md-phd student-to-student advice


(updated by students with a few tweaks from Maggie in spring 2019)


Frequently Asked Questions


  • Many, many, generations of MD PhD students have done this before you. Many will do this after you. You are not alone. No situation is so unique it has not been seen before. You can do this and get through it successfully!
  • Start thinking about defending your PhD and returning to clinics far ahead of time. It’s never too early to let your committee know what your goals for the length of your PhD are.
    • Budget about a year from submission of a paper to acceptance and publication.
    • Plan early! Talk to your thesis committee about it early so everyone is on the same page and they can help you come up with a feasible timeline for wrapping up your thesis.
  • The Office of Student Affairs (OSA) “Career Night” booklet has really helpful student-to-student guidance on choosing electives and planning for the residency process.  Some sections include specific MD-PhD advice. (Look online or contact the OSA staff).  Very helpful to review this long before returning.
  • The Survival Guide to the Clinics from OSA is another excellent resource. (Look online or contact the OSA staff).
  • RELAX! Most people said that they were much more worried than they needed to be and the transition was a lot smoother than expected. The medical class you are rejoining does not know as much as you think they do. Most people felt they actually knew more “practical” stuff about being in the clinic (what to do, where to find information) than the class they rejoined. But in the end, we ALL get lost in the hospital and don't know stuff.  So don't feel too anxious.
  • Ultimately, focus above all on caring for the patients you come into contact with. If you do that, a lot of the work of becoming a competent doctor will follow naturally.
  • Be very open and vocal about where you are in your training, and that you may need a bit more guidance/benefit of the doubt. Your peers and seniors will be much more proactive about helping you when you don’t remember how to read an EKG or the different types of hyponatremia, or even practical things like setting up EPIC access at home (critical).
  • Get EPIC access on your phone and your laptop before you start any patient care. This will help TREMENDOUSLY. Getting UptoDate access on your phone is super useful and can make you look like a rockstar during rounds when there’s a question the team doesn’t know the answer to that could change patient management. Also, with EPIC and UptoDate on your phone you essentially don’t need an open computer station (hard to come by in the hospital) unless you’re actively writing a note or putting orders in. Otherwise, Cureatr access on your phone can be useful for communicating with nurses sometimes. Having the UPHS phone book app on your phone can also save a bit of time when you need to get a hold of someone.



  • MED 250. This course is awesome because it is pass-fail.
    • You join a medical team, get your own patients, examine them and present them to the team.
    • You also get access to patient records so you can remind yourself of how to take notes and also get familiar with navigating the electronic medical record
    • In addition, depending on the timing, you may have the chance for small, personal didactics on high-yield topics like EKG and chest X-ray interpretation.
    • It’s a great way to be thrown back into the clinical world in a scenario where there’s actually no grade!
  • There’s also a standardized patient course you can take, MED 240, which is also very helpful



  • This answer depends on what rotation you are on but in all cases, you’ll need to have a blank sheet of paper for taking notes on your patients, a pen, and a stethoscope on your person. On your first day, follow guidelines below but be sure to then ask someone on your team what is expected of you!
    • In pediatrics, you will be asked to *not* wear your white coat. It scares kids and is a potential source of patient-doctor-patient transmission of infection.
    • On a medical team, have a reflex hammer, penlight, quick cheat sheet on references for common medical lab test values (electrolytes, anion gap, etc)
    • On a surgical team, stuff your white coat pockets with supplies such as kerlix, ABD pads, gauze pads, ace bandages, small suture kit.



  • That everyone forgets details, concepts, pathophysiology, jargon etc. Be kind to yourself!
  • Put in the work you need to get yourself back to a level of clinical competency you can be proud of.
  • Find people on your team who love to teach and learn from them.



  • Whether I would remember everything I needed to remember.
  • Being “behind” or “rusty” as a returning MD-PhD. If you are enthusiastic, kind, and curious, people will tend to cut you a good amount of slack.



