Should I do research during the first two years? I am not certain if I want to do a competitive specialty.

Oct 30, 2019
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To preface this, I am starting at a US MD medical school next year. I hear that if you want to do a competitive specialty you need to have a ton of research since your first year. However, I do not know if I want to do a competitive specialty or if I will even have a competitive STEP score for it. Hence, I wanted to ask the following questions: Should I do research during the first two years?

It's a tough question because first I hear that you should be doing research in the competitive specialty since day 1. However, I don't even know if I will receive a STEP score that is competitive enough for those specialties and I haven't even spent any time learning about those specialties yet so I don't even know if I want to do a competitive specialty.

My plan at the moment is: Spend the first two years adjusting to medical school. Learning the material well and then try my best at STEP. If I discover that I scored a competitive STEP score for certain competitive specialties then I would shadow some physicians and learn more about whether those specialties were a good fit for me and then spend the next two years doing research in those fields.

What I like about this plan is that it allows me the proper time to adjust to medical school and ensure that I know the material well. What I don't like is that I don't know how I am going to fit in research during 3rd and 4th year. 3rd year will be all clerkships and 4th year would give me only a few months to do research before residency applications open.

Personally, I doubt I need to do research day 1 for competitive specialties but I want to see what others think.

Note: I probably sound very naiive to a lot of you guys but I have just recently been admitted to medical school and I am just trying to figure out what is the best path for me moving forward into medical school. During my freshman year of college, I overcommitted to research and ECs freshman year which made the start of my college career a little bumpy. I don't want to make the same mistakes so please try to be nice about my misunderstandings of certain things

Tl;dr I want to spend the first two years of med school making sure I adjust well to med school and to learn the material well and do well on STEP 1. However, it seems that if I don't commit to a competitive specialty day 1 of medical school by doing research then it will put me at a serious disadvantage when applying to those residencies.

EDIT: Also if anyone has any good books or posts about great advice for going into medical school. Such posts or book recommendations would be appreciated!
 

aldol16

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1) Step 1 is most important. Having a bad Step 1 score will make everything an uphill battle. Don't neglect your Step studying. But also don't go overboard with it. Leave time for ECs and just your own sanity. It doesn't require that much time outside of classes if you're learning the key physiological concepts in class very well.

2) You should always err on the side of caution in terms of specialty. It's always easier to aim for something more competitive and then switching out than the other way around.

3) Do not plan on doing substantial research during 3rd and 4th years. Clinical rotations take a boatload of time and you really need to do well on those too. The research you do get done will be on your own time outside of that - and there's not that much free time. In addition, research projects take time. Peer review itself can take months. So chances are, if you start 3rd year, you won't get a paper out by the time you submit ERAS. Start that research early.

4) You don't want to overload yourself either during the adjustment period. Take the first semester of med school easy. Focus on classes and convince yourself that you can handle it and do well. Explore some research mentors. Reach out, talk to them, get an idea of projects. Going to lab meetings is a good way to get a feel for what each PI does. Then you can make a choice (or choices) during your second semester of first year and get started on research. Then you have your whole first summer to build on that, as well as the first and middle parts of second year.
 
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deleted985251

1) Step 1 is most important. Having a bad Step 1 score will make everything an uphill battle. Don't neglect your Step studying. But also don't go overboard with it. Leave time for ECs and just your own sanity. It doesn't require that much time outside of classes if you're learning the key physiological concepts in class very well.

2) You should always err on the side of caution in terms of specialty. It's always easier to aim for something more competitive and then switching out than the other way around.

3) Do not plan on doing substantial research during 3rd and 4th years. Clinical rotations take a boatload of time and you really need to do well on those too. The research you do get done will be on your own time outside of that - and there's not that much free time. In addition, research projects take time. Peer review itself can take months. So chances are, if you start 3rd year, you won't get a paper out by the time you submit ERAS. Start that research early.

