Path to competitive residencies....

[coolnad17]

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Hi there,

First of all, I really hope this is the right to place my questions below. If not, please feel free to move the thread or guide to me existing threads related to my question(s), I did search and read a bunch of threads before posting:

I will be starting my first year of medical school in August and although I have no idea which specialty I'd like to go into, I would like to keep all my options open. So if I want to go into one of the more competitive specialties when the time comes, what should I be doing other than concentrating on maintaining a high GPA and doing well on the USMLE tests in the next 3-4 years?

I understand that there isn't a simple formula to being competitive for residencies, but i'm just looking for suggestions so I can at least begin to think about the best ways to spend my free time for the next few years.

From reading SDN, it seems like the things that were important for getting into medical school such as health-care experience, volunteer work, and published research are also factors important for competitive residency programs.

Essentially, i'm just wondering what you guys have done (specifically) during your time in medical school to become better candidates for competitive residency programs.

Thanks for the help in advance.

 

[Fiddlergirl]

The ECs are nice, but aren't as big a part of the process as they were for getting into med school. The biggest factors are your Step 1 score and your 3rd year grades, with recommendation letters and your personal essay a smaller but still important part of the application. That said, research is important for the more competitive residencies (ROAD) and other ECs can't hurt.
Remember, after the first two years there won't be a lot of time for volunteer work or any other EC.

For me:
1) Worked my but off in the first two years so that (hopefully) I can do well on the step 1.
2) Did some research last summer, and got a poster out of it. Just presented the work at a regional EM conference.
3) Was the co-president of my schools EM interest group.
4) Did a lot of volunteer work, but I don't expect that to help me for residency. That was just for me.
5) Played my violin every chance I got. Once again, not expecting that to help much for residency application, but I wanted to have some fun before 3rd year.

 

[njbmd]

Hi there,

First of all, I really hope this is the right to place my questions below. If not, please feel free to move the thread or guide to me existing threads related to my question(s), I did search and read a bunch of threads before posting:

I will be starting my first year of medical school in August and although I have no idea which specialty I'd like to go into, I would like to keep all my options open. So if I want to go into one of the more competitive specialties when the time comes, what should I be doing other than concentrating on maintaining a high GPA and doing well on the USMLE tests in the next 3-4 years?

I understand that there isn't a simple formula to being competitive for residencies, but i'm just looking for suggestions so I can at least begin to think about the best ways to spend my free time for the next few years.

From reading SDN, it seems like the things that were important for getting into medical school such as health-care experience, volunteer work, and published research are also factors important for competitive residency programs.

Essentially, i'm just wondering what you guys have done (specifically) during your time in medical school to become better candidates for competitive residency programs.

Thanks for the help in advance.

There is no 1-2-3 magic for getting into a competitive residency. Your first job will be to perform as best you can in medical school. This means matriculating at the school that you feel most comfortable in and one that suits your learning style.

The next thing is that you have to do well in all of your coursework. Sure P=MD/DO but the top performers at any medical school have more choices period. This means achieving the best grades that you can without becoming obsessive. You have to consider the company that surrounds you in that your classmates are top performers from undergraduate/graduate school and that you are one of many. You have to find a way to distinguish yourself academically and professionally which is where good grades and strong board scores will help.

Don't expect to be able to erase a poor pre-clinical performance with USMLE/COMLEX. It isn't going to happen. Your coursework is your main prep for these exams and no amount of memorization of a review book is going to get you a top score. Doing well in your coursework followed by a thorough and systemic review will get you where you want to be.

After pre-clinical performance, you need a strong clinical performance. Again, a strong clinical year does not erase a poor pre-clinical performance but clinical grades are weighted more than pre-clinical grades. You are also graded pretty subjectively during third year so don't "pi-- off" your fellow classmates or your house staff team. Jerks no matter how academically talented do not get very far during the clinical years.

Right now, if you have an acceptance,you need to work on getting everything ready for a smooth transition into medical school. If you are searching for housing or out of money, your grades will suffer. Don't let this happen. You can also rest and relax if you have the logistics done for starting school in the fall because you are likely not going to have much free time once school starts and the exams are looming. (No this doesn't mean that you can "pre-study" this summer).

Once you get further along in your medical studies, you can contact individuals at your medical school in terms of being able to connect with a research project or to do research. You don't HAVE to do research in order to get into a competitive residency especially if you have no interest in research but research with strong academics can make you a stronger candidate. Also keep in mind that if your academics are not good, research isn't going to put you into the competitive ranks either. Being published is great but not at the expense of your academics. You don't need healthcare experience in medical school.

