If I want to possibly pursue a competitive specialty and my program is true p/f clinical, does it behoove me to start research asap in M1? If my school isn’t T20 and has no off or discovery preclinical period, is it possible to match into something competitive without a research year? Highly improbable?
Question about competitive specialties
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AnatomyGrey12
Lol yes. But yes if your school is true P/F then I would start research early.
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Thanks for posting the Charting Outcomes. They made for informative reading.
Could you repost?
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Look at the links below AnatomyGrey12's post.
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The main issue with "starting research early for a competitive specialty" is that many students only figure out WHICH competitive specialty interests them after doing clerkships or even subinternships. If I had a nickel for every budding neurosurgeon or orthopedist who arrived on the med school campus, only to change their mind after doing said rotation (and maybe meeting love of life and imagining have a family, etc), I would be very wealthy. Moreover, starting research as an M1 often distracts students from the more important basic science and clinical science learning. I think that occasional shadowing as an M1 in "competitive specialties" (which is much different than pre med shadowing, as M1 shadowers actually have malpractice coverage, so can actually do small tasks) is more valuable than getting too deep in research in order to get a jump start and advantage as a residency applicant.
I will also point out that even though the clerkships may be P/F at some schools, the departments are often expected to rank the students when they apply for residency. This is standard in ORTHO and EM, and becoming so for even IM and other specialties, especially for medical schools with P/F clinical years. So "no grades" does not mean that the residency programs will be unable to distinguish students.
I will also point out that even though the clerkships may be P/F at some schools, the departments are often expected to rank the students when they apply for residency. This is standard in ORTHO and EM, and becoming so for even IM and other specialties, especially for medical schools with P/F clinical years. So "no grades" does not mean that the residency programs will be unable to distinguish students.
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AnatomyGrey12
1st bolded: If someone can't do research and still do classwork and learn medicine then they are horrible time managers. In the first two years I already have 3 published manuscripts in very well regarded sub-specialty surgery journals (like actual studies not case report fluff), 2 more that will be submitted within the next 2 weeks or so, and have done well in coursework. On top of that I have a wife and kids who I give time to every day. Many of the people going into these super competitive specialties have been gunning for it since day 1. If you wait until the end of 3rd year to pursue one of these fields you are squarely behind ENT Eddy who was gunning from the beginning and has a CV better than some attendings and also smashed class/boards all while managing to be the best clinical student at the school.
2nd bolded: Research will be infinitely more valuable to a residency application than shadowing. Every specialty likes to see output, yes they do like specialty specific research in the very competitive fields but good output is good output and quality research, even if in a different field, is a big boon.
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Hey Grey. Are you doing clincal research?
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It is not that M1 shadowing will be seen as more important than research by residency directors. It won't. However, it might give med students a real view into some of these competitive specialties early on so that they can decide WHICH specialty in which they should start doing research by M1 summer.
This is my day job - advising medical students while in medical school. I have had students spend 3 years being ORTHO gunners and then do ORTHO rotation and decide that it is not for them bc they 1. hate back pain clinic OR hate that their life is completely scheduled and therefore controlled by the OR scheduler. I had another student decide during his second UROLOGY rotation that it was a lot more work than he thought and that he did not like the surgeries. You can imagine it was worse when he ultimately applied in OPHTHO and his application was full of urology research and urology student interest group leadership roles, and UROLOGY rotations. (He ultimately had to take 2 years of after med school to do OPHTHO research to prove his dedication to a change in specialty.). Another Neurosurgery prospective decided that with the imminent birth of his first child, that he wanted to be more of a family man - in a way that his own MD father had not. This could have been avoided by some shadowing and some introspection. My recommendation is that when med students first arrive to medical school, they need to immerse themselves in the material, and make friends/support systems, begin to learn the new language of medicine, and get exposure at a new level, to a host of specialties before jumping into research in the "wrong" competitive specialty. I think it is akin to asking a 13 yo which college they would like to attend. They might have ideas, and some end up at exactly where they wanted to be when asked at 13yo, but many others choose somewhere different...
