Defer acceptance for 1st author (Cell)? Or start med school this year for ~3rd?

[medbikesurfsleep]

Hi Everyone, I'm hoping to hear people's opinions on this dilemma I find myself in. Should I defer my medical school acceptance for 1 year to finish a project I have been working on and submit it as the 1st author? My PI (renowned in the field) is very confident that we can publish in a big name journal (most likely Cell, but also thinks Nature or Science would be appropriate). Alternatively, should I just start med school this summer and still be a high middle author (most likely 3rd).

I'd like to know how beneficial a first authorship (pre-med school) would be for boosting my application to competitive residencies (neuro/ortho/plastic surgery). I definitely plan to do research in medical school but don't think I'll have the time or resources to lead another project of this caliber.

Thanks in advance for taking the time to read this and share your insight.

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[Grogu]

I would go to school in the fall. You don't know for sure the direction the paper will go, and even so one paper in Cell as a 1st (vs 2nd or 3rd) author is likely not going to have a significant impact on your residency application when you look at the entire thing. If you've done that much work on the project, then push to remain 1st author, or take 2nd author with the distinction "these authors contributed equally", which was something my lab did in this type of situation when a student was leaving but did a ton of work on the project already.

I'm sure someone else can comment more on the weight the paper might have in residency apps, but by delaying you're also giving up a year of a being a physician, both the satisfaction of the career and the >300K salary that comes with it in those competitive specialties. Now if you want the satisfaction and closure of completing the project yourself before starting your next journey, that's a different situation.

 

[Princeton Medical Student]

Just go.

 

[Banco]

If you have a guaranteed spot, and you really want to be first author, and you really see research playing a big role in your career, and a deferment is approved, then sure why not. Otherwise 2nd or 3rd is also a huge accomplishment, and a famous journal high authorship will get some eyes come residency application time.

Word of warning - even when a PI expects something to be published in Nature/Science/Cell, there's never any guarantee. I speak from experience, unless you're at the revisions stage from one of those specific journals, it's more likely that you won't get published in those 3. Not that these are the only good journals out there but keep that in mind.

 

[Mad Jack]

Go. You never know what behind-the-scenes stuff can happen with papers being published, it's an unknown and you'll still be an author. The difference between first and third author five years from now is probably going to be nothing in the grand scheme of your life

 

[seeinghowitgoes]

Go to med school. Easy decision.

First, anybody who does research can remember a time they thought, or were told by a mentor, that their project would be highly publishable in top journals only to see it tumble to something more pedestrian. Unless this person has unethical pull at the journals (I.e. is an editor and can therefore more or less guarantee a favorable outcome) then nothing is guaranteed.

Second, if you want to do basic science work for your career you’ll need a PhD to have any chance at funding (unless you are one of the very very rare folks with an MD only doing basic science work and getting enough funding to have a lab and buy down clinical time - and I wouldn’t count on it), and at that point one paper from before medical school will therefore not be what propels your career. If you do not want to do basic science work in your career then having even a fantastic basic science publication means nothing for your career (departments want you to bring in money, so unless past work is a sign that you’ll be doing research and bringing in grants they really don’t care about past papers). It also likely does little for a residency app (most people reading residency apps are nearly research-illiterate, and even those that aren’t will care more about what you did in medical school).

Third, the most meaningful thing you’d get out of this is a mentor, and if your PI was offering you this project it would stand to reason you’ve done good work with them before and already have a mentor in them.

To sum it up - very little to gain by deferring in your situation.

 

[Catalystik]

Should I defer my medical school acceptance for 1 year to finish a project I have been working on and submit it as the 1st author? My PI (renowned in the field) is very confident that we can publish in a big name journal (most likely Cell, but also thinks Nature or Science would be appropriate). Alternatively, should I just start med school this summer and still be a high middle author (most likely 3rd).

I'd like to know how beneficial a first authorship (pre-med school) would be for boosting my application to competitive residencies (neuro/ortho/plastic surgery). I definitely plan to do research in medical school but don't think I'll have the time or resources to lead another project of this caliber.

Is the research related to the specialty you plan to train for? If it's a highly-selective program (Neurosurgery, Rads, Opthalmology, Ortho, Derm, Plastics), are you highly likely to have the stats, LORs, on-going research productivity in med school, and outstanding application that will appeal to those programs? If the answer to both questions is a guaranteed yes, then a first author pub will help you. How much? Just "somewhat." It will not outweigh the other factors mentioned.

 

[Mr.Blackdoc.5]

Have high and a first authorship in Cell, Nature sub journals, etc.

go to school. There is no guarantee on any projects.

PI is looking out for their best interests because you would provide continuity. Don’t know how half a year of work would demote you from even a co-first authorship if you’ve done a bulk of the work.

