Reference Letter from PI

[Guest aktpkb]

Hey guys, I am need of some advice. I want to ask my research prof for a med school reference letter. The dilemma is how do I go about asking him when I have already expressed an interest in research (which is true). I enjoy reserach for sure, but I want to go into medicine so what should I do? I know I have to be honest, but he might take it that I wasn't since I told him I like research.:|

 

Help me! thx.

[Guest Kirsteen]

Hi there,

 

First, you need to assess the nature of your relationship with your PI so that you can best weigh how to approach him for a letter and if you should do so at all. Most folks appreciate candor and honesty and a thoughtful and sincere request; however, if your supervisor might resent your application to medical school (as some do), and potentially scuttle your ability to get a good letter, or sour your remaining months with him, then you might not wish to request a letter at all. In all, you are the best judge of your relationship with him, so have a think before you approach him re: how and if you will.

 

If you feel that your supervisor might be willing to write you a positive letter for medical school then you can couch your request in a way that demonstrates and explains your dual liking for research as well as medicine. For example, you might wish to explain how you came to be interested in both pathways, and if you would like to continue with some research during medical school or beyond, you could share those sorts of thoughts as well. Lastly, you might wish to provide your PI with your gameplan for the next year or so while you are applying to medical school. No doubt, they might be concerned re: your timeline for finishing your research work. Putting them at ease by demonstrating that you've thought about that might help.

 

Cheers,

Kirsteen

[Guest aktpkb]

Hi Kirsteen,

I know my PI and he would not have any sort of resentment over me applying to medical school. Many other students have applied from my lab and they have all received full support from him. But there is one major difference, they were all graduate students, while I am an undergraduate. I have this nagging feeling that by telling him I want to go to medicine, he would see it as losing a potential graduate student.

 

I keep playing out the potential discussion with him in my head and all I can imagine is his "disappointment" over me placing going to medical school as the superior choice to research.

 

As for going into something like md/phd, I have thought about it, but for the purposes of this year (I am entering 3rd year), it is not an option, so how can I say to him that for this year, I am placing medicine over research, but next year, if I apply for md/phd, they are equal again?

 

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[Guest 007]

You could always just be honest and say that you've really enjoyed your time doing research with him and you're looking foward to doing more research in the future, but for right now you want to do medical school and then ask if he would be willing to write you a strong letter of recommendation. If questioned, you could explain the different routes you are considering.

[Guest ilitvino]

I guess the key question is whether or not you have told your PI that you want to do grad school? If you have not -- you are ok.

 

I wish to stress that as a med student resident and later as a physician you will have many opprortunities to do research. You can do research rotations in the med school, do a long fellowship and stay in a lab for a couple of years. After such long fellowship you can go and start your own lab in a clinical department in a canadian or US faculty of medicine. Also, many physicians are engaged in translational and clinical research. (Translational research is taking the basic science knowledge and applying it in clinic-- the famous bench to bedside !) Note that many, many physicians do research. Notice that many nobel prizes in medicine and chemistry are awarded to MDs.

 

So... you can go to medical school and prepare yourslf to do quality research. (and, of course, you absolutely must go to med school to do clinical research). In addition, you can explain that you love research, but it is important for you to remain connected to the human side of medicine. You don't want to study gene A and protein B or prepare and file small molecules (therapeutics) all your life -- you want to be able to work with patients, see how disease presents itself and let that drive your research efforts (academically and inspirationally).

 

Also, you can say that you have concerns over the funding outlook in basic research. Currently, CIHR funding in Canada is not growing and many grants are getting cut (the same trend is occuring in NIH in the US). In the states current success rate for NCI grants is only 16%! I am talking -- some of the excellent scientists here get their grant proposals rejected! Read this article:

www.macleans.ca/topstorie...830_107830

Hence, you can explain that you love research and you want to do research, but you want a bit of a safety mechanism...

 

Best regards,

Ivan

[Guest aktpkb]

Hi Ivan,

You make some excellent points. First of all, we haven't really discussed about my future in the lab yet so I have not made mention of grad school.

