PSTP Heme-Onc fast-track vs Categorical IM and Combined IM programs

[2KOTN]

So I am a 4th year MD/PhD student who has a PhD in Bioengineering, though more specifically in Computational Biology and Cancer Genetics. I applied pretty broadly to IM-PSTP fast-track programs, Categorical IM, IM/Genetics and Med/Peds. I think my ideal practice at the moment is to go into Cancer Genetics both in clinic, specializing in patients with a genetic cause of cancer in both treatment and prevention. I also want to participate in Bioinformatics research in the future looking at the genetic origins of cancer.

I think the big problem for me is ranking fast-track programs relative to categorical or IM/Genetics or Med/Peds. I have:

4 PSTP
5 Categorical IM
1 IM/Genetics
6 Med/Peds

Of course, outside my PSTP interviews, my endgame is to apply Oncology with or without Heme.

As far as my initial thoughts go, I do enjoy the protected research time and love medical research, but I also am not sure I'd be happy with only 20% clinic and I'm not sure 2-years of IM is enough training. I could do categorical IM, but my scores are kind of trash (200-210 range STEP 1), so I am worried about re-entering the fellowship match and its competitiveness. I think IM/Genetics or Med/Peds are excellent clinical choices because I love the patient population, but I'm not sure its going to be overkill as far as clinic training.

I'd love to hear any thoughts about ranking. Is PSTP enough clinical training? Will I likely match into Heme-Onc with a categorical residency? What advantage if any would a Medical Geneticist-Oncologist bring to the table? And What advantage if any would a Med-Peds Oncologist bring to the table?

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[Oncmudphud]

So I am a 4th year MD/PhD student who has a PhD in Bioengineering, though more specifically in Computational Biology and Cancer Genetics. I applied pretty broadly to IM-PSTP fast-track programs, Categorical IM, IM/Genetics and Med/Peds. I think my ideal practice at the moment is to go into Cancer Genetics both in clinic, specializing in patients with a genetic cause of cancer in both treatment and prevention. I also want to participate in Bioinformatics research in the future looking at the genetic origins of cancer.

I think the big problem for me is ranking fast-track programs relative to categorical or IM/Genetics or Med/Peds. I have:

4 PSTP
5 Categorical IM
1 IM/Genetics
6 Med/Peds

Of course, outside my PSTP interviews, my endgame is to apply Oncology with or without Heme.

As far as my initial thoughts go, I do enjoy the protected research time and love medical research, but I also am not sure I'd be happy with only 20% clinic and I'm not sure 2-years of IM is enough training. I could do categorical IM, but my scores are kind trash (200-210 range STEP 1), so I am worried about re-entering the fellowship match and its competitiveness. I think IM/Genetics or Med/Peds are excellent clinical choices because I love the patient population, but I'm not sure its going to be overkill as far as clinic training.

I'd love to hear any thoughts about ranking. Is PSTP enough clinical training? Will I likely match into Heme-Onc with a categorical residency? What advantage if any would a Medical Geneticist-Oncologist bring to the table? And What advantage if any would a Med-Peds Oncologist bring to the table?

I can’t answer all your questions but I can give my input on a few. I’m a MD PhD who applied to both categorical and fast track programs back in the day. My rank list was mixed, but I ultimately matched to my second choice, a categorical program. I was initially somewhat disappointed that I didn’t match into my first choice, which was a fast track. Fast forward three years later and I’m really grateful I didn’t match directly into the fast track. Your above fears are true for me; I needed three years of IM to feel confident. Not everyone does.

While You’re right about the hem/onc match being competitive but that PhD helps a lot, especially if you were productive. It did me way more favors when applying for fellowship than residency. The other thing is that I got waaaaaaaay better interview invites when applying for fellowship than I did when I applied for fellowship. I would have sold myself short if I’d gone straight into a PTSP program from a tier perspective. And, trust me, I wasn’t a rock star medical student and am by no means an amazing resident. Solidly average at best.