 

[OrthoTraumaMD]

Hi Everyone, I'm hoping to hear people's opinions on this dilemma I find myself in. Should I defer my medical school acceptance for 1 year to finish a project I have been working on and submit it as the 1st author? My PI (renowned in the field) is very confident that we can publish in a big name journal (most likely Cell, but also thinks Nature or Science would be appropriate). Alternatively, should I just start med school this summer and still be a high middle author (most likely 3rd).

I'd like to know how beneficial a first authorship (pre-med school) would be for boosting my application to competitive residencies (neuro/ortho/plastic surgery). I definitely plan to do research in medical school but don't think I'll have the time or resources to lead another project of this caliber.

Thanks in advance for taking the time to read this and share your insight.

I can tell you that for ortho residency, no one will care about what you did in premed. Go to med school.

 

[GoSpursGo]

As someone who is playing the academic medicine rat race, a first autho pub in a high impact journal would be huge. But at the same time, nothing is ever guaranteed—I thought my first author paper should have been ready to submit in summer 2019, and we FINALLY submitted in fall 2020. Plus, speaking from experience, authorship contributions always get political, and regardless of what your PI says now the people who would be first author instead of you with undoubtedly be jostling to get your first author slot. bottom line, everything in research takes longer than you think, and authorship is not guaranteed until you actually start writing. So I lean toward going to Med school

one small caveat: for super competitive specialties, it is not unusual to wind up doing a research year. If that would potentially be in the cards anyways, then if the deferral would be granted it wouldn’t be CRAZY to defer and consider this your “research year.” A single high-impact paper would likely be more valuable than a bunch of little throwaway papers that you could achieve in a later research year. So, you could consider that aspect.

regardless of your decision, one word of advice: start writing now. At a minimum you can start creating your figures and writing the results/methods for the experiments you have already done. If you lock that contribution in, it becomes much harder later for them to try and move you down the authorship list.

 

[EdgeTrimmer]

My kid is almost two years behind on his first author paper despite his best efforts since PI expanded scope and also technical issues so don't assume you can get it done in one additional year.

 

[GoSpursGo]

My kid is almost two years behind on his first author paper despite his best efforts since PI expanded scope and also technical issues so don't assume you can get it done in one additional year.

Goodness, so much this. There is always "just one more experiment." The "last figure" experiments are always enticing, because theoretically they are the provocative last piece that elevates the impact of the paper so they can theoretically have fewer repetitions and thus, theoretically, can be done quickly. The problem is that these are invariably the most technically difficult experiments, so it can take a ton of trial and error to make the experiments work, if you can even get them to work at all.

Herein lies the inherent tension between the senior author who always wants to get into the higher-impact journal, and the first author who always just wants to get the paper out. And why as attractive as deferring for this paper may seem, you really need to consider what happens if things go sideways on this project.

 

[Goro]

Med school now.

Don't assume that a deferral is that easy to get, either. Most are given for emergencies or health reasons.

 

[DNAJB6]

Is it worth one year of attending salary to you? If so, defer. If not, go to school.

 

[Tenk]

Nobody gives a crap what you did in research before med school unless it was some Nobel prize winning **** in which case why the hell would you go to med school...

 

[Orims]

I am graduate student and I have been working on my manuscript for over a year, basic science. I am leaving in two months and don't think we will submit since my PI is dragging his feet. Made peace with this and will ride into the medical school sunset without thinking about it twice.

Work hard and publish while in medical school, don't spend a year (or more) on something that might drag out for a long time. What if you stay the year, submit a few months before med school starts and then you have to get through revisions and reviewer hell during MS1? I wouldn't wish that on my worse enemy (not that I have any, haha).

 

[WheezyBaby]

As someone who is playing the academic medicine rat race, a first autho pub in a high impact journal would be huge. But at the same time, nothing is ever guaranteed—I thought my first author paper should have been ready to submit in summer 2019, and we FINALLY submitted in fall 2020. Plus, speaking from experience, authorship contributions always get political, and regardless of what your PI says now the people who would be first author instead of you with undoubtedly be jostling to get your first author slot. bottom line, everything in research takes longer than you think, and authorship is not guaranteed until you actually start writing. So I lean toward going to Med school

one small caveat: for super competitive specialties, it is not unusual to wind up doing a research year. If that would potentially be in the cards anyways, then if the deferral would be granted it wouldn’t be CRAZY to defer and consider this your “research year.” A single high-impact paper would likely be more valuable than a bunch of little throwaway papers that you could achieve in a later research year. So, you could consider that aspect.

regardless of your decision, one word of advice: start writing now. At a minimum you can start creating your figures and writing the results/methods for the experiments you have already done. If you lock that contribution in, it becomes much harder later for them to try and move you down the authorship list.

