AMA - 4th Year Med Student Applying to Surgical Sub

[pbrocks15]

Title says it all. I need to kill some time and don't wanna think about the match.

Mid-tier school in the NE.
> 15 publications
> 20 posters/conference presentations
Took 2 years off before med school

Not mentioning my specific surgical sub right now to stay anonymous. Feel free to ask anything.

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[82Scout]

How many happy little trees did you paint on them posters?

 

[Davidfromcali]

Do you feel like the pedigree and rank of your school has significantly affected the strength of your application?

 

[Saturday’s Child]

How many of those pubs did you get during med school? And were they for clinical research and/or within your surgical area of interest?

 

[pbrocks15]

How many happy little trees did you paint on them posters?

Haha I've probably taken down more forests than I put up in med school (hint: I put up none)

Do you feel like the pedigree and rank of your school has significantly affected the strength of your application?

Hmm, this is a good question. I think that it does matter, but it's all relative. For example, if you are a super stellar applicant coming from a lower tier school, then honestly, most programs don't care THAT much. BUT, if you are a less than stellar applicant coming from a higher tier school, then you have wiggle room to match at a good academic place (even though your application overall might not be that strong). Know what I mean? So, even though I have a stellar application, I think I would have gotten MORE academic/prestigious programs (not that it REALLY matters) if I was at a higher tier school.

How many of those pubs did you get during med school? And were they for clinical research and/or within your surgical area of interest?

I got one from before medical school. The rest were during med school. I would say 5 are case reports and the rest are either original research or reviews. Only 1 basic science paper, which was from before med school. The rest were clinical research including chart reviews, meta-analysis, systematic reviews, etc.

Clinical research is so much easier, although it might not have as big as an impact as some of the basic science research that gets done.

 

[Dr. Anonymouss]

Did you do research during preclinical years or just over the ms1-ms2 summer and clinical years? If so did you find it easy to manage clinical research during pre-clinical studies.

 

[pbrocks15]

Did you do research during preclinical years or just over the ms1-ms2 summer and clinical years? If so did you find it easy to manage clinical research during pre-clinical studies.

My summer research got my involved with a good department and that got me 5 publications. But those studies I kept in touch with and continued to work on those projects throughout my 2nd year.

I got 5 case reports published during third year of patients I saw on the floor that I thought were interesting. I got maybe 2 original papers done that year.

In regards to the pre clinical years, it's all about two things:

1. Get involved with a project that can actually amount to a publishable paper. This take a little insight into what is a good project and is the team/department/PI reasonable.

2. Small bites everyday on the project. I dont agree with people who take the entire day off to work on a project. That's not what research is. You should take an hour everyday and chip away at a project. Then send it to your PI. Then see what they say. That is what makes it more reasonable during the pre clinical years.

 

[efle]

Did you already know during preclinical you wanted to live in a hospital for the next 5+ years, or not until your surgery clerkship?

 

[pbrocks15]

Did you already know during preclinical you wanted to live in a hospital for the next 5+ years, or not until your surgery clerkship?

I knew I liked surgery before coming to medical school. That's partially why I went hard in regards to research. A lot of people don't know what they want to do until they are in their third year. I think I did have an advantage in all honesty because I did know what I want, but those who find it out later can make it work just fine also.

Also, some surgical subs are a little more reasonable ( ENT, Optho, Urology are somewhat easier some might say compared to Ortho, Neurosurg, Vascular and Gen Surg).

 

[efle]

I knew I liked surgery before coming to medical school. That's partially why I went hard in regards to research. A lot of people don't know what they want to do until they are in their third year. I think I did have an advantage in all honesty because I did know what I want, but those who find it out later can make it work just fine also.

Also, some surgical subs are a little more reasonable ( ENT, Optho, Urology are somewhat easier some might say compared to Ortho, Neurosurg, Vascular and Gen Surg).

Idk man I did selectives in ENT and plastics and it was the ENT chief who sat me down and told me (with a 1000 yard stare) that if there's anything other than surgery you could ever see yourself doing, go do that other thing.

Ain't never heard the likes of that from the Derm peeps.

 

[pbrocks15]

Idk man I did selectives in ENT and plastics and it was the ENT chief who sat me down and told me (with a 1000 yard stare) that if there's anything other than surgery you could ever see yourself doing, go do that other thing.

Ain't never heard the likes of that from the Derm peeps.

Everyone in surgery says that.

It's all relative. Was he a head and neck ENT? They have tougher lives then a totally outpatient ENT clinic. Same goes for Ortho. You could be an Ortho Onc and have a tough life, but then you could also do ortho/plastics hand and have a better life.

You'll get very different answers depending on who you ask in that sub specality which sucks.

So the residency difficulty does not always dictate how hard your life will be as an attending.

