Residency vs. MBB

[grenouille]

I'm an MD-MBA student in the "lucky" position of either pursuing residency or a job at McKinsey/Bain/BCG. While I love meeting diverse patients, learning their perspectives on the world, and helping them, I don't particularly enjoy clinical problem solving. I much prefer thinking about bigger picture issues with the healthcare system or population health. Additionally, I loathe documentation; I had no idea doctors spend 50+% of their time with the EHR fulfilling billing requirements when I signed up for medical school. Also, I speak several foreign languages, and I would love to live and work internationally, which medicine makes difficult.

Long term, I would like my primary job to be running a health-related business or doing healthcare investing, but I think it would be rewarding to practice one day every week or two to stay grounded in clinical practice and the diversity of patients' life experiences. MBB would be amazing business training. Residency would give me more legitimacy in the medical world and open doors in the house of medicine, but would maybe close (or at least delay) some in business/investing. I'm not sure residency is worth it because I feel like it just delays me from doing what I want to do. Moreover, I have a an extreme amount of debt, and I worry I will have no choice but to practice medicine for 5-10 years once I finish residency to pay off that debt, because business options initially won't be as lucrative. What would you recommend?

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[LookForZebras]

Both are great options and will open up doors for you. I suggest doing a residency, though. (I almost always say do a residency when asked variations on this question.) Clinical experience in a care-directive capacity is one of the few things that really sets an MD apart from other professionals. As you mentioned, having done a residency and being board certified really legitimizes you as a physician.

Also, there are plenty of physicians who enter management consulting after residency. Don't feel like now is your only opportunity to take a job with one of the big firms.

 

[LobsterMan]

I completed my residency, practiced medicine for a couple of years (and still practice), and am at MBB.

I think the real question that you will have to answer for yourself is "what in medicine is personally meaningful and irreplacable to me?" If the 1:1 patient encounters don't fulfill you in a unique, personal way, then I think the argument can be made that there are a LOT of jobs out there that can/will be interesting, challenging, and directed at helping others. I personally found MBB more intellectually stimulating. It certainly gives you a wider breadth of knowledge, constantly places you on a steep learning curve, is focused on personal/leadership development, is cushier in terms of hours/pay, and will dramatically accelerate your career and open countless doors.

Despite what others say, as long as you're not applying to a super competitive specialty like derm or plastics, you CAN also do a couple of years at MBB then go to a top-tier residency. There are several people that I personally know who have done so.

My advice would be to try to arrange for an internship at MBB to see what you think. Compare it to a sub-internship in the medical specialty of your choice. Compare the two.

Also, MBB are extraordinarily flexible once they extend an offer. I have friends who completed an internship and told MBB that they would go on to complete residency (which, in some cases, was 7 years). MBB said "Great. Get in touch with us when you're done. We'll keep a spot for you."

As for me, I personally found that the one aspect of medicine that cannot be replaced in other fields occurs in the 1:1 patient interactions and relationships you build when you support patients or families through a difficult/trying time. The medicine itself is rather algorithmic, inefficient, documentation-heavy. But because the 1:1 interactions are irreplacable, I plan on sticking with medicine. Others don't, and that's fine too!

 

[ZenArcher35]

Despite what others say, as long as you're not applying to a super competitive specialty like derm or plastics, you CAN also do a couple of years at MBB then go to a top-tier residency. There are several people that I personally know who have done so.

Also, MBB are extraordinarily flexible once they extend an offer. I have friends who completed an internship and told MBB that they would go on to complete residency (which, in some cases, was 7 years). MBB said "Great. Get in touch with us when you're done. We'll keep a spot for you."

Thanks for sharing your experience. I’m actually in the same boat as OP as well but wanted to ask further about doing a couple years in consulting and then still being able to go to a top-tier residency.

Ultimately, I have very a strong geographical preference for residency that offers basically 1-2 top-tier options (to be specific, think Boston or Bay Area so MGH/BWH or UCSF/Stanford - but won’t specify which), with the rest in the area being mid-tier or lower. If my goal is to match at a residency specifically of this caliber, would you say from your/your friends’ experience that doing ~2 years at the MBB post-graduation would still allow me to maintain my competitiveness for these places (assuming I’m currently competitive for them)? And if so, how did you/they approach the narrative around this to programs?

Asking because the overwhelming majority of opinions I’ve heard, as you allude to, has been that this choice would significantly harm my ability to do so.

 

[emiko]

Interested in this topic as well and wow! sounds like MBB has been aggressive in recruiting MD's. I recently graduated and decided to take up the MBB offer. Like all of you, I struggled a lot with the decision of residency vs MBB. My advisor at the medical school actually said that I have about 3 year max to decide if I want to go back and do the residency, given that what I do at MBB is related to medicine.

I would be interested in knowing the paths people have taken if they decided to work for MBB and later go do a residency. Like ZanArcher35, I am also geographically restricted due significant other's job (in a major city, like Boston/SF/NYC). I do believe I would have been a pretty competitive applicant as a 4th year, and my advisor did say she thought I would do well even if I took time off.

However, would still be good to hear about examples. Unfortunately, as much as my advisor was helpful, there were limited examples of people going from MD at my school to MBB then back to residency. Among the few that I know who didn't do residency, one stayed on and became a MBB partner, and the other became a successful entrepreneur after a short time at a MBB. No one that I knew actually went back to residency. I am sure it's not because they couldn't match and they have been very accomplished in the paths they have chosen, but it would be helpful to know the potential barriers if I do decided to go back to clinical medicine.

Thanks for sharing your experience. I’m actually in the same boat as OP as well but wanted to ask further about doing a couple years in consulting and then still being able to go to a top-tier residency.

Ultimately, I have very a strong geographical preference for residency that offers basically 1-2 top-tier options (to be specific, think Boston or Bay Area so MGH/BWH or UCSF/Stanford - but won’t specify which), with the rest in the area being mid-tier or lower. If my goal is to match at a residency specifically of this caliber, would you say from your/your friends’ experience that doing ~2 years at the MBB post-graduation would still allow me to maintain my competitiveness for these places (assuming I’m currently competitive for them)? And if so, how did you/they approach the narrative around this to programs?

Asking because the overwhelming majority of opinions I’ve heard, as you allude to, has been that this choice would significantly harm my ability to do so.