How do people get so many publications from doing research?

[Konigstiger]

With STEP going P/F, publications have become more important. And on SDN, I see a lot of people giving advice to people applying for competitive specialties by telling them to pump out more publications as if a publication is just something you can pick up at the corner store.

This has been the complete opposite of my experience. The last time I did research was in undergrad, which was mind-numbingly boring and resulted in no publications despite working in the lab the entire summer. In medical school, I've asked professors at my school about their research and potential opportunities, but they made it very clear that you would be unlikely to get any sort of publication out of it because of how long the process of submitting manuscripts takes and how little medical students realistically contribute. Furthermore, the research at my school (DO school) is all bench research, which I find very unappealing and would rather not do again if at all possible. I tried reaching out to several hospitals/MD schools nearby to see if they could spare any research opportunities, but every time I was either ignored or got an affirmative response and was then ghosted when I followed up. And even if I had got an opportunity at those places, what's there to guarantee that I could get a publication out of it?

I'm curious as to how anyone with a bunch of publications managed to get them. My experience has been that publications are nearly impossible to come by, and yet the tone from many posts on here suggest the complete opposite. What am I doing wrong? I'm also in my second year now. Is it even possible for me to get publications at this point? When would I find the time and how would I ensure that I won't just be used and then get nothing out of it like in undergrad? I'm not really aiming for anything extremely competitive, but still, research would be nice to have on my application.

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[DOVinciRobot]

Clinical research is able to be published much faster.

 

[mvenus929]

Clinical research can be literally anything from a case series/retrospective chart review (which if you're efficient, can be done within a few months) to randomized, placebo-controlled clinical trials (which usually are recruiting and collecting data for months to years).

In general, it is faster to get published doing clinical research than bench research.

My first research project took about 4-5 years from conception til publication. Probably would've been faster with a different mentor (who set deadlines and had a goal of publication from the start), but it still took time. My second I jumped into the middle of, but it still took about 2 years from when I started to publication. My third I did over the course of about 9 months (it was a subanalysis of data I was collecting for a bigger project, and I did all the data analysis myself). My fourth project I'm having a hard time getting published and have been working on it for almost 2 years; my fifth we are also having a hard time getting published, but have been working on it for about 18 months. So even project within clinical research can be hugely variable on how quickly they can get done and published.

 

[TelemarketingEnigma]

In addition to what others have said, keep in mind that the publications stats in the NRMP data include "abstracts, presentations, and publications." So this is everything from a poster presentation at a small local student conference, to a full article in Nature or Cell. They might be anywhere from first author to 16th+ author. And not all med student research is GOOD research - many students do incredible work, but there's a frustrating amount of fluff out there.

It helps to be working with a PI/lab group that emphasizes trainees publishing and presenting work (or getting their names on group publications). Not every lab will be like that.

 

[Matthew9Thirtyfive]

What everyone else has said. Clinical research can be done fairly quickly. I did a meta analysis that I just finished the first draft on. Took 4 months from conception to finishing the first draft, and that was with weeks of no work due to busy inpatient rotations, etc. I’ve done abstracts and case reports that I literally did in 2-3 days. It’s not even close to bench research in that you can literally generate the whole idea, run the whole thing, and get first author in less than 6 months.

 

[GoSpursGo]

Yeah if all you have available to you is bench research it's going to be essentially impossible to publish. You need clinical research.

My suggestion would be to reach out to the PD of your home program for whatever specialty you're interested in and see if they know of any faculty in their department who are looking for a medical student to help move a study along. Sometimes this is fruitful, other times it's a dead end, but I think you're more likely to get a response from a PD who has a vested interest in potentially recruiting good future residents than cold emailing faculty.

 

[Lawpy]

With STEP going P/F, publications have become more important. And on SDN, I see a lot of people giving advice to people applying for competitive specialties by telling them to pump out more publications as if a publication is just something you can pick up at the corner store.

This has been the complete opposite of my experience. The last time I did research was in undergrad, which was mind-numbingly boring and resulted in no publications despite working in the lab the entire summer. In medical school, I've asked professors at my school about their research and potential opportunities, but they made it very clear that you would be unlikely to get any sort of publication out of it because of how long the process of submitting manuscripts takes and how little medical students realistically contribute. Furthermore, the research at my school (DO school) is all bench research, which I find very unappealing and would rather not do again if at all possible. I tried reaching out to several hospitals/MD schools nearby to see if they could spare any research opportunities, but every time I was either ignored or got an affirmative response and was then ghosted when I followed up. And even if I had got an opportunity at those places, what's there to guarantee that I could get a publication out of it?

I'm curious as to how anyone with a bunch of publications managed to get them. My experience has been that publications are nearly impossible to come by, and yet the tone from many posts on here suggest the complete opposite. What am I doing wrong? I'm also in my second year now. Is it even possible for me to get publications at this point? When would I find the time and how would I ensure that I won't just be used and then get nothing out of it like in undergrad? I'm not really aiming for anything extremely competitive, but still, research would be nice to have on my application.

The answer is finding a niche and being really good at it

Also finding an attending/PI who’s a good mentor is critical. Unfortunately the answer is school specific but i’m sure there are good mentors everywhere

 

[Maximus2020]

The most obvious answer here is luck. But, strategy and finding the right people are essential too.

Background:

• I had 20+ publications (high impact factor journals) before submitting ERAS. No PhD. This, plus my extra degree, made me stand out from every other applicant.
• I had the high Step scores and all Honors/AOA, but if you are gunning for top 10 programs/hospitals, assume every applicant has those at baseline. Thus, you need to differentiate yourself.
• All my interview questions were on my research and my extra degree. Quantity and quality matters.
• Quantity: People that think abstracts or posters are on the same level as pubs or oral presentations (not posters) are just wrong. Submitted status also means nothing. If it's not in publication, it doesn't count.
• Quality:
  • First or second author only - otherwise it is questionable if you even did anything or were just put on the author list for kicks.
  • High impact journals in the specialty of your research; not open access pay-to-publish, or unheard of BS journals
  • Case reports mean next to nothing; you need full manuscripts, doesn't matter if retrospective or prospective

The How:

• None of this came easy. Indeed luck was part of it, but I worked my butt off to get the job done
• First, write off bench research; this is a waste of time when you are going after quantity; only go after clinical research
• Second, finding a "good" mentor is the hardest step in this process
  • Good does not just mean the chair of the department or the nice attitude PI
  • You need a PI who publishes; go on Pubmed, search for the PI by name, and ensure he/she has published in the past year; if not, pass, don't work with this person
  • Every institution/hospital has a directory of faculty; go through each person, look at what they have published on Pubmed, see if it is interesting to you and then reach out via email; do this for two or three faculty members
  • Then, treat this like a business/job interview; dress up, meet with him/her in person, be forward about your goals, list what value you can provide to the PI's group, etc. At the same time, get a sense of how the PI operates (you are interviewing them too)
• Once you have found the mentor or multiple mentors, you need to learn how to do research - the whole process
  • This is where a lot of people struggle; just because you find a mentor doesn't mean you are golden
  • Do you actually know to review the literature, how to write, what an IRB proposal is, what the manuscript submission process, etc.?
  • I did not (no one does), but thankfully my PI had a senior medical student who was the lead of the research group; he took me under his wing and taught me how to become a prolific and efficient researcher
• Next, project ideas; a good PI has limitless ideas and is always sending them out via email or discussing in monthly meetings; you are not expected to create your own ideas; if the PI does expect this, then leave - that is not a good PI; you are new and need to be brought up gradually to this level
• Take on your first project and get it done asap; speed/efficiency are key; forget going out to a movie or taking a weekend trip; do the work, learn, etc.