This is more or less my opinion. Taking at face value that this is truly going to end up in a monstrous journal, if you have a true interest in academic medicine / research, that type of 1st author publication is meaningful - most productive researchers are never published in those journals. Obviously, it is by no means guaranteed which makes the decision much murkier, but I would at least consider it depending on your own career ambitions

 

[aldol16]

Go to med school. Research should be seen as a complement to studying medicine, not the main idea. The idea is to learn medicine and become a physician, not a researcher. For those competitive specialties, it is important to do research on top of excelling in your med school studies and boards but the differential impact of a 3rd vs 1st author publication in something you did before med school isn't likely to matter.

For those specialties, what's important is productivity and volume. Getting into good journals as first author is obviously great but having high productivity / multiple papers and field-specific papers are important. It can also help you build connections with faculty which is really important for those specialties.

 

[Ellatha]

This is more or less my opinion. Taking at face value that this is truly going to end up in a monstrous journal, if you have a true interest in academic medicine / research, that type of 1st author publication is meaningful - most productive researchers are never published in those journals. Obviously, it is by no means guaranteed which makes the decision much murkier, but I would at least consider it depending on your own career ambitions

+1 and lmao at your name. Also, a 1st author in Cell would make you competitive at a top school like Harvard or Stanford, assuming your MCAT and GPA are on par as well.

 

[ChiDO]

Not even a good question. Medical school 100%.

Not once did we interview someone in orthopaedic residency just because they were published in a well known journal.

 

[eteshoe]

Agree with all the earlier responses. I just wanted to add an additional point. Even if your "story" fits within the scope of the big three (CNS), just go ahead and add an additional year to the timeline for revisions, resubmissions, etc. I say all this as a grad student who's been dealing with Cell for the last 1.5 yrs and just finally getting the story over the finish line - take your acceptance and get this long journey started.

 

[deleted1065184]

Agree with all the earlier responses. I just wanted to add an additional point. Even if your "story" fits within the scope of the big three (CNS), just go ahead and add an additional year to the timeline for revisions, resubmissions, etc. I say all this as a grad student who's been dealing with Cell for the last 1.5 yrs and just finally getting the story over the finish line - take your acceptance and get this long journey started.

THIS! And if revisions are substantial without OP being around to make them/do necessary re-writing of the manuscript, their name could potentially slide from 1st to 2nd or later depending on the lab publishing policies. It happened to me years ago. And it was fair, because the story had changed considerably by the time all reviewer concerns were addressed and the paper was resubmitted.

 

[and 99 others]

Nobody gives a crap what you did in research before med school unless it was some Nobel prize winning **** in which case why the hell would you go to med school...

I can tell you that for ortho residency, no one will care about what you did in premed. Go to med school.

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

 

[ChiDO]

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

We "care" knowing that you did research and understand the process to get published. We do "care" if you can talk about your research and didn't just get your name on a paper for no work. I "don't care" where you got published in college. I would have NO clue that "Cell" is a hard journal to get into.

I don't think we have ever seen an application and go wow, we must interview this guy because he has all the publications. Maybe other residency programs care. I would guess most ortho programs don't care for your undergrad pub in "whatever journal"

 

[Banco]

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

I don’t think this is true. It’ll depend on the residency/program, but things don’t simply “not count” because it was before medical school. It totally depends on context. To people who are in the know with regards to the research field, a first author in Nature/Science/Cell/other high impact journal is going to be impressive regardless of when it was done. But with all things it really depends. Highly research intensive/academic residencies will love it. Some others won’t care much.

 

[GoSpursGo]

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

I mean, I think that some of the comments above are a bit hyperbolic. Research is research, and the "point" of a publication is that you are capable of undertaking a rigorous scientific investigation and see it over the finish line. That sort of know-how doesn't expire, even if you don't get brownie points for it being in your eventual field of interest and showing how "committed" you are to jumping over the hoops. And down the line if you are serious about being a physician scientist, that cell paper will be huge in terms of supporting your grant applications, so a residency will know you actually do have potential to excel in academia if you so choose. That's meaningful to some academic big-wigs who are, themselves, in the academic rat race. And sure, maybe no one has ever said "look at all these publications we have to interview them," but if they have the grades and the score and the letters, I'm sure an impactful pub would help differentiate from the other rockstar applicants.

Again... not that this is really relevant to the OP's decision, which is fraught with all kinds of uncertainties if they choose to pursue the pub. You still would need to do all of the other box-checking once you get to med school, and a year in your life is a high price for something that isn't a sure thing. But I think it's a little silly to pretend that getting a first author pub in a journal with a 35+ impact factor is not meaningful just because it was in undergrad.

