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ZBL

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ZBL last won the day on January 13

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About ZBL

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  1. Come back when you’re a 4th year med student 300K in the hole and panicking about government funding cuts to doctors and how there’s no jobs, and how you’re about to blow 10K+ on a trans Canada interview tour for a residency position where you will work 90hrs per week for 5 years at the equivalent of minimum wage yet you’re now 30+ with a wife and kid to support in a city away from your family and friends who all have careers and are progressing in their life and meanwhile you’re wondering why the hell you did this to yourself as you eat an expired package of kraft dinner at 4am in a hospital basement while your pager is going nuts because “FYI” Mr. Jones’ K+ is 5.1. At that point, regardless of how much you love being a doctor and helping people, let’s see if you’d still prefer pennies.
  2. Honestly if you’d be equally happy doing FM, just do FM and save yourself a summer of research, and 3-4 extra years of residency
  3. Yes I think the rationale for cutting it short is the MD, but in my view (and many PhDs) is that this is incorrect. Medicine teaches medicine, just as a BSc in computer science or physics teaches those things - doesn’t prepare someone any more or less for a PhD which is a research degree at its core. I think some PGME/CIP programs have a belief that an MD gives some preliminary research training, but that’s really not the case. An MD is no more prepared for a medically oriented PhD than a physics BSc for a physics PhD for instance. Many years ago, before there was such competition for academic medicine, many physicians undertook research fellowships instead of PhDs and today are leaders at big centres. That will essentially never happen in today’s day - so many academic departments require grad training essentially to be considered. There are remarkably few MD-only academics leading basic science or applied science labs, and in terms of NIH funding MD/PhDs are routinely more successful than their MD-only counterparts, even those with research fellowships. In many cases, the post-MD research fellowships are very different from the way PhD research would be done as well. I think there’s also a difference between managing a research team of people with specific areas of expertise, and being the person with that expertise yourself - no right or wrong avenue, but the latter is significantly more challenging for an MD-only to accomplish, while either one can potentially do the former. Now, despite all that, I totally agree there’s a fine balance between doing what you need to do in a PhD and getting out, taking so long that you are wasting time and not getting anything more out of it. and blowing through it too fast such that you don’t get enough out of it. I think 4-6 years in total of grad studies is the sweet spot (including any time spent in a masters). Keep in mind that at most PhD granting institutions, the typical scenario is someone without a MD - so while the PhD may be shortened, there’s usually the expectation of a few years of post-PhD fellowship on top of it so it eventually adds up, whereas for MD/PhDs many times we get away without doing a research fellowship afterwards. Bottom line I think is there’s no fast route to all of this stuff, and the career of a physician with MD and PhD training (regardless of when that’s undertaken) is significantly, significantly delayed from our MD-only colleagues.
  4. Will add that a lot of the 3 year PhD’s happen due to someone’s requirement to get a PhD rather than their choice - many specialties “need” this now to get an academic job, despite the fact most never do research once they’re a staff. So for those people, I can see why there’s a willingness to just get it done and check off the PhD box so to speak - doing the PhD for the wrong reasons really, which maybe is wrongly perpetuated by our current academic medicine situation.
  5. It often does, but it should not! It is really at the expense of the quality of training. A proper PhD should be 4 years minimum (5-6 if counting time in a masters) - if one is investing time into a PhD it should be done to the full extent in my opinion. Many PGME departments are quick to let MDs fly through it with less course requirements or low quality projects, presumably thinking that MDs come to the table with some baseline research qualification over a BSc (which MDs dont - we just have content knowledge, just like BSc’s do), but the graduates really don’t come out as strong that way. After all, one year is usually coursework and planning your project, then there’s a candidacy exam (usually 3-4 months solid to study), and execution of a substantial research project (or series of projects) of appropriate scale, complexity and novelty for a PhD, plus writing, collaborating on other projects, supervising students etc. Three years is just too fast to do all that properly in a PhD and come out of it as an expert capable of leading a research team independently.
  6. Every year that delays the start of your practice as a board certified MD is a year you miss out on billing 300-400K or higher per year. For a 4-5 year PhD that’s done before med school, during med school, or during residency, that’s a lot of money to miss out on. So you need to weigh the benefits that a PhD may give you for your career (residency matching, jobs opportunity/diversity, research/academia, etc), vs the potential financial drawback. in terms of doing a PhD before or during med school, or during residency, the issue is funding. A PhD before med school and you can apply for all the typical PhD awards, but you may not get them. A MD/PhD you can apply for the same awards, but also potentially receive additional funds to cover some med school costs, which is nice, again if you get them. Doing it in residency and you get paid a resident salary guaranteed which is more than any PhD award but also may not entirely make up for the scenario of being a fully funded MD/PhD (which is not a guaranteed thing). My advice is if you are unsure about the PhD, but for sure want to do med school then do the MD and residency first. The financial offset of doing a MD/PhD is paid for likely within 6 months of working as a staff.
  7. Agree. Not to mention the opportunity cost of doing a PhD at any point with an MD is at minimum $1 million, closer to $2 million in billings for many specialties.
  8. If you really want to do med school, I would do that first. No MD/PhD, no PhD first. Do the med school thing while you’re young. Then if you really want you can do a PhD in residency or as a staff where in both cases you will be paid well to do that.
  9. As above. Never heard of this but if miracles exist, this would be it.
  10. FYI I am not aware of any engineering graduate program that will allow you to finish in one year, let alone enter without a completed undergrad related to engineering.
  11. Pro tip: Don’t be a gunner. Staff and residents can smell the stink of a gunner, and it’s not pleasant. Make your moves towards a competitive specialty only once you know for sure what that specialty is all about and why you’d want to do it over any other.
  12. This is like asking “what blackjack table am I more likely to win on?” There’s no such thing as one that’s less competitive - only that they might be looking for different things, which you’ll have no way of knowing in advance.
  13. Buy a fancy vacation. Buy an upgraded car. Buy a top hat. You only live once and now you are net positive. Have some fun.
  14. GIM is the devil. That’s the difference.
  15. I’d venture to guess that no one in their right mind would do 5+ years of surgical residency/fellowship only to work clinic (which is very expensive to open up, and a separate limiting factor altogether). Not to mention that killing time in a clinic does absolutely nothing to improve your chances at getting hired for OR time, and in fact it may be a negative as you’ll be out of touch with key players in hiring and your skills will decline. If clinic is the plan, and you’d be happy with it, don’t do a surgical residency. Simple as that.
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