Applying to faculty positions and residency?

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tortuga87

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I am thinking about applying to tenure track (TT) faculty positions as well as residency programs at the end of the MD/PhD program. I know only a minority of people do this, but I am wondering if anyone on here has taken that route and can shed some light on the process. What were the logistics like? Did you have to start applying during MS3 clinicals? How did you approach doing two sets of interviews? What happens if you get a TT offer after the match? Would also appreciate advice from those who did not go through the process but are knowledgeable about it.

My plan is to just go for the TT position, if I get a TT offer. Otherwise, I will go to residency. My PhD is in a quantitative field where applying for TT positions straight out of PhD is not uncommon. Thanks!

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So you are just going to apply for Ph.D. positions only? Because a university isn't going to hire an M.D. in any faculty position who has no clinical training. If that's the case, then whatever is the norm for your Ph.D. is the path you should take. Tenure track positions have university-specific requirements and so you'll have to see what those are and if you would be eligible. Honestly, I would be very surprised to see any university offer a tenure track position to a fresh Ph.D. candidate with no history of grant support (don't know if that's your case) and who hasn't completed post-doc training, but maybe that is your field.

As for the residency, if you match and then decide to back out, that is a NRMP violation. It is breaking a contract. Typically you are barred from participating in the match for several years (and sometimes permanently).
The Match Commitment: What You Need to Know - The Match, National Resident Matching Program

Again, I don't know what your specific goals are and how they relate to your Ph.D., but tenure track faculty versus residency... well, would you rather be a Ph.D. or an M.D./Ph.D? Because like I said, in the academic realm, without residency/fellowship training, your M.D. is worthless.
 
This happens and there was a poster here a few years ago who had a similar question. He ultimately chose to do a residency. This is not rare for fields like CS/Econ/epi.

Just know that your salary starting as an assistant professor even in CS is likely low 100s, whereas, in general a full time physician scientist job should start in the high 100s low 200s. That 3-4 year investment may be worth a lifetime salary improvement and job stability. Your salary cap as a physician scientist IN GENERAL is higher, though of course individual milage varies greatly. That said, if your PhD is in CS the job stability of being a physician may be not that big of an advantage, given Googles of the world. Other thing is if you want to jump a level in terms of "prestige" this is the time to do it, if that's your thing... i.e. if you went to state U for mdphd it's easier to match at Harvard and stay top tier for faculty. It's unlikely you'd be able to do that doing a tenure track job search regardless of the field.

It really depends on if you want to be a doctor/physician scientist or not as ^^. I agree that you should make a decision before apply to residency since there's no point in applying to both. Totally different career track.

There are some very rare cases such as someone started a TT while doing a residency, and is now a department chair in his mid 30s (true story). If you are asking the Internet how to do this this probably doesn't apply to you.
 
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As for the residency, if you match and then decide to back out, that is a NRMP violation. It is breaking a contract. Typically you are barred from participating in the match for several years (and sometimes permanently).
The Match Commitment: What You Need to Know - The Match, National Resident Matching Program

I agree that you should make a decision before apply to residency since there's no point in applying to both. Totally different career track.

Applying to one or the other... sounds very stressful. Applying to TT jobs is not like residency where you will get in at least somewhere. And who knows about the quality of the offers, if you do get any. Is this really the only way?

I also find it hard to believe that there is a +70K boost in salary from doing only one day a week of clinical work unless you do neurosurgery or something, where you basically cant be doing 80/20 anyways but more like 80/50 (yes 130%). +10-20K more sounds more realistic
 
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Applying to one or the other... sounds very stressful. Applying to TT jobs is not like residency where you will get in at least somewhere. And who knows about the quality of the offers, if you do get any. Is this really the only way?

I also find it hard to believe that there is a +70K boost in salary from doing only one week a day of clinical work unless you do neurosurgery or something, where you basically cant be doing 80/20 anyways but more like 80/50 (yes 130%). +10-20K more sounds more realistic
Well, if you are industry funded, then maybe you can garner a bigger salary, but the NIH has a salary cap based on federal restrictions. Additionally, most physician-scientists aren't fully supported by grant support (nor do most want to be because of the salary cap), so one has to make up the difference to the university some how and that's through seeing patients. Yes, the university/medical center gets some revenue through indirect costs to the grant, but the university/medical center gets far more revenue from patient care than from research grants. And when one sees patients and generates revenue (ie RVUs), one salary increases far more than if one did more science.
 
