Paul Savage graduated from the MD-PhD program at McGill University in 2019. His research focused on mechanisms of drug sensitivity in breast cancer, using patient-derived tumor models. He then pursued residency training in general surgery at the University of Toronto.
Core rotations and electives are designed not only to broaden and enhance your knowledge base across the various disciplines of medicine, but also to give you opportunities to explore specialties you might pursue as a career. Generally speaking, the choices discussed in this chapter are made around the same time as you are returning to the wards (Chapter 18, Preparing for Your Return to the Wards) and will impact your future choice of residency (Chapter 22, Choosing the Right Residency, Applying, and Interviewing). Strategies for selecting rotations and electives have long been passed down by word-of-mouth from more senior medical trainees. These are naturally largely anecdotal, with no single approach being foolproof. Here, we discuss some of these strategies in general, as well as some special considerations for MD-PhD students.
Finding Your Future Specialty
While many MD-PhD trainees develop areas of clinical interest related to the topic of their doctoral studies, this is not always the case. The reality is that most research subjects are approached clinically through multidisciplinary teams and can therefore be addressed through careers across a multitude of specialties. For example, if you are interested in mechanisms of chronic pain, you may develop clinical interests in anesthesia, neurology, psychiatry, or family medicine. If your PhD was focused on pediatric brain tumors, you may consider pursuing neurosurgery, pediatric hematology-oncology, or radiation oncology. While the theory of a given topic may pique your curiosity, you need to be passionate about the day-to-day medical practice to develop a sustainable career as a physician-scientist. A large proportion of MD-PhD students end up finding clinical interests outside of their PhD research field, which they decide to further pursue in residency. Your doctoral training provides you with a transferable skill set that can be adapted to many fields and should not limit you to specific specialties.
WHAT YOU NEED TO KNOW
Exposure to the field in question is key when picking a medical specialty.
Elective strategies are highly personalized. Spend time reflecting on your own values.
Start the process early and respect deadlines.
Don’t stress; nobody has the perfect rotation stream or elective schedule.
Take all advice (including this) with a grain of salt.
The factors that influence your decision in specialization are highly individualized and covered in Chapter 22. Some of the reasons to consider a given specialty include the types of patient encounters, the patient population, the acuity of illness, whether there is a surgical/procedural component, the feasibility of developing a parallel research program, lifestyle, competitiveness of matching to residency positions, and ...