<p>Kat - I believe MBA is a highly valuable degree, that will keep many options open later in one’s professional career. Investment community surely loves to have business-savvy MD to vet out their health care related thesis, I can think many other doors would open if 100% clinical is not his thing. Your son got right “influence”.
Frugal - my observation following various threads here, I’d imagine at end of this competitive/relentless process, they all get tired, drained, loaded in debt, probably feel a bit “entitled”, when their peers in other career are so much ahead financially and living situation.
If Brown is right, most competitive specialties favor extra research year, then the word shall go out to the pre-meds. We are making it harder for our brightest, most caring, unselfish kids. </p>
<p>texaspg, I think DS believes his score is good (good enough for his targeted specialty) but is definitely not a mind bogging one as you said. Many of his peers who aim high and worked much harder than him will likely do better than him. I do not really know what would be considered as a very good score but I am aware that his is higher than the example score IWBB happens to mention earlier.</p>
<p>Talking about work ethics, I remember that, at one time, BDM said those students from public colleges tend to be able to work more hours than those from private colleges. There may be some truth in it. But maybe some international ones or “newer immigrants” may be even more so.</p>
<p>The additional research year topic comes up recently just because the financial aid form has this question. I guess the school needs to know how to calculate the COA or the OOP price for each student after MS3. His debt level keeps going up and will likely hit 6 figures right before he graduates. (The school seems to be only slightly “shy” about asking for parents’ contribution directly, but is more bold about asking the student to get loans, as compared to the FA in the college years. It is very different from tmdsas schools, where, if I remember it correctly, the students are treated more as adults and all or most of the expenses are their responsibilities, at least on paper.)</p>
<p>frugal,</p>
<p>I totally appreciate that not all change is good. For example, the work hour restrictions have not shown any benefit and if they have made any difference, it is for the worse.</p>
<p>But one of your points brings up a slightly different point:
My response to this is: why is the staffing situation such that someone needs to work a 72-84 hour shift because one physician needs to care for his/her (yes, I went there 
) wife? I also could say, why is it wrong that someone doesn’t want to work 72-84 hours straight? Couldn’t I question the physician for not hiring someone to take care of his/her bedridden wife so that they don’t have to miss the shift? Isn’t that what home health aides are for? Which physician’s time/family is more valuable? I know you can’t get an aide instantly, but surely you can get one within a few hours and not make someone work an extra 2+ days straight?</p>
<p>Talking about working hours, I was sick early last years. Two doctors who took care of me do not talk very favorably about their residency years. One of them even kind of accused the system of taking advantage of them. (He said they could hire more people if they are short of hands. They are not willing to just because they can - so as to maximize their profit. This doctor actually also moonlight in his early years in ER doing grave yard shifts for many years and paid back his debt relatively quickly. He is not the kind who chooses to get an MD and residency training, and very soon work fewer hours (like the wife of one of my coworkers.) He just thinks the system (medicare as set up by the politicians) is not fair to these new doctors-in-training. Yes, he is not very old - likely in practice for about 7 or 8 years only.) The other doctor, a surgeon, just said luckily he was young back then and could tolerate how he was treated better while that young – he went through some 6-year BS/MD program in some midwest state med school when this kind of program was still available. He seems to be glad that he had not “wasted” too many years in med school and spent more of his youth years in the training of his specialty. (Just his POV.)</p>
<p>I have heard about those pyramid residencies, if I understand correctly a certain number of residents are actually competing against each other as to who continues on in subsequent years. Yikes!</p>
<p>Also, I understand both sides of the generational issue. My DD asked me to start looking into the reality of life for women in certain fields, I have read a ton of MD blogs this past couple of years, trying to get a perspective on the long term and help DD possibly determine some questions to ask, questions she might not have thought of herself.</p>
<p>I do see that many MDs who take the time to write blogs (which would be an interesting subset in and of itself) do want real lives, they want to see their kids and their spouses and be active. I have spoken to a friend, my age, whose husband is a specialist surgeon, he has not done much in the raising of their kids. I assume they have made a great living, but I can recall even when the kids were young and we traveled together, that time off was for him to rest not parent. She has done all the heavy lifting and I am not sure that is right, either.</p>
<p>It does seem like all across the country things are moving toward more of an employee shift work mentality in many specialities. It will be interesting to see how it all pans out.</p>