The PI: must be efficient, full of ideas, have a track record of publishing prolifically and frequently, and has worked/currently works with other med students or post-docs. Not his/her first rodeo.

After the first or few papers, then auto-pilot kicks in. You begin to tag-team projects with other med studs, so you get to be on their paper and them on yours. Each paper published can turn into multiple posters or oral presentations. Then, you become the senior med student, train younger med studs who help you with your papers, get grants/funding, work on bigger projects, and now as an attending the auto pilot keeps going.

This is not common. I understand that part of this was luck no doubt. But, if you lack initiative, which many med studs do, you will never get beyond 1 or 2 pubs at best. Take your time and seek out a good mentor first. You will know when you find one and it is not easy.

 

[Lawpy]

The most obvious answer here is luck. But, strategy and finding the right people are essential too.

Background:

• I had 20+ publications (high impact factor journals) before submitting ERAS. No PhD. This, plus my extra degree, made me stand out from every other applicant.
• I had the high Step scores and all Honors/AOA, but if you are gunning for top 10 programs/hospitals, assume every applicant has those at baseline. Thus, you need to differentiate yourself.
• All my interview questions were on my research and my extra degree. Quantity and quality matters.
• Quantity: People that think abstracts or posters are on the same level as pubs or oral presentations (not posters) are just wrong. Submitted status also means nothing. If it's not in publication, it doesn't count.
• Quality:
  • First or second author only - otherwise it is questionable if you even did anything or were just put on the author list for kicks.
  • High impact journals in the specialty of your research; not open access pay-to-publish, or unheard of BS journals
  • Case reports mean next to nothing; you need full manuscripts, doesn't matter if retrospective or prospective

The How:

• None of this came easy. Indeed luck was part of it, but I worked my butt off to get the job done
• First, write off bench research; this is a waste of time when you are going after quantity; only go after clinical research
• Second, finding a "good" mentor is the hardest step in this process
  • Good does not just mean the chair of the department or the nice attitude PI
  • You need a PI who publishes; go on Pubmed, search for the PI by name, and ensure he/she has published in the past year; if not, pass, don't work with this person
  • Every institution/hospital has a directory of faculty; go through each person, look at what they have published on Pubmed, see if it is interesting to you and then reach out via email; do this for two or three faculty members
  • Then, treat this like a business/job interview; dress up, meet with him/her in person, be forward about your goals, list what value you can provide to the PI's group, etc. At the same time, get a sense of how the PI operates (you are interviewing them too)
• Once you have found the mentor or multiple mentors, you need to learn how to do research - the whole process
  • This is where a lot of people struggle; just because you find a mentor doesn't mean you are golden
  • Do you actually know to review the literature, how to write, what an IRB proposal is, what the manuscript submission process, etc.?
  • I did not (no one does), but thankfully my PI had a senior medical student who was the lead of the research group; he took me under his wing and taught me how to become a prolific and efficient researcher
• Next, project ideas; a good PI has limitless ideas and is always sending them out via email or discussing in monthly meetings; you are not expected to create your own ideas; if the PI does expect this, then leave - that is not a good PI; you are new and need to be brought up gradually to this level
• Take on your first project and get it done asap; speed/efficiency are key; forget going out to a movie or taking a weekend trip; do the work, learn, etc.

The PI: must be efficient, full of ideas, have a track record of publishing prolifically and frequently, and has worked/currently works with other med students or post-docs. Not his/her first rodeo.

After the first or few papers, then auto-pilot kicks in. You begin to tag-team projects with other med studs, so you get to be on their paper and them on yours. Each paper published can turn into multiple posters or oral presentations. Then, you become the senior med student, train younger med studs who help you with your papers, get grants/funding, work on bigger projects, and now as an attending the auto pilot keeps going.

This is not common. I understand that part of this was luck no doubt. But, if you lack initiative, which many med studs do, you will never get beyond 1 or 2 pubs at best. Take your time and seek out a good mentor first. You will know when you find one and it is not easy.

This is solid advice and i completely agree with all of this

 

[Dr Meow]

For me, I worked 7 years at NIH/Biotech doing lots of bench research to get 7 bench pubs/abstracts. You can try applying to the NIH IRTA program and stay there for many years. But it's not worth your time. I decided I wanted to do medicine afterwards so my pubs were just kinda a thing I accumulated with time.

I'm not sure how clinical research works. Would be nice to get a few of those.

 

[GoSpursGo]

The most obvious answer here is luck. But, strategy and finding the right people are essential too.

Background:

• I had 20+ publications (high impact factor journals) before submitting ERAS. No PhD. This, plus my extra degree, made me stand out from every other applicant.
• I had the high Step scores and all Honors/AOA, but if you are gunning for top 10 programs/hospitals, assume every applicant has those at baseline. Thus, you need to differentiate yourself.
• All my interview questions were on my research and my extra degree. Quantity and quality matters.
• Quantity: People that think abstracts or posters are on the same level as pubs or oral presentations (not posters) are just wrong. Submitted status also means nothing. If it's not in publication, it doesn't count.
• Quality:
  • First or second author only - otherwise it is questionable if you even did anything or were just put on the author list for kicks.
  • High impact journals in the specialty of your research; not open access pay-to-publish, or unheard of BS journals
  • Case reports mean next to nothing; you need full manuscripts, doesn't matter if retrospective or prospective

The How:

• None of this came easy. Indeed luck was part of it, but I worked my butt off to get the job done
• First, write off bench research; this is a waste of time when you are going after quantity; only go after clinical research
• Second, finding a "good" mentor is the hardest step in this process
  • Good does not just mean the chair of the department or the nice attitude PI
  • You need a PI who publishes; go on Pubmed, search for the PI by name, and ensure he/she has published in the past year; if not, pass, don't work with this person
  • Every institution/hospital has a directory of faculty; go through each person, look at what they have published on Pubmed, see if it is interesting to you and then reach out via email; do this for two or three faculty members
  • Then, treat this like a business/job interview; dress up, meet with him/her in person, be forward about your goals, list what value you can provide to the PI's group, etc. At the same time, get a sense of how the PI operates (you are interviewing them too)
• Once you have found the mentor or multiple mentors, you need to learn how to do research - the whole process
  • This is where a lot of people struggle; just because you find a mentor doesn't mean you are golden
  • Do you actually know to review the literature, how to write, what an IRB proposal is, what the manuscript submission process, etc.?
  • I did not (no one does), but thankfully my PI had a senior medical student who was the lead of the research group; he took me under his wing and taught me how to become a prolific and efficient researcher
• Next, project ideas; a good PI has limitless ideas and is always sending them out via email or discussing in monthly meetings; you are not expected to create your own ideas; if the PI does expect this, then leave - that is not a good PI; you are new and need to be brought up gradually to this level
• Take on your first project and get it done asap; speed/efficiency are key; forget going out to a movie or taking a weekend trip; do the work, learn, etc.

The PI: must be efficient, full of ideas, have a track record of publishing prolifically and frequently, and has worked/currently works with other med students or post-docs. Not his/her first rodeo.

After the first or few papers, then auto-pilot kicks in. You begin to tag-team projects with other med studs, so you get to be on their paper and them on yours. Each paper published can turn into multiple posters or oral presentations. Then, you become the senior med student, train younger med studs who help you with your papers, get grants/funding, work on bigger projects, and now as an attending the auto pilot keeps going.

This is not common. I understand that part of this was luck no doubt. But, if you lack initiative, which many med studs do, you will never get beyond 1 or 2 pubs at best. Take your time and seek out a good mentor first. You will know when you find one and it is not easy.