4) You don't want to overload yourself either during the adjustment period. Take the first semester of med school easy. Focus on classes and convince yourself that you can handle it and do well. Explore some research mentors. Reach out, talk to them, get an idea of projects. Going to lab meetings is a good way to get a feel for what each PI does. Then you can make a choice (or choices) during your second semester of first year and get started on research. Then you have your whole first summer to build on that, as well as the first and middle parts of second year.
When going for a competitive residency, what are the most important factors? I just got into med school so am trying to figure out how the whole residency application process goes
 
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slowthai

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There's always the option of a research year if you decide to focus solely on step the first two years or if you discover "late" (during 3rd year) that you want a highly competitive specialty and you don't have any research.

The reason why I put late in quotes is that for the most competitive specialties, you're pretty much behind the eight ball if you're not gunning from day 1. Gunning in this case just means doing everything you need to do to produce a top tier app for your specialty of choice.
 
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slowthai

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When going for a competitive residency, what are the most important factors? I just got into med school so am trying to figure out how the whole residency application process goes

If we're talking the most hardcore specialties like plastics or nsx, you want these things: at least a 250 step, smash your away rotations + great letters of recommendation from the attendings you worked with, publish a crapton of papers or a few high quality first author ones (like pick one, lol), honors in all clinical rotations.

Some specialties at this level put a relative emphasis on research because they are more academic/research focused (IR, nsx, ENT). But all of them require research because they are just very competitive (ortho, PRS, derm, etc).

Some specialties absolutely require away rotations (nsx, ortho, plastics). For some, you can "get away with" doing just one or none (ENT and derm).

Then there's the somewhat controversial AOA. Like I've said before, I can guarantee you that it's absolutely not a must or even a soft requirement to match into any field. It is really a bonus that may elevate your app to a significant extent or to a smaller extent, depending on the specialty and the program. Some specialties value it more, like derm and PRS. You'll see a greater proportion of applicants with AOA in these fields than in others. With that said, getting AOA is a crapshoot. You may be able to have a lot more certainty in achieving a certain step score than achieving AOA, depending on your school's criteria for it. It may be straightforward, like a 250 step and top 10% preclinical or it may be some weird popularity contest. Some schools may not even have AOA.

For step 2, nowadays, it's become more important because of the competition. Ideally, you want to surpass your step 1 score, or at least do around the same level. I've heard stories of interviews going like this: "Oh, you got a 260 on step 1 but a 230 on step 2, what happened?" Those are words I never want to hear, lol. But people argue that for certain specialties that don't require a step 2 score by a certain date (or at all), you should just hold your step 2 score, because the risk of dropping down too far relative to your step 1 is too much. I completely agree.

If you want to look at some data evaluating relative importance of these factors by specialty, check out the most recent NRMP Program Director Survey.

Feel free to ask any clarifying questions. I didn't want to make this post too too long, lol.
 
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operaman

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The post above really nailed it.

OP, your idea about taking time to get used to medical school is a good one. I don’t think it takes 2 years to do that. You can also explore research and various fields during your first 2 years without much time commitment. If you find something you like, you have the summer after m1 to bang out some quality pubs and this is traditionally when people really start on research.

A lot really depends on your own academic chops and how you handle the rigors of Med school. If you’re hanging on for dear life and barely passing, then you don’t have time for research. If you’re doing well and near the top of your class then you’re probably headed for a decent board score too and maybe you have time for a little research on the side. You won’t really know how you stack up until classes start.

If you really struggle, then you might be better off delaying research until after step 1. You might even consider a separate research year between the clinical years. Lots of options available and you’ll want to be flexible enough to adapt to whatever you need.
 
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deleted985251

If we're talking the most hardcore specialties like plastics or nsx, you want these things: at least a 250 step, smash your away rotations + great letters of recommendation from the attendings you worked with, publish a crapton of papers or a few high quality first author ones (like pick one, lol), honors in all clinical rotations.

Some specialties at this level put a relative emphasis on research because they are more academic/research focused (IR, nsx, ENT). But all of them require research because they are just they very competitive (ortho, PRS, derm, etc).

Some specialties absolutely require away rotations (nsx, ortho, plastics). For some, you can "get away" with doing just one or none (ENT and derm).