  • Getting used to having to take frequent exams again.
  • Going from a setting of rigorous and often-collegial debate (and a pursuit that qualified me as the leading expert on a specific but nonetheless important topic), to a setting that wass quite hierarchical and a pursuit that constantly confronted me with my limited knowledge.
  • Not having control over my own schedule, and putting in long hours. (On the flip side, it was often liberating to have more structure and simply be told what to do!)



  • People leave to varying degrees.
    • Leaving completely with all papers wrapped up: Advantage is that once you return to clinics it is difficult to make time to make time to go into the lab on nights and weekends.
    • Leaving while a paper or project still needs finishing up: Talk with your PI ahead of time and have clear expectations of who in the lab is going to help you get the work done and how exactly their contributions will be reflected in authorship.
    • Leaving while an additional project is in very early stages: You can make plans with the PI to return to lab during the early part of your 4th year of medical school while you are interviewing for residency and have more free time.
  • No matter what you do, be careful about shortchanging time with patients to go back to the science – it usually shows, and people may not appreciate it!
  • Also, depending on what rotations you’re on, going back to lab “in your free time” may be totally unfeasible when you don’t have “free time.” Even on lighter services you’ll need to study for the shelf during clerkship rotations. It can be done, but be very realistic with yourself about how much energy you can throw into science when you’re been awake since 6am and just got out of the hospital at 6pm.  Many students have much more time to go back to lab in MS4 after applications are out.



  • Ideally, plan to return to clinics with enough time to take some vacation time, take a prep course (e.g. MED 250), and do a little reading on your own to help you feel prepared for your first clerkship back. 
    •  You will have a lot of terms and medical jargon to re-learn. Give yourself the time you need.
    • If things work out so you don’t have enough time to prep before clerkships start, then hit the ground running and study on your own to regain familiarity with terms, procedures, concepts etc. that you will be expected to know.
  • Optimal timing varies a lot depending on multiple factors. Be sure to plan well in advance, utilize the Career Night Booklet and seek advice from faculty, Maggie / Helene and more senior students.



  • Budget ~$600 or so for STEP 2CK and ~$1200 for STEP 2 CS in exam fees.
  • Helene (registrar) will send emails on how to register for these exams. Register as early as possible to get your preferred test sites.  Be aware of the School’s deadline for completing the exams.
  • Most people plan to take STEP 2CS shortly after they complete their sub-Is. That is when your physical exam and history skills are likely back up to par with the rest of your medical school classmates.
  • For STEP2 CK, you can take the exam whenever you are done with most/all of your core clerkships. Some will say you only need 2 weeks to study, and others prefer more time, esp if they did not do as well as hoped on STEP1. Know yourself and how much work you usually need to do for standardized exams. Plan ahead for the time you need to get a score you can be proud of.
  • Study materials:
    • For Step 2 CS, use a guidebook such as the Kaplan or First Aid STEP 2 CS coursebooks. Also use the online practice website provided by usmle to practice your timing.
    • For STEP 2CK, use Uworld. Get a subscription and practice, practice, practice! Be sure to do active and not passive learning as you will need understanding of core concepts to pass the exam.


Recommended Books & Resources

Most people use online resources these days. There is now a Penn Med borrowing library in the JMEC lounge. No need to buy textbooks; borrow what you need and return after you’re done!

  • Before returning / During Refresher
    • OnlineMedEd: This series of free videos covers lots of basic pathophysiology, diagnosis, and treatment topics. They are relatively short (generally 10-30 minutes), can be sped up, and are already grouped by rotation. If you don’t want to crack a big textbook, this is a great easy way to get back into it.
    • Bates Physical Exam: review the basics (if that)!
    • First Aid for the USLME Step 2: Clinical Skills -very high yield chief complaints and good review of questions to ask & physical exam findings to look for
    • Rapid Interpretation of EKGs by Dale Dubin, MD or The Only EKG Book You’ll Ever Need by Malcolm Thaler.
    • Learning Radiology: Recognizing the Basics by William Herring.
  • Core Clerkships -see recommendations from Guide to Clinics
  • Refer to the section of MD-PhD website section on “navigating the final two years” which this is linked from.  The section on tips and resources is reviewed annually by faculty and updated.