 

[dienekes88]

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

I will say that many residencies will see that Cell paper and be very impressed. Having said that, you really don't know if it is going to get into Cell. Its a definite gamble. One of the critical elements is going to be exactly how close you are. If this one year you are talking about includes time for revisions and additional experiments, then I think it totally makes sense to defer. If this is just a year of finishing experiments to get this submitted for the first time, then you have a tough choice to make, and it depends in large part on the practices of your lab. Many labs will keep the author order even if someone else finalizes the revisions, but unfortunately it doesn't look like this is the case for you.

I don't agree that this is one year of attending salary difference. You may be able to alter your entire course by making yourself significantly more competitive at the most competitive residency programs or fields by having a first author cell paper independent of the field you publish it in. Many people (including me) would say that a Cell paper is worth more than 1 year of attending salary. Same for Nature, Science, and the New England Journal of Medicine. A paper like this is probably worth more than an R01 grant. All of this doesn't matter if you don't plan on pursuing a competitive specialty or a career in academics, though.

 

[deleted1065184]

Many people (including me) would say that a Cell paper is worth more than 1 year of attending salary. Same for Nature, Science, and the New England Journal of Medicine. A paper like this is probably worth more than an R01 grant. All of this doesn't matter if you don't plan on pursuing a competitive specialty or a career in academics, though.

I mostly agree with everything else, except for this.

1) A single Cell paper is absolutely *not* worth more than an R01. This isn't really debatable, tbh. No PI is going to choose a Cell paper over an R01. WIth R01 money, you can fund research for multiple high-impact papers and pay trainee salaries.

2) I also don't agree that it is worth a year (or more) of attending salary if the person does not plan on continuing research. If they plan to have a very fruitful research career, this paper may help a little (emphasis on a little). But anybody who is heavily involved in research will tell you that a single paper cannot make a person, especially one done before even starting medical school.

It is the body of work that matters. A Cell paper during a postdoc can help a person get a research-oriented faculty position. A Cell paper before even starting medical school will not, although it will still look nice. Having a Cell paper just to have it, even when you don't plan on having a research-heavy career, is just not going to be very helpful long-term.

 

[dienekes88]

I mostly agree with everything else, except for this.

1) A single Cell paper is absolutely *not* worth more than an R01. This isn't really debatable, tbh. No PI is going to choose a Cell paper over an R01. WIth R01 money, you can fund research for multiple high-impact papers and pay trainee salaries.

2) I also don't agree that it is worth a year (or more) of attending salary if the person does not plan on continuing research. If they plan to have a very fruitful research career, this paper may help a little (emphasis on a little). But anybody who is heavily involved in research will tell you that a single paper cannot make a person, especially one done before even starting medical school.

It is the body of work that matters. A Cell paper during a postdoc can help a person get a research-oriented faculty position. A Cell paper before even starting medical school will not, although it will still look nice. Having a Cell paper just to have it, even when you don't plan on having a research-heavy career, is just not going to be very helpful long-term.

Matter of opinion.

I would venture a guess that most R01s don't yield papers at the level of Cell/Nature/Science/NEJM, so I disagree with the supposition that a PI will use that R01 and get like 3 Cell papers. Its important to a PI to keep the lab funded, absolutely, but plenty of PIs spend an entire R01 trying to chase the dream of a cell paper and don't end up getting it.

You are also talking about a cell paper in isolation. If this person can get a first author cell paper, its unlikely that he won't be able to get a few more solid papers in the next 10 years unless research is just not an interest. So think about this: one trainee has 10 pubs in journals impact factor 3-8 and a first author publication in cell; the other has 10 publications in similar journals and no cell paper or maybe a middle author. I know who I'm more impressed with, and it isn't even close. It is a part of the overall research profile. But for almost any CV, it would be the crown jewel.

 

[Ellatha]

I mostly agree with everything else, except for this.

1) A single Cell paper is absolutely *not* worth more than an R01. This isn't really debatable, tbh. No PI is going to choose a Cell paper over an R01. WIth R01 money, you can fund research for multiple high-impact papers and pay trainee salaries.

2) I also don't agree that it is worth a year (or more) of attending salary if the person does not plan on continuing research. If they plan to have a very fruitful research career, this paper may help a little (emphasis on a little). But anybody who is heavily involved in research will tell you that a single paper cannot make a person, especially one done before even starting medical school.

It is the body of work that matters. A Cell paper during a postdoc can help a person get a research-oriented faculty position. A Cell paper before even starting medical school will not, although it will still look nice. Having a Cell paper just to have it, even when you don't plan on having a research-heavy career, is just not going to be very helpful long-term.

A single paper in Cell can make a scientific career.

 

[deleted1065184]

A single paper in Cell can make a scientific career.

