Uncertainty and research

[NeuralNetwork]

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Before the school year starts, I was just hoping to understand a couple basic key things so that I know what I need to do as soon as everything gets going. I know the typical response for someone in my position is, "You haven't even started school" or "worry about step 1 first", but I was just hoping for a straight forward serious answer.

Basically, there are many specialties which I have considered doing, and I know that this can all change drastically as soon as I start rotations. So my question is, when does the average medical student engage in research? More importantly, what if you find that you are interested in a specialty that is considered very competitive after doing rotations? The assumption would be that you would need a good amount of research for some of those specialties, but if you didn't know that you wanted to do it until 3rd/4th year then how do you compensate for the lost time? Does the research need to be specific to that field, or does any research help?

I'm not thinking ahead to start working specifically on competitive specialties, but rather I am hoping to keep the doors open for any options I may feel aligns most with what I want. Thanks guys

 

[Phyozo]

Before the school year starts, I was just hoping to understand a couple basic key things so that I know what I need to do as soon as everything gets going. I know the typical response for someone in my position is, "You haven't even started school" or "worry about step 1 first", but I was just hoping for a straight forward serious answer.

Basically, there are many specialties which I have considered doing, and I know that this can all change drastically as soon as I start rotations. So my question is, when does the average medical student engage in research? More importantly, what if you find that you are interested in a specialty that is considered very competitive after doing rotations? The assumption would be that you would need a good amount of research for some of those specialties, but if you didn't know that you wanted to do it until 3rd/4th year then how do you compensate for the lost time? Does the research need to be specific to that field, or does any research help?

I'm not thinking ahead to start working specifically on competitive specialties, but rather I am hoping to keep the doors open for any options I may feel aligns most with what I want. Thanks guys

A lot of medical students start up their research either through elective months during the first year or during summer between M1 and M2 year. Some specialties which are incredibly competitive basically require research in the field (ex Derm, Rad/Onc) and a lot of people who think they might be interested in those specialties get started early and/or take extra years dedicated to building their CV. For most specialties, however, any research is better than no research and doesn't really matter what it's on as long as you are productive in it.

 

[jtdMU2010]

M1 here so take my advice lightly I suppose. My M1 class is just beginning research this summer. I don't know of anyone that is a current M1 doing research in my class. A good portion of the class is doing research for 1 or 2 months during the summer at the school. Others are going to various universities to do research in the summer. I imagine some will continue into second year. Like you said, research is important for the more competitive specialties but I don't think it matters what you choose to do research in if you are unsure of your specialty. PDs surely understand that sometimes people don't pick a specialty until much later and may not have research in that particular area. Being a doctor, you have to know a little about every specialty and bodily system so I'd say any research in any area is fine. I think the best thing to do if you're unsure in the first two years is do some clinical research in IM, Neuro, FP, etc. (The core rotations you do third year since all doctors will have rotated through these). Some type of IM makes the most sense since almost all residencies do an IM intern year. I have no clue what I want to do but it won't be anything ultra competitive like Ortho, RadOnc, Optho, NeuroSurg or Derm. I see myself in IM or ER and even though those don't require research per se, I'll engage in research starting this July and hope to carry it through M2 year. Most likely an IM clinical research project perhaps focused on cardiovascular issues. The heart is important for everything so that's solid research no matter what field, right? haha Hope that helps. Someone feel free to correct me if wrong (I could use the info as well).

 

[loveoforganic]

I wouldn't recommend anyone take up research obligations coming into first year. Get school under control and play it by ear. I'll tell you what my personal plan is, for whatever it's worth to you. As a preface, I'm an M1 MD/MPH student and will be taking a gap year between 2nd and 3rd year to complete the MPH.

Undergrad - previously wrote research proposal I still have interest in.

M1 - Will be revising that research proposal to be more realistic and up to date during this coming February. Will submit to IRB after completion/revisions with mentor with hopes to complete feasibility study this summer (this is a clinical, not basic sciences project, fwiw).

M2 - Not crap, unless I suddenly get a hell of a lot smarter and find a lot of extra time. Possibly some final data collection from the summer if I don't quite get through it.