Other than doing well and making sure that you put yourself in a position to have minimal distractions so that you can concentrate on your academics, you do your best. In the end, you may likely find out that you are:

• Not particularly interested in the most competitive specialties even though you are academically strong enough to enter one of these.
• Not academically strong enough to enter the most competitive specialties.

Get out of the pre-med syndrome where you have to compare yourself to everyone in the class around you and concentrate on doing your own work as best you can. In the end, only you are responsible for what you achieve.

My strong academics (all grades and boards) gave me options.

 

[Hoody]

Is research absolutely necessary? I'm a non trad, working full time and finishing pre reqs. I don't have a lick of research to my name. Had I gone pre med earlier in my life, I probably would have....but hindsights always 20/20 right?

If, by the grace of God, I get in, can I become involved in research then...or will it be too little too late?

Theoretically speaking, if I aced my classes and nailed my Steps, could I even think about something like neurosurgery with no research experince?

 

[Hoody]

Once you get further along in your medical studies, you can contact individuals at your medical school in terms of being able to connect with a research project or to do research. You don't HAVE to do research in order to get into a competitive residency especially if you have no interest in research but research with strong academics can make you a stronger candidate

oops, should have read your (whole) post before posting my questions... 😳

 

[drizzt3117]

Is research absolutely necessary? I'm a non trad, working full time and finishing pre reqs. I don't have a lick of research to my name. Had I gone pre med earlier in my life, I probably would have....but hindsights always 20/20 right?

If, by the grace of God, I get in, can I become involved in research then...or will it be too little too late?

Theoretically speaking, if I aced my classes and nailed my Steps, could I even think about something like neurosurgery with no research experince?

I think you'll be less competitive for the top programs but this type of stuff is so competitive, anything less than ideal candidates will have a tough time.

 

[LuciusVorenus]

Is it fair game to include pubs/conferences you did in undergrad? For example when they say x % of students admitted to Y program were published/had research, is that only including the med school years?

 

[lord_jeebus]

Is it fair game to include pubs/conferences you did in undergrad? For example when they say x % of students admitted to Y program were published/had research, is that only including the med school years?

Yeah, it can (and should) be included.

 

[lord_jeebus]

From reading SDN, it seems like the things that were important for getting into medical school such as health-care experience, volunteer work, and published research are also factors important for competitive residency programs.

That's about the relative emphasis on those things. Clearly without strong USMLE and clinical evaluations, research isn't going to save you.

 

[Hoody]

....looks like I'll stick to my pulmonology plan. 🙂

 

[lord_jeebus]

If you don't mind my threadjacking, is it better to spend your M1/2 summers doing research or shadowing at other hospitals?

Research. Shadowing is meaningless when you're going to spend 2 years doing real clinical training.

And does it look bad if you spend time at, for example, California hospitals when residency apps come along and you're interviewing at a program in Chicago?

I don't think it would matter at all.

 

[coolnad17]

First of all - everybody, thank you for all the great responses, and please keep them coming. This is exactly the stuff I was looking for. I kinda' went through my undergrad haphazardly and somehow ended up doing things right enough to secure a seat in med school. Don't want med school to be the same way. I'd like to be informed and prepared.

Also, I completely understand that there is PROBABLY nothing that makes up for low grades and USMLE scores. I'm not looking for things to replace good grades and high scores, just merely looking for ways to set myself apart from the large part of my class who will probably also have good grades and high USMLE scores.

Once again, thanks for all the responses.

 

[drdude21]

A related question: summer after M1, would it hurt to do a non-research activity, like a school-sponsored program in another country? In other words, is there sufficient time later on to get involved in research, so that I won't be hurting myself by not doing it that summer?

 

[DrArete]

Two step process:

 

[drizzt3117]

A related question: summer after M1, would it hurt to do a non-research activity, like a school-sponsored program in another country? In other words, is there sufficient time later on to get involved in research, so that I won't be hurting myself by not doing it that summer?

The short answer is yes but a lot of it depends where you go to school and what kind of student you are. Some people have much more time than others.

 

[coolnad17]

bump please.

 

[jdh71]

Is research absolutely necessary? I'm a non trad, working full time and finishing pre reqs. I don't have a lick of research to my name. Had I gone pre med earlier in my life, I probably would have....but hindsights always 20/20 right?

If, by the grace of God, I get in, can I become involved in research then...or will it be too little too late?

Theoretically speaking, if I aced my classes and nailed my Steps, could I even think about something like neurosurgery with no research experince?

Neurosurgery will likely require some sort of research interest, as most programs have years of research built in, so you'll have to get involved during your first few years of medical school to get a match, most likely.