<p>I don’t blame old timers for noticing and commenting on the young pups new & different attitude, dealing with all these special snowflake kids en masse ca be challenging 
But I do fault some of the specialties who seem to take a perverse pride in the malignancy of their program, just because they did it that way does not mean it is the right way now. And, yes, I am aware I have a dangerous amount of information gathered online not in person! I would never tell DD that “this is how it is, I read it on the interwebs” but would use the info I see to give her avenues to research for herself, in person and with her mentors.</p>
<p>I work for one of those very large physician management companies, run by business people, that have spawned over the last 2 decades. This trend began in emergency medicine and now transcends many different specialties. So, you are exactly right, why would a scenario exist that one absent doctor would damage the staffing balance. This is what has happened as Wall Street’s wealthy private equity firms became involved in medicine. To make the profits that the firms required, staffing has been managed based on metrics (numbers, ratios, etc.). We are staffed so tightly that one person leaving leads to these heavy hours. We have absolutely no say in how many people we can hire. If we don’t like it, we are shown the door. There are several hundreds of groups being managed this way and we are quickly getting into a situation where there is no place to run. If it was up to me, we would have twice the number of physicians in the group.</p>
<p>mcat2: the system was definitely taking advantage of the residents. And it was worst. I remember my uncle on Q2 call in NYC throughout his residency and was on backup call when he was post call. The residents went on strike in the 1980s just to go to Q2 call without the backup. Though the hours have improved, I have seen some decrease in skillset in the Allopathic surgical fields. The decrease in work hours, which I do support, has come with its detriments. I have to admit that the DO programs are very good with providing the surgical volume though lack on the academic side. My only answer would be to limit the hours except the last year prior to graduation. IMHO, this would give the residents more volume and experience in real life work hours before they graduate.</p>
<p>
This is pretty much exactly what I was expecting to hear.</p>
<p>To go back to the research year question, gotta love the NRMP and the data they make available. They surveyed programs in the various specialties that participate in the main match (unfortunately that means no urology or optho) and asked them to rate on a 1-5 scale how important various things were (with 5 being most important). Here are the averages per specialty for demonstrated interest in research (<a href=“http://b83c73bcf0e7ca356c80-e8560f466940e4ec38ed51af32994bc6.r6.cf1.rackcdn.com/wp-content/uploads/2013/08/programresultsbyspecialty2012.pdf):”>http://b83c73bcf0e7ca356c80-e8560f466940e4ec38ed51af32994bc6.r6.cf1.rackcdn.com/wp-content/uploads/2013/08/programresultsbyspecialty2012.pdf):</a></p>
<p>Rad-Onc 4.5
NeuroSurg 4.2
ENT 4
Plastics 3.8
Derm 3.7
Ortho 3.7
Vasc Surg 3.7
Neuro 3.6
Child Neuro 3.5
Path 3.4
Radiology 3.4
Surg 3.3
PM&R 3.2
Anesthesiology 3
OB/GYN 3
Psych 3
Peds 2.8
EM 2.7
IM 2.7
IM/Peds 2.7
FM 2.1</p>
<p>Just to chime in, the “extra year” thing seems to be quite popular among the CC crowd but quite unpopular among me and my friends. I happen to be pals with 2 of the guys in my class who will end up taking an extra year, and I think there are maybe only 2-3 more total doing an extra program (which would be about 5% of the class total). One of them took a year between M2 and M3 for a research year, and the other will take a year between M3 and M4 to sync up with his GF who is currently M2 at another school (which has a required research year, that they will be completing together, in the same city as each other for the first time in years!)</p>
<p>I literally cannot imagine another year of medical school/delaying graduation/delaying my career another year, and I applaud those of you/your kids who can tolerate dragging out this agonizing process even more. Hats off to you!</p>
<p>I, on the other hand, am figuring out how to navigate the world of applying to residency. Oy vey.</p>
<p>In regard to interest in research, D. was advised (she is just ears for now, lots of questions), that so many are stating their interest in research during the interview, that it might be a breath of fresh air to hear that applicant is actually more interested in patient care (if it is actually true) and not inclined to lie about his/her position. D. does not mind research, but it is certainly not as enjoable as working with people. But she abolutely loves to be in charge. This part is definitely attractive. </p>
<p>Frugaldoc- Son’s senior thesis, was about the economics of healthcare public vs. private (econ major) so he knew somewhat abut to which your are speaking…specifically the business models being used here and abroad. His junior paper was the beginning of the research and continued to his senior year thesis. He was joined by 2 other students doing their thesis’ crunching all the numbers (math majors). Presented interesting findings…their thesis advisor/preceptor went on to use the info for his research resulting in a nobel prize for econ. </p>
<p>With this info/research son is following a “path” for his future which included some research, certain degrees (education) and work experience. And again alum from his first undergrad school have played a surprisingly influential role. </p>
<p>Kat</p>