Hard disagree. As I said earlier, a Cell paper during a postdoc (or maybe grad/med school) can help jumpstart a career. But even then, it is the body of work that will make a scientific career. In fact, most of the successful scientists I know did not get a CNS paper until later in their career, after they had already established a lab. On the other hand, I know of numerous people who had a CNS paper during their postdoc and have been struggling to publish since (probably will not get tenure). Also, please find me an example of somebody who got a Cell paper as a postbacc/tech (before even starting med/grad school) and it alone made their career? I've literally never heard of this. To think a single Cell paper can make a career is ridiculous. OP should go to medical school. If they really want to remain involved in research, many more opportunities will arise. A single paper does not make a career.

 

[deleted1065184]

Matter of opinion.

I would venture a guess that most R01s don't yield papers at the level of Cell/Nature/Science/NEJM, so I disagree with the supposition that a PI will use that R01 and get like 3 Cell papers. Its important to a PI to keep the lab funded, absolutely, but plenty of PIs spend an entire R01 trying to chase the dream of a cell paper and don't end up getting it.

You are also talking about a cell paper in isolation. If this person can get a first author cell paper, its unlikely that he won't be able to get a few more solid papers in the next 10 years unless research is just not an interest. So think about this: one trainee has 10 pubs in journals impact factor 3-8 and a first author publication in cell; the other has 10 publications in similar journals and no cell paper or maybe a middle author. I know who I'm more impressed with, and it isn't even close. It is a part of the overall research profile. But for almost any CV, it would be the crown jewel.

This is all opinion, but I really want you to go ask some PIs which they'd prefer and see. Most R01s probably don't yield CNS or NEJM papers, but they are going to be getting other papers at the very least. Again, the goal of science is not to get one of those papers, and many PIs don't care to publish there at all (Michael Eisen a ton of people at Berkeley, for example). The goal is to get money that will fund your research/lab, publish good papers (which are not limited to CNS and NEJM), use those papers to get more money, and repeat the cycle.

And yes I'm talking about the paper in isolation because this is what the entire conversation is about and has been since the very beginning. It does us no good to try and guess what OP will do in the future, because we simply don't know. I know numerous people who were first authors on a CNS paper and later had struggling scientific careers.

And the last part of your response is a red herring. I never stated that having a Cell paper wasn't impressive, which is how you're making it seem. In fact, I explicitly said it will look nice. In this strangely specific example you've given, 10 papers (if solidly done), regardless of the journals, would be extremely impressive and may them highly competitive for research-based positions. A Cell paper would certainly look nice, but I disagree with any notion that it alone will get them a job over this other person.

Many of the best and most impactful papers are not published in CNS and NEJM. In fact, the most rigorous ones are often in field-specific journals. Senior scientists (the ones who will be reviewing the CVs) are not wowed by CNS and NEJM papers the way students and trainees are. They're looking for numerous factors, including if they'll be coming in with funding (having a K99/R00 on the job market for a faculty position is definitely more valuable than a CNS/NEJM paper). Funding ofc isn't a requirement, but it is far more helpful on the job market than a single paper.

So let's switch up your example. Person 1 has 10 papers (maybe or maybe not a CNA/NEJM middle author paper) and a K99/R00. Person 2 has 10 papers (including a CNS/NEJM first author paper) but not funding. Schools are going to fight for person #1 lol

 

[GoSpursGo]

I will say that many residencies will see that Cell paper and be very impressed. Having said that, you really don't know if it is going to get into Cell. Its a definite gamble. One of the critical elements is going to be exactly how close you are. If this one year you are talking about includes time for revisions and additional experiments, then I think it totally makes sense to defer. If this is just a year of finishing experiments to get this submitted for the first time, then you have a tough choice to make, and it depends in large part on the practices of your lab. Many labs will keep the author order even if someone else finalizes the revisions, but unfortunately it doesn't look like this is the case for you.

I don't agree that this is one year of attending salary difference. You may be able to alter your entire course by making yourself significantly more competitive at the most competitive residency programs or fields by having a first author cell paper independent of the field you publish it in. Many people (including me) would say that a Cell paper is worth more than 1 year of attending salary. Same for Nature, Science, and the New England Journal of Medicine. A paper like this is probably worth more than an R01 grant. All of this doesn't matter if you don't plan on pursuing a competitive specialty or a career in academics, though.

I agree with your underlying thesis that this paper could be career trajectory-altering, but that it's extremely risky to defer acceptance based on the hope that it lands you a first-author Cell paper. It could get delayed, the "last figure experiment" might not work, the PI could take the story in a new direction, and of course you could just get rejected.

The whole Cell paper vs. R01 debate is kind of amusing because really, both of them are incredibly valuable. The answer is definitely R01. You publish in Cell to obtain the R01, so R01 is the end-goal (and thus the more valuable feather in your cap, even if perhaps CNS papers are more rare). The end-goal of the R01 is to publish again and start the cycle of funding anew. But that's probably not super relevant to the underlying question in the thread.