This is my day job - advising medical students while in medical school. I have had students spend 3 years being ORTHO gunners and then do ORTHO rotation and decide that it is not for them bc they 1. hate back pain clinic OR hate that their life is completely scheduled and therefore controlled by the OR scheduler. I had another student decide during his second UROLOGY rotation that it was a lot more work than he thought and that he did not like the surgeries. You can imagine it was worse when he ultimately applied in OPHTHO and his application was full of urology research and urology student interest group leadership roles, and UROLOGY rotations. (He ultimately had to take 2 years of after med school to do OPHTHO research to prove his dedication to a change in specialty.). Another Neurosurgery prospective decided that with the imminent birth of his first child, that he wanted to be more of a family man - in a way that his own MD father had not. This could have been avoided by some shadowing and some introspection. My recommendation is that when med students first arrive to medical school, they need to immerse themselves in the material, and make friends/support systems, begin to learn the new language of medicine, and get exposure at a new level, to a host of specialties before jumping into research in the "wrong" competitive specialty. I think it is akin to asking a 13 yo which college they would like to attend. They might have ideas, and some end up at exactly where they wanted to be when asked at 13yo, but many others choose somewhere different...
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You gave me a lot to think about. I am interested in uro, ent and heme/onc. I was planning on just doing uro research day one but shadowing is probably something i should consider before i get too deep. So if i end up hating uro i can at least try to pivot my research between the summer of m1 and m2 into my preferred specialty.
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AnatomyGrey12
I agree.
Lol no one needs two years of extra research to apply to any specialty. He didn't "have" to do this.
I agree people need exposure, but good research is good research and people need to get past this idea that research absolutely must only be in the specific field for it to be a benefit to their app. If people from my DO school can match super competitive specialties (at MD programs) with research that isn't field specific then so can any USMD student. Obviously field specific is BEST, but any quality research is still really really good. The fact of the matter is that most of the applicants to these specialties were building there app long before 3rd year, and people who wait until then to go for it are at a disadvantage. My point is if you think you might want a competitive specialty and you get the opportunity to start research early (obviously still being able to do well in class) then you should do it.
You think it's a bad thing that they were doing things for neurosurgery even though they ultimately changed? Sorry, but even if this person switched to FM they likely learned valuable things about the research process. I'm not seeing how this is a bad thing.
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AnatomyGrey12
No. I believe it's classified as cross-sectional.
Looking at the MD Charting outcomes from 2018 for orthopedic surgery, I found the % matched for the following research profiles:
# RESEARCH PROJECTS/EXPERIENCES
0 - 50%
1 - 91%
2 - 79%
3 - 85%
4 - 87%
5+ - 83%
# ABSTRACTS/PRESENTATIONS/PUBLICATIONS
0 - 72%
1 - 79%
2 - 76%
3 - 86%
4 - 85%
5+ - 84%
Based off this data, at least within this specialty, it appears that you have diminishing returns with regard to research/output. Now this data isn't program specific and it is certainly possible that more competitive (i.e. higher ranked, more academic) programs may look for more substantial output but if the baseline goal is just to match into the field, I don't see that one necessarily has to "gun" and push out as many publications as possible. Granted, I am just a member of the matriculating class of 2019 so I don't know much about the inner workings of residency programs and I'd be interested to hear more knowledgeable people's take on this data.
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AnatomyGrey12
You can't isolate any one application metric. Look at the percent matched within each board score bracket, as you add more research outcomes the percent matched goes up. For example, selecting for the last 3 years in orthopaedic surgery among MD applicants: individuals within the 230-239 score bracket had a a match rate of 48% with no research. Change the research outcomes number to 5-10 and the percentage jumps up to almost 80%.....
In fields that are more research heavy like neurosurgery the difference is even more striking. Only 2 people applied neurosurgery without research that had 250+ scores. One matched. In the exact same score bracket if you have 11-15 research outcomes 97% of people matched. Now how do you get 11-15 research outcomes? You either start early, or do a research year. Personally I'd rather spend a little more effort doing research early on than lose a year of attending salary.
