Practicing in a different subspecialty than your research

[deleted728364]

So I’d like to do research that’s within the same specialty as my clinical interest, but my clinical interest would require an unrelated fellowship. I know that it’s common for MD-onlys who do the fellowship to practice in both the general specialty and the subspecialty.


Am I making my life harder by applying with that as my narrative? I happen to have separate interests that drives me to MD/PhD, but am not so interested in doing research or practicing in an area that overlaps clinic and rsrch.

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[Lucca]

Im not sure I understand what you’re asking. Are you planning on having completely unrelated research efforts and clinical practice *from the beginning*??

would be easier if u said what it is specifically you’re interested in and why u want an md/PhD

 

[deleted728364]

Why MD: Had an illness related to a certain subspecialty of neurology. During the process of diagnosis and treatment, I learned of certain bureaucratic obstacles that led to mis/delayed diagnosis. Specifically, diagnostic standards were changed at the request of CMS in order to cut costs. My interest in clinical medicine is to (1) counsel/treat patients similar to me and (2) participate in bureaucracies that control clinical guidelines for my illness and related disorders.

Why PhD: Without those health issues, I probably would have been straight PhD. I'm interested in the intersection between deep learning, dynamical systems, and neuroscience. I can't really provide much more of a reason other than it's really fn cool and I consistently enjoy myself while learning about the subject(s) or in the lab. I also know that I would be really, really dissatisfied if I didn't at least make an attempt at an academic career in this field.

Why MD/PhD: It seems the best way to both see patients and run a basic science lab is through an MD/PhD degree. Perhaps I could go to a T5 med school instead, but unforunately I didn't get a 520 haha

Unfortunately, it seems that there isn't much overlap between this flavor of computational neuroscience and the neurology subspecialty related to my clinical interest. Going through all the recently awarded BRAIN grants, and scouring the web for a week on all the prominent comp neuro labs and labs related to my clinical interest, I found only a few publications that had this overlap, and a single lab in Europe. There is no strong community of researchers with this overlap. I suspect the reason is that it's very hard to design experiments where these computational methods - despite their popularity - are effective. The only feasible experiments are related to the motor system, so most labs focus on BCIs for prosthetics, or movement disorders (closed loop DBS etc).


I should note that it's not like I'm trying to be a plastic surgeon and run an oncology lab. I simply want to do a fellowship, but my research will overlap heavily with my residency. I don't see how the conflict between subspecialty vs research makes my plan unfeasible.

Also, because it's likely I won't get the coveted 80/20, I could easily do one or two days a week treating movement disorders and another in the sub-specialty. Apparently many neurologists do this and a quick google search returns a number of MD/PhD neurologists who do this.

 

[JoaoMoutinho]

By the time you finish school and then residency/fellowship, a lot of things are going to change. Your clinical and research interests could very well change in spite of how you currently feel, and the funding environment/priorities will likely be significantly different. There will also be new technologies that don't currently exist. If you start in an MSTP this fall and graduate in 8 years then do 4 years neuro residency, that's 12 years– think about how different things were in 2008 compared to now. They will similarly be quite different in 2032. Things that might not be a hot topic at all right now could be huge (or come and have gone) by the time you finish your training.

Also, you'll be surprised to learn that a lot of things can actually be related to each other– to use your example of plastics and cancer research, as part of my rotation last summer I collaborated with a plastic surgeon who successfully runs a melanoma lab. Another anecdote comes from a conversation with an alumnus from my program who recently got the dream faculty job and grant after finishing an ophtho fellowship. He currently researches amblyopia, and he told me that he's found opportunities to collaborate currently based on research he did during his PhD years on seemingly unrelated metal ion transport (or something like that). In theory we are getting clinical and graduate training in large part to be able to make connections that other people can't.

Focus on getting into an MSTP, work hard, and see what opportunities arise for you to do what you want to do and be happy.

 

[deleted728364]

Focus on getting into an MSTP

My concern is that if i write:

"I want to practice in X specialty for [compelling reason] and do research in Y field because [lots of rsrch experience, primary interest/compelling reason]"

Then adcoms will - for whatever reason - see this in a negative light.

My current PI has stressed that if I want to practice in X, then I need research goals in X.

 

[Lucca]

My concern is that if i write:

"I want to practice in X specialty for [compelling reason] and do research in Y field because [lots of rsrch experience, primary interest/compelling reason]"

Then adcoms will - for whatever reason - see this in a negative light.

My current PI has stressed that if I want to practice in X, then I need research goals in X.

You shouldnt approach the application with this mindset, period. In the app you make the best possible case for why you want to be a physician scientist AND why you think the MD/PhD is the right path to do it. You back up that argument with thousands of hours of research experience and a few hundred hours of clinical experience in addition to the myriad other decorations and activities which round you out as a human being and make you interesting on paper. No one expects you to propose a blueprint for your entire career at this stage of your training, and in fact I would strongly discourage you from even attempting to do this.