, if your motivation is primarily CV padding the worst thing that can happen is that you don’t finish your PhD and lose a little time. If you are successful in finishing a PhD and you match in neurosurgery under the false pretenses of wanting to pursue academics the worst thing that can happen is that you join the majority ranks who also opt for private practice. PDs and chairs will be disappointed, but they won’t kick you out. As previously mentioned in another post, at many programs being MudPhuD is not predictive for an academic career. It is arguably the best preparation for this path, but not a guarantee. In the 3 cases where I’ve been able to talk to private practice MudPhuD neurosurgeons spousal/family reasons are cited as why they gave up academics (sometimes against their will… e.g., for the sake of their marriage). Life happens.

With regards to “impure” intentions… this is a continuum. Afterall, most applicants are not interested in research but do it to enhance their CVs. Pursuing a PhD is at the extreme end of the spectrum. I don’t know anyone like this personally. All the people I am familiar with have been MSTP and entered med school intending on doing a PhD already. I chose MSTP because my academic neurosurgical mentors said if they had to do it over they would have done MD/PhD. I am glad I took their advice.

D. muscipula, thanks for your post. It’s always nice to read the opinions on this website, as they’re often thoughtful and provoking. I had an unrelated inquiry about neurosurgical personality. We had an attending surgeon (not neuro-) explain to us that as we rotate through clerkship year, we’ll come to find that we vibe with certain specialists over others-that we’ll naturally enjoy being around people working in particular fields. Is there a distinctive neurosurgical personality or commonality that many/most neurosurgical trainees possess? Thanks.