Research years in residency

[SpikesnSpookes]

I don't mind research, but extending residency by 2 mandatory research years is a big turn off to me. Do many of the top general surgery residency programs require these research years? What fellowships after general surgery require these research years?

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[LucidSplash]

The key here is that "top" is in quotation marks. The interpretation of what is a top program is heavily slanted towards academic powerhouse with big research engines. There are plenty of excellent programs out there which will train you to be a general surgeon at graduation and give you the opportunity to do a fellowship but aren't Ivory towers requiring 2 years of bench research. If you know what kind of fellowship you want to do, that will help determine if you need the 2 years of bench research.

 

[GeneralSurgeon4Life]

Basically all of the top programs it is a de facto requirement and at more or less the top 30 programs the majority of residents do it.

Technically speaking no fellowships "require" it but if you want realistic shot at peds surg or surg onc you need the time. Ditto if you are trying to match at the "top" fellowships even in less competitive fields.

Research is definitely important. But don't try knocking anything out of the park. Otherwise, you end up like this poor dude: http://www.huffingtonpost.com/entry/eugene-gu-research-congress_us_581a3d79e4b01a82df6460de

 

[SpikesnSpookes]

Okay, so what are these research years like? They sound obviously easier than a residency year - is that true? Sounds like a pain in the a$$ to prolong finishing residency by 2 years for research...

 

[mimelim]

I don't mind research, but extending residency by 2 mandatory research years is a big turn off to me. Do many of the top general surgery residency programs require these research years? What fellowships after general surgery require these research years?

Okay, so what are these research years like? They sound obviously easier than a residency year - is that true? Sounds like a pain in the a$$ to prolong finishing residency by 2 years for research...

When I applied ~5 years ago, I interviewed at many of the "top" academic GS residencies in addition to the integrated vascular programs. Every single one of them had an explicit requirement of 2 years of research or it was simply expected. It is one of the reasons why the integrated programs are attractive. I did 2 years of research during my residency, but that is still 2 fewer years than if I had ended up at one of those GS programs.

Regarding research years. It all depends on where you are at. Some programs have highly structured years, others do not. In general, they are much lighter than your clinical years, which doesn't say much.

 

[SpikesnSpookes]

Can you get away with doing 1 research year in those that require 2 if you get a lot done during that research year? I was hoping to go into cardiothoracic surgery..

 

[SouthernSurgeon]

Can you get away with doing 1 research year in those that require 2 if you get a lot done during that research year? I was hoping to go into cardiothoracic surgery..

My experience was that two years were exponentially more productive than one. Ie I published double digit papers my second year compared to 2 I think my first year.

Real research takes time and investment.

On a more practical note you're at the whims of your program for stuff like this. It's not typically like you just get to say nah Ima gonna do one year then just come back from the lab early.

 

[ram006]

Agree.

If you commit to 7 years you should expect to do 7 years. I matched into a 5 year categorical position and "negotiated," if you can call it that, 1 year. Had they not been able to accommodate I would have likely gone straight through--which would have been a mistake.

When you're on the bottom looking up, the years seem like a big deal. Being on the tail end now, residency passed fairly quickly.

I was happy with my match so ultimately one year was sufficient but I left probably 5-7 publications on the table that were never completed. At one program, I got grilled about it pretty hard. That second year does really make a difference.

If your goal is to be a community surgeon, research makes no sense. If you want to be a CT surgeon I'm still not sure it's mandatory to match at any program. If you want to go to a "powerhouse/elite/prestigious/whatever you want to call it" program, quality research, prestige of your GS program and in-service exams will matter. That's pretty much standard for any match.

 

[mimelim]

My experience was that two years were exponentially more productive than one. Ie I published double digit papers my second year compared to 2 I think my first year.

Real research takes time and investment.

On a more practical note you're at the whims of your program for stuff like this. It's not typically like you just get to say nah Ima gonna do one year then just come back from the lab early.

My program gave me the option to come back after 1 year mid way through. Glad I didn't take them up on it. Like you, the second year was the big one. Multiple clinical trials going in addition to my more typical stuff. Certainly not for everyone, but personally, if you want to do it right, you need 2 years.

 

[Buzz Me]

It's tough to be very productive after only one year of lab research. If your goal is to beef up the CV and present at meetings, I would plan on going into the lab for two years.

 

[SpikesnSpookes]

I understand that I am an ignorant 3rd year med student...but 2 more years just sounds terrible.

 

[pikapp84]

I understand that I am an ignorant 3rd year med student...but 2 more years just sounds terrible.

No one is forcing you to do any of this. If you don't want a competitive fellowship, don't do research. Research is a privilege, not a requirement. Go straight through and hope to match at a fellowship w/o doing any lab time, or go into private practice and be happy. There's plenty of us that will take your spot in a lab, don't worry!

 

[LucidSplash]

Well then don't do any research. You don't have to. Again, plenty of great programs out there that don't require research. You can still do most fellowships without doing dedicated bench research time. You can still do clinically-based research without doing dedicated time. It is harder to do so, but you can.