But yeah, you'll have an easier life in medicine probably.

 

[efle]

Everyone in surgery says that.

It's all relative. Was he a head and neck ENT? They have tougher lives then a totally outpatient ENT clinic. Same goes for Ortho. You could be an Ortho Onc and have a tough life, but then you could also do ortho/plastics hand and have a better life.

You'll get very different answers depending on who you ask in that sub specality which sucks.

So the residency difficulty does not always dictate how hard your life will be as an attending.

But yeah, you'll have an easier life in medicine probably.

Yeah he had just matched a private practice nose job fellowship in Boston so I think he realized his priorities in life haha

 

[CosmeticLeFort3]

Did you always know you wanted that specialty

 

[oatsidy29]

I don't know if you're still replying, but I'm curious if you could give any insight on what type of research to do? For me, I know I want to do surgery, but I don't know what specialty at this point. When trying to match, will it matter if all of my research is in Neurosurgery but I am trying to match ENT (or any other combo)? Is there just general "Surgical" research? Thank you in advance!

 

[Gilakend]

How much, if at all, did your potential lifestyle as an attending play into your decision?

Did you have good connections in the field before applying? If so, were they from research, clinical experiences, just reaching out, etc.?

Thanks!

 

[dogbert2234]

I attend an institution that only has a year of pre-clinical education, and our 3rd year is more open for research, career exploration, etc. With that in mind, how long did it take you to publish on these projects you worked on in your pre-clinical years? Wondering if I need to be busting it as a first-year student (and potentially during clinical year) or if I can reasonably have enough time to publish clinical research over the course of my third year.

 

[pbrocks15]

Did you always know you wanted that specialty

I did. I was always interested in it but I did give a lot of other surgical AND non surgical specialities a thought throughout med school. In the end, I felt like this is what I enjoyed most. Although, honestly, a lot of medicine is fun.

I don't know if you're still replying, but I'm curious if you could give any insight on what type of research to do? For me, I know I want to do surgery, but I don't know what specialty at this point. When trying to match, will it matter if all of my research is in Neurosurgery but I am trying to match ENT (or any other combo)? Is there just general "Surgical" research? Thank you in advance!

Sorry, I didn't get notifications about this thread so just seeing it now.

Your question comes up a lot. In general, a few surgical subs prefer at least one project in their specialty. There is always the exception that someone found Nerosurg late and was like "THIS IS GREAT" and then apply with a ton of research is surg onc. That discussion will come up, and the response will just be "I found NSG late, and I thought I liked Surg Onc, so I was doing Surg Onc research." It's as simple as that.

If you know you want to do Ortho, you really should do some ortho research. I think most surgical subs just use that to gauge TRUE interest in the field. Can you talk about ortho research in a way that shows you understand some things? Etc etc.

So, in the end, I wouldn't worry about it too much early on. Later, when you know what you want to do, try to get on a project in that field where you know you can learn the material sort of well and discuss it come interview season.

How much, if at all, did your potential lifestyle as an attending play into your decision?

Did you have good connections in the field before applying? If so, were they from research, clinical experiences, just reaching out, etc.?

Thanks!

I did NOT have good connections in the field before applying. I did consider lifestyle a lot though. I think lifestyle is important and I think its also important to understand surgical residency lifestyle. Not all surgical residencies are THAT horrible. Some are more manageable than others. I think you have to really consider the lifestyle of the attending though. People make fun of certain specialties (sometimes the Ortho Hand guys/gals, because they don't work that much) but that's fine! They have different priorities. Your application can take you farther than a lot of connections, too.

I attend an institution that only has a year of pre-clinical education, and our 3rd year is more open for research, career exploration, etc. With that in mind, how long did it take you to publish on these projects you worked on in your pre-clinical years? Wondering if I need to be busting it as a first-year student (and potentially during clinical year) or if I can reasonably have enough time to publish clinical research over the course of my third year.

I can write so much on this but I'll keep it short. here are important things to keep in mind:
1. You need to find publishable projects. You have to be able to recognize which projects are just utter BS, which the attendings are just doing because someone is telling them they need to do stuff so they do some random dumb project that has no real end. So you really need to understand which attendings are doing good work and are actually publishing. Like see who is doing the work that has been successfully published. This will help more than just getting started early
2. You need to put in work over a period of time. I believe in starting early. I think you should get involved early, sometime during first year, with a project or two. you don't need to be first author and you don't need to be doing ALL the work. But this will help you get your feet wet in the research world.
3. Don't get stepped on. If you need to review 2000 charts, then yeah ask for help from another med student or two, but don't do 80 hours of research per week. Make sure to allot the appropriate time to research and the appropriate time to studying.
4. Your clinical year can be used for so many things. I would spend it in a lab with the department you think you're going to go into. So if you want to do Neurosurg, then do a year of neurosurg research and get to know the team. Go to grand rounds. Try to go to the OR a little. Don't actually just spend the whole year doing research. I have >25 publications. I don't think anyone looked someone with 10 publications differently than me. After a certain number, the numbers don't matter. So this year shouldn't really be all about research. It should be getting to the attendings and the department to solidify if that field is for you. This also can get you letters and everything too. I wish my school did this honestly.