There are parts of this (especially the parts about finding a mentor, collaborating with a senior person in the lab who isn't the PI, persevering, etc) that I agree with. There are other parts that are just totally unrealistic (ie saying that middle author or presentations don't count--they aren't on the same level, but it's silly to suggest they're worthless, and sometimes you need to let someone else be first/second to play nice within the group).

Maybe a lofty goal to aim for, but if you can do 30% of what is outlined here you'll likely be fine.

 

[operaman]

The most obvious answer here is luck. But, strategy and finding the right people are essential too.

Background:

• I had 20+ publications (high impact factor journals) before submitting ERAS. No PhD. This, plus my extra degree, made me stand out from every other applicant.
• I had the high Step scores and all Honors/AOA, but if you are gunning for top 10 programs/hospitals, assume every applicant has those at baseline. Thus, you need to differentiate yourself.
• All my interview questions were on my research and my extra degree. Quantity and quality matters.
• Quantity: People that think abstracts or posters are on the same level as pubs or oral presentations (not posters) are just wrong. Submitted status also means nothing. If it's not in publication, it doesn't count.
• Quality:
  • First or second author only - otherwise it is questionable if you even did anything or were just put on the author list for kicks.
  • High impact journals in the specialty of your research; not open access pay-to-publish, or unheard of BS journals
  • Case reports mean next to nothing; you need full manuscripts, doesn't matter if retrospective or prospective

The How:

• None of this came easy. Indeed luck was part of it, but I worked my butt off to get the job done
• First, write off bench research; this is a waste of time when you are going after quantity; only go after clinical research
• Second, finding a "good" mentor is the hardest step in this process
  • Good does not just mean the chair of the department or the nice attitude PI
  • You need a PI who publishes; go on Pubmed, search for the PI by name, and ensure he/she has published in the past year; if not, pass, don't work with this person
  • Every institution/hospital has a directory of faculty; go through each person, look at what they have published on Pubmed, see if it is interesting to you and then reach out via email; do this for two or three faculty members
  • Then, treat this like a business/job interview; dress up, meet with him/her in person, be forward about your goals, list what value you can provide to the PI's group, etc. At the same time, get a sense of how the PI operates (you are interviewing them too)
• Once you have found the mentor or multiple mentors, you need to learn how to do research - the whole process
  • This is where a lot of people struggle; just because you find a mentor doesn't mean you are golden
  • Do you actually know to review the literature, how to write, what an IRB proposal is, what the manuscript submission process, etc.?
  • I did not (no one does), but thankfully my PI had a senior medical student who was the lead of the research group; he took me under his wing and taught me how to become a prolific and efficient researcher
• Next, project ideas; a good PI has limitless ideas and is always sending them out via email or discussing in monthly meetings; you are not expected to create your own ideas; if the PI does expect this, then leave - that is not a good PI; you are new and need to be brought up gradually to this level
• Take on your first project and get it done asap; speed/efficiency are key; forget going out to a movie or taking a weekend trip; do the work, learn, etc.

The PI: must be efficient, full of ideas, have a track record of publishing prolifically and frequently, and has worked/currently works with other med students or post-docs. Not his/her first rodeo.

After the first or few papers, then auto-pilot kicks in. You begin to tag-team projects with other med studs, so you get to be on their paper and them on yours. Each paper published can turn into multiple posters or oral presentations. Then, you become the senior med student, train younger med studs who help you with your papers, get grants/funding, work on bigger projects, and now as an attending the auto pilot keeps going.

This is not common. I understand that part of this was luck no doubt. But, if you lack initiative, which many med studs do, you will never get beyond 1 or 2 pubs at best. Take your time and seek out a good mentor first. You will know when you find one and it is not easy.

Perhaps one of the best posts on this topic. Spot on.

I will say that a submitted publication in ERAS looks pretty darn similar to a fully published one because it goes in the same spot on the app and you have to read closely to see the status. Some faculty will definitely notice, but some don’t. There’s been a time honored tradition of people submitting a ton of papers right before ERAS so you can submit the app before the paper rejection arrives.

Middle author papers are better than nothing and are definitely nice for helping that initial visual impact when reviewing a CV, but nobody has any illusions about the level of involvement for author #12 out of 19.

The key to case reports is titling it such that it isn’t immediately obvious it’s a case report. Some journals have rules about this, but some are more lax. Then there’s also the old trick of finding 1-2 more patients and making a case series. Lots of ways to dress things up a bit. Nobody is fooled by it, but it may help to check the research box for most faculty reviewing an application.

Your experience was similar to mine, though you put my productivity to shame! It’s definitely nice when that snowball effect starts to kick in and you get people under you doing more of the grunt work while you supervise and add your name to the paper. Another student ahead of me got a ton of papers by figuring out how to query the SEER database and so racked up pubs by being listed on every student retrospective he helped search the data set. Another got good at systemic reviews and meta analysis and churned a ton of those out too.

So many options, and all hinges on finding the right mentors.

 

[Maximus2020]

Agree that ERAS can be manipulated. Being an interviewer, it is (should be) much easier to see past the fluff. Interviewers will (should) straight up ask what did you actually do for the project.

Re: first/second author, I would never just let someone be in that spot for kicks/giggles. Any good group/PI understands that those spots should go to the individuals who performed the most work. The PI and chair of the dept often occupy the last 2 positions. The middle - to me as a reviewer - is a suboptimal spot to be in. Yes, it is a pub tied to your name on a Pubmed search and that is something, but anyone who understands the process and has published will scrutinize that in an interview or app review.

As for presentations, it is well known that it is extremely easy to get a poster presentation. A local poster presentation at one's medical school means next to nothing. It's like getting a participation trophy for playing soccer, even if you just sat on the bench. I don't say these things to be mean or harsh. I'm just avoiding the sugar coating to be as real as I can with people on here.

Oral presentations make a huge difference to me. If you speak at a national conference on your research topic, rather than have an e-poster, then I see you as a strong candidate who knows the research and contributed well to it, even before I ask you in the interview. Oral presentations are much harder to get obviously.

 

[GoSpursGo]

Agree that ERAS can be manipulated. Being an interviewer, it is (should be) much easier to see past the fluff. Interviewers will (should) straight up ask what did you actually do for the project.

Re: first/second author, I would never just let someone be in that spot for kicks/giggles. Any good group/PI understands that those spots should go to the individuals who performed the most work. The PI and chair of the dept often occupy the last 2 positions. The middle - to me as a reviewer - is a suboptimal spot to be in. Yes, it is a pub tied to your name on a Pubmed search and that is something, but anyone who understands the process and has published will scrutinize that in an interview or app review.

As for presentations, it is well known that it is extremely easy to get a poster presentation. A local poster presentation at one's medical school means next to nothing. It's like getting a participation trophy for playing soccer, even if you just sat on the bench. I don't say these things to be mean or harsh. I'm just avoiding the sugar coating to be as real as I can with people on here.

Oral presentations make a huge difference to me. If you speak at a national conference on your research topic, rather than have an e-poster, then I see you as a strong candidate who knows the research and contributed well to it, even before I ask you in the interview. Oral presentations are much harder to get obviously.

Again, I agree with parts of this, specifically in regards to being able to explain what you did on your project. We will put people in our group on papers as middle author, but will usually go out of our way to give them a small piece of data to analyze so that they can answer that question. Of course 4th author is "sub-optimal," but as you said that should mean you didn't have to put nearly as much work in as if you were first/second. Part of being a good team player is chipping in where you can on others' papers.

The point about a poster presentation is specialty-dependent, and honestly just overly harsh. If someone is applying to derm/neurosurgery/ortho/etc, then yeah you need to get "real" pubs. If you're applying to IM, peds, or something else that is non-competitive, then *any* research that results in *any* deliverable is valuable to me. It shows that at least you're able to synthesize your research and present it. Yeah it's a bit of a participation trophy if you present it at your school forum, but participating is still better than the loads of students who list a "research experience" but never even bothered to present it.