<p>Just to be clear about how popular these things are. At schools where research years are “incredibly popular” we are still only talking about 1/4-1/3 of the class. The majority of medical students are not doing them at schools where they are “incredibly popular” and obviously the schools where they are less popular have even fewer.</p>
<p>I get that it used to be far less, but it sorta sounded like people were starting to lose perspective about the fact that we’re still talking about a minority that is usually closer to 0 than it is to the majority.</p>
<p>
I sure hope you really meant “not as enjoyable as diagnosing, examining, and treating patients” because research, even in the basic sciences, still requires a lot of interaction with people.</p>
<p>
</p>
<p>It is funny you say that because D has mentioned that one thing her research year has taught her is that she would not want to only do research…though she consulted with people, being the only person working on her project was lonely for her. </p>
<p>D took the research year to build off of the type of work she had done in graduate school (MPhil in medical anthropology), and to better position herself for the kind of residency that will lead to the kind of fellowship that will eventually lead to an academic environment where she can have a clinical practice and continue research with a public/global health focus. A lesser but still significant reason for doing it was (as someone wrote earlier) to sync with the person who was her partner at the time. Unfortunately their long distance relationship became too difficult to maintain during the clinical years. </p>
<p>I think that IWBB hit it regarding the number of students taking a research year in D’s class…1/4 to 1/3.</p>
<p>^lot of interaction with people during research is not near the same level of interraction as dealing with patients and reporting hisotry to doc. She can only recommend, she cannot treat, she is not MD. She does enjoy people interraction during research but not so much upwards as down. Upwards communication sometime is frustrating, just the same as everywhere else, people have higher priority than somebody else’s projects.</p>
<p>Kristin,
As usual, D. feels the same, cannot wait to break out of academics and the same in regard to Residency application…foggy, ton of questions, we still do not know what is Prelim year and where to find them, except that they are more intense than Transitional, but location of Prlim might be better for her, location is always D’s criteria #1.</p>
<p>I’m not saying research is the same thing as working with patients, but I know many people who would automatically assume anyone who cited “not working with people” as a reason to dislike research as simply a person who didn’t really do research and doesn’t know what they are talking about.</p>
<p>I assumed that those were your words you wrote, not hers, but wanted to point out their flaw in case that is what she’s going around saying.</p>
<p>Can somebody please explain to me how a couples match works? Also, any info of how it worked out for people you know. Do they have to apply to the same specialty, or is it just the same location but can be different programs? Ugh…when does all this madness end! :)</p>
<p>elleneast - did your daughter go abroad for M.Phil? I don’t see too many discussing it in US.</p>
<p>“Can somebody please explain to me how a couples match works? Also, any info of how it worked out for people you know.”</p>
<p>The way I read it - If IWBB finds a child bride still in college who is just now coming to the medical school, he can work a couple or more years extra on his research in order to snychronize his residency with hers. :p</p>
<p>
=)) Indeed. People currently applying to medical school (the 2013-2014 cycle) will most likely be my classmates in the clinical years.</p>
<p><a href=“http://www.nrmp.org/new-e-learning-online-tutorial-couples-match/”>http://www.nrmp.org/new-e-learning-online-tutorial-couples-match/</a> (10 minute tutorial)
<a href=“NRMP Couples Match Example”>U-M Web Hosting;
<p>A shorter explanation for how couples match works is that just as an individual submits a rank list and the algorithm tries to match you into the program that you ranked highest that also ranked you, couples matching involves two people identifying themselves as a couple and submitting a rank list of every possible pair of results. The system then tries to match you into the highest pair. When there is a medical couple, couples matching definitely provides the highest chances for a good outcome as it allows one person to give up matching into a higher choice program in exchange for being in the same city. If you do it in separate years, then the first person is going to have to be matched without the algorithm being able to consider the success of the 2nd person.</p>
<p>This is just worst case scenario, but what happens when couples don’t match together? Btw, IWWB, my D will be roommates next year with A.</p>
<p>It does happen that a couple fails to match together. (I think D1 said that happened to peeps in the class 2 years ahead of her.) Then there are basically 2 choices: the couples separate, each going to their own program (at least for the first year); or they can sit out a year and try to couples match again the next year.</p>
<p>(The couple at D1’s school did the latter and did couple match the next year, albeit at a lower-ranked program than those they had applied to originally. She said they were told they had ‘over-reached’ first time around. One half of the couple had the goods for the programs they applied to but the other half just didn’t even come close to being what the program typically accepted. And the PDs didn’t want the better half enough to take the lesser half.)</p>