Should I take a research year?

[TheRealReel]

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Hey guys. I’m about to start my fourth year and am still trying to figure out what I want to do with my life. I’m thinking about taking a research year, to not only strengthen my CV (I only have two abstracts and a poster pres at my institution) but to help me decide on what to do (figuring out between ophtho, ENT or medicine subspecialty). I'm currently having a great deal of anxiety about this, and it seems like every day I change my mind about things (probably because I am panicking). I've settled on these because I enjoy patient contact and having longitudinal relationships with them, as well as the ability to work with my hands. I'm reaching out here because I clearly need advice, as I change my mind on this almost every day and am starting to have insomnia and panic attacks regarding my current situation.

For reference, I go to a top 20 med school, Step 1 >250, mixed H/HP clinical grades (H in fam medicine, psychiatry, surgery, and a graded elective course in radiology), not AOA. I was going to go into another surgical sub-specialty until the middle of May, but when I was on my sub-internship in the field, I unfortunately found out I couldn't actually see myself doing it (the surgeries, anatomy, personalities, etc were not for me, and I never got experience in this field during clerkship year). When I spoke to my institution, my dean said that a research year could be a huge red flag if you aren't a publishing machine and you don't know exactly what you are going to do research in, which makes sense, and makes taking an extra year a bit risky.

I see my options as such:

1. Don't take a research year and go into medicine: This offers the widest range of possibilities after residency (in terms of fellowships) and is the only route I could reasonably take if I did not take a research year. I think I could be happy doing GI or interventional cards, but I worry that my lack of research and my HP in medicine will keep me from matching at a good institution, making fellowship more of a question than guarantee. I know that I wouldn't be happy if I was just a general internal medicine doctor, which also gives me some concern about this.

2. Do take a dedicated research year and figure out what field to go into: this would make ENT or ophtho available as options. I'm currently on an ophtho rotation and really like it; lots of patient care, generally healthy-ish people (lots of diabetes, though), cool procedures that aren't 5-6 hours a piece, and the eye is actually pretty cool. I already have ophtho research lined up, as well. If I took the research year, I'd also like to explore ENT as it also seems to fit what I want out of medicine. I'd get a little bit of time to breathe and hopefully, be more clear-headed in my approach to this. At my school, they do not charge us a full year of tuition if we take a research year (we still pay for housing and a small fee to keep us enrolled as a student for hospital privileges), which means the financial burden is not immediately severe (you would lose a year of attending salary, but I'd rather feel confident in what I was doing and be happy than getting another 300k, I guess).

Any advice would be appreciated. I keep ****ting on myself almost every day about my choices and thinking what a ****-up I've been for not deciding sooner, so I'd like to figure this out...

 

[mistafab]

Flip a coin

Heads you go into medicine
Tails you take a research year

Whatever it lands on, would that make you happy? Your gut instinct will tell you the right choice. The coin flip helps you see your real feelings about it.

 

[TheRealReel]

I'm currently leaning towards the research year, tbh. When I did the coin flip, I found myself hoping it landed on tails (research year)... at this point, if I went into medicine, I would be scrambling to get LoRs as the one person who could write me a very strong LOR would be writing my chairman's letter, leaving two letters I would need to get in a short amount of time (this spring, I've been taking more procedural electives like anesthesia, IR and urology instead of medicine electives).

Would programs wonder why I took a research year if my step score is already decent? I feel like most posts I read suggest a research year if your score is below average, and I worry that it would be obvious that I was just coming to a specialty decision late and that would end up really hurting me.

 

[medstud268]

I'm currently leaning towards the research year, tbh. When I did the coin flip, I found myself hoping it landed on tails (research year)... at this point, if I went into medicine, I would be scrambling to get LoRs as the one person who could write me a very strong LOR would be writing my chairman's letter, leaving two letters I would need to get in a short amount of time (this spring, I've been taking more procedural electives like anesthesia, IR and urology instead of medicine electives).

Would programs wonder why I took a research year if my step score is already decent? I feel like most posts I read suggest a research year if your score is below average, and I worry that it would be obvious that I was just coming to a specialty decision late and that would end up really hurting me.

So, I matched into ENT this year; so can only talk about a research year from that fields perspective. I was very close to taking a research year, but decided against it last second due to a variety of factors. I met many people who did take a research year, and as long as thy were productive, I don’t think it hurt any of them. I ended up marching at a well regarded Midwest program, and of my co interns 2 did the year, while 2 didn’t. I met many people on the trail who did do a research year who ended up getting a lot more interviews at the research heavy programs. I will say that it’s important to figure out what field to go after in your year off if you decide as being productive and building connections is the useful part.

 

[Cyphix]

I personally think taking a research year would be a great idea. Long story short is that taking just one year to make sure you really know what you want to do is pennies compared to the decades you will spend practicing whatever field you end up in. You've worked incredibly hard to get to this point, don't shortchange yourself at the last minute when you have the opportunity to take time to really evaluate what you want.

A research year is great not only just for the "on paper" stuff i.e. publishing and going to conferences, but you get the opportunity for solid mentorship, getting to know people in the department (this is especially value in specialties like ENT/Ophtho), learning about the field, and most importantly: time for personal growth / self-reflection / putting the constant grind of being a doctor on pause for a bit.

I have never met a classmate who regretted taking a research year. Don't put too much pressure on yourself about being a "publishing machine" - people often exaggerate how 'productive' you're expected to be. Follow what you're interested in, try to align yourself with a decently productive mentor (pubmed them, see whether they have worked with med students in the past), work hard, and the publications will come.

Lastly, there is inherent flexibility in a research year. You could start off the year doing Ophtho research while having time to shadow in ENT / whatever medical specialty you want. If you decide halfway through you'd rather do a different field, there's no harm in switching. This is purely anecdotal, but I know someone who did a very similar thing (switched from ENT to Rad Onc halfway through research year) and matched at a top Rad Onc program. It's definitely doable, and I think the research year is a very solid move for someone in your situation.

 

[evilbooyaa]

Dude(tte) you have a > 250 Step 1. Research year is, IMO, for people that have to make up a deficiency in their application, or have the step score and really want to end up not only in a competitive specialty, but at the best/most research heavy programs WITHIN a competitive specialty.

If you end up going into IM you will match just fine with a 250 Step 1 at a very well regarded academic program that sends 95%+ of interested residents into the fellowships of their dreams.

Ophtho/ENT if you do aways, get LoRs, and get some research under your belt, you should have a good chance of matching somewhere in the country.

All of this is dependent on you not being a weirdo or excessively location limited.

I would feel it to be really silly to switch research objectives halfway through a research year unless you prepared by doing stuff that covered both (IE for the example above about ENT to Rad Onc --> Do research in head and neck cancer from a clinical outcomes perspective).

A research year to me is one year less of attending salary. I did one but that's because I was in the former group in the first line. I met a few like me, and a few that were in the latter group. I didn't meet anybody who took a research year just to "figure out" what they wanted to do. Change your rotations ASAP to rotate in whatever you're interested in.