At some point, if I were to become a physician, I would like to do some clinical research as well. It seems like what it comes down to is what sort of path I want to take. I can wait another year, apply for md/phd, or apply this year for md and later on during residency, then do research or do research after residency.

 

With respect to your safety mechanism, wouldn't that be construed as having financial security?

 

 

Another question: is it possible for someone with an md degree, but NOT a BSc, MSc, or Phd to do clinical reseach?

[Guest peachy]

As for going into something like md/phd, I have thought about it, but for the purposes of this year (I am entering 3rd year), it is not an option, so how can I say to him that for this year, I am placing medicine over research, but next year, if I apply for md/phd, they are equal again?

Choosing to do an MD/PhD program is a pretty big committment. That's three to five years of graduate school to get a PhD. It's certainly not something that you should be considering because it'll help you get a reference letter!

 

Just be honest with him! If you honestly like research, and you also honestly want to be a doctor, then tell him that. He's probably had dozens of students who went on to medical school - it's pretty common. You won't be the first one to tell him this.

[Guest aktpkb]

Choosing to do an MD/PhD program is a pretty big committment. That's three to five years of graduate school to get a PhD. It's certainly not something that you should be considering because it'll help you get a reference letter!

 

Peachy: I think you have misunderstood me. I certainly know that Md/Phd is a big commitment - by the time a student in that program finishes both med and PhD, one will be already in their 30's about. However, I am honest when I say that I would consider it in 4th year, but this is not to appease my PI in order to write me a reference letter.

[Guest uteng]

You do not have be an MD to do clinical research. You need an MD involved if your research requires an intervention with a patient though or something where you need to capture part of the patient procedure though.

 

As a researcher, or student, you can propose a clinical study, gain support from an MD or department, run it through ethics, and away you go. You could even do chart reviews on past charts without an MD, though you may want one to make sense of them

 

In my opinion you should not mention the downsides of research noted my ilitvino in your discussion with your PI - keep in mind this is their chosen path

[Guest ilitvino]

Dear Collegues,

 

I will actually beg to differ with uteng and say that you absolutely do need an MD degree to do clinical research. Currently, I am completing a Ph.D. at the Johns Hopkins School of Medicine (Baltimore, MD) and I can say from my experience that it is very difficult to do anything clinically without an MD. The laws state that you cannot touch a patient without an MD degree (you will always have to have a full-fledged physician by your side). Also, if you are a Ph.D. (not even talking about people with just a masters or a bachelors) -- you will have to accept a second-class or third-class citizen status in the project and department.

 

Also, I think that there is nothing wrong in frankly discussing the funding difficulties. The fact that you have investigated this matter only underscores your scholarity and maturity. All faculty and researchers are aware of the situation. I am sure your PI will be mature enough to openly discuss this with you.

 

Finally, in your situation, unless you are absolutely passionate about doing a Ph.D. (as a part of an MD-Ph.D. program), I would say go straight into an MD program and then just do a long fellowship in an area of your interest.

Regards,

Ivan

[Guest aktpkb]

If what I understand from this correct, you need an MD to do clinical research, but not necessarily a PhD only.

This raises the question of whether you need some sort of graduate level work in addition to MD to do clinical research?

 

Ivan: what are these fellowships you mention of? Are they for MDs in particular who just want to do some research as well?

 

Because if there exists the opportunity to earn an MD degree first, and then add the research component in, that would be great.

[Guest uteng]

Well ilitvino we both agree you can't perform an intervention on a patient without an MD.

 

I'm currently doing clinical research though. The PI is an MD, but I came up with the protcol, got ethics approval, recruited the physicians (with the use of the PI's name of course), recruited patients and obtained consent, and will be doing the analysis, and writing up the results. Since I don't have the patient load he does, I can devote all of my time to the study. I can't do this without him, no question, but I don't feel like a second-class or third class citizen as you put it. Different hospital, different staff, different perspectives I guess.

 

As one of the MDs puts it, an MD/PhD will grease the wheels, make it easier to apply for grants, but when it comes down to it the research productivity will win out regardless of MD, PhD, or any other letters you care to throw in.

