Specialty after a postdoc

[moonlightbrat]

Hi everyone! I'm planning to go to the US right after clerkship (Quebec uni). I have a PhD and I've actually realized that I want to pursue research instead of a career as a hospital worker. My plan is to go straight into a postdoc after clerkship, skipping CaRMS. However, I would like to know how hard it would be to come back to med if I ever decide to do a specialty later in the future. Let's presume that I'll have quite some success during my postdoc and following years as an MD-PhD researcher 

[Bambi]

If you ever have any intention of becoming licenced to practice, common sense dictates to do residency immediately after graduation and become licenced. Any other approach will open yourself up to unnecessary issues. Anyhow, this is my advice for what it is worth. As to whether or not you will choose to practice, this is an entirely different matter. In the best case scenario, delay is not helpful to you.

[1D7]

1 hour ago, moonlightbrat said:

Hi everyone! I'm planning to go to the US right after clerkship (Quebec uni). I have a PhD and I've actually realized that I want to pursue research instead of a career as a hospital worker. My plan is to go straight into a postdoc after clerkship, skipping CaRMS. However, I would like to know how hard it would be to come back to med if I ever decide to do a specialty later in the future. Let's presume that I'll have quite some success during my postdoc and following years as an MD-PhD researcher 

I agree with the above. If you wish to practice as a physician, it's best to do residency immediately.

If you did do a postdoc, logistically I believe you should in theory be eligible to re-enter in the first round even years after medical school (though you should verify that with CaRMS). However, the longer you are out of medical school, the more people will question if you are able to function clinically jumping into residency. Ultimately you have to be able to handle call duties, which in some specialties requires a very high degree of independence. Also your clinical reference letters will be far out of date.

I think the specialties that are most open are those that are least competitive and have relatively easier overnight call duties, usually FM, public health, and pathology. Beyond that, I think a successful research heavy background may be perceived a plus in certain specialties that are driven a lot by research (mainly IM/subspecialties, neurology).

I feel that people would question if you're comfortable/capable of jumping directly into 24+ hr call if you were applying to a surgical specialty, or even radiology & anesthesia. You might be able to mitigate this if you are working directly with the PD of a program you are interested in as a postdoc, but at that point it comes down much more to luck.

[moonlightbrat]

2 hours ago, Bambi said:

If you ever have any intention of becoming licenced to practice, common sense dictates to do residency immediately after graduation and become licenced. Any other approach will open yourself up to unnecessary issues. Anyhow, this is my advice for what it is worth. As to whether or not you will choose to practice, this is an entirely different matter. In the best case scenario, delay is not helpful to you.

Thank you, Bambi! I don't want to close that door completely, but I don't think I'll want to practice as a doctor. I just want to know if it's feasible to do your residency years after your clerkship. I would only be interested in research-heavy specialties like medical genetics.

[moonlightbrat]

54 minutes ago, 1D7 said:

I agree with the above. If you wish to practice as a physician, it's best to do residency immediately.

If you did do a postdoc, logistically I believe you should in theory be eligible to re-enter in the first round even years after medical school (though you should verify that with CaRMS). However, the longer you are out of medical school, the more people will question if you are able to function clinically jumping into residency. Ultimately you have to be able to handle call duties, which in some specialties requires a very high degree of independence. Also your clinical reference letters will be far out of date.

I think the specialties that are most open are those that are least competitive and have relatively easier overnight call duties, usually FM, public health, and pathology. Beyond that, I think a successful research heavy background may be perceived a plus in certain specialties that are driven a lot by research (mainly IM/subspecialties, neurology).

I feel that people would question if you're comfortable/capable of jumping directly into 24+ hr call if you were applying to a surgical specialty, or even radiology & anesthesia. You might be able to mitigate this if you are working directly with the PD of a program you are interested in as a postdoc, but at that point it comes down much more to luck.

Hi 1D7! Thank you so much for your answer. I would actually only be interested in research-oriented specialties. My research focuses on genetics, and I think that medical genetics is the only specialty that I would consider. Also, I would specialize in the US, not in Canada. It sounds complicated, I know, but I do think that I have a bright future in research, so maybe that would help me convince the geneticists that I'm capable of joining them even years after clerkship. Nonetheless, this is only a possibility. I do think I'll just stick to research. I just wanna know if the door will remain open.

[1D7]

1 hour ago, moonlightbrat said:

Hi 1D7! Thank you so much for your answer. I would actually only be interested in research-oriented specialties. My research focuses on genetics, and I think that medical genetics is the only specialty that I would consider. Also, I would specialize in the US, not in Canada. It sounds complicated, I know, but I do think that I have a bright future in research, so maybe that would help me convince the geneticists that I'm capable of joining them even years after clerkship. Nonetheless, this is only a possibility. I do think I'll just stick to research. I just wanna know if the door will remain open.

I think it is probably better to reach out to residents/staff at your institution, as well as SDN or Redd.it since there are more Americans there. Americans in general tend to look more favourably upon research years than Canadians.

I believe in the US you can enter genetics via residency applying to the NMRP match system, or enter it via fellowship. But to be eligible for the NMRP you need the USMLEs and look into the visa situation.

Additionally, somewhat recently they announced that Canadian & American medical schools will no longer be considered reciprocal for students graduating by 2026. I don't know the exact details but you should clarify if you will be considered an IMG or USMG by the time you plan on applying to the specialty, as that will affect how you navigate the system and your chances (i.e. IMG pool for the match, needing ECFMG certification). I do not believe genetics usually fills up every spot for now but its possible it becomes more popular in the future as it plays an increasingly larger role in diagnostics.

[Bambi]

15 hours ago, moonlightbrat said:

Thank you, Bambi! I don't want to close that door completely, but I don't think I'll want to practice as a doctor. I just want to know if it's feasible to do your residency years after your clerkship. I would only be interested in research-heavy specialties like medical genetics.

Focus on what ID7 has posted! For many, many reasons, I would reverse the order of what you propose to do - in your own best interests - with a view  to accomplishing your career goals.