Public health gap year b/w M2/M3 - Hopefully larger scale implementation of the feasibility study conducted summer of M1. Very dependent on the feasibility study though, and it could potentially require a small amount of funding (<$10k, but still makes me consider this less likely than more likely). If that doesn't pan out, whatever clinical research under a med school faculty member I can find and have interest in / time for.

M3 / M4: Continued clinical research as time / opportunity permits

 

[Valadi]

If you're even considering something competitive then get started in research from the getgo. 3hrs a week doing data mining will pay dividends when you're an m4 and need a letter of rec. If you're equally interested in 2 competitive fields, then go with whichever department publishes more. I know several people that have multiple pubs going into m4 by following this strategy. Wish I did it myself.

 

[bassvp]

This may be a stupid question, but what is the best way to find out which departments publish a lot of research?

 

[loveoforganic]

Look up their faculty members' publications :x

 

[JP2740]

Look up their faculty members' publications :x

lol what would be considered "a lot"

 

[Butler]

If you're even considering something competitive then get started in research from the getgo. 3hrs a week doing data mining will pay dividends when you're an m4 and need a letter of rec. If you're equally interested in 2 competitive fields, then go with whichever department publishes more. I know several people that have multiple pubs going into m4 by following this strategy. Wish I did it myself.

Do not do this until you are certain you can handle the classload. Stepl > > Research for competitive specialties. Learn the material and learn it well!

 

[dragon529]

But one has to realize performance/grades in classwork do not directly correlate with step1 scores. Your school might test you on minutiae in order for that high pass or honors. But if you understand the concepts and apply to various scenarios then that'll be big on step1. However, I've heard of many stories where a AOA/240 board/no pubs might be at a disadvantage to a non-AOA/240board/several pubs. At the end.. you have to judge yourself how to balance between research/pre-clincal grades/step1 times. What works for 1 person doesn't mean it'll work for you.
My $0.02

 

[drizzt3117]

Do not do this until you are certain you can handle the classload. Stepl > > Research for competitive specialties. Learn the material and learn it well!

True to a certain pt; over 250 the differences are minimal.

 

[JP2740]

True to a certain pt; over 250 the differences are minimal.

What does that mean?

 

[drizzt3117]

Do not do this until you are certain you can handle the classload. Stepl > > Research for competitive specialties. Learn the material and learn it well!

What does that mean?

Depending on specialty, increasing your score has pretty serious diminishing returns past 250. Perhaps plastics/derm are exceptions.

 

[mmmcdowe]

If you're even considering something competitive then get started in research from the getgo. 3hrs a week doing data mining will pay dividends when you're an m4 and need a letter of rec. If you're equally interested in 2 competitive fields, then go with whichever department publishes more. I know several people that have multiple pubs going into m4 by following this strategy. Wish I did it myself.

Agree, a little effort early on can result in pubs eventually.

 

[Valadi]

3 hours a week will not affect your class grades or board scores. It will just require some motivation on your end to watch 3 hours less tv. Put another way, you could do it during 3 one hour lunch-breaks during the week between classes. I was massively surprised at how much more work I got done 3rd year compared to my first two years - with rare exception, a lot of time is spent wasted.

Pubs say something that board scores do not: that you are committed and know how to carry the ball to the other end of the field. I'm doing a research fellowship at a top plastics department and on interview day what they discussed about applicants was not 240 vs 250, it was commitment to plastics as demonstrated by research production.

Moreover, if you start early you can lock-down a summer research position and they will let you know about paid fellowships, and you can get hooked up with a killer LOR. If you decide you don't like whatever you're doing research in, there will be NO hard feelings from your PI as they'll understand you're a junior med student and weren't sure what you were interested in when you started. Usually they'll help set you up with a faculty member in your department of choice who is a big-dog for getting more pubs and letters of rec.

There's more reasons to get involved early. For minimal work they may need more people to present at national conferences. It means your name on an abstract, a means to network with people from other programs, and an opportunity to get your name known. They may fund your time working. Where I am, we have a med student putting in 3-5 hours a week and is getting paid for it ($50/wk is great pocket money). If you show an early commitment, you also will be hooked up with other opportunities where someone can front you like international missions -- and you won't feel bad about taking a week off of your summer fellowship to do it since you've been putting time in all along.

