Is the risk of going after an I6 CT program worthwhile as an MD/PhD?

[ChordaEpiphany]

I always saw myself as a classic IM --> Subspecialty MD/PhD. However, mentorship from a CT surgeon has me convinced I'll be happier in surgery. I love the intense lifestyle, the acuity of cases, the more focused clinical workflow (fewer, but more involved cases), and the unique opportunities for research in my field.

I just can't get over the risk of not matching. I6 programs are notoriously competitive, and the alternative is gen surg. Most academic programs require two extra years of research (I've heard this is optional for MD/PhDs some places, but that it is discouraged to the point of being a moot point in many programs). COVID has already added a year to my PhD. I'm not sure if I can stomach another intense decade long training marathon. I don't mind long hours. I am sick of living like a student, though, and I'd prefer not to keep up this act into my 40s.

I could likely put myself in a good position to match. I would have at least one fantastic letter from a PD and plenty of time to do research. Step 1 will be P/F, but my score was >250 and will be reported, and I hope I will continue to perform well academically (e.g., step 2, clerkships, etc...). Are there any other options here, or do people just wind up rolling the dice in this situation? Can you do a 5-year gen surg residency and still match competitively in CT?

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[Medstart108]

I always saw myself as a classic IM --> Subspecialty MD/PhD. However, mentorship from a CT surgeon has me convinced I'll be happier in surgery. I love the intense lifestyle, the acuity of cases, the more focused clinical workflow (fewer, but more involved cases), and the unique opportunities for research in my field.

I just can't get over the risk of not matching. I6 programs are notoriously competitive, and the alternative is gen surg. Most academic programs require two extra years of research (I've heard this is optional for MD/PhDs some places, but that it is discouraged to the point of being a moot point in many programs). COVID has already added a year to my PhD. I'm not sure if I can stomach another intense decade long training marathon. I don't mind long hours. I am sick of living like a student, though, and I'd prefer not to keep up this act into my 40s.

I could likely put myself in a good position to match. I would have at least one fantastic letter from a PD and plenty of time to do research. Step 1 will be P/F, but my score was >250 and will be reported, and I hope I will continue to perform well academically (e.g., step 2, clerkships, etc...). Are there any other options here, or do people just wind up rolling the dice in this situation? Can you do a 5-year gen surg residency and still match competitively in CT?

I don't think you'll need to do the 2 years of research if you already have a PhD. Is your PhD related to CT? Regardless, if anything, having an MD/PhD would probably help you in trying to get into I6. You can definitely do a 5 year gen surg residency and be competitive for CT. If you ask me, I think the traditional path has very few disadvantages, the biggest one might be slightly lower competence in terms of cardiology but on the other hand probably would make you a better general thoracic surgeon.

Be careful about CT though if you are sick of living like a student. Realistically, you can't budget for any less than 7 years of training ahead and you'll be living like a student for all of those. Only choose this field if you feel like you can get over that feeling. Nothing would make you more miserable than years tacked onto your training when you barely felt able to tolerate 6.

 

[deleted50541]

I don't think you're rolling the dice if you decide to apply to for an I6. I personally come across only 1 or 2 PhDs each application cycle, so it's relatively unique and definitely works in your favor. If you continue to mentor with this CT surgeon and get involved in CT-related research, then I think you'll be in a good position. Consider going to meetings and getting involved in the student-interested groups if you're not already. Student & Resident Resources | STS

Yes, all of the applicants at the interview stage present with mostly stellar credentials. But what I've found sets the better candidates apart is being able to articulate why they're interested in CT surgery, what their immediate goals are as a resident, and their longer term career goals. Something to start thinking about now.

 

[SpliceOfLife]

You sound like a good candidate for I6 if this is what you really want to do.

If you have a PhD they will likely waive your research years requirement (but of course thats program-specific).

If you want to do thoracic, you should probably go the general surgery route since thoracic relies so heavily on general surgery principles and techniques. If you are interested in cardiac, then the I6 pathway is uniquely suitable for you, since you are an older student with an interest in research. I6 will reduce your training time which you have already prolonged with your PhD. You won't be boarded in general surgery, but if your goal is academic medicine (which I'm assuming it is if you are a PhD) then you likely won't be doing general surgery anyway as a CT surgeon. This will give you a few more years to build your surgical practice and an earlier time at getting started in a lab as an attending/investigator.