MD/PhD Rad Onc chances with 203 step 1

[ganglia777]

MD/PhD from top 30 school with low step 1, and 30+ publications by the time I apply. Assuming a high step 2 score, what are the chances of matching? Does a PhD make up for a barely passing step 1?

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[Radiator20]

Aren't there more spots this year than US seniors applying? If the same holds true next year, then I imagine you would match. How well is a different question.

Not that you asked, but one piece of advice. With those stats, people will be tempted to see you as: strong researcher, weak clinician. Outstanding clinical grades and Step 2 would help to mitigate that perception.

 

[evilbooyaa]

Agree with everything above. Assuming application numbers don't increase significantly next year (which I would be surprised if they do) there will continue to be more spots than applicants. Regardless, with that many publications I imagine you will match somewhere - would recommend applying to every program in the country. Even once you start residency, I'd work really really hard to make sure you seem like you are on top of the material appropriate for your year, if not more advanced than that.

 

[emt409]

MD/PhD from top 30 school with low step 1, and 30+ publications by the time I apply. Assuming a high step 2 score, what are the chances of matching? Does a PhD make up for a barely passing step 1?

This was essentially me. I was told at the beginning of med school that as long as you had a PhD, no one cared about Step 1. So my Step 1 was ****e.

That may have been true in 2007 when I started, but now everyone and their mother has a PhD applying to rad onc. But if you're applying this year, you'll definitely match.

 

[Neuronix]

I was told at the beginning of med school that as long as you had a PhD, no one cared about Step 1.

They stopped saying that where I trained when four MSTP grads failed to match in one year

MD/PhD from top 30 school with low step 1, and 30+ publications by the time I apply. Assuming a high step 2 score, what are the chances of matching? Does a PhD make up for a barely passing step 1?

As others have written, it's going to depend highly on how competitive rad onc ends up being when you apply. Even for the relatively small number of residency positions that support serious research such as Holman pathway, they still used to like those high step scores. Now they'll sort of take what they can get. A high step 2 score will help--though should be aiming for like 260+ to even try to make up for that step 1 score.

One other factor: how related to rad onc are your 30+ publications? Many programs would rather see applicants with directly related rad onc work that could fit right into their faculty's research, rather than someone with research potential that they're not sure how to integrate into their department.

Additional thought: are you sure you want to do rad onc? Opportunities to continue lab based research are limited in this specialty. This post FM vs path chances in top west coast programs for MD/PhD with low step 1 makes me question your motivations a bit. Have you really thought about things and come to the conclusion you want to do rad onc for some reason?

 

[ganglia777]

They stopped saying that where I trained when four MSTP grads failed to match in one year

One other factor: how related to rad onc are your 30+ publications? Many programs would rather see applicants with directly related rad onc work that could fit right into their faculty's research, rather than someone with research potential that they're not sure how to integrate into their department.

Additional thought: are you sure you want to do rad onc? Opportunities to continue lab based research are limited in this specialty. This post FM vs path chances in top west coast programs for MD/PhD with low step 1 makes me question your motivations a bit. Have you really thought about things and come to the conclusion you want to do rad onc for some reason?

Thanks for the feedback. Rad onc is my top choice (main interest is cancer, but rad onc has better hours than heme-onc and is only 5 years instead of 6 (3+3)), however I would settle for path at a top program as a backup. Having a barely passing step 1, I assumed I was out of the running already but recently learned that fewer and fewer apply to rad onc due to job security concerns with immunotherapy being on the rise.

5 of the publications are related to heme-onc (immunotherapy EBM/outcomes) but not rad onc. I'm planning to get more publications, probably also in EBM and outcomes research but for patients treated with radiation. Unfortunately my PhD was in bioinformatics/genomics and is essentially irrelevant (what a waste of 6 years).

 

[medgator]

but recently learned that fewer and fewer apply to rad onc due to job security concerns with immunotherapy being on the rise.

Has nothing to do with immunotherapy

 

[Haybrant]

Has nothing to do with immunotherapy

Always interesting to imagine what the oncs are teaching the med students these days. Still remember a lecture from med school about the future of nanoparticles and such specific targeting of cancer cells that there would be zero side effects!!

 

[Radiator20]

OP, wherever you are getting your information, you desperately need to find better sources.

Rad onc applications down, yes. As others have said, not even remotely due to immunotherapy. Whoever told you that is not someone you should trust regarding other questions either.

PhD in bioinformatics/genomics is “irrelevant”? Again, whoever told you this is deeply confused. On the contrary, it is highly relevant if you wish to make it so, and it has the potential to be viewed very favorably at savvy programs.

Choosing rad onc over med onc due to one incremental fewer year of training is not wise. One year is one year, field is the rest of your career. I won’t disagree the lifestyle and income are better but those should not be your only reasons.

 

[FindMeOnTheLinks]

If anything, improvements in immuno- and targeted therapy may render radiation MORE useful and relevant

 

[Radiator20]

If anything, improvements in immuno- and targeted therapy may render radiation MORE useful and relevant

https://www.nejm.org/doi/full/10.1056/NEJMra065241

I think this is a good conceptual framework, not just for breast, but for thinking broadly about importance of local control in the face of changing systemic tx. For example, lymphoma is probably farther right on this curve. Locally advanced NSCLC, further left (pre-durva) - but maybe now with durva moving to midpoint where local control will be more critical due to lower competing risks of distant failure. Etc.

I do think it's important to acknowledge that immune checkpoint blockade, unlike virtually any small molecule targeted therapeutic for virtually any solid tumor, does actually generate some apparent cures for at least some histologies even in metastatic disease. So I would say targeted therapy moved us not very far on this curve in most cases, whereas the effect of ICB may be greater, but still remains tbd for most disease sites in the up-front setting.