Bottom line, be upfront that you can invest a small amount of time each week, stay with it, and you will go far. If you're good and likeable, it's also a great way to lock your home program down for residency.

 

[Valadi]

FYI: Ideally what you want to be on are retrospective case studies that you can do from home. It'll require 0 thinking on your end, and is very tedious, but at least you'll be able to do it in your pjs on a rainy day and will result in a definite, quick and dirty publication.

 

[Valadi]

This may be a stupid question, but what is the best way to find out which departments publish a lot of research?

Ask residents from each dept or m3s/m4s interested in the fields. They'll usually know.

 

[JP2740]

3 hours a week will not affect your class grades or board scores. It will just require some motivation on your end to watch 3 hours less tv. Put another way, you could do it during 3 one hour lunch-breaks during the week between classes. I was massively surprised at how much more work I got done 3rd year compared to my first two years - with rare exception, a lot of time is spent wasted.

Pubs say something that board scores do not: that you are committed and know how to carry the ball to the other end of the field. I'm doing a research fellowship at a top plastics department and on interview day what they discussed about applicants was not 240 vs 250, it was commitment to plastics as demonstrated by research production.

Moreover, if you start early you can lock-down a summer research position and they will let you know about paid fellowships, and you can get hooked up with a killer LOR. If you decide you don't like whatever you're doing research in, there will be NO hard feelings from your PI as they'll understand you're a junior med student and weren't sure what you were interested in when you started. Usually they'll help set you up with a faculty member in your department of choice who is a big-dog for getting more pubs and letters of rec.

There's more reasons to get involved early. For minimal work they may need more people to present at national conferences. It means your name on an abstract, a means to network with people from other programs, and an opportunity to get your name known. They may fund your time working. Where I am, we have a med student putting in 3-5 hours a week and is getting paid for it ($50/wk is great pocket money). If you show an early commitment, you also will be hooked up with other opportunities where someone can front you like international missions -- and you won't feel bad about taking a week off of your summer fellowship to do it since you've been putting time in all along.

Bottom line, be upfront that you can invest a small amount of time each week, stay with it, and you will go far. If you're good and likeable, it's also a great way to lock your home program down for residency.

Lab or clinical and why

 

[Valadi]

Lab or clinical and why

Clinical. Publishes faster.

A mass-production attending told me, "You could be pipetting for a year and not get as many - or even one - pubs as if you sat down at data mined for a few retrospective studies." Do the lab stuff if you have a whole year, or have an overwhelming compulsion to go into that. I'll say this, though: I don't know many attendings who spend much time in a lab doing basic science, but I do know plenty of PIs that have a full-time clinical practice with little to no basic science training and conduct basic science research. They develop a question, hire a PhD to run things in the lab, and have students/postdocs do the work.

 

[JP2740]

Clinical. Publishes faster.

A mass-production attending told me, "You could be pipetting for a year and not get as many - or even one - pubs as if you sat down at data mined for a few retrospective studies." Do the lab stuff if you have a whole year, or have an overwhelming compulsion to go into that. I'll say this, though: I don't know many attendings who spend much time in a lab doing basic science, but I do know plenty of PIs that have a full-time clinical practice with little to no basic science training and conduct basic science research. They develop a question, hire a PhD to run things in the lab, and have students/postdocs do the work.

Is there a preference when you apply? Any differences between the specialties? I want to do neuro.

 

[Valadi]

Neurology or neurosurg?

Generally, no, there's no difference when you apply. I've heard that rad onc is big on the basic/translational stuff with lots of physics, so they might be the exception. What you may come across is departments that are big one some type of research that you have experience in. So if one place does a lot of basic science peripheral nerve work, and your research is basic science peripheral nerve work, then you have a better in. There's no way to plan that kind of stuff out years in advance, though.

This stuff I hear from people that 'basic science trumps clinical' is just nonsense. In the end, impact and volume are what matters. If you can jump on a NEJM or Nature project, then get on it. Likewise if you can get with a guy who will put you on 10 papers, stick with him. Basic, clinical, doesn't matter. Impress with IF and numbers.

 

[JP2740]

Neurology or neurosurg?