Basically, you can't approach research as a med student with the mindset that it's only worth doing it if you're getting a first/second author original research manuscript/oral presentation at a national conference. It's great if you get that, but just because a project might not get you to that level doesn't mean it isn't worth doing.

 

[Lawpy]

There are parts of this (especially the parts about finding a mentor, collaborating with a senior person in the lab who isn't the PI, persevering, etc) that I agree with. There are other parts that are just totally unrealistic (ie saying that middle author or presentations don't count--they aren't on the same level, but it's silly to suggest they're worthless, and sometimes you need to let someone else be first/second to play nice within the group).

Maybe a lofty goal to aim for, but if you can do 30% of what is outlined here you'll likely be fine.

I have never seen people being put first/second author just for the sake of being nice

 

[GoSpursGo]

I have never seen people being put first/second author just for the sake of being nice

That's not what I was suggesting. I meant it's unreasonable for one person to dominate all of the projects within the group and demand to be first/second author on every paper.

 

[Lawpy]

That's not what I was suggesting. I meant it's unreasonable for one person to dominate all of the projects within the group and demand to be first/second author on every paper.

Why? If they’re taking the lead from start to end on all of them (such as if the projects all share a certain key skill that person has), being first/second author is the correct approach. The second author position still gives a junior researcher the opportunity to write the paper with guidance so it’s not like it’s selfish.

However if the projects are focusing on different but related things/skills on a topic, then dividing the work and aiming to be 3rd author would be better.

 

[TelemarketingEnigma]

Why? If they’re taking the lead from start to end on all of them (such as if the projects all share a certain key skill that person has), being first/second author is the correct approach. The second author position still gives a junior researcher the opportunity to write the paper with guidance so it’s not like it’s selfish.

However if the projects are focusing on different but related things/skills on a topic, then dividing the work and aiming to be 3rd author would be better.

because when you do team based research, one person should not be taking lead from start to finish on all papers. They should, however, be supporting their research teammates in ways that deserve recognition but not lead authorship. Commonly, a research lab will have multiple simultaneous separate but related projects happening that are lead by different people but can build off of each others work. And for a major project involving the whole lab group, people will have different skills to contribute - some are great at statistics, some are great at theory, some are just hard workers. Sometimes your teammates will contribute more than you, and deserve recognition for that.

There are many fields where solo authorship on every paper is the norm, but that's not been my experience in medicine.

 

[Lawpy]

because when you do team based research, one person should not be taking lead from start to finish on all papers. They should, however, be supporting their research teammates in ways that deserve recognition but not lead authorship. Commonly, a research lab will have multiple simultaneous separate but related projects happening that are lead by different people but can build off of each others work. And for a major project involving the whole lab group, people will have different skills to contribute - some are great at statistics, some are great at theory, some are just hard workers. Sometimes your teammates will contribute more than you, and deserve recognition for that.

There are many fields where solo authorship on every paper is the norm, but that's not been my experience in medicine.

I think you’re talking about projects with different skillsets involved as opposed to projects with one skillset where someone is uniquely good at. If someone is good at database stuff and can push through projects efficiently, taking the lead on everything related to database work is the ideal approach rather than spending the time training others and rewriting things to get papers out. The idea in this case is about efficiency and maximizing output the fastest.

Big projects with different skillsets involved can be more fairly assigned to anyone else based on who took the lead. Based on my experience, taking the lead on everything even with different skillsets gets overwhelming so delegating tasks to others in these complex projects can help. But papers based on the same skillset can and should be taken the lead by the same person

 

[TelemarketingEnigma]

I think you’re talking about projects with different skillsets involved as opposed to projects with one skillset where someone is uniquely good at. If someone is good at database stuff and can push through projects efficiently, taking the lead on everything related to database work is the ideal approach rather than spending the time training others and rewriting things to get papers out. The idea in this case is about efficiency and maximizing output the fastest.

Big projects with different skillsets involved can be more fairly assigned to anyone else based on who took the lead. Based on my experience, taking the lead on everything even with different skillsets gets overwhelming so delegating tasks to others in these complex projects can help. But papers based on the same skillset can and should be taken the lead by the same person

no i'm just talking about research and teamwork in general

Especially as you get into higher impact research, it's pretty rare that you'll be doing work that involves only one single skillset. Even churning simple things out based on chart review and database work still requires doing background lit review, and interpreting results, and writing the actual manuscript, and other contributions that are often shared by multiple people. sure one person can do all that work for all the projects if they want, but at a certain point if you're good enough at it, you should start mentoring other people to do work too. and multiple viewpoints contributing will often make for better research.

I'm also not someone who is a fan of the current med student research machine, so i don't think "efficiency and maximizing output" is necesarily the best thing to prioritize all the time. Though i acknowledge it'll happen and is many students focus. I AM a big fan of teamwork and interdisciplinary approaches so I place more value in that

 

[Lawpy]

no i'm just talking about research and teamwork in general

Especially as you get into higher impact research, it's pretty rare that you'll be doing work that involves only one single skillset. Even churning simple things out based on chart review and database work still requires doing background lit review, and interpreting results, and writing the actual manuscript, and other contributions that are often shared by multiple people. sure one person can do all that work for all the projects if they want, but at a certain point if you're good enough at it, you should start mentoring other people to do work too. and multiple viewpoints contributing will often make for better research.

I'm also not someone who is a fan of the current med student research machine, so i don't think "efficiency and maximizing output" is necesarily the best thing to prioritize all the time. Though i acknowledge it'll happen and is many students focus. I AM a big fan of teamwork and interdisciplinary approaches so I place more value in that

I don’t think we disagree. I just think people shouldn’t be shamed into having too many first authors just because they took the lead on so many projects that all hinge on their key skillsets. Others can and should help and they can take 2nd/3rd/middle authors etc

 

[TelemarketingEnigma]

I don’t think we disagree. I just think people shouldn’t be shamed into having too many first authors just because they took the lead on so many projects that all hinge on their key skillsets. Others can and should help and they can take 2nd/3rd/middle authors etc

I don't think anyone is shaming necessarily, but how did they get to the point of having such spectacular research skills without ever working with others? that's what we're pointing out - working with others is a key part of research and especially as a junior researcher means you won't be in charge of every single project you contribute to. you can and should get first author papers, just not every single one of them. and as you get more experienced, you'll transition to being a senior author and supporting junior authors getting their own first author papers.

 

[GoSpursGo]

I don’t think we disagree. I just think people shouldn’t be shamed into having too many first authors just because they took the lead on so many projects that all hinge on their key skillsets. Others can and should help and they can take 2nd/3rd/middle authors etc

This just is not how any research group works in reality. There are a number of projects going on, and no matter how super awesome someone (especially a medical student) may think they are, they are not going to be the only one with a useful skillset that deserves first author recognition on every single one. And you're going to be pretty unpopular if every time a new project is proposed you're constantly demanding to take the lead in the group. You need to be able to play a supporting role on some projects, let your colleagues get their turn at recognition, and then you all win.

 

[Lawpy]

I don't think anyone is shaming necessarily, but how did they get to the point of having such spectacular research skills without ever working with others? that's what we're pointing out - working with others is a key part of research and especially as a junior researcher means you won't be in charge of every single project you contribute to. you can and should get first author papers, just not every single one of them. and as you get more experienced, you'll transition to being a senior author and supporting junior authors getting their own first author papers.