 

[TelemarketingEnigma]

The one thing I will note that could change the circumstances is that occasionally, really really high profile research/PIs will get a conditional approval from the journal before the actual paper is even fully written/submitted. I have a pre-med school nature family pub (middle author, not the Nature but very high impact for the field) that we knew in advance would be going to that journal (in large part because of some heavyweight co-authors). I've also worked with large research consortiums that were big enough deals that they knew the flagship papers out of that grant would end up somewhere really nice, it just may take a few rounds of revision (those usually aren't pre-med led papers though). It doesn't sound like that's the case with OP, but if it is then i would maayyybe consider staying for the paper. Otherwise med school all the way imo - it's nice to have a fancy paper on my resume, but I do think it's more significant to people in that field of research than to most people in clinical medicine

 

[dienekes88]

This is all opinion, but I really want you to go ask some PIs which they'd prefer and see. Most R01s probably don't yield CNS or NEJM papers, but they are going to be getting other papers at the very least. Again, the goal of science is not to get one of those papers, and many PIs don't care to publish there at all (Michael Eisen a ton of people at Berkeley, for example). The goal is to get money that will fund your research/lab, publish good papers (which are not limited to CNS and NEJM), use those papers to get more money, and repeat the cycle.

And yes I'm talking about the paper in isolation because this is what the entire conversation is about and has been since the very beginning. It does us no good to try and guess what OP will do in the future, because we simply don't know. I know numerous people who were first authors on a CNS paper and later had struggling scientific careers.

And the last part of your response is a red herring. I never stated that having a Cell paper wasn't impressive, which is how you're making it seem. In fact, I explicitly said it will look nice. In this strangely specific example you've given, 10 papers (if solidly done), regardless of the journals, would be extremely impressive and may them highly competitive for research-based positions. A Cell paper would certainly look nice, but I disagree with any notion that it alone will get them a job over this other person.

Many of the best and most impactful papers are not published in CNS and NEJM. In fact, the most rigorous ones are often in field-specific journals. Senior scientists (the ones who will be reviewing the CVs) are not wowed by CNS and NEJM papers the way students and trainees are. They're looking for numerous factors, including if they'll be coming in with funding (having a K99/R00 on the job market for a faculty position is definitely more valuable than a CNS/NEJM paper). Funding ofc isn't a requirement, but it is far more helpful on the job market than a single paper.

I'm going to disagree with you on the statement that senior scientists aren't going to be impressed by a single high impact first author paper. Nobody is hired at the assistant professor level with funding.

Separately, my only experience is with surgery, and clinical volume seems to drive hiring more than grants.

So let's switch up your example. Person 1 has 10 papers (maybe or maybe not a CNA/NEJM middle author paper) and a K99/R00. Person 2 has 10 papers (including a CNS/NEJM first author paper) but not funding. Schools are going to fight for person #1 lol

I'm not sure that a trainee much less a med school applicant can have a K99/R00.

 

[dienekes88]

I agree with your underlying thesis that this paper could be career trajectory-altering, but that it's extremely risky to defer acceptance based on the hope that it lands you a first-author Cell paper. It could get delayed, the "last figure experiment" might not work, the PI could take the story in a new direction, and of course you could just get rejected.

Of course. Research always involves a bit of luck, and oftentimes more than a bit of luck. I'd rather have the chance to have this big paper with a deferment, because all you're losing is one year.

The argument that this guy shouldn't do an extra year before med school would hypothetically be the same as the one to advise everyone against doing research years during residency. I have to say, my research time in residency was one of the best times of my life... and incredibly academically productive.

The whole Cell paper vs. R01 debate is kind of amusing because really, both of them are incredibly valuable. The answer is definitely R01. You publish in Cell to obtain the R01, so R01 is the end-goal (and thus the more valuable feather in your cap, even if perhaps CNS papers are more rare). The end-goal of the R01 is to publish again and start the cycle of funding anew. But that's probably not super relevant to the underlying question in the thread.

This is overall a fair point. I don't know that the R01 is the end goal unless you're at least like 80/20 research-to-clinical. If you have someone who is 80% clinical and 20% research then you just need the research to get promoted and have enough going on in your lab to get foundation grants to sustain it and keep doing experiments.

 

[deleted1065184]

I'm going to disagree with you on the statement that senior scientists aren't going to be impressed by a single high impact first author paper. Nobody is hired at the assistant professor level with funding.

Separately, my only experience is with surgery, and clinical volume seems to drive hiring more than grants.

I'm not sure that a trainee much less a med school applicant can have a K99/R00.