Then there's the somewhat controversial AOA. Like I've said before, I can guarantee you that it's absolutely not a must or even a soft requirement to match into any field. It is really a bonus that may elevate your app to a significant extent or to a smaller extent, depending on the specialty and the program. Some specialties value it more, like derm and PRS. You'll see a greater proportion of applicants with AOA in these fields than in others. With that said, getting AOA is a crapshoot. You may be able to have a lot more certainty in achieving a certain step score than achieving AOA, depending on your school's criteria for it. It may be straightforward, like a 250 step and top 10% preclinical or it may be some weird popularity contest. Some schools may not even have AOA.

For step 2, nowadays, it's become more important because of the competition. Ideally, you want to surpass your step 1 score, or at least do around the same level. I've heard stories of interviews going like this: "Oh, you got a 260 on step 1 but a 230 on step 2, what happened?" Those are words I never want to hear, lol. But people argue that for certain specialties that don't require a step 2 score by a certain date (or at all), you should just hold your step 2 score, because the risk of dropping down too far relative to your step 1 is too much. I completely agree.

If you want to look at some data evaluating relative importance of these factors by specialty, check out the most recent NRMP Program Director Survey.

Feel free to ask any clarifying questions. I didn't want to make this post too too long, lol.
Thanks for the reply! So when is the best time to start doing research? Also, when is the best time to decide between two competitive specialties? I did both IR and ortho research in my undergrad so I was super interested in both fields. And on the director survey, it says something about an MSPE, what is this and how do you improve your scores in that? Also what is AOA and how do you achieve that?
 

slowthai

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Thanks for the reply! So when is the best time to start doing research? Also, when is the best time to decide between two competitive specialties? I did both IR and ortho research in my undergrad so I was super interested in both fields. And on the director survey, it says something about an MSPE, what is this and how do you improve your scores in that? Also what is AOA and how do you achieve that?

No problem. Usually people start either in the second half of M1 or in the summer after M1.

I'd recommend shadowing attendings from both fields and seeing how you like one over the other. This is like the most free time you'll have, so it's better to start now.

The MSPE usually gives a generic statement about your performance, like he/she was a good med student in many more words. If you have class rank, it'll include your percentile, like top 25% or whatever. Just don't screw up by like cheating or something and your MSPE will be fine. Some programs don't even look at it, lol.

AOA is a med school honor society that you get nominated for. Like I said, it's different at every school. Some schools require you to be a superhuman with top 15% preclinical grades, 250+ step 1, research out the wazoo, volunteering, becoming an astronaut, etc. I've heard of one school where classmates nominate you, which is the weirdest thing ever. In that case, I guess it's reserved for the coolest inviduals in the class.
 

aldol16

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When going for a competitive residency, what are the most important factors? I just got into med school so am trying to figure out how the whole residency application process goes

I would say number one by a long shot is Step 1. That's why it's so important to do well on it and why people study so damn much for it. Then, depending on the field, it's some mix of clinical grades, research, connections/letters, and AOA if your school has it. For clinical grades, obviously it looks the best to honor all your core rotations. But within the core rotations, people in some surgical fields tend to say if nothing else, do well in medicine and surgery. Obviously honoring all of them looks best.

Research is a tougher one. For a competitive field, you're going to want to have research because everyone else applying will as well. How much research depends on where you want to go. If you want to go to the academic powerhouses - which also tend to be the ones with the most "prestige" - then obviously research will matter (quality and quantity). However, if you want to go into the field but don't care if you end up at a research powerhouse or not, then the quantity of research will matter less.

In any competitive field, you also will want strong letters and connections. Ideally, you would have three (or more, depending on field) strong letters from big names in the field. The big name goes a long way because people recognize it. A big name who trained at the program you're applying to is an even bigger plus. But if you can't check off all those boxes, then I'd say prioritize getting strong letters. Connections and networking also matters. Hence why most competitive specialties will require away rotations. These are auditions where it's your chance to impress. At many places, the vast majority of their residents were rotators. f
 
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