They either self learned, had prior background in fields like computer science/engineering, or were the only ones who initially worked with the attending/PI until the PI became more established. It doesn’t have to be a senior student or resident teaching these things. It can be directly from the faculty themselves who are trying to establish their own careers

 

[Lawpy]

This just is not how any research group works in reality. There are a number of projects going on, and no matter how super awesome someone (especially a medical student) may think they are, they are not going to be the only one with a useful skillset that deserves first author recognition on every single one. And you're going to be pretty unpopular if every time a new project is proposed you're constantly demanding to take the lead in the group. You need to be able to play a supporting role on some projects, let your colleagues get their turn at recognition, and then you all win.

I highly doubt most med students have experience in skillsets like advanced database analysis and machine learning. People from computer science and engineering backgrounds have that experience and can uniquely churn out a lot of high quality papers with support from engineering faculty and attendings. Now of course if there are other people (like grad students and postdocs) with that experience, it makes sense to distribute the work accordingly

 

[GoSpursGo]

I highly doubt most med students have experience in skillsets like advanced database analysis and machine learning. People from computer science and engineering backgrounds have that experience and can uniquely churn out a lot of high quality papers with support from engineering faculty and attendings. Now of course if there are other people (like grad students and postdocs) with that experience, it makes sense to distribute the work accordingly

Well as you said, it's very rare that medical students have skills in advanced database analysis or machine learning, so I'm not sure why you were approaching this question from that standpoint since that would be unhelpful to the vast majority of people reading this thread 🙂

 

[TelemarketingEnigma]

I highly doubt most med students have experience in skillsets like advanced database analysis and machine learning. People from computer science and engineering backgrounds have that experience and can uniquely churn out a lot of high quality papers with support from engineering faculty and attendings. Now of course if there are other people (like grad students and postdocs) with that experience, it makes sense to distribute the work accordingly

we're speaking from experience here, idk what to tell you. churning out the data is not the only thing that goes into writing papers - in my own experience, if someone had a skillset like this and was the only one in the lab who could do it, then sure they will help churn out data for a bunch of papers but they won't actually write all those papers, and therefore won't get first author on all of them

for example, in one of the research groups i'm a part of, we had a phd student who did most of the stats for our papers (because that's what he liked and was good at). but those numbers have to be put into context for them to be a compelling research paper. there would often be someone else (or multiple someones else) who conceptualized the study, did the background research, did grunt work, and wrote up the analysis and discussion. While the phd student rightfully got 2nd-3rd author on a ton of papers (depending on contribution) the person who did most of the work of authorship got the 1st author spot. sometimes that was the phd student, but if we had waited for him to lead every single paper, we would have published way less stuff. instead he contributed his skills to a lot of things, other people contributed their own skills, and we published more things as a team.

 

[Lawpy]

Well as you said, it's very rare that medical students have skills in advanced database analysis or machine learning, so I'm not sure why you were approaching this question from that standpoint since that would be unhelpful to the vast majority of people reading this thread

Because i’m saying if the projects are primarily focused on those skillsets (and they play a big role in clinical research and a major factor why some MS4s applying to residency have 20+ high impact papers) and there’s only one person with that specific skillset, having them take the lead and push out first author papers is not unreasonable nor is it poor play.

I already agreed that bigger, more complex projects will require many skills and giving first author to someone who took the lead and did much of the work is better

we're speaking from experience here, idk what to tell you. churning out the data is not the only thing that goes into writing papers - in my own experience, if someone had a skillset like this and was the only one in the lab who could do it, then sure they will help churn out data for a bunch of papers but they won't actually write all those papers, and therefore won't get first author on all of them

for example, in one of the research groups i'm a part of, we had a phd student who did most of the stats for our papers (because that's what he liked and was good at). but those numbers have to be put into context for them to be a compelling research paper. there would often be someone else (or multiple someones else) who conceptualized the study, did the background research, did grunt work, and wrote up the analysis and discussion. While the phd student rightfully got 2nd-3rd author on a ton of papers (depending on contribution) the person who did most of the work of authorship got the 1st author spot. sometimes that was the phd student, but if we had waited for him to lead every single paper, we would have published way less stuff. instead he contributed his skills to a lot of things, other people contributed their own skills, and we published more things as a team.

I’m speaking from experience too, and again, you’re talking about projects with different skillsets involved. Someone who only focuses on just churning out the data will unlikely get first author in anything. Maybe our approaches are different, but i don’t work on anything without having a good understanding of the background material involved (enough to the point where i can freely write a paper quickly in the event the original person who worked on it had abandoned the project for whatever reasons). The first author should be given to someone who took the lead on the project not necessarily someone who did the most work (although these things share a lot of overlap).

But this again is an aside from my point that we should not criticize people who just so happen to be productive enough to get several first authors. Usually in these cases, the PIs themselves are much much more productive that other people in the group will also have several first and second authors. This is not an extreme or rare case. I don’t disagree with the value of teamwork

 

[TelemarketingEnigma]

i think we're just talking in circles but

The first author should be given to someone who took the lead on the project not necessarily someone who did the most work (although these things share a lot of overlap).

authorship politics can get complicated but if someone is the "lead" without doing the work i usually think of that as a senior author situation - in medicine, they typically go last (though this is not true of all fields)

But this again is an aside from my point that we should not criticize people who just so happen to be productive enough to get several first authors. Usually in these cases, the PIs themselves are much much more productive that other people in the group will also have several first and second authors. This is not an extreme or rare case. I don’t disagree with the value of teamwork

look, i am productive enough to have several first author projects. I'm not criticizing that. I'm just pointing out the reality of how it often works, both in medical school and from my experience working on some high impact research before med school. in addition to those first author projects, i have a number of middle author projects. if you're working in a lab/field where 1-3 author papers are the norm, then maybe you're only getting 1st author papers with your PI, thats awesome! but with larger teams that contribute to each other's work, it's those other projects that the PI is managing where you'll get brought in as a middle author.

 

[GoSpursGo]

But this again is an aside from my point that we should not criticize people who just so happen to be productive enough to get several first authors. Usually in these cases, the PIs themselves are much much more productive that other people in the group will also have several first and second authors. This is not an extreme or rare case. I don’t disagree with the value of teamwork

We're talking past each other. Nobody is criticizing people who are productive enough to get multiple first author pubs, we're suggesting that expecting to get first/second on every single paper is an unrealistic goal for anyone, especially a student.

 

[Lawpy]

i think we're just talking in circles but

authorship politics can get complicated but if someone is the "lead" without doing the work i usually think of that as a senior author situation - in medicine, they typically go last (though this is not true of all fields)


look, i am productive enough to have several first author projects. I'm not criticizing that. I'm just pointing out the reality of how it often works, both in medical school and from my experience working on some high impact research before med school. in addition to those first author projects, i have a number of middle author projects. if you're working in a lab/field where 1-3 author papers are the norm, then maybe you're only getting 1st author papers with your PI, thats awesome! but with larger teams that contribute to each other's work, it's those other projects that the PI is managing where you'll get brought in as a middle author.

Ok i don’t disagree with any of this, except in groups where multiple attendings are involved, senior authorship discussions become challenging so allocating the first author spot to one attending who worked on it earlier is usually the norm

We're talking past each other. Nobody is criticizing people who are productive enough to get multiple first author pubs, we're suggesting that expecting to get first/second on every single paper is an unrealistic goal for anyone, especially a student.

This i agree mostly unless the research group is small and there’s only one person with a particular skillset that the group is focusing heavily on.

 

[seeinghowitgoes]

agree with most of what’s been discussed, would just add that you should take some things with a grain of salt.

