undergraduate research and residency

[impassivemd]

Hi. I know that research experience makes a difference in getting into some residency programs (especially non-primary care residencies). I plan to do one summer of research between my M1 and M2 years, which isn't a whole lot. However, I have about three years of research in Biochemistry/Genetics from my undergraduate years and a few publications in some upper-level journals.

I know my undergraduate research experience will help me secure a residency. My question is how much will it help? When most programs specify "research experience," are they referring mostly to medical research experience or do they mean any type of scientific research?

I can't imagine a lot of medical students having the time to engage in serious research experiments. At my medical school, students are only given real opportunities for research during the first two summers, which isn't a lot of time. So what do these residency programs mean? Any help would be appreciated.

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[impassivemd]

I'm sure glad I posted this in the residencies forum and not some forum that has nothing to do with my topic. LOOK AT ALL THE RESPONSES!

Cmon people. I have a real problem here. I am leaving my position as a research technician, and it would be nice to have some facts or opinions about this topic when I tell my boss that he should keep me informed of any future publications. It would also be nice to know which type of residency programs value research the most. Neurology? Radiology? Cardiology?

Anybody?

 

[Becket]

While there isn't that much time during med school to do research, a lot of students do find the time both between 1st and 2nd yr and during elective time during years 3/4 for it. When applying for residency, it's of course best to have done research in the field that you're interesting in entering; but since some people don't figure out what field they want to enter until relatively late in med school, research in any field is better than none. Generally, the more competitive the residency, the more important previous research experience is. So for fields like surgery (especially ortho and neuro), derm,ENT,and some others, it's looked upon highly

 

[Future GI Guy]

Impassive...
I'd be interested in knowing what you want to do, residency-wise. It would make a difference in my response.

However, let me say that, unless you published some articles during your undergraduate years, or perhaps earned an advanced degree, your research might not benefit you as much as you think.

A lot of the better schools encourage their students to take a year off during medical school and do something, either research or a project of some other kind.

For example, I have a friend at Stanford, and he took a year off, working on a very interesting project. He says that nearly half his class will finish in 5 years, rather than 4 years.

This is a far cry from my school, a primary care allopathic school in Missouri, where most of us will finish in four years.

This is not to say there isn't time during your 4 years to do research; I just think, in some instances, there's more time than you think because some programs will flex to 5 years instead of 4.

 

[Future GI Guy]

As I re-read your initial statement, I see that you did publish in some "upper-level journals." That's wonderful, and you're right, it should benefit you.

I don't know that it will "secure you a residency position" in all things, however.

I mean, if you want to do ENT, you're going to have to have aced the Steps (I and II), and done a little something more during medical school than the standard pass. You might have to be in AOA, and you might even have to have a halo hovering over your head at the interview. Not many people in ENT care about your genetics publications, but they might be wary if you didn't honor in Surgery.

One is never guaranteed a spot in anything. If you don't agree, talk to the 3% of US Medical Students who didn't match in Internal Medicine or Pediatrics. Those are supposed to be "guaranteed" positions for US grads, and they had to scramble.

Now, from what I understand about the three residencies you asked about...

As for Neurology, you can sleep walk through medical school and (as long as you pass the steps on the first try) secure a position. It's the least competitive of the three that you mention.

Radiology, on the other hand, is a different deal. Research would be nice. Here's a topic: design a study looking a Nuclear Radiologists vs Non-Nuclear Radiologists, and see if there's any increased cancer risk for the Nuclear ones. I'm not kidding, it would be an interesting, provocative study.

As for Cards....that's a whole 'nother ball of wax, simply because you don't apply for Cards right out of Medical School (I assume you knew that). What happens here is, you shine during your IM years, preferably at a large academic center, and you do some research there....there should be much more time alloted for research in residency, but this differs from program to program.

One more thing; I don't know about your school, but I sure do get a lot of time off during my 4th year (about 4-5 months). That's a large chunk, and one that could be used for some clinical projects that don't require the minute-to-minute attention that bench work might.

 

[impassivemd]

Thanks for the responses.

My school is just like yours GI guy, in that it focuses on primary care and emphasizes graduation in four years. Over 60% of students match with primary care residencies.

Now, I have nothing against primary care. I am certainly interested in it; however, I just don't think I would be any good at it. The people that know me best see me as a specialist or someone involved in research or writing. I even took a test (MSAT?) in which you enter your personality traits and it spits out which residency you are best suited for--family practice came up dead last. In addition, most primary-care physicians that I know are unhappy with their specialty, and wish they would have chosen something else.

I have recently become very interested in neurology and radiology. I knew radiology was a hard match, but why is neurology a relatively easy match?

In order to specialize, I think I'm going to have to work extremely hard at getting some Honors and at doing well on Step 1. That's going to be tough considering the level of my classmates. However, I'd be curious to know how it works at your school GI guy. Do you find that most students do not work as hard as they could because they are going into primary-care residencies, which are easier to match with?

Regarding time off, I don't think we get much. We may get a few weeks in between electives during fourth year, but that's it. Taking a year off is unheard of at my school, though I would LOVE to do that.

 

[Future GI Guy]

GI guy,
I don't know why Neurology is not as competetive. I don't see a lot of medical progress in Neurology, the kind you see in something like Radiology or Cardiology. In Radiology, for instance, you have brand new computers every year which offer totally awesome images never before seen. Cardiology and Cardio-thoracic surgery will always be popular because they deal with the #1 killer, and advances are happening quickly.

I recently heard on National Public Radio, an interview with a Neurologist, and he suggested that over the next few years, Neurology and Psychiatry would become one residency (much the same way that Obstetrics and Gynecology combined.)

This would be a good thing, as they begin to find Physiological explanations for Psychological problems. And the human-genome project (and, hopefully, a quick mastery of gene therapy--i.e. replace the huntington gene) will lead to some very exciting progress in this area.

That said, it's still not as competitive as the other four specialties