I have no direct experience with this but it doesn't sound like a bad idea to me, if it's really true that people get TT positions in your field without a postdoc.

You still have 1-2 years of clinical rotations after you complete your PhD. Could you make that a lighter schedule by stretching it out over 2 years, and use the time to apply TT? That way you could still do the match if you didn't get a position.

Again without knowing anything about your field, I'm guessing you would be less competitive for TT after having done 3-4 years of irrelevant clinical training, vs up-and-coming fresh grads with recent high-impact papers. If you think you are competitive now I wouldn't waste that opportunity. You can always go back to residency.
 
Applying to one or the other... sounds very stressful. Applying to TT jobs is not like residency where you will get in at least somewhere. And who knows about the quality of the offers, if you do get any. Is this really the only way?

I think if you don't know the answer to this question you aren't really ready for a TT job. If you think THIS is stressful just wait till you have to apply for R01s or NSF every 5 years with a 10-20% funding rate. Or I guess maybe your field doesn't need extramural funding. Also, remember these two processes are kind of out of sync. TT jobs often require a reply within a week or two if not a few days or else they move down the list. Why do you think that guy I mentioned above went for a residency instead?

You could try to do both--it's like applying to PhD vs. MD/PhD. It's not really recommended. TT job offers and residency spots are really not comparable directly to each other.

I also find it hard to believe that there is a +70K boost in salary from doing only one week a day of clinical work unless you do neurosurgery or something, where you basically cant be doing 80/20 anyways but more like 80/50 (yes 130%). +10-20K more sounds more realistic

You better believe it. Increasingly the difference is becoming >70k. This has to do with a variety of factors including flattening of the federal research budget, physician shortage, etc. etc. This number btw also reflects the increasing salary gap (increasingly closer to 100k than 50k) between academic (esp. anything below top 10 schools) and industry (i.e. at the principal scientist level), for very similar reasons. It's not that physician scientists have such high salaries. Not at all. MD salaries merely kept up with inflation. It's that PhD salaries (and NIH grant budgets) have NOT kept up with inflation, and in anything remotely biomedical at anywhere but the top 10 (and even then) have truly sucked spectacularly in the last 10 years. Of course, feel free to ask around, don't take my word for it.
 
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I think if you don't know the answer to this question you aren't really ready for a TT job. If you think THIS is stressful just wait till you have to apply for R01s or NSF every 5 years with a 10-20% funding rate. Or I guess maybe your field doesn't need extramural funding. Also, remember these two processes are kind of out of sync. TT jobs often require a reply within a week or two if not a few days or else they move down the list. Why do you think that guy I mentioned above went for a residency instead?

You could try to do both--it's like applying to PhD vs. MD/PhD. It's not really recommended. TT job offers and residency spots are really not comparable directly to each other.



You better believe it. Increasingly the difference is becoming >70k. This has to do with a variety of factors including flattening of the federal research budget, physician shortage, etc. etc. This number btw also reflects the increasing salary gap (increasingly closer to 100k than 50k) between academic (esp. anything below top 10 schools) and industry (i.e. at the principal scientist level), for very similar reasons. It's not that physician scientists have such high salaries. Not at all. MD salaries merely kept up with inflation. It's that PhD salaries (and NIH grant budgets) have NOT kept up with inflation, and in anything remotely biomedical at anywhere but the top 10 (and even then) have truly sucked spectacularly in the last 10 years. Of course, feel free to ask around, don't take my word for it.

Thanks for this response. The field is theoretical stats/CS related, so I just need a desk, notepad and a computer to do research. Maybe some data that has already been collected by someone else. Hence the low startup costs, hence the ability to go to TT after PhD. Extramural funding is important to support your salary and get tenure but not as critical as in the wet lab, as I understand; definitely not at the volume as wet lab researchers.

I am surprised by the >70k difference. How does that work? My understanding is that the department will only pay you for 4 days for research and then an extra day for clinical if you do the 80/20 thing. Where does that extra 70k come from? Is this an average that also includes ppl doing say 50/50 or the majority clinical? It would make more sense in that case
 
Thanks for this response. The field is theoretical stats/CS related, so I just need a desk, notepad and a computer to do research. Maybe some data that has already been collected by someone else. Hence the low startup costs, hence the ability to go to TT after PhD. Extramural funding is important to support your salary and get tenure but not as critical as in the wet lab, as I understand; definitely not at the volume as wet lab researchers.