Neuro-surg is competitive but not in the same way as, say Radiology or Derm. The specialty tends to self-select, meaning you don't get people saying, "Hmmm, I guess I wouldn't mind doing neuro surg" or "I want to make a lot of money so I'll do neuro surg!" . . . neurosurg, like CT surg, and general surg, is a lifestyle . . . not a "lifestyle specialty".

 

[coolnad17]

Is it better to have some kind of idea of what you want to do when you start med school so you can choose your activities accordingly?

For example, I imagine that being involved in neuro-surgery related research wouldn't do much good if you wanted to pursue radiology? Is that true or do they not really care about what research you did as long as it was quality research?

Also...if you do research in neuro-surgery for 2 years and realize in year 3 that neuro-surgery isn't your thing. Did you research does go to waste if you change your mind?

The same goes for other things....

 

[Cleavername]

hm just to add one more question to this, does the medical school you are in play a role in how compeptive you are for a top residency?

 

[Jihad]

Lets say I was intrigued by NSurg (have read up a lot about the pros and cons) but was aware that I may change my mind in med school. Other specialties that sound interesting to me are orthopedics or some other surg specialty or maybe cards or neuro.

As far as research is concerned, if I get a lot done in a NSurg lab will that still be acceptable and competitive is I cange my mind to one of the other competitive specialties down the road?

If not, what would be a "good specialty" to do research in at the beginning knowing that my interests could change?

 

[TexasPhysician]

A related question: summer after M1, would it hurt to do a non-research activity, like a school-sponsored program in another country? In other words, is there sufficient time later on to get involved in research, so that I won't be hurting myself by not doing it that summer?

Very competitive fields don't care about this as much as other things.

Fields like Emergency Medicine would love to see you providing care in the Himalayas or similar....

 

[TexasPhysician]

Lets say I was intrigued by NSurg (have read up a lot about the pros and cons) but was aware that I may change my mind in med school. Other specialties that sound interesting to me are orthopedics or some other surg specialty or maybe cards or neuro.

As far as research is concerned, if I get a lot done in a NSurg lab will that still be acceptable and competitive is I cange my mind to one of the other competitive specialties down the road?

If not, what would be a "good specialty" to do research in at the beginning knowing that my interests could change?

Research is always been in your chosen field. However research is still great to have no matter what field you apply. I would choose a field that allows you to publish the most (quantity and quality) if you can't publish in your chosen field.

A friend of mine matched neurosurgery at Mayo (first choice) after publishing numerous articles in anesthesia. Most of my research was in Derm and I chose a different field as well. Everyone still loved to see that I was effective at publishing data.

 

[TexasPhysician]

Is it better to have some kind of idea of what you want to do when you start med school so you can choose your activities accordingly?

For example, I imagine that being involved in neuro-surgery related research wouldn't do much good if you wanted to pursue radiology? Is that true or do they not really care about what research you did as long as it was quality research?

Also...if you do research in neuro-surgery for 2 years and realize in year 3 that neuro-surgery isn't your thing. Did you research does go to waste if you change your mind?

The same goes for other things....

The main reason residency programs like seeing research is because they eventually would like you to publish articles with them or become a prominent researcher in the field, etc. Learning the process of publishing an article is a pain when you are already busy enough during residency.

No published research will ever be a waste of time. It's just an added bonus if you are already publishing in your field.

 

[TexasPhysician]

Neurosurgery will likely require some sort of research interest, as most programs have years of research built in, so you'll have to get involved during your first few years of medical school to get a match, most likely.

Neuro-surg is competitive but not in the same way as, say Radiology or Derm. The specialty tends to self-select, meaning you don't get people saying, "Hmmm, I guess I wouldn't mind doing neuro surg" or "I want to make a lot of money so I'll do neuro surg!" . . . neurosurg, like CT surg, and general surg, is a lifestyle . . . not a "lifestyle specialty".

I'd argue that neurosurg is more competitive than radiology. Sure the numbers are high on average for radiology, but there are a LOT of spots in radiology (1000+/year). If you are ok with matching anywhere in radiology as a US MD applicant, you don't need very competitive scores.

 

[TexasPhysician]

First of all - everybody, thank you for all the great responses, and please keep them coming. This is exactly the stuff I was looking for. I kinda' went through my undergrad haphazardly and somehow ended up doing things right enough to secure a seat in med school. Don't want med school to be the same way. I'd like to be informed and prepared.

Also, I completely understand that there is PROBABLY nothing that makes up for low grades and USMLE scores. I'm not looking for things to replace good grades and high scores, just merely looking for ways to set myself apart from the large part of my class who will probably also have good grades and high USMLE scores.