I didn't say they weren't impressed, I said they're not wowed. And this was in the context of a Cell paper vs. an R01. Cell paper is "nice!" R01 is "wow, you're gonna be able to fund an entire research laboratory!" lol. And there are numerous grants that you can apply for as a postdoc that will fund not only part of your postdoc training but also your lab for the first few years.

Wrt hiring, it will entirely depend on the institution. Most clinical divisions at my school care far more about research output/funding when it comes to hiring. You can give most people a higher volume, but you can't magically turn a physician into a rigorous scientist because medical school doesn't train you to become a scientist. I never said a trainee or medical school applicant can have a K99/R00 (although if we're discussing grants, there are numerous research grants available to MD and MD/PhD students such as the F30).

The fact of the matter is that an R01 is much more impressive and desired than a Cell paper. And the bottom line for OP is that, for numerous reasons, it would not be a good idea to decline medical school acceptance with the hope of getting a Cell paper. I just recently had a manuscript accepted in a Cell family journal (not Cell) that took an additional 7 months to publish from initial submission to publication. And unless OP is doing SARS-CoV-2 research, theirs will probably take even longer (~ 1.5-2 years) with no guarantee that it will be in Cell. OP if you're reading this, please accept the medical school offer lol, more opportunities to publish great work will arise.

 

[GoSpursGo]

Of course. Research always involves a bit of luck, and oftentimes more than a bit of luck. I'd rather have the chance to have this big paper with a deferment, because all you're losing is one year.

The argument that this guy shouldn't do an extra year before med school would hypothetically be the same as the one to advise everyone against doing research years during residency. I have to say, my research time in residency was one of the best times of my life... and incredibly academically productive.

This is overall a fair point. I don't know that the R01 is the end goal unless you're at least like 80/20 research-to-clinical. If you have someone who is 80% clinical and 20% research then you just need the research to get promoted and have enough going on in your lab to get foundation grants to sustain it and keep doing experiments.

If you look at my prior posts, I made the exact point that this would basically be equivalent to a research year in Med school. You can make the argument, you just need to be aware that this isn’t a slam dunk and realistically weigh the risks associated with the decision.

Its actually a little worse than a residency research year, because you’re presumably getting paid a resident salary for those. Of course there’s no guarantee that a project like this comes along again.

An 80% clinical person isn’t writing a Cell paper

 

[Ellatha]

Hard disagree. As I said earlier, a Cell paper during a postdoc (or maybe grad/med school) can help jumpstart a career. But even then, it is the body of work that will make a scientific career. In fact, most of the successful scientists I know did not get a CNS paper until later in their career, after they had already established a lab. On the other hand, I know of numerous people who had a CNS paper during their postdoc and have been struggling to publish since (probably will not get tenure). Also, please find me an example of somebody who got a Cell paper as a postbacc/tech (before even starting med/grad school) and it alone made their career? I've literally never heard of this. To think a single Cell paper can make a career is ridiculous. OP should go to medical school. If they really want to remain involved in research, many more opportunities will arise. A single paper does not make a career.

You got that from vickus. Working in Essex County. Page 98? Yeah I read that too.

 

[Osteosaur]

Who knows what the future will hold. Its great your PI is supportive but research can takes longer than you think. Its a good opportunity, sure, but do you want to be a doctor or not? PIs are always "very confident" then surprised by rejections.

Also "deferring" may not be something the school allows. They want to fill their class with people who want to be in their class.

Do you really want ortho or neurosurgery or are you keeping your options open?

It comes down to if you are really gunning for something specific, or want to get your life started and cut the bull****. Don't think of it as "a year of attending salary" unless you're banking on needing to be in a nursing home when you're 85. Think of it as one more year of being an attending in your thirties and living the good life with your SO/kids/whatever.

 

[dienekes88]

If you look at my prior posts, I made the exact point that this would basically be equivalent to a research year in Med school. You can make the argument, you just need to be aware that this isn’t a slam dunk and realistically weigh the risks associated with the decision.

Agree.

Its actually a little worse than a residency research year, because you’re presumably getting paid a resident salary for those. Of course there’s no guarantee that a project like this comes along again.

Probably true.

An 80% clinical person isn’t writing a Cell paper

Also probably true. I have seen an 80% clinical faculty member have a resident in the lab write a Cell/Nature/Science paper though.

 

[dienekes88]

I didn't say they weren't impressed, I said they're not wowed. And this was in the context of a Cell paper vs. an R01. Cell paper is "nice!" R01 is "wow, you're gonna be able to fund an entire research laboratory!" lol. And there are numerous grants that you can apply for as a postdoc that will fund not only part of your postdoc training but also your lab for the first few years.

Wrt hiring, it will entirely depend on the institution. Most clinical divisions at my school care far more about research output/funding when it comes to hiring. You can give most people a higher volume, but you can't magically turn a physician into a rigorous scientist because medical school doesn't train you to become a scientist. I never said a trainee or medical school applicant can have a K99/R00 (although if we're discussing grants, there are numerous research grants available to MD and MD/PhD students such as the F30).