I am surprised by the >70k difference. How does that work? My understanding is that the department will only pay you for 4 days for research and then an extra day for clinical if you do the 80/20 thing. Where does that extra 70k come from? Is this an average that also includes ppl doing say 50/50 or the majority clinical? It would make more sense in that case

I work in the same field. It's not as simple as you think. 1) what's the point of getting on TT if you don't care about getting tenured? 2) Tenure at any reputable institution invariably requires your own grant, either methodological development or infrastructure oriented. You can get promoted if you have lots of soft money FTE on other people's grants, but you won't get tenured. Not really sure if that kind of a job is really better than being a doctor. You basically won't have an independent line of research that you can claim is your own. You are just a practicing statistician. Maybe you don't need to BRING a grant TO the job market (like the "wet people" do), but you will still need grants in the long run. 3) It's no longer true that biomed related CS research, especially certain fields of CS (i.e. machine learning) doesn't require a big budget. Essentially what's going on is you have to get money to develop a small software/data science team to do very specialized/boutique but fairly heavy duty software development. Most of "wet lab" budget isn't related to equipment but because it's labor intensive. Similarly clinical research are expensive because of labor requirements. It used to be that you can have one postdoc and take care of all of the analytic needs of multiple research groups, but in the age of "Big Data" you often need multiple data scientists to work on various facets of ONE problem or generate a usable product/impactful paper. Also the degree of collaborative work is going up--since you often need physician/domain expertise. Where do you get other people's time/effort? You have to raise money. Doesn't have to be NIH. Can be Microsoft. Can be the Ford Foundation. Still. 3 grants a year. Rinse, repeat. Yes, it's not as competitive yet in this area to get grants, but I can assure you it'll get there in good time.

FYI, the same job in industry is not very different. You are in charge of managing a team of junior developers/software engineers to solve a specific problem on a deadline and a budget. There are actually some advantages of the NIH system since the deadlines on feds schedule are always millions of small puzzles, so you can blame other people when things don't get done on time, and nobody works on holidays. Good luck with that if you work for Facebook--go eat pee and sleep at the office.

I suppose if you are doing theoretical CS or pure theory in stats you could aim for a pure hard money spot with mostly teaching without having to raise much money. But that kind of job typically comes with the low salary I was talking about as well as other undesirable features (i.e. teaching undergrads/MPH students stats/CS 101 at an unsustainable 4/4 schedule).

W.r.t. salary: you eat what you kill. Academia is as corporate as corporate. Small schools have limited endowment. Large schools that have big endowments don't want to waste it on people who don't have a track record for raising money. So they may give you some hard money support, but it will come with strings: teaching/service (esp. in your case, statistical service). They can't justify budgeting a large endowment on your salary support if you don't show enough promise to bring in money later on. Now that said, if you are a super star and publish in NSC all the time they might give you a startup, but that's a separate issue and you wouldn't come here sound confused. The reason that academic physician salary is 70k+ higher is that full time physician salary is 100k+ higher. So if they don't pay you 70k+ higher you leave. Simple supply and demand. Believe me the amount of RVU they'd be able to get out of that 25% FTE will be WAY more than 70k. It's just a matter of exploiting you a little less than others if they see "value" in your ability to raise money through some other mechanism.

Feel free to formally apply and not take the offers of course for your own entertainment, but to be honest I would just go ahead and informally have your CV shopped by dept chairs of the places you are interested in. They'll tell you the truth. If you are really a superstar they'll tell you. In fact if you are really a superstar you should've already developed a national reputation and people would've reached out to you already, and your own dept chair should be making calls on your behalf. "Formally applying" is really just a formality.
 
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Sluox is right on target here imo.

To quote my post-doc advisor: "Doing MD/PhD without a residency is ****ing stupid."

The researcher's life is too unstable, and the MD without further training really does nothing for you.

I'm shocked you can still get a tenure track offer straight out of a PhD these days. Then again I'm kind of shocked tenure still exists.

Just my 2c from a "clinical assistant professor." If you hate clinical medicine, maybe my choices wouldn't be right for you.
 
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