Once again, thanks for all the responses.

Getting awards would be nice also.

 

[Appless]

The main reason residency programs like seeing research is because they eventually would like you to publish articles with them or become a prominent researcher in the field, etc. Learning the process of publishing an article is a pain when you are already busy enough during residency.

No published research will ever be a waste of time. It's just an added bonus if you are already publishing in your field.

does it matter if its bench or clinical? honestly im not huge into research or academic medicine, its just not where my heart is at. Though it seems like to get a decent residency or to even advance my career i have no choice but to embrace research and academic medicine at least through my training years regardless of how much i may or may not like it. During undergrad i did about 2 years of clinical research and while its not my passion i certainly enjoyed it a lot more then bench research (which i hate with a passion!!!!!). Is one type of research seen as better then the other? Or does it not matter. Personally while i enjoyed clinical more, it also seemed easier to get published clinically/present somewhere, while basic science research at the bench not so much...am i wrong in assuming that?

 

[calvinNhobbes]

From my experience and understanding (at least in ortho), all residents are required to have a "publishable" research project completed during their residency (this is a ACGME requirement). The reason residency programs want you to have research experience is so they know you are capable of doing it while also balancing clinical work and studying. It doesn't matter if it is clinical or basic science, do some research in med school and hopefully get a poster or paper out of it.

 

[mordounhas]

http://www.aamc.org/programs/cim/chartingoutcomes.pdf

For the fields you think you may one day be interested in, I'd suggest looking at this. It will let you know something about the students who got into certain specialties in 2009 (I'm not sure when the 2010 charting outcomes will be out, but I'm guessing not for a few months). It will be 5 years out of date by the time you graduate if you're starting in the fall and finish in 4 years, but it still should be somewhat helpful and it's my understanding that new versions come out yearly.

That being said, like most things, I wouldn't take it as a guarantee of anything. If you look, there are students every year who fail to match into certain specialties even with excellent (250+) step 1 scores. AOA students fail to match (though usually not many), people who do lots of research fail to match. Additionally, you'll find interesting tidbits like the fact that most of the people who tried to match into diagnostic radiology with a step 1 score in the 220s were successful in 2009 (74 vs 18)- though it doesn't say what kind of programs they were going to (community vs academic).

Hope it helps.

 

[jdh71]

I'd argue that neurosurg is more competitive than radiology. Sure the numbers are high on average for radiology, but there are a LOT of spots in radiology (1000+/year). If you are ok with matching anywhere in radiology as a US MD applicant, you don't need very competitive scores.

Meh. I was just trying to adress the differences in attitudes. You have to WANT TO do neurosurg . . . I'd be interested to see the # of applicants per position. If someone is motivated they can find the information from the NRMP.

 

[jdh71]

does it matter if its bench or clinical? honestly im not huge into research or academic medicine, its just not where my heart is at. Though it seems like to get a decent residency or to even advance my career i have no choice but to embrace research and academic medicine at least through my training years regardless of how much i may or may not like it. During undergrad i did about 2 years of clinical research and while its not my passion i certainly enjoyed it a lot more then bench research (which i hate with a passion!!!!!). Is one type of research seen as better then the other? Or does it not matter. Personally while i enjoyed clinical more, it also seemed easier to get published clinically/present somewhere, while basic science research at the bench not so much...am i wrong in assuming that?

Yes, you have to play the game.

At the more prestigious places basic science >> then clincal research.

 

[TexasPhysician]

does it matter if its bench or clinical? honestly im not huge into research or academic medicine, its just not where my heart is at. Though it seems like to get a decent residency or to even advance my career i have no choice but to embrace research and academic medicine at least through my training years regardless of how much i may or may not like it. During undergrad i did about 2 years of clinical research and while its not my passion i certainly enjoyed it a lot more then bench research (which i hate with a passion!!!!!). Is one type of research seen as better then the other? Or does it not matter. Personally while i enjoyed clinical more, it also seemed easier to get published clinically/present somewhere, while basic science research at the bench not so much...am i wrong in assuming that?

If you can publish something big in bench research, it could be huge. This is very hard to do however, and I wouldn't recommend trying unless you are getting a PhD.

I would recommend sticking with clinical research. It is more fun (my opinion), easier to publish, and doesn't have the time constraints that bench research does. While it may be easier to publish here, it is still perceived very well and is what most people do anyway.

 

[coolnad17]

How hard is it to get into AOA? What % of each class gets in? What does it really take?

Any AOA members care to elaborate...

Thanks

 

[TexasPhysician]

How hard is it to get into AOA? What % of each class gets in? What does it really take?

Any AOA members care to elaborate...

