Incoming M1 Needs Advice: Balancing keeping an open mind with existing interests

[irohisthegoat24]

Hi everyone! Incoming M1 here. Maybe it has been the extended time at home before school, but I find myself really overthinking about how to get started on the right foot at medical school. I've been interested in neurosurgery for the longest time (majored in it in undergrad, all my research experience has been in it) and I've been told that for competitive fields, it's important to start early. However, I really see the value in embracing medical school for what it is and keeping an open mind. I sit here loving to learn about the brain and think neurosurgery is for me, but without being in the OR and learning more about the field- it's impossible for me to say I really know what it's like! Not to mention, shadowing will be hard/impossible early due to COVID-19 restrictions (and for good reason!)

So my question is, what are some tips you all have for balancing keeping an open mind in medical school while also laying the foundations for maybe shooting for a competitive residency? Should I try to find research right away? What really defines starting early? Just want to make sure I keep a grounded perspective and don't ruin this first year of medical school worrying about the wrong things.

Thanks everyone!

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[slowthai]

The best way to keep an open mind is to kill step.

I'm joking, but the point is, you want to keep all the doors open for yourself. You can go all out for neurosurg for 3 years and then end up wanting something else entirely that's either another similarly competitive specialty or a less competitive one but a competitive program or location. Research and everything else can always be acquired. You get no redos with step.

You can find research right away or you can wait until you get settled before you start reaching out to PIs. You can use your best judgement for that. As far as research goes, I'd say "early" is typically anytime before the summer of M1.

 

[theonlytycrane]

1st semester of M1 just meet your classmates, pass your classes and figure out what resources you like (anki, q-banks, etc).

Does your school have a neurosurgery dept? If so, after the 1st semester get in contact with them to shadow in clinic / OR. Be interested / not annoying and they'll prob give you a research project to do over the summer (hopefully it's paid).

In the spring of m1/all of m2 get EHR access and figure out how to read the chart and do a basic presentation in clinic. Then go to your attending's clinics in your spare time and see the patients with them (read the chart, see the pt, present to the attending, write notes etc). Super easy way to shine in clinic and also you get to learn more about the field. Then they also will know you even better = more research opportunities and they will know you before you rotate as a 3rd year.

If you do this^, you'll be stronger in 3rd year and have an idea if you actually like neurosurgery. In 3rd year you can do your elective in it and eventually a sub-i to make sure. You'll have to balance this with crushing your classes (hopefully P/F) and boards (f step 2) though cause neurosurgery is super competitive.

 

[irohisthegoat24]

The best way to keep an open mind is to kill step.

I'm joking, but the point is, you want to keep all the doors open for yourself. You can go all out for neurosurg for 3 years and then end up wanting something else entirely that's either another similarly competitive specialty or a less competitive one but a competitive program or location. Research and everything else can always be acquired. You get no redos with step.

You can find research right away or you can wait until you get settled before you start reaching out to PIs. You can use your best judgement for that. As far as research goes, I'd say "early" is typically anytime before the summer of M1.

Thank you! For sure killing STEP1 is an amazing way to keep all those doors open- do you think it is still the same case even though Step is P/F now? My thinking was that this change would now put more stress on trying to get exposure and involvement in desired fields early

 

[Fatalis]

Enjoy the ride and you’ll figure out where you fit in and what speciality is for you. Along the way, jump on any opportunity to buff your CV. Even if it’s not for the field you want, it’s always good experience and good for networking

 

[slowthai]

Thank you! For sure killing STEP1 is an amazing way to keep all those doors open- do you think it is still the same case even though Step is P/F now? My thinking was that this change would now put more stress on trying to get exposure and involvement in desired fields early

"Kill step" really means kill step 1 if it's still scored for you guys and kill step 2 if it's not.

The greater stress will be on step 2 first and foremost. You can be as involved as you want, but an uncompetitive step 2 score will be hard to come back from. There's time for research and involvement in your field of interest. You can even do a research year if you end up needing to.

 

[carrots28]

I would shadow and explore other options even if you think you would never do it. I ended up deciding on a specialty I never shadowed because I thought I would hate it and didn't get exposure till third year. From my experience, about 50% of people changed their mind about specialty by the end of third year.

Form what I heard, people who are interested in neurosurgery start getting involved early on, since publications are really important for that field. You have the most time during first year so I would take advantage of that time to start getting involved in research and getting to know your neurosurgery department.

 

[Mass Effect]

How could you have been interested in neurosurgery for the longest time when you've never been in the OR? It sounds like you're interested in neuroscience and there's a difference because the neuroscience fields are wide open. Neurosurgery just happens to be part of it.

Go to school, meet your classmates, study hard, learn the material, and leave ALL options open. Even if you do decide on neurosurgery, no one's going to hold it against you that you didn't hop on research projects during orientation.

 

[Tenk]

Nobody accidentally ends up in neurosurgery. They aren’t like: yeah I was thinking family practice but I have neurosurgery as my backup in case I don’t match.

If you want neurosurgery you have to work for it. Luckily most of the stuff you do can help you match in almost any other field in case you change your mind. So sprint. Sprint right out of the gate because your competition is gonna be sprinting right there alongside you.

 

[longhaul3]

Out of all specialties, neurosurgery is the one you need to get working on earliest. Shadow in the OR as soon as they will let you. Shadow ortho, radiology, gen surg, and ob/gyn as well to see how they compare. They all have commonalities, and it's easy to get drawn in the first time you see a craniotomy; you need to figure out whether you're actually interested and not just starry-eyed. Do this within the first 3 months. If you think you could see yourself doing it, start looking for research opportunities by winter break. Show that you are a hard worker and turn around your contributions to projects before the residents/attendings ask for them.

If you don't like it, run away. There's nothing to be ashamed of. As tenk said, nobody ends up in neurosurgery by accident. It is brutal and only for the people who really like it.

In the spring of m1/all of m2 get EHR access and figure out how to read the chart and do a basic presentation in clinic. Then go to your attending's clinics in your spare time and see the patients with them (read the chart, see the pt, present to the attending, write notes etc). Super easy way to shine in clinic and also you get to learn more about the field. Then they also will know you even better = more research opportunities and they will know you before you rotate as a 3rd year.

If you do this^, you'll be stronger in 3rd year and have an idea if you actually like neurosurgery. In 3rd year you can do your elective in it and eventually a sub-i to make sure. You'll have to balance this with crushing your classes (hopefully P/F) and boards (f step 2) though cause neurosurgery is super competitive.

I have never heard of a pre-clinical med student doing this and would definitely not recommend it. Getting involved in research and showing your face at grand rounds are how you get your department to learn who you are. Then you can demonstrate your clinical ability as a sub-i after you've learned WTF you're doing during your clerkship year.