1) so much of it is luck (as many have stated) - if you have a mentor who publishes a lot, you’ll get published a lot. Honestly there are a lot of sub specialty paper mills that just publish garbage in sub specialty journals - probably ok for career advancement but I dunno how those folks look in the mirror like “yea really happy with the random noise I contributed to the literature today.”

2) not all fields are equally hard to publish in - on average Gen med journals are a lot harder to publish in than Gen surg journals that are a lot harder to publish in that neurosurgery journals that are a lot harder to publish in that (insert super sub- specialty journal here). Not to take away from most sub-specialty journals, and clearly if you’re in a sub specialty where it’s easier to publish than yea publish 20+ cuz that’s what you’re competing against, just don’t compare 20+ pubs (even in “top” sub specialty journals) to like 10+ pubs in good gen med journals - it’s apples and oranges a lot of the time and will just drive you nuts.

3) lots of people with lots of pubs are not good at research and write really bad papers. One of the best most rigorous researchers I know (full prof, world renowned) has 80. If you want to be a researcher yea you have to hit some quantity mark, which will differ by field depending on what’s already known (some fields have more low hanging fruit than others) and how easy it is to publish (surgical journals accept way lower Ns in their studies, for example, so papers can be churned out faster) - but also after a critical mass people in the know understand the influential researcher vs the person who just pumps out papers as part of a paper mill. Certainly becomes easy to tell when having a conversation with the person.

Anyway, that isn’t to take away from the advice offered on this thread about how to be super productive. I agree with a lot of it. Just don’t confuse productivity and playing the game with worth or if you’re setup with the skills to make an impact as a researcher when you’re an attending.

 

[GoSpursGo]

Ok i don’t disagree with any of this, except in groups where multiple attendings are involved, senior authorship discussions become challenging so allocating the first author spot to one attending who worked on it earlier is usually the norm


This i agree mostly unless the research group is small and there’s only one person with a particular skillset that the group is focusing heavily on.

If this is really your situation then good for you. I just am not sure how that is helpful for the OP given that he/she is having trouble just getting started And while it's obvious that first author>second author>middle author, when someone is just trying to get started I think we all need to have some perspective that any contribution is meaningful. There's no need to discourage people who can't or don't want to get 20+ first author pubs, which was the distinct message I received from some of the posts.

 

[Lawpy]

If this is really your situation then good for you. I just am not sure how that is helpful for the OP given that he/she is having trouble just getting started And while it's obvious that first author>second author>middle author, when someone is just trying to get started I think we all need to have some perspective that any contribution is meaningful. There's no need to discourage people who can't or don't want to get 20+ first author pubs, which was the distinct message I received from some of the posts.

I was discussing this in tangent to the thread because the discussion seemed to be dismissive against those with many first authors (yes it was clarified later on this wasn’t the case). That discussion emerged from that post on the 20+ papers, which while a rare and extreme scenario, actually has good advice in it

 

[Maximus2020]

Research publishing tends to fire up some people haha.

My take on authorship: often the first author is the one who writes the manuscript. Statisticians, grunt work data and table/figure makers, etc. won't be first author unless they write a good chunk of the paper. Writing the paper, in my opinion, take the most time and skill. Writing is an art and a well-written paper sounds beautiful like a symphony.

I don't agree that most of success in publishing is luck. Perseverance is key. I've had many papers rejected, sort through all the comments from reviewers, re-work them, re-submit elsewhere, publish, etc. Publishing is akin to climbing mountains.

I also don't agree with seeinghowitgoes take on journal publishing. The impact factor is the gold standard, no matter the specialty. Yes, NEJM and JAMA are cool and really tough to publish in, but a sub-specialty journal alone does not make it easy to publish it. Impact factors exist for a reason.

Finally, regarding quantity, this is a tough case to make either way. I go mostly by the H-index and know plenty of >250 prolific authors with amazing H-indices. A few >1000. Promotions are often (should be) tied to the H-index. At the same time, I agree that there plenty of people who plagiarize/duplicate publish, or find other ways to pump up the numbers.

 

[aldol16]

Yeah, clinical research is a different world from basic science research. Basic research you might spend 2 years on and not get a paper out of it. Clinical research you fail early and you tend to find something that sticks earlier on and are able to publish early too. Usually clinical projects based on observational data don't take more than a few months to do. It takes longer to get it through review and publishing but the actual project isn't that long. Compare that to basic science projects which might require you to fail 1000 times before something works.

 

[seeinghowitgoes]

Research publishing tends to fire up some people haha.

My take on authorship: often the first author is the one who writes the manuscript. Statisticians, grunt work data and table/figure makers, etc. won't be first author unless they write a good chunk of the paper. Writing the paper, in my opinion, take the most time and skill. Writing is an art and a well-written paper sounds beautiful like a symphony.

I don't agree that most of success in publishing is luck. Perseverance is key. I've had many papers rejected, sort through all the comments from reviewers, re-work them, re-submit elsewhere, publish, etc. Publishing is akin to climbing mountains.

I also don't agree with seeinghowitgoes take on journal publishing. The impact factor is the gold standard, no matter the specialty. Yes, NEJM and JAMA are cool and really tough to publish in, but a sub-specialty journal alone does not make it easy to publish it. Impact factors exist for a reason.

Finally, regarding quantity, this is a tough case to make either way. I go mostly by the H-index and know plenty of >250 prolific authors with amazing H-indices. A few >1000. Promotions are often (should be) tied to the H-index. At the same time, I agree that there plenty of people who plagiarize/duplicate publish, or find other ways to pump up the numbers.

Definitely disagree about the luck part (as it pertains to publishing during training specifically) - if a PI says “here is this project I conceptualized and this statistician did the work for, can you write it” you have gotten into a great group to be able to publish a lot because you have to do very litte (I’ve taken projects from conceptualization to funding to data gathering to data analysis to writing to dissemination and also just been handed data and asked to write a paper - the latter is about 100x easier). You won’t necessarily leave a great researcher if you’re just given data and told to write (because you haven’t had to write protocols, code anything, get funding, etc) but you will have many pubs. That to me is the luck part. When you’re the PI and applying for funding and having to conceptualize all the projects on your own publishing is certainly not “luck,” but for a med student or resident to walk into the right research setting where they’re either slapped on projects or given fully formed ideas and data to work with is.

Impact factor I think is good for comparing within fields, absolutely trash comparing across fields. I also tend to group into tiers rather than look at absolute numbers (>20, 10-19, 5-9, or something along those lines), which may make it a bit easier to compare across fields but I don’t know. Agree overall H index should be considered when looking at a body of work, but lol if somebody has 1000 pubs (and yes I too have experience with those folks) I don’t respect their research prowess anymore than I do a person worh 100 pubs - I respect their ability to play a game and setup organizations (there are some great thought pieces out there about the issues with the 500+ paper crew).

My bigger point is simpler and remains: do not compare number of pubs of an [insert subspecialty surgeon] with a health services researcher with a basic scientist with a med student or resident assisting in one of these fields. Focus on doing good work. The numbers will be different, the quality and impact may be different and will usually not be accounted for in the numbers (and impact factor isn’t a great proxy for those things across fields), and folks who publish early and often usually had a lot of luck getting early numbers - it’s not necessarily indicative of superior ideas or skill. If you want to be a researcher in your career you can absolutely do it with only a few pubs in med school/residency (I do say a few pubs are probably necessary because the best predictor of future publishing is prior publishing, so probably good to learn the trade and get something out there before finishing training). I give this advice as somebody who had 20+ pubs before finishing med school and 40+ pubs before the end of residency and can see how that has helped me but also how folks who are far far less productive during training are doing just fine all around me assuming they learned quality even if they didn’t get quantity in their training times.