Thanks

Some schools don't even have AOA. Every school does it a little different. You usually need to be top 15% of your class + extra stuff.

 

[TexasPhysician]

What's the best way to network in fields you don't typically encounter until M4?

The anesthesia resident said earlier that research > shadowing during the summer, and that makes sense to me. It seems that you have to do some shadowing though in order to get to know people, but when is the best time?

For instance, do you just e-mail the radiology chief during the year to ask what opportunities there are for shadowing the residents? Do you ask departments at other universities when you're home for Winter break, etc?

Research is a good way to help network. You could shadow for your own benefit (know what field is best for you), but its not necessary.

 

[coolnad17]

Another question.

Once you're in year 3 and you have a better idea of what you want to specialize in and where you want to go...does it help to do some electives away from your school at residency programs you're interested in?

Thanks

 

[drizzt3117]

Another question.

Once you're in year 3 and you have a better idea of what you want to specialize in and where you want to go...does it help to do some electives away from your school at residency programs you're interested in?

Thanks

yeah, in 4th year it can help.

 

[coolnad17]

yeah, in 4th year it can help.

Thanks for your response.

Are electives at your own institution...or away, competitive? Or can you usually get what you want?

If competitive, what do they look for? Grades?

Thanks

 

[drizzt3117]

Thanks for your response.

Are electives at your own institution...or away, competitive? Or can you usually get what you want?

I think it depends a lot on the institution and specialty, i think it's common for schools to be pretty accomodating to their own students if they're competitive.

If competitive, what do they look for? Grades?

Thanks

letters, step, research whatever, might be a nonissue at the home institution.

 

[loljkttyl]

Thanks for your response.

Are electives at your own institution...or away, competitive? Or can you usually get what you want?

If competitive, what do they look for? Grades?

Thanks

Based on personal experience, it has more to do with the timing of your app rather than your grades. If you apply to an away program and list MULTIPLE different possible electives/date combinations and apply EARLY, you have a pretty good shot.

 

[coolnad17]

Thanks a lot. Good to know.

 

[drizzt3117]

Based on personal experience, it has more to do with the timing of your app rather than your grades. If you apply to an away program and list MULTIPLE different possible electives/date combinations and apply EARLY, you have a pretty good shot.

Yeah I think applying early is very important.

 

[Cleavername]

hm just to add one more question to this, does the medical school you are in play a role in how compeptive you are for a top residency?

i just edited my question, can some one please answer me plz lol.

 

[drizzt3117]

i just edited my question, can some one please answer me plz lol.

yes it does.

 

[Cleavername]

yes it does.

how badly? is it as much influence as your undergrad's effect to medical school? or like if i gone to a low ranked school i wouldn't have much shot at a good residency?

 

[MedcatHouse]

how badly? is it as much influence as your undergrad's effect to medical school? or like if i gone to a low ranked school i wouldn't have much shot at a good residency?

Now this is an interesting question, but it's hard to think of many others that have been discussed ad nauseam as this one has...

 

[drizzt3117]

how badly? is it as much influence as your undergrad's effect to medical school? or like if i gone to a low ranked school i wouldn't have much shot at a good residency?

There's been like a billion threads on this. It'll make a difference. For some programs it might be a lot. For some it might be miniscule. In the end you should go where you feel the most comfortable (financially, academic reputation, culture, curriculum, location, proximity and presence of friends/family) because you'll succeed best there.

 

[TexasPhysician]

hm just to add one more question to this, does the medical school you are in play a role in how compeptive you are for a top residency?

VERY little. All US MD programs can land you a great residency.

 

[Cleavername]

VERY little. All US MD programs can land you a great residency.

i would imagine your USMLE, step 1 score and just over all grade in med school would play the majority of the role.

 

[drizzt3117]

i would imagine your USMLE, step 1 score and just over all grade in med school would play the majority of the role.

There's a lot of factors and not all of them are in your control. The med school you attend, though, if you have multiple options, IS one of the few things in your control. Depending on what programs you're targeting, it could make a difference but as I said before, it's less important than putting yourself in a position to succeed. I would note however, that the vast majority of posters who are saying that your med school doesn't matter are attending unranked schools... Jus' saying...

 

[Cleavername]

There's a lot of factors and not all of them are in your control. The med school you attend, though, if you have multiple options, IS one of the few things in your control. Depending on what programs you're targeting, it could make a difference but as I said before, it's less important than putting yourself in a position to succeed. I would note however, that the vast majority of posters who are saying that your med school doesn't matter are attending unranked schools... Jus' saying...

how about the compeptive ones dermatology or anethesiology or pathology? cause i like pathology lol.