Generally, no, there's no difference when you apply. I've heard that rad onc is big on the basic/translational stuff with lots of physics, so they might be the exception. What you may come across is departments that are big one some type of research that you have experience in. So if one place does a lot of basic science peripheral nerve work, and your research is basic science peripheral nerve work, then you have a better in. There's no way to plan that kind of stuff out years in advance, though.

This stuff I hear from people that 'basic science trumps clinical' is just nonsense. In the end, impact and volume are what matters. If you can jump on a NEJM or Nature project, then get on it. Likewise if you can get with a guy who will put you on 10 papers, stick with him. Basic, clinical, doesn't matter. Impress with IF and numbers.

I feel you man. I think I'm going to go the basic science route and gain those skills just so that avenue isn't closed to me later on.

 

[gettheleadout]

Valadi, I find your posts in this thread extremely helpful. Just want to give you some kudos. 👍

 

[Valadi]

Valadi, I find your posts in this thread extremely helpful. Just want to give you some kudos. 👍

Thanks!

 

[pandoraone]

Neurology or neurosurg?


This stuff I hear from people that 'basic science trumps clinical' is just nonsense. In the end, impact and volume are what matters. If you can jump on a NEJM or Nature project, then get on it. Likewise if you can get with a guy who will put you on 10 papers, stick with him. Basic, clinical, doesn't matter. Impress with IF and numbers.

Really stupid question, but how can you find projects that are NEJM or Nature caliber? I would be ecstatic at being a middle or late author on any of these super journal papers but how can one fine out and get onto such a project?

Thanks

 

[MudPhudHopeful]

Really stupid question, but how can you find projects that are NEJM or Nature caliber? I would be ecstatic at being a middle or late author on any of these super journal papers but how can one fine out and get onto such a project?

Thanks

Unfortunately, there is no formula for determining which projects are high caliber. Papers that are published in those journals are high-impact research, which is difficult to determine. All research projects address important questions to an extent, but identifying those projects that are truly high caliber requires an intimate knowledge of the given field. In other words, you need to know what the major challenges/gaps in knowledge in a field are in order to be able to assess whether a project will solve a major problem or advance the field. This requires a lot of reading on your own, which would make it difficult to do from scratch along with medical school, especially since you really don't learn about diseases/pathophysiology until second year. It's a different story if you have been heavily involved in a particular research field (ie undergrad) and are familiar with the field.

Moreover, requirements for authorship is usually pretty strict. It depends on your PI, but usually you can't just do the data analysis or do an experiment or two. Authorship usually requires that you make an intellectual contribution to a project, which usually means having an idea about some aspect or direction to take the project, designing experiments to test that idea, performing the experiments/collecting the data, analyzing the data, writing up a portion of the paper, etc.

The best advice that I can give you to increase your chances is to find PI's that regularly publish in such journals, such as Nature/Science/NEJM, and ask them if they have a project that you could get involved in and be prepared to work hard and put in a significant amount of time. Unfortunately, even if you do find a good project, there is an element of uncertainty. As was mentioned previously, you could spend a year pipetting stuff and not have a publication to show for it. There is no guarantee that the project will pan out in the way that you hope or you could get scooped, but that is just the nature of science. Thus, there is a certain element of luck as well.

 

[psychmdhopeful]

FYI: Ideally what you want to be on are retrospective case studies that you can do from home. It'll require 0 thinking on your end, and is very tedious, but at least you'll be able to do it in your pjs on a rainy day and will result in a definite, quick and dirty publication.

Thanks for all your helpful responses Valadi! Just curious, do you think these case studies would be sufficient for the more competitive specialties like Ortho? Or are publications a must?

 

[CDI]

I'm also curious about research/publications and their importance. Are they only important if they are targeted to a competitive specialty, and only really looked at if you get 250+ Step 1?

Also, if you do research in say rad onc at a really reputable place, cause its a great opportunity, but are actually aiming for IM, will that still help any or is that kind of pointless?

 

[notbobtrustme]

True to a certain pt; over 250 the differences are minimal.

Getting to 250 is no easy feat; it's 95%+ percentile. It's easy to look in hindsight, but no one really knows what they will score beforehand. It's not like you can do the calculations and partition your time accordingly. There's no formula that says "study 500 hours for a 250 then do research with the rest of your free time."