 

uteng

[Guest Kirsteen]

Hi there,

 

ilitvino, I too completed my MSc (pre-medical school) with a project centered around radiosurgical treatment of arteriovenous malformations. Pretty clinical stuff. Although it may differ from department to department or from university to university, I certainly was not treated like a second-class clinical research citizen at UofT. I was responsible for writing my own funding applications and the research protocol, as well as for conducting the research and writing up the paper. There are 3 names followed by "MD" on that paper, but they are sandwiched in between the names of myself and that of my supervisor.

 

You're absolutely correct in that you do need an MD degree to tackle clinical research, but you certainly don't have to be the person holding the degree.

 

Cheers,

Kirsteen

 

P.S. I also completed some Clinical Epidemiology courses at Johns Hopkins and although many of the folks in my classes were MDs, not all of us were.

[Guest ilitvino]

Ivan: what are these fellowships you mention of? Are they for MDs in particular who just want to do some research as well?

 

Ususally, people will complete their MD degrees and then will go into a residency program. It depends on you choice of a program, but in internal medicine, for instance, you can then complete a fellowship within a particular division of internal medicine -- ongology, gastroenterology, infectious diseases, etc. While completing a fellowship, you will have to spend some time in lab studying a relevant disease process. How long you want to train in the lab is entirely up to you and your PI. This is the time, when you can get plenty of research experience.

Regards,

Ivan

[Guest aktpkb]

Ususally, people will complete their MD degrees and then will go into a residency program. It depends on you choice of a program, but in internal medicine, for instance, you can then complete a fellowship within a particular division of internal medicine -- ongology, gastroenterology, infectious diseases, etc. While completing a fellowship, you will have to spend some time in lab studying a relevant disease process. How long you want to train in the lab is entirely up to you and your PI. This is the time, when you can get plenty of research experience.

 

Would it make a difference if someone did not have a BSc and entered medicine after three years?

[Guest ilitvino]

Would it make a difference if someone did not have a BSc and entered medicine after three years?

 

No, it would make no difference. After you get an MD degree your Bachelors Degree is pretty much irrelevant (and worthless). In other words, you can have one bachelors or two or three or none at all and it will be all the same.

Regards,

Ivan

[Guest blinknoodle]

hey aktpkb,

 

I totally understand your anxiety about asking your supervisor about a reference letter. As others have mentioned, it is best to gauge how your supervisor will feel about you applying to medical school (assuming that if they support you then a LOR will be no problem). One of my research supervisors *COMPLETELY* flipped out after I told him I was simply *applying* to medical school, mainly because I think he felt like he was losing a potential grad student. I wasn't planning on asking for a med LOR, but it definitely confirmed not to ask for a LOR for medical school or even something research related, or to consider staying in his lab for any graduate work! We ended up building a really good relationship throughout the rest of the year which was best for both of us.

[Guest aktpkb]

hey blinknoodle,

If I understood you correctly, you were not interested in a LOR from your supervisor, but the topic of applying to medical school came up?

Right now, I am trying to determine how my PI has handled other undergraduates applying to med because I think that will give me an indication of the situation.

And I understand why PI's may not take this situation too well because they may be losing a potential grad student like you said.

[Guest aktpkb]

No, it would make no difference. After you get an MD degree your Bachelors Degree is pretty much irrelevant (and worthless). In other words, you can have one bachelors or two or three or none at all and it will be all the same.

 

I was always under the impression that having a BSc would be more advantageous with a MD. Isn't that why most schools are turning towards having an undergrad degree as a requirement? In fact, UT says on their website that they won't be offering deferrals to third year students who are wanting to finish up their degrees.

[Guest satsumargirl]

I was always under the impression that having a BSc would be more advantageous with a MD. Isn't that why most schools are turning towards having an undergrad degree as a requirement?

 

After you have your MD your BSc isn't really going to matter.

I think the reason why schools are going toward requiring a completed undergrad is because they can. There are a large number of applicants and those that have finished the full 4 years have an extra year of life experience and also that is usually when you do your undergrad research thesis (if your program requires it) so you also get some research/critical thinking skills.