Let me know what other questions you all have

Also, as a random shameless plug, I'm selling all my books. Link to the post is here: TONS of Med school Books for sale (name your price)

 

[GameOfZones]

Clinical research is so much easier

RE: this, can you elaborate a bit on what exactly clinical research is? is it a lot of old chart review? finding unique patient cases and doing a study on them? excel sheets? because i've heard this point that clinical research is easier from many people, but as someone who has only been involved in basic science research, i don't really have a good understanding for what the other side of the coin really is about. thanks!

 

[efle]

RE: this, can you elaborate a bit on what exactly clinical research is? is it a lot of old chart review? finding unique patient cases and doing a study on them? excel sheets? because i've heard this point that clinical research is easier from many people, but as someone who has only been involved in basic science research, i don't really have a good understanding for what the other side of the coin really is about. thanks!

My experience in basic science: Plan experiment. Try to do experiment. Spend months troubleshooting until you can finally do the experiment and get good data. Analyze and write up.

Clinical research: Think of a question. Find some med student or pre-med who will be your data extraction monkey, and sic them on your fat stack of hundreds of charts. Wait a while until they bring you the precious data in an excel sheet (or redcap). Analyze and write up.

As you can tell, that middle section is a lot easier and a lot more reliable to perform in a clinical retrospective than basic science. For someone like a med student with erratic schedule and a strong desire to be productive with posters/abstracts/pubs, retrospectives win all day every day.

The downside is that being a data extraction monkey is also a lot more boring than solving problems at the bench. Good thing we're already all masochists. There are more exciting options in clinical research like prospective randomized trials, but again much harder to get reliably involved in during med school.

 

[GameOfZones]

My experience in basic science: Plan experiment. Try to do experiment. Spend months troubleshooting until you can finally do the experiment and get good data. Analyze and write up.

Clinical research: Think of a question. Find some med student or pre-med who will be your data extraction monkey, and sic them on your fat stack of hundreds of charts. Wait a while until they bring you the precious data in an excel sheet (or redcap). Analyze and write up.

As you can tell, that middle section is a lot easier and a lot more reliable to perform in a clinical retrospective than basic science. For someone like a med student with erratic schedule and a strong desire to be productive with posters/abstracts/pubs, retrospectives win all day every day.

The downside is that being a data extraction monkey is also a lot more boring than solving problems at the bench. Good thing we're already all masochists. There are more exciting options in clinical research like prospective randomized trials, but again much harder to get reliably involved in during med school.

Hey thanks, really helpful write up here. Seems it's a quick way to become productive and have multiple pubs to one's name.

I suppose the lure of authorship is enough to get other med students or pre-meds to be willing to extract all that data?

 

[efle]

Hey thanks, really helpful write up here. Seems it's a quick way to become productive and have multiple pubs to one's name.

I suppose the lure of authorship is enough to get other med students or pre-meds to be willing to extract all that data?

You are correct, in fact we frequently get emails where residents and fellows explicitly invite us to help with their data in exchange for putting our name on it.

I mean, look at the average numbers of posters/abstacts/pubs being listed on ERAS for specialties like neurosurg, derm, and plastics. They're listing ~15 things now! Wow! So much valuable, productive reseach!

The dirty little secret is that it's a bunch of posters and middle authorships on retrospectives and reviews. Also a bunch of duplicate listings for projects that get presented multiple times as well as published, and usually, it's published in a specialty-specific low IF journal.

But yes, that's the game. Trade a bunch of labor-hours doing chart review and, after a couple years of that, you should have a nice long list of middle authorships to list on ERAS.

 

[brgiant1398]

Can OP or anyone comment on when it might be advantageous to take a year off to do research? From my limited understanding of googling this, it seems that people only recommend it if you're going into a very competitive surg sub-specialty (ie. neurosurg) or maybe are eyeing becoming more of a physician scientist. If you are just really passionate about a certain subject and have a willing mentor, is it worth sacrificing a year, even if you are not applying for a competitive residency?

 

[efle]

Can OP or anyone comment on when it might be advantageous to take a year off to do research? From my limited understanding of googling this, it seems that people only recommend it if you're going into a very competitive surg sub-specialty (ie. neurosurg) or maybe are eyeing becoming more of a physician scientist. If you are just really passionate about a certain subject and have a willing mentor, is it worth sacrificing a year, even if you are not applying for a competitive residency?