If you put in the work and then change your mind, which happens a lot as was pointed out above, your application is not damaged because you have some neurosurgery publications. You simply then switch to research towards your new field and point out your previous publications as evidence that you know how to take a project to completion. I've had an ENT PD tell me face to face that while field specific research is always a plus, not having research at all (or just a case report from 3rd year) is a great way to get your app tossed in the round filing cabinet.
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@AnatomyGrey12 did you start research early in M1? I really want to go hard in research early so I don't have to rush later on.
My plan is to try to get research in the summer before I start in the medical school I matriculate in.
You rarely visit the premed section so I really want to get your thoughts. You really know your stuff and I appreciate your commentary in the medical school forum.
Thank you.
My plan is to try to get research in the summer before I start in the medical school I matriculate in.
You rarely visit the premed section so I really want to get your thoughts. You really know your stuff and I appreciate your commentary in the medical school forum.
Thank you.
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AnatomyGrey12
I started the beginning of second semester after I felt I had a good grasp on my routine for class. Then I really hit it hard the summer between M1-M2, and the best outcomes I have came from that summer. You honestly don't really need to start research before you matriculate. That's a low reward scenario IMO, just enjoy your summer and then first semester feel out what the opportunities are so you can maybe start doing a little bit by second semester, with the big focus finding a quality research gig for the summer.
Thanks for providing that info. Are the breakouts in the file linked in your signature or is there another source? It makes sense that within a score bracket adding research improves likelihood of matching - it's an application improvement. I'd be curious to see the effect in a higher score bracket, say 260-270, and if the effect is diminished.
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I don't know where they're getting those numbers, because the NRMP Outcomes report for US Seniors pretty clearly states that those who matched had an average of 14.2 abstracts/presentations/publications, not 5.8. Additionally, out of the 156 who matched, only 18 had fewer than 5 research projects. (Edit: seems like 5.8 is the average for all specialties. I have no idea why they chose to mention it in the plastic surgery section, of all places.)
Additionally, the way I see it, it certainly is true that you can have 20 M1s who all gear up to do ortho research, with only 5 of those actually staying in ortho when application time comes. But those 5 applicants will probably have much more competitive applications than someone who decided to wait until their 3rd year elective to do any research, and the 15 that didn't stick with ortho will at least have research experience (and hopefully pubs) under their belt that will be attractive to PDs.
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AnatomyGrey12
No it's from the interactive charting outcomes where you can filter stuff.
This. I see it as a win-win scenario. You either have field specific research that gives you a big leg up, or you have research experience (hopefully with pubs like you mention) that you can point to and talk about all the things you learned from it and how you want to take those skills and apply them further.
This is all in light of the fact that OP says their school is true P/F which means they will likely be able to have a lot of time to be able to balance school, research, and chill time.
Alright you all, this might be asking a lot, but could someone either direct me to a breakdown of pros/cons of competitive specialties or post it yourself for 1 or 2 of them? I would normally search them up myself, but it’s my understanding that some of them have changed (rad onc, optho) for the worse in the past 5 years, so old sdn threads may in fact be too dated.
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Rad onc competitiveness is down (honestly don't recommend going in it).
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AnatomyGrey12
What? Pros and cons for why any specialty is a good choice is extremely subjective and based on a lot of personal preferences....
I will say this: avoid rad onc like the plague.
More data is good haha. How at least could I find non-dated information about each of them?
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AnatomyGrey12
Like what kind of info are you looking for? It sounds like you have no experience with competitive specialties and are just wanting to pursue them because it sounds cool to say.....
I was just referring to things like job markets, overhead, malpractice likelihood, and work hours
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What about someone who has experience in 1 competitive field but decides on another later on? In my gap years I have worked in Rads and have been able to get 3 abstracts, 2 pubs, and 2 conferences attended. BUT I dont think I will go into the field but have interests in surgical subspecalties that intersect with rads (mainly ortho). Does the research have to be specifically in the field you are applying to or will I be able to include my current research as well?
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AnatomyGrey12
My whole point in this thread is that good research is a benefit to your app, regardless of what field it is in. Once in medical school look for some ortho research but yes your current research will go on your app and is part of your research profile.
Go shadow.