 

 

As for clinical research, you absolutely do not need to be an MD to do clinical research. First, MDs are not the only clinicians out there....there are physios, OTs, nurses, SLPs, audiologists, RDs etc. that are ALL clinicians who are involved in "clinical" reasearch.

 

Second, it is hard to be a good clinican and a good researcher at the same time. Just because you went to med school doesn't mean you will know how to go about doing research (they will still maybe give you money....but will an MD know what to do with it? That is what grad school teaches you, and I know MDs who are involved with research and have no clue about stats or anything, so they work with PhDs who essentially do the research after they've come up with the clinical questions). In the PhD world it is generally accepted that MDs don't do good research. And why would they be expected to be ...they spent 4 years of med school doing clinical work and then more residency doing clinical work with maybe a bit of research thrown in. The PhD has done potentially a 2 year Masters, a 4-5 year PhD and maybe 1 or 2 post-docs learning just about research. (of course there are exceptions and there are MD/PhDs)

 

In some cases where procedures are involved an MD would need to be part of the team. But often it's the PhD who is really leading it.

 

Take names on papers with a grain of salt. My first publication has me first author, then an MD and then a PhD.

The MD has no clue what I did, how I did it, or how to even explain the results. The MD wasn't even in the country for half the time I was doing my research. Essentially you know the first author did alot and probably most of the work. But the rest you don't really know.

[Guest medeng]

A bit off topic, but a pretty good description of the order of authors on papers!

 

www.phdcomics.com/comics/...omicid=562

[Guest 007]

Honestly, I wouldn't worry about it so much, aktbpk. It sounds like you have a good relationship with your professor. I asked my PI that I was a summer student with if he would be willing to write me a strong letter of reference and he said yes, and I felt his response was genuine and so I brought the papers in for him within a few days. I think most people realize that at this stage in the game, you are still exploring different options and I even know of some PI's who prefer that you make the decision now to do something else rather than them putting in the time to train you during a masters and have you leave without doing a phD. Most would also rather have someone in their lab who is genuinely interested in doing the grad work at that point in time than someone whose interests lie elsewhere.

 

I'm sure your PI has dealt with this situation before and will deal with it again. I'd just go for it and if you get the sense they aren't going to write you a good letter, then don't give them the papers and find someone else.

 

Don't let the fear of something that might happen prevent you from getting where you want to be. If you're worried about losing the contact in case you later want to do a masters with this PI, then just put in the effort over the next few years to stay in touch and show you're still interested in their work.

 

Edited to Add: I reread your posts and again, I reiterate, don't let their emotions and potential disappointment prevent you from taking the career path you want. Their feelings are their own responsibility. Sometimes, you have to do what you need to do for yourself.

[Guest blinknoodle]

hey blinknoodle,

If I understood you correctly, you were not interested in a LOR from your supervisor, but the topic of applying to medical school came up?

Right now, I am trying to determine how my PI has handled other undergraduates applying to med because I think that will give me an indication of the situation.

And I understand why PI's may not take this situation too well because they may be losing a potential grad student like you said.

 

Yup, I had no intentions of getting an LOR from my supervisor for meds [future LORs for research were a definite possibility], but the topic of med school applications came up somehow. Even though I was at an early stage of the applications, he felt I was a strong candidate and thus assumed he'd lost a (potential) grad student. There is some good advice here, and I'd suggest at least letting your PI know you're considering medical school which should clear up future expectations. The funny thing about my supervisor was that he knew I was considering MD/PhD programs (and even gave me a contact for someone who was working on implementing a new MD/PhD program at my university) but somehow went ballistic when I mentioned it again 4 months later. Heck, PIs are human too - they have their good days and bad days - and I learned a lot more than just research during that thesis project.

 

Btw, that authorship link was hilarious.

[Guest aktpkb]

Thanks everyone for their responses! I will speak with my PI within the next few weeks and just ask the darn question, haha.

 

I know that I can't live in doubt of potential consequences because if I don't take chances, opportunities will not come.