The fact of the matter is that an R01 is much more impressive and desired than a Cell paper. And the bottom line for OP is that, for numerous reasons, it would not be a good idea to decline medical school acceptance with the hope of getting a Cell paper. I just recently had a manuscript accepted in a Cell family journal (not Cell) that took an additional 7 months to publish from initial submission to publication. And unless OP is doing SARS-CoV-2 research, theirs will probably take even longer (~ 1.5-2 years) with no guarantee that it will be in Cell. OP if you're reading this, please accept the medical school offer lol, more opportunities to publish great work will arise.

OP isn't declining medical school acceptance. That would be different. Its a deferral. The OP is still going to be able to go the following year. Unless I'm reading something wrong.

We can disagree on the relative value of the two: i think of the R01 as being like having 5 first round draft picks and the cell paper like having a shutdown cornerback on the roster... people get first round draft picks to get that cornerback, I would rather just have the cornerback. I will concede that the money makes a difference, though, and with respect to lab sustainability... that's a good point.

 

[FamMed4Life]

Hi Everyone, I'm hoping to hear people's opinions on this dilemma I find myself in. Should I defer my medical school acceptance for 1 year to finish a project I have been working on and submit it as the 1st author? My PI (renowned in the field) is very confident that we can publish in a big name journal (most likely Cell, but also thinks Nature or Science would be appropriate). Alternatively, should I just start med school this summer and still be a high middle author (most likely 3rd).

I'd like to know how beneficial a first authorship (pre-med school) would be for boosting my application to competitive residencies (neuro/ortho/plastic surgery). I definitely plan to do research in medical school but don't think I'll have the time or resources to lead another project of this caliber.

Thanks in advance for taking the time to read this and share your insight.

If it is worth taking a $200,000+ pay cut to you, then go for it. Otherwise, I would just start medical school. Honestly, you might be able to stay as the first author especially now that step is Pass/Fail if it would only take you a few additional months and you could wrap up what you need to do in person before the end of the summer. However, I agree with the other people who said you also don't know what direction the paper will necessarily go. I find researchers to be sometimes overly optimistic. I think the fact that you are on a publication in a major journal is already going to look good to residencies and unless you are planning on going into something like Ortho, you probably don't need more than that and honestly, if you are planning on going into something competitive you might want to take a research year later with another mentor doing clinical research in your preferred field.

 

[Ellatha]

I didn't say they weren't impressed, I said they're not wowed. And this was in the context of a Cell paper vs. an R01. Cell paper is "nice!" R01 is "wow, you're gonna be able to fund an entire research laboratory!" lol. And there are numerous grants that you can apply for as a postdoc that will fund not only part of your postdoc training but also your lab for the first few years.

Wrt hiring, it will entirely depend on the institution. Most clinical divisions at my school care far more about research output/funding when it comes to hiring. You can give most people a higher volume, but you can't magically turn a physician into a rigorous scientist because medical school doesn't train you to become a scientist. I never said a trainee or medical school applicant can have a K99/R00 (although if we're discussing grants, there are numerous research grants available to MD and MD/PhD students such as the F30).

The fact of the matter is that an R01 is much more impressive and desired than a Cell paper. And the bottom line for OP is that, for numerous reasons, it would not be a good idea to decline medical school acceptance with the hope of getting a Cell paper. I just recently had a manuscript accepted in a Cell family journal (not Cell) that took an additional 7 months to publish from initial submission to publication. And unless OP is doing SARS-CoV-2 research, theirs will probably take even longer (~ 1.5-2 years) with no guarantee that it will be in Cell. OP if you're reading this, please accept the medical school offer lol, more opportunities to publish great work will arise.

what would you rather have: an R01 or Watson and Crick’s paper detailing the structure of the DNA double helix?

 

[andalukia]

what would you rather have: an R01 or Watson and Crick’s paper detailing the structure of the DNA double helix?

R01 cuz we arent in 1950s and im sure that the same paper will not accepted :> pls say something more contributing next time

 

[Ellatha]

R01 cuz we arent in 1950s and im sure that the same paper will not accepted :> pls say something more contributing next time

Complete straw man argument.

 

[wagonwheel23]

Any research year costs you a year of attending salary. Are you willing to pay $250,000+ for the chance you get a first author paper in Cell?

 

[OrthoTraumaMD]

So, residencies don't care about pubs if they were published at any time before med school? That seems pretty crazy to me. Research is research, why does it matter if it was done during undergrad/gap years?

Ortho residencies don’t, particularly research that isn’t in ortho. And I’m pretty sure ortho topics aren’t published in cell.