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[2KOTN]

Thanks for the insight. I think it is good to know that Fellowship may be even more favorable than the residency match if things go well. Is there any advice as to what to do to keep my research at least above water during residency?

 

[lulu09]

So I am a 4th year MD/PhD student who has a PhD in Bioengineering, though more specifically in Computational Biology and Cancer Genetics. I applied pretty broadly to IM-PSTP fast-track programs, Categorical IM, IM/Genetics and Med/Peds. I think my ideal practice at the moment is to go into Cancer Genetics both in clinic, specializing in patients with a genetic cause of cancer in both treatment and prevention. I also want to participate in Bioinformatics research in the future looking at the genetic origins of cancer.

I think the big problem for me is ranking fast-track programs relative to categorical or IM/Genetics or Med/Peds. I have:

4 PSTP
5 Categorical IM
1 IM/Genetics
6 Med/Peds

Of course, outside my PSTP interviews, my endgame is to apply Oncology with or without Heme.

As far as my initial thoughts go, I do enjoy the protected research time and love medical research, but I also am not sure I'd be happy with only 20% clinic and I'm not sure 2-years of IM is enough training. I could do categorical IM, but my scores are kind of trash (200-210 range STEP 1), so I am worried about re-entering the fellowship match and its competitiveness. I think IM/Genetics or Med/Peds are excellent clinical choices because I love the patient population, but I'm not sure its going to be overkill as far as clinic training.

I'd love to hear any thoughts about ranking. Is PSTP enough clinical training? Will I likely match into Heme-Onc with a categorical residency? What advantage if any would a Medical Geneticist-Oncologist bring to the table? And What advantage if any would a Med-Peds Oncologist bring to the table?

I have the same kind of trash scores that you have (and matched at decent nationally-known fellowship). I agree with @Oncmudphud that having a PhD for heme/onc applications is HUGE. I have a good friend from the same residency, same-ish residency performance and LORs (AFAIK), same tier medical school, somewhat higher step scores than mine -- only difference was that she has a PhD with great pubs pre-residency. She barely continued her research in residency (did a few months in a wet lab and generated a few abstracts, no pubs in residency) while I worked my tail off with dozen+ abstracts and publications (albeit in clinical research w/o lab). She matched at one of the "top 4" programs (with 2-3 interviews at them) while I had none.

I think as long as you have interesting research pre-residency as a PhD and get adequate LORs in residency you should be more than fine for fellowship. I can't personally comment on how a PSTP compares though since I don't have a PhD. I heavily considered Med-Peds at one point but I agree with you, it's entirely too heavily clinical (unless you REALLY enjoy clinical time) and I didn't need both adults and kids -- I enjoyed seeing both but ultimately felt I didn't need to train with both. Also I personally felt Med-Peds docs are more and more pigeonholed out of many jobs (in my med school they forced them to either see adults or kids, not both) and their only niche is essentially inherited disorders, so unless you find one that ties in well with heme-onc AND find a place that supports you to just see those patients, IMO doing a med-peds residency is overkill for purposes of heme-onc.

 

[Oncmudphud]

Thanks for the insight. I think it is good to know that Fellowship may be even more favorable than the residency match if things go well. Is there any advice as to what to do to keep my research at least above water during residency?

I didn’t do a huge amount of research in residency, honestly. I had a couple pubs by wrapping up some stuff I’d continued during med school. But, otherwise, my research during residency was minimal. My philosophy was that I’d spent enough time establishing my research skills. Residency was time for me to focus on clinical stuff.


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[pandaNH4]

I'm an MD/PhD in a similar situation. I went on a bunch of PSTP interviews, but thinking about ranking categorical programs more highly based on location. The thing I am struggling with most is how to factor in residency program prestige. How much would my fellowship options be limited by going to a program like NYU vs. a program like WashU? I'm from the northeast and have most of my friends/family there, but am not really tied down there in any significant way. My med school grades are bad, but my board scores are slightly above the national average and I had a productive, but not super productive PhD (2-3 first author pubs, 2-3 lower author pubs, and lots of abstracts, posters, etc.)