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Poor Undergrad - give up Derm?


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3 hours ago, blah1234 said:

I think bringing grades back would be the greater evil. While there is anxiety and stress about matching I would have to say that my experiences as a student and my observations as a instructor reveal general collegiality between students. I think if you put in a number or grade that helps stratify students which can impact their job prospects then we will approach to how law school is which can be cutthroat and competitive. I think the stress of medicine comes from the subject material right now and if we bring grades back I worry that students will start being antagonistic towards each other which is another level of stress they don't need. 

Perhaps you or your institution are doing something right (for example, posing questions to individual students rather than to a group as a whole?). Unfortunately, given the stress over clerkship evaluations with regards to residency matching, my medical school friends and I found the environment quite competitive. Often it was uncomfortable to answer questions correctly in front of peers, or to be in the right place at the right time and be offered a procedure that not everyone else had yet had the opportunity to do, because of the thinly veiled hostility that could result (of course, when staff/residents were out of earshot; good cheer was the norm until then). 

Back to the original question, I agree that a student's candidacy is based on their current performance and if felt to be strong, it is unlikely that the undergrad transcript would make any dent in their desirability. If it's being used as a discriminator, the program is probably on the fence about the student anyway.

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1 hour ago, Lactic Folly said:

Perhaps you or your institution are doing something right (for example, posing questions to individual students rather than to a group as a whole?). Unfortunately, given the stress over clerkship evaluations with regards to residency matching, my medical school friends and I found the environment quite competitive. Often it was uncomfortable to answer questions correctly in front of peers, or to be in the right place at the right time and be offered a procedure that not everyone else had yet had the opportunity to do, because of the thinly veiled hostility that could result (of course, when staff/residents were out of earshot; good cheer was the norm until then). 

Back to the original question, I agree that a student's candidacy is based on their current performance and if felt to be strong, it is unlikely that the undergrad transcript would make any dent in their desirability. If it's being used as a discriminator, the program is probably on the fence about the student anyway.

You're right I shouldn't be generalizing my experiences as I have only experienced one medical school. I am sad to hear that it wasn't collegial everywhere. 

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6 hours ago, ZBL said:

This same mentality applies to why it’s so hard to get an academic position - it is insufficient to simply be a good/smart clinician, and board scores are not used for hiring. 

I'm convinced at least 50% of the reason it's hard to get an academic spot is people want an academic position is to stay in a big city. For every research loving staff, there is another one who doesn't really care about academic medicine but sure loves living in Calgary/Toronto/Quebec City etc. and is willing to play the academic game in order to love where they want. 

Out of the people I know who went into academic centers, probably only half of them care about research and academia at all. 

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44 minutes ago, NLengr said:

I'm convinced at least 50% of the reason it's hard to get an academic spot is people want an academic position is to stay in a big city. For every research loving staff, there is another one who doesn't really care about academic medicine but sure loves living in Calgary/Toronto/Quebec City etc. and is willing to play the academic game in order to love where they want. 

Out of the people I know who went into academic centers, probably only half of them care about research and academia at all. 

ha 100% agree. I think many med students would be very surprised at the limited amount of research many so called academic doctors actually do. It is just that in a ton of places, as you say, the only way to remain in the city and work is to work at the academic centre. There are ton of reasons people want to remain there of course way beyond research opportunities. 

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1 hour ago, NLengr said:

I'm convinced at least 50% of the reason it's hard to get an academic spot is people want an academic position is to stay in a big city. For every research loving staff, there is another one who doesn't really care about academic medicine but sure loves living in Calgary/Toronto/Quebec City etc. and is willing to play the academic game in order to love where they want. 

Out of the people I know who went into academic centers, probably only half of them care about research and academia at all. 

Oh I don’t doubt or disagree with this at all. Once you’re in you can do what you want (just like residency applications, once you’re in you’re in and all the ECs don’t matter). But in both cases, to get in you have to play the game. 

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2 hours ago, ZBL said:

Oh I don’t doubt or disagree with this at all. Once you’re in you can do what you want (just like residency applications, once you’re in you’re in and all the ECs don’t matter). But in both cases, to get in you have to play the game. 

assuming you don't ever want to advance I suppose :) Research output etc still is the main way to climb the ladder. 

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8 minutes ago, rmorelan said:

assuming you don't ever want to advance I suppose :) Research output etc still is the main way to climb the ladder. 

Don't you need a certain level of output to even stay? You can't just coast if the original position was looking for a researcher of a certain calibur. 

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39 minutes ago, blah1234 said:

Don't you need a certain level of output to even stay? You can't just coast if the original position was looking for a researcher of a certain calibur. 

Most academic staff I know are coasters. Probably center and position dependent on how much you can coast. 

Also, even academic centers need to provide even routine specialty services. The less academically inclined staff seem to do more of the heavy lifting clinical care. 

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14 minutes ago, rmorelan said:

assuming you don't ever want to advance I suppose :) Research output etc still is the main way to climb the ladder. 