Research years are primarily done between MS3-MS4 for people with 1) a deficit to make up for, like lower board score or 2) they've got no prior research and fell in love with something that de facto requires it these days (like derm or surgical subs).

The third group that takes a research year out of honest love for research work are very few and far between, because it makes a lot more sense to graduate faster and do that down the road when you're better paid and/or have more clout and ownership of the project. There are many residencies and fellowships at academic centers with built-in research years too, making it even more redundant to take a year during med school unless you need to.

 

[pbrocks15]

Can OP or anyone comment on when it might be advantageous to take a year off to do research? From my limited understanding of googling this, it seems that people only recommend it if you're going into a very competitive surg sub-specialty (ie. neurosurg) or maybe are eyeing becoming more of a physician scientist. If you are just really passionate about a certain subject and have a willing mentor, is it worth sacrificing a year, even if you are not applying for a competitive residency?

I agree with @efle said. There are a lot of general positive to a research year: better LORs, publications (hopefully) that will come up during residency and maybe even get you interviews, getting to know the department (aside from LORs) which can make them know you better and possibly take you instead of the other students who didn't do a research year. etc etc. Cons are usually that you're going to take a year from being an attending (I don't buy this much, I don't think it really matters that much), loans accrue interest, you can possibly shoot yourself in the foot if you don't get any publications or if the department doesn't like you.

If you are not going to a competitive residency but maybe want to go to a top tier IM/Peds/Radiology etc place then a research year can help you. Is it necessary? No. A lot of people don't do them for those specialties, BUT I have a friend who did a research year at the NIH and matched at a top IM institution.

 

[pbrocks15]

RE: this, can you elaborate a bit on what exactly clinical research is? is it a lot of old chart review? finding unique patient cases and doing a study on them? excel sheets? because i've heard this point that clinical research is easier from many people, but as someone who has only been involved in basic science research, i don't really have a good understanding for what the other side of the coin really is about. thanks!

I agree again with what @efle said. In the end, the real discussion is between time and data. How much time it takes to get good data is a huge difference between basic science and clinical research. Clinical research can largely be done from public databases, where you can pull millions of patients data and get significant results in minutes!! This paper might not make it to the NEJM, but sometimes they actually do. I also worked in basic science wet lab research before medical school as a research assistant. The questions being asked were "larger" than in clinical research, so to speak. The process, as @efle mentions, is really arduous. We used a lot of animals and zebrafish models etc etc. You get the point.

As students, we can make more sense of clinical research. "Oh wow, longer operative time leads to increased infections....PUBLISH!" Things like this are easy to understand and work through as a medical student. But the pathway for congenital malformations of the XYZ is so complex...you get the point.

Hope this helps. Do clinical research. I also have a few big publications from my basic science years and they didn't get ANY love on the interview trail. These were papers in strong journals on something totally random, but when they saw that I had research that was more relevant to the field and something they can talk about, they went for that. So this goes to show, even if you do some ground breaking work, it also has to be relevant sometimes to the person on the other side of the table, otherwise it can easily get missed OR they just prefer to talk about something else.

 

[newaccount4decisionss]

Great stuff! How many first author publications did you have (that were not case reports)?

 

[pbrocks15]

Great stuff! How many first author publications did you have (that were not case reports)?

I think I can only say I first authored 4 publications or so that were full studies or reviews at the time of submitting my application. Three projects are now in submission where I'm first author and those also were on my application.

As you can see, a lot of what is easy and accessible to medical students are case reports. Also, you want to work with other students on projects. Don't always just look out for first author projects for yourself. This also happens a lot to medical students were you just pull the data for them through chart reviews and get your name on the paper.

 

[newaccount4decisionss]

Thank you for giving insights!
Is there sufficient time to do research during the clinical rotations? If so, around how many hours per week? Is it mostly during the weekends?
What's the highest impact factor for the first-author and non-first author journals you've published in?

 

[pbrocks15]

Thank you for giving insights!
Is there sufficient time to do research during the clinical rotations? If so, around how many hours per week? Is it mostly during the weekends?
What's the highest impact factor for the first-author and non-first author journals you've published in?

Yes, there is sufficient time to do research during clinical rotations but to an extent. You shouldn't be coming home crunching numbers all night long. You still have to do work and study. I would say you can maybe dedicate a good 5-10 hours a week doing research (including the work you'd put in during weekends). This is a good amount of time and honestly some weeks you'll be doing nothing and then other weeks when you have to meet deadlines for abstracts for conferences and all then you can maybe get closer to the 10, if not more (but doubt it).

I want to somewhat remain anonymous, but highest impact was not from medical school and was from my research before medical school. It was in one of the journals you name daily as a medical student/attending (big journal, probably the first one you think about). As a medical student first author, the highest impact I want to say is 3.5.