 

[Maximus2020]

Agree with luck in finding a PI like that, but no one can write a paper from scratch with no experience. That takes a lot of effort. Getting said paper accepted to a high quality journal is also not luck. So, it is a combination of the two, but I do believe luck only gets your foot in the door.

Re: 1000 versus 100, if the former has most of his/her pubs in high impact factor journals while the latter does not, then it is not just a game. If flimsy journals, then agreed.

Unfortunately, most med school/residency/fellowship program/admissions directors will not follow your advice of not comparing quantity. Quantity is and always will be the easy way for those folks to make decisions. If a basic science researcher has only 1 pub, even if it is in Nature, but a clinical researcher has 20+ pubs, some or many of which are in high impact factor journals, the latter will almost certainly get the interview slot over the former.

 

[GoSpursGo]

Re: 1000 versus 100, if the former has most of his/her pubs in high impact factor journals while the latter does not, then it is not just a game. If flimsy journals, then agreed.

Unfortunately, most med school/residency/fellowship program/admissions directors will not follow your advice of not comparing quantity. Quantity is and always will be the easy way for those folks to make decisions. If a basic science researcher has only 1 pub, even if it is in Nature, but a clinical researcher has 20+ pubs, some or many of which are in high impact factor journals, the latter will almost certainly get the interview slot over the former.

I really think you're being way too black and white in the advice you're giving. To the first point, a surgeon is going to get way more pubs as middle authors just because they get added to every basic science paper that uses the research samples that they generate. That doesn't necessarily mean they're more prolific in publishing their own independent work, or that they would necessarily help a med student publish. So once you get to an arbitrarily large number of publications, I agree with the general premise that the number of pubmed-indexed articles becomes less useful in identifying a good research mentor.

I see the latter hypothetical of 1 Nature paper vs. 20+ clinical papers frequently. That hypothetical just isn't realistic because nobody has a single 1st author Nature paper as their only publication, it's always the culmination of many years of work and usually builds on a few preliminary pubs. And you're just wrong--a handful of impactful 1st author basic science papers means that not only is someone productive from a research standpoint, but they have also built up some preliminary data that could form the basis of future grant applications. This is something that anyone within academia understands, and in this case the quality of basic science work absolutely can equal or overcome the quantity of clinical publications.

The risk in basic science research, obviously, is that most of the time it doesn't result in a Nature pub, or even anything publishable at all, which is why I generally agree with the idea that someone looking to do research for the express purpose of boosting a residency app should stick to clinical research.

 

[aldol16]

I don't agree that most of success in publishing is luck. Perseverance is key. I've had many papers rejected, sort through all the comments from reviewers, re-work them, re-submit elsewhere, publish, etc. Publishing is akin to climbing mountains.

Agree that one should always persevere. I think publishing a paper somewhere is not luck - it has to do with the quality of the paper. But as I'm sure you know from your own experience, publishing a paper in any particular journal has a large component of luck. It depends on which reviewers you get and what their preconceptions and biases are, which deputy editor reviews the paper, etc. If it all works out, then you get accepted with revision. If you get a bad reviewer or two who have notions about your work that are outside of what you're actually doing, you get rejected from that particular journal. But if your work is good, another journal will pick it up.

I also don't agree with seeinghowitgoes take on journal publishing. The impact factor is the gold standard, no matter the specialty. Yes, NEJM and JAMA are cool and really tough to publish in, but a sub-specialty journal alone does not make it easy to publish it. Impact factors exist for a reason.

I think what they're saying is that the impact factors for many subspecialties are lower as an aggregate metric across the subspecialty than the impact factors for journals like NEJM or JAMA. I don't think you would argue against the fact that it is harder to publish in NEJM or JAMA than any of the top subspecialty journals in any field - not in good faith anyway.

 

[Maximus2020]

I see the latter hypothetical of 1 Nature paper vs. 20+ clinical papers frequently. That hypothetical just isn't realistic because nobody has a single 1st author Nature paper as their only publication, it's always the culmination of many years of work and usually builds on a few preliminary pubs. And you're just wrong--a handful of impactful 1st author basic science papers means that not only is someone productive from a research standpoint, but they have also built up some preliminary data that could form the basis of future grant applications. This is something that anyone within academia understands, and in this case the quality of basic science work absolutely can equal or overcome the quantity of clinical publications.

Not sure why having 1 paper in this example is unrealistic, but ok say 2 or 3 papers. Pick another journal, whatever. Doesn't matter. I agree with your analysis about the grant stuff, but again, I am speaking in the context of interviewing for residency here. When it comes time for the interview, no adcom member would pick the 1-3 papers over the 20+ unless the latter papers are clearly a joke/useless.

I also just disagree with you about the surgeon example. This is where my experience with surgeons differs from yours. Those I work with are the senior authors or first authors who create the idea and either mentor a young faculty member, or write a seminal article they were invited to do., etc. I rarely see these surgeons serve as middle authors. But again, that's where different people on here have different experiences.

 

[GoSpursGo]

Not sure why having 1 paper in this example is unrealistic, but ok say 2 or 3 papers. Pick another journal, whatever. Doesn't matter. I agree with your analysis about the grant stuff, but again, I am speaking in the context of interviewing for residency here. When it comes time for the interview, no adcom member would pick the 1-3 papers over the 20+ unless the latter papers are clearly a joke/useless.

I also just disagree with you about the surgeon example. This is where my experience with surgeons differs from yours. Those I work with are the senior authors or first authors who create the idea and either mentor a young faculty member, or write a seminal article they were invited to do., etc. I rarely see these surgeons serve as middle authors. But again, that's where different people on here have different experiences.

I mean I mostly think your first point is kind of irrelevant. Both applicants in that scenario will be highly sought after 🙂 And at some of those top programs that you talk about, grant writing absolutely can matter—one of the neurosurgery residents working in our lab applied for and got a 3 year $150k grant. So at the level of recruitment that kind of background can come into play.

And yes, most surgeons at major centers will have their own research programs and high impact articles. But if you’re really at the 1000 level you’re gonna have a lot of middle authors.

 

[PhD_to_DO]

With STEP going P/F, publications have become more important. And on SDN, I see a lot of people giving advice to people applying for competitive specialties by telling them to pump out more publications as if a publication is just something you can pick up at the corner store.

This has been the complete opposite of my experience. The last time I did research was in undergrad, which was mind-numbingly boring and resulted in no publications despite working in the lab the entire summer. In medical school, I've asked professors at my school about their research and potential opportunities, but they made it very clear that you would be unlikely to get any sort of publication out of it because of how long the process of submitting manuscripts takes and how little medical students realistically contribute. Furthermore, the research at my school (DO school) is all bench research, which I find very unappealing and would rather not do again if at all possible. I tried reaching out to several hospitals/MD schools nearby to see if they could spare any research opportunities, but every time I was either ignored or got an affirmative response and was then ghosted when I followed up. And even if I had got an opportunity at those places, what's there to guarantee that I could get a publication out of it?

I'm curious as to how anyone with a bunch of publications managed to get them. My experience has been that publications are nearly impossible to come by, and yet the tone from many posts on here suggest the complete opposite. What am I doing wrong? I'm also in my second year now. Is it even possible for me to get publications at this point? When would I find the time and how would I ensure that I won't just be used and then get nothing out of it like in undergrad? I'm not really aiming for anything extremely competitive, but still, research would be nice to have on my application.