I'd rather climb the high performance sports car and expensive liquor ladder. That ladder is way more fun. #bigpimpin

Hahaha

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Yes, the position should detail the expectations for academic contributions, as overseen by the chair. As stated, this could vary considerably, from someone whose main academic responsibilities are to supervise learners as they pass through, to someone who is expected to produce a certain level of scholarly output.

I suspect someone whose CV suggests they are "coasting" after meeting initial requirements for academic appointment / promotion might experience more difficulty in making a lateral move to another urban academic practice, for example compared to a rising star new grad whose CV shows no such downward trend. Nothing wrong with that if you're decidedly and permanently settled in an area (until retirement), but does prompt one to consider the longer term.

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23 minutes ago, blah1234 said:

Don't you need a certain level of output to even stay? You can't just coast if the original position was looking for a researcher of a certain calibur. 

oh no you can coast coast coast if you want in most places. The issues are moving up or moving sideways to another location. 

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19 minutes ago, NLengr said:

I'd rather climb the high performance sports car and expensive liquor ladder. That ladder is way more fun. #bigpimpin

Hahaha

ha!

I should point out there is also coasting completely, and just doing the minimum to not be complete obvious about it. Get the odd fellow or good resident to do the grunt stuff, or to come collaboration with others to reduce the real work involved and voila you can float along for ages. Do it long enough and you will be promoted academically too - and once you hit associate professor that is basically the end for even most hard working professor researchers. People stay at that level forever.   

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8 hours ago, blah1234 said:

Yea, the mentors in my field and centre seem perennially stressed about their academic demands. Perhaps they're overplaying the stress but it was enough to turn me away.

some once described it to me as similar to marathon training. 

No one needs to run a marathon. It isn't even particular good exercise (running one doesn't build you up it tears you down). You can be perfectly healthy never running one or anything even close to that - you just have to do some exercise. 

but often once you start running marathons you start become obsessed with all kinds of things anyone else would think is nuts - the clothing, the shoes, saving minutes off your time, the complex training schemes, the diet....... it is endless and never ending. You are surrounded by people equally obsessed with marathons - there are magazines, books, and videos all about marathons. Plus just like marathons there are handful of people that everyone knows that are great at it and well known and respect for it. If you want to be one of those people - well you are going to put in a ton of work to do it and probably still be pretty lucky as well. If you are successful you won't really get paid for it, but you will get a lot of things you can hang on your wall. 

Still you don't actually have to run any marathons. Unless you want to, and that is fine. More than fine - you do you and all that. But most people look at it that and say...no I don't think I will train so much that I can run for 3+ hours straight.  Those people are fine too. 

 

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Since this thread seems to have gone into a different direction, taught I'd update you guys on an email I just got this morning from one of the derm program directors I emailed. I won't say exactly what they said or which program, but to paraphrase, it was strongly implied that my application would be at a severe disadvantage with the situation I described in the email (same situation I described in this post).

 

Since it's already a 50/50 shot to match into derm any way, and given that so many program directors didn't even reply to me, and the reply I did get wasn't exactly reassuring, I'm going to go ahead and say I will no longer be pursuing a Derm residency. The elevated risk of going unmatched is unacceptable to me. I made this comment to help out anyone in the future who might be in a similar situation, hopefully they can find this post. 

 

Thank you all for your help

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On 7/10/2019 at 7:03 AM, tavenan said:

Since this thread seems to have gone into a different direction, taught I'd update you guys on an email I just got this morning from one of the derm program directors I emailed. I won't say exactly what they said or which program, but to paraphrase, it was strongly implied that my application would be at a severe disadvantage with the situation I described in the email (same situation I described in this post).

 

Since it's already a 50/50 shot to match into derm any way, and given that so many program directors didn't even reply to me, and the reply I did get wasn't exactly reassuring, I'm going to go ahead and say I will no longer be pursuing a Derm residency. The elevated risk of going unmatched is unacceptable to me. I made this comment to help out anyone in the future who might be in a similar situation, hopefully they can find this post. 

 

Thank you all for your help

-

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12 hours ago, tavenan said:

Since it's already a 50/50 shot to match into derm any way, and given that so many program directors didn't even reply to me, and the reply I did get wasn't exactly reassuring, I'm going to go ahead and say I will no longer be pursuing a Derm residency. The elevated risk of going unmatched is unacceptable to me. I made this comment to help out anyone in the future who might be in a similar situation, hopefully they can find this post. 

 

Thank you all for your help

Thanks for the update. Unfortunate because of your circumstances of full-time work during university, which could be viewed favourably in terms of work ethic. 

Yes, it would be unlikely that any program without knowledge of or investment in you would offer any sort of encouraging response, especially in a field where they presumably do not lack for strong candidates. Nice of that PD to provide a candid perspective. With a smaller pool, they might have more time to examine applications in detail. 

I don't know how important elective performance is in derm, but presume that it is likely to be significant. I can appreciate your view that you'd be putting your eggs in one basket to shoot for your home program,  or to rely on your ability to outshine other candidates on the elective circuit. Best of luck with your path forward, and finding other avenues with similar elements that appeal to you.

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