 

[caffeinemia]

This is the reason why I went straight plastics, I did so much research as an undergrad and med student that I was done by the time I got to residency. Thus far, I've written a measly 2 or 3 papers or whatever and am sooooo done with it.

Research years are good years to take care of big personal life choices. Say --- getting hitched, popping out babies, buying a house. Essentially, research is like doing a regular job with a bit of overtime ... so it's potentially a mini-break. Anyhoo, surg onc, peds surg, and CT probably all like research years. And yeah, all those top gs programs are very research heavy -- i interviewed at P&S and they were sooo proud of some resident who was like 40 and took a break to do a phd before finishing residency and I was like... uhhhh nopes; wnat to make a dolla dolla bill before i retire..

 

[droliver]

I personally would not take a GS residency position that required a 2 year research break, especially if I was planning on do a sub-speciality fellowship which are often 2-3 years themselves. That kind of length of training isn't reasonable anymore given the costs of education and the dramatically diminishing ROI of a MD degree in practice.

 

[Dr.LeoSpaceman]

I personally would not take a GS residency position that required a 2 year research break, especially if I was planning on do a sub-speciality fellowship which are often 2-3 years themselves. That kind of length of training isn't reasonable anymore given the costs of education and the dramatically diminishing ROI of a MD degree in practice.

Except if you want to do Peds Surg or Surg Onc, where research years are essentially mandatory. And even for other fellowships where it may not be mandatory to get a spot, it is something that makes you competetive at the "top" fellowship programs.

So if you know you'll need research to get into the fellowship of your choice, it's actually better to go to a program that requires it since it facilitates the process. "Allowing research" is much different than having a structured program meant to support research time and facilitate productivity.

 

[SpikesnSpookes]

No one is forcing you to do any of this. If you don't want a competitive fellowship, don't do research. Research is a privilege, not a requirement. Go straight through and hope to match at a fellowship w/o doing any lab time, or go into private practice and be happy. There's plenty of us that will take your spot in a lab, don't worry!

Don't worry? Lmao. Don't get your panties in a bunch.

I've completed 8 projects while in medical school, and frankly I wouldn't want to extend my residency training by two years for the "privilege" of doing research, especially when I could facilitate some as an attending.

 

[Dr.LeoSpaceman]

Don't worry? Lmao. Don't get your panties in a bunch.

I've completed 8 projects while in medical school, and frankly I wouldn't want to extend my residency training by two years for the "privilege" of doing research, especially when I could facilitate some as an attending.

Let me guess, the 8 projects were chart review/database work? I think you need to consider the difference between"doing research" and being a surgeon-scientist. If you're just interested in publishing single institution retrospective studies, sure you can facilitate those as an attending without any additional research experience. But if your goal is to pursue extramural funding and oversee rigorous surgical science (either basic or health services research), then you will almost certainly need additional research/postdoc time. The fact that you say that you "don't mind research" is instructive. Those "top programs" aren't looking for people who will tolerate the research as a means to an end. They're looking for people who view research as an important aspect of their career, and who want to use that time to develop a potential career in academic surgery.

 

[deleted547339]

Theres got a be a shift in our educational system at some point. Our predecessors were able to go through medical school for much cheaper, then train in general medical specialties and become heavy hitters in research. Now people expect you to give up your first born child in medical school loans, go to residency, take time out of residency to do research, do a fellowship, and get a MS or PhD if you expect funding.

One of the older guys where I work has no formal research training but has published some 400 articles/chapters and is an editor of the top journals in the country. You just can't do that any more. The system can't keep going on like this. You can't train until your 40, have 300K in debt and just be applying for K awards which you probably will get passed up for anyway.

 

[ram006]

I personally would not take a GS residency position that required a 2 year research break, especially if I was planning on do a sub-speciality fellowship which are often 2-3 years themselves. That kind of length of training isn't reasonable anymore given the costs of education and the dramatically diminishing ROI of a MD degree in practice.

People don't consider this enough. I chose to do PRS bc I truly could not see myself being a happy general surgeon in 10 years. The opportunity cost is a reality and one I decided to accept after about a year of going back and forth with my decision. It doesn't mean it's not one of the worst financial mistakes of my life though...

 

[sinombre]

Is it possible to moonlight during research years? (and if so how much could that mitigate the opportunity cost?)

 

[Deadpool87]

People don't consider this enough. I chose to do PRS bc I truly could not see myself being a happy general surgeon in 10 years. The opportunity cost is a reality and one I decided to accept after about a year of going back and forth with my decision. It doesn't mean it's not one of the worst financial mistakes of my life though...

Genuinely curious as to why it was such a bad financial decision?

 

[ram006]

Genuinely curious as to why it was such a bad financial decision?

Just straight numbers, extending training by 3 years to make about 60k/year in comparison to 300-400k (average contract signed by my co-chiefs) for those three years. That's roughly about a million dollars of lost income. While it's possible I may make up the difference, it's certainly not guaranteed and most probably that I won't (based on average incomes of the two specialties).

