I hate going to the MudPhud retreat every year. It's mostly basic science people talking about western blots and flow cytometry and whatever else they do. And nobody has a clue about epidemiology so I spend all day explaining myself to people who promptly glaze over and then walk away.
And then there are the round table discussions we have with various basic science faculty members. NOT ONE of whom ever has the foggiest idea what Epidemiology is or what a person can do with that degree. As for career advice? The best any of them could come up with was, "Oh, I know a person who has a masters in Epi. She is a full time clinician and does a little research in her spare time. You could do that."
Translation: She has been unable to get any grants to fund protected research time, and as such she is NOT a successful investigator. To put it bluntly, she has flopped. She has to see patients 5 days a week in order for the hospital to employ her. She will never get tenure.
And that's about the best it gets from the basic science people. Most of them find out what I'm doing, glaze over immediately, and direct their attention to the cell and molecular biology person who is sitting on their other side.
FYI -- The career I want is one in which I see patients 1/2 day per week and do research the other 90% of my time. I would probably quit medicine if I had to be a full time clinician. Why? Because it SUCKS. Seeing patients part time and spending the majority of time on research is far far far preferable.
Why am I bringing this up now? I met with the MD-PhD program advisor yesterday, and we talked about what I want my life to be like 10-15 years from now. And that I need to start learning how to package myself so that I'll be able to differentiate myself from all the people who get masters degrees in epi when they do their fellowships. So I don't end up a full time clinician.
Which means I need to figure out what I want to do with my life. STAT.
So I've narrowed it down to a couple of things based on the areas I'm interested in:
1. Oncology -- Via heme onc, rad onc, or surg onc (less likely -- it's really hard to do really good research as a surgeon)
What do I like about it? I like the way the doctors interact with their patients. I find tumor biology interesting. The changes in treatments and tumor marker specific targeting are completely revolutionizing how cancer is being treated. Plus the myriad of options available makes it hard for patients to decide which treatment to choose. Really interesting field with a lot of trailblazers ahead of me who have carved out research careers.
Downside: How do I think of a topic to study?
2. Neuroscience -- via Neurology or Psychiatry (my husband really wants me to be an ophthalmologist, but I just don't see it happening).
What do I like about it? I've always found behavior really interesting, and the pharmacology is fascinating. There is a huge amount of Epi research that needs to be done. I also liked the way the psychiatrists (less so the neurologists) talked with their patients. I think there are going to be a lot of advances in the understanding of mental illness and it would be nice to be on the leading edge of that research.
Downside: How do I think of a topic to study?
3. Health Services research -- via Emergency, or frankly anything else.
What do I like about it? You can do research that affects a large number of people and is immediately applicable to patients. I really enjoy economics and cost-effectiveness research, and I've done it before so it comes more easily to me than some of these other subjects.
Downside: The thing is, I'm not sure how excited I am to spend my career coming up with the algorithms (picture the one used to assess whether the patient has a PE) that doctors use to treat patients for the rest of my life. So, it's falling farther down on my list.
Everyone I talk with is like, "Come see me again once you've made a decision, and we'll talk more." Or, "Come see me when you've thought of a topic and we'll talk more."
Well, how the heck am I going to think of a topic when I am just beginning to learn about the field? There is just so much out there! How does anyone do it? Ugh. But of course coming up with a topic -- or the process of doing so -- is the secret of not ending up a full time clinician. It's also part of what I'm supposed to learn how to do as an MD-PhD student.
Hopefully I'll get there in the next year or so.
5 Pearls of Wisdom:
I hate the feeling when you are trying to move forward, have a general idea but just can't make that one crucial decision. I also hate the feeling of moving forward in some areas of your life but feel like your standing still in others.
Can't we all be grown ups already??
Seriously though, with all the decisions a plain old MD student has to make I can't imagine my boyfriend handling the additional PhD decisions well.
Good luck!
have you thought about doing ID...many ID physcians have epi or other MPH backgrounds and they do research 90% of the time. I am a Pharmd who does outcomes research in transplant patients. Just another idea. I think Heme/onc would be great too. Good luck.
Your hubby wants to "see" you become an Ophthalmologist! Hilarious. And now back to reality.
Anon -- I actually have thought about ID. I didn't even realize transplant ID was a field until my medicine rotation, and it seemed really cool. I've thought about allergy and immunology too, for what it's worth.
But, I only have room for three electives before my sub-i so I have to draw the line some place. I am sure that I will take an ID elective when I return from PhD-land, or perhaps even as part of this "clinical connections" think they make us do.
Ultimately I decided I liked heme/onc because of the nature of the doc-patient relationship as well as the biology and complex decision making.
RAG, You are a dork.
;-)
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