I'm only a first year osteopathic medical student so I've got no credibility to discuss how important publications will be to matching but as someone who has a few publications and other scholarly products under his belt, I can tell you a few things that you can do to increase your odds of putting yourself in a position to get a few scholarly products before you graduate. First, think outside of the box. At my medical school (and I get this from a lot of my mentees too) many of my classmates who want to do research think of research as nothing more than bench or clinical research. The fact is that there is a whole world of community and public health-related work that goes untapped and I've found that many of these researchers are VERY willing to work with medical students and they frequently have more time (and patience) to teach valuable skills such as quantitative and qualitative data analysis. Next, network and maintain those networks! I have stayed in touch with most of the folks that I have worked with over the years and its paid dividends. One of my connections at UNLV pulled me into a COVID-19 project last year (examining stress and resilience in communities of color during COVID-19) and we've put out several scholarly products, three of which I was listed as the first author on. Just this week, we started the second phase of this project and I anticipate being just as productive as we were during the first phase of the project. This leads to another point and that is seek mentors who want to help you grow your CV. The two PIs of the COVID work that I am doing are giants in the world of community and public health and have both been doing this work for 30+ years. They both have said that they are not interested in being 1st author on the works that we put out because they are already established in their careers and this time, they are most interested in helping the next generation of students establish their careers, whatever they may be. Everyone on our team has had the chance to take the lead on at least one scholarly output. Last, when you see opportunities to have an audience for your work, take it. I was fortunate to present a poster at the recent 2021 AMA Research Challenge and I'll be presenting a poster and giving a 30 minute talk at the 2022 Beyond Flexner Conference.

 

[mvenus929]

The PI and chair of the dept often occupy the last 2 positions.

This is very culture dependent. None of my department chairs have gotten honorary authorship and they shouldn't unless they're putting in some effort beyond allowing the faculty PI time to do the research. I gave authorship to one of the mentors I worked with because she helped give feedback throughout the research project and worked with the population I was studying, but beyond that, everyone else earned their keep throughout the process.

 

[seeinghowitgoes]

This is very culture dependent. None of my department chairs have gotten honorary authorship and they shouldn't unless they're putting in some effort beyond allowing the faculty PI time to do the research. I gave authorship to one of the mentors I worked with because she helped give feedback throughout the research project and worked with the population I was studying, but beyond that, everyone else earned their keep throughout the process.

Completely agree - also only in certain fields (I.e. the subspecialty fields). Just another reason why comparing numbers across fields, or pretending that a person with 500+ pubs is somehow a better researcher or has more impact through research than the person actually doing the studies with only 100 is misguided.

Quantity may make some egos feel better at night, but quality is what *may* have a chance at helping patients (even then, it’s a big gap between paper published and patient benefit). Med students going through this thread getting obsessed with pub numbers, please stop and focus on being good at what you do research-wise - success will follow.

 

[TelemarketingEnigma]

This is very culture dependent. None of my department chairs have gotten honorary authorship and they shouldn't unless they're putting in some effort beyond allowing the faculty PI time to do the research. I gave authorship to one of the mentors I worked with because she helped give feedback throughout the research project and worked with the population I was studying, but beyond that, everyone else earned their keep throughout the process.

My personal experience with this has been that chairs etc were included on major papers that describe big programs/initiatives or highlight institutional priorities in some way, but not smaller projects, especially not student led projects. But in the cases they were included they typically at least gave comments on the paper, it was never purely honorary

Likely varies widely by culture as you said

 

[ChordaEpiphany]

Middle author papers are better than nothing and are definitely nice for helping that initial visual impact when reviewing a CV, but nobody has any illusions about the level of involvement for author #12 out of 19.

Agree, but I think they have an outsized impact at the start of someone's career. It's really a shame. When applying for my F30 I had only one publication, a first author basic science pub in a respectable journal. I also had a few patents from the same work. My first submission went "not discussed" and two reviewers specifically called out a "weak publishing record." Meanwhile, we keep a database of F30 summary statements and others who submitted with 2-3 mid author papers were praised for their productivity.

When I resubmitted 8 months later I had a few mid-author papers. One reviewer specifically noted that my first author paper was "impressive for this stage, shows independence, and should be viewed highly." It was that reviewer's scores that ultimately pushed me inside the funding pay lines.

Having published everything from high-impact basic science to softball clinical pubs, this is how I'd rank overall effort. If "100" is the amount of effort required to publish a first author, high-impact basic science paper, I'd put mid-author at "20" and deep mid-author (e.g., 12 of 19) at "5". On the same scale, I'd put an average clinical first author at "10-20" and clinical mid-author at "1-5". The difference is so striking I don't even think we should include them on the same part of a CV. You can't do part-time basic science research. You can't even really do a single research year in basic science and expect to be productive. There's a reason PSTP programs exist.

I see the latter hypothetical of 1 Nature paper vs. 20+ clinical papers frequently. That hypothetical just isn't realistic because nobody has a single 1st author Nature paper as their only publication, it's always the culmination of many years of work and usually builds on a few preliminary pubs.

I've actually seen this pretty often, or at least more often than expected. I think it's even more common in MD/PhD circles, because people tend to laser in on a single project and do 6 years of work in 4 (while eschewing the side projects that would ordinarily fill out a CV). We interviewed a post-doc in exactly this situation last week for our lab (1 Cell paper, literally nothing else published), and we had 1 MD/PhD graduate with a single Nature paper recently. There are probably more papers submitted, but some PIs love to just hoard data until it's enough for a CNS or Nature X paper. Sometimes that means compressing two students' entire PhD into a co-first author Science paper. I've seen it happen.

As for OP's question, being a researcher is a lot like being an entrepreneur. Money doesn't come proportionately to work. Similarly, I've found that approaching my career in a much more "entrepreneurial" fashion has worked out quite well in comparison to traditional advice like, "grind in the lab and do good, consistent science." In the lab, carve yourself out a niche that is useful to everyone, but that only you can do. For instance, a friend of mine became proficient in AFM and managed 5 mid-author papers. Similarly, MDs with great computational or data analysis skills can make a name for themselves in a department and become the go-to student for particular types of grunt work. This can lead to many mid-author publications.

Getting lots of first author pubs is a combination of picking the right mentor, area, and project. There is no shortcut to a first author paper, but some PIs make it much easier than others.

 

[Konigstiger]

Thanks everyone for your insights. I noticed some people said they got research during their third year. Did you ask the physicians you rotated with and they just brought you in on ongoing projects? It seems like third year research is my only hope now, but I'm clueless as to how to actually go about that when you're working/studying all day and then changing the people you work with every few weeks.

 

[CuriousMDStudent]

Following up on what OP asked. How do people get on these case series/studies during 3rd year. As I enter the latter half of my 2nd year and soon into 3rd year. I don't think I can tack on another full on clinical study anymore.

Did you all ask your rotating attendings when you thought of something or did your attendings bring it up to you?

 

[calivianya]

Following up on what OP asked. How do people get on these case series/studies during 3rd year. As I enter the latter half of my 2nd year and soon into 3rd year. I don't think I can tack on another full on clinical study anymore.

Did you all ask your rotating attendings when you thought of something or did your attendings bring it up to you?

It’s kind of a luck thing, to be honest. If you end up working with something weird/unusual you’ll know that, because everyone will be oohing and aahing over it. When you hear people saying things like, “that’s so unique!” ”I’ve never seen that complication before!” etc. just ask your attending if he/she thinks it would make a good case report, and if you can be the one to do it.

It kind of happens organically. You can also let your attendings/residents know you’re looking to write up a case report and maybe they’ll let you know if they run across something, if they remember that you’re looking. I didn’t get anything this way.

I ended up with three case studies - two of them were patients I had, and one was a patient one of my friends in med school had. I had her do some of the writing on one of mine and she did the same for me. She looked up background/incidence of the disease on mine and helped write the intro, and I did the same for her, so we shared, and we were both online for all of the conferences where our stuff was presented.

I feel like our classmates are the best resources, tbh, because people don’t always want to bring us in.