 

[ram006]

Yes, but the availability of it is ovviously institution dependent (and dependent on the schedule/expectations/mercy of your lab mentor).

Best case scenario I've heard of residents bumping their income up to a low six figure range - 125-150k per year. So compared to attending money that's still an opportunity cost of >100K per year.

Bottom line for me, as someone both pursuing a very competitive field and very competitive programs - it was worth it.

If I was making a financial decision I would have just done EM or anesthesia - 3-4 yrs training and probly a higher salary than I'll ever make. But it's not what I'm passionate about and I'll be just fine financially despite the "opportunity cost" of the research experience.

There's something to be said about having the career you wanted as opposed to just chasing the most money. If those two goals align then great. If not, I'll take career satisfaction over money and likely work longer.

 

[SpikesnSpookes]

Yes, but the availability of it is ovviously institution dependent (and dependent on the schedule/expectations/mercy of your lab mentor).

Best case scenario I've heard of residents bumping their income up to a low six figure range - 125-150k per year. So compared to attending money that's still an opportunity cost of >100K per year.

Bottom line for me, as someone both pursuing a very competitive field and very competitive programs - it was worth it.

If I was making a financial decision I would have just done EM or anesthesia - 3-4 yrs training and probly a higher salary than I'll ever make. But it's not what I'm passionate about and I'll be just fine financially despite the "opportunity cost" of the research experience.

You seriously make less as a surgeon than EM/anesthesia?

 

[ram006]

You seriously make less as a surgeon than EM/anesthesia?

There are examples of the opposite as well, but for a three year residency they do come out swinging...

 

[Winged Scapula]

You seriously make less as a surgeon than EM/anesthesia?

That may be the case with his future as an academic surgeon.


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[ram006]

That may be the case with his future as an academic surgeon.


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There are some pretty impressive academic salaries in surgery out there, though.

 

[Winged Scapula]

There are some pretty impressive academic salaries in surgery out there, though.

There are for the famous, the infamous, and the bigwigs.

I have no doubt that our southern surgeon will become one of those but initially as a rank-and-file surgeon he's not going to command those seven-figure salaries.


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[Salamechton]

Thanks everyone for the input. I have 2 questions:
1) It is generally implied that if one wants to match into any peds surg or Surg Onc fellowship program (regardless of prestige, not just CHOP or MSK), one pretty much must do research years. What is the consensus for any plastic surgery program (after GS)? Are research years also implied to be "required" if one wants a realistic shot to any program? Or are they just expected if you want to go to a "prestigious" PRS program?

2) A question about research in general during residency. Having been on the residency interview trail recently, some programs seem to require their residents to do basic science research only (ie, those residents won't get time off if they are interested in doing clinical research only).
For fellowship application purposes, what is generally considered better? Heavy basic science research for 2 years, leading to perhaps 1 or 2 papers (and perhaps even do 3+ years of research and get a PhD along the way)? Vs. clinical research for 2 years (eg, straightforward retrospective chart reviews), pumping out several papers? Interested in plastics FWIW.

Trying to see if this is a factor I should consider in my ranking for residency programs.

Thanks!

 

[caffeinemia]

Is it possible to moonlight during research years? (and if so how much could that mitigate the opportunity cost?)

Depends on program and yes. You could earn maybe 100k a year if you work hard and are lucky w the position/specialty? I know surgical residents who did ICU moonlighting. Not so bad right?

 

[caffeinemia]

There are some pretty impressive academic salaries in surgery out there, though.

True. But chairman/service line exec positions are not just offered willy nilly.

The EM/Anesthesia salaries come out high, but typically are employed positions. There's still room for private surgical practice where salaries are appreciably different.

 

[AsianPersuasion]

Thanks everyone for the input. I have 2 questions:
1) It is generally implied that if one wants to match into any peds surg or Surg Onc fellowship program (regardless of prestige, not just CHOP or MSK), one pretty much must do research years. What is the consensus for any plastic surgery program (after GS)? Are research years also implied to be "required" if one wants a realistic shot to any program? Or are they just expected if you want to go to a "prestigious" PRS program?

2) A question about research in general during residency. Having been on the residency interview trail recently, some programs seem to require their residents to do basic science research only (ie, those residents won't get time off if they are interested in doing clinical research only).
For fellowship application purposes, what is generally considered better? Heavy basic science research for 2 years, leading to perhaps 1 or 2 papers (and perhaps even do 3+ years of research and get a PhD along the way)? Vs. clinical research for 2 years (eg, straightforward retrospective chart reviews), pumping out several papers? Interested in plastics FWIW.

Trying to see if this is a factor I should consider in my ranking for residency programs.

Thanks!

I'm curious about this too as GS is on my radar.

 

[ragha1234]

research is not equal to competitive fellowship in general.
research is equal to what type of career you ultimately want to pursue - research just shows your career interest.
research or lack thereof can help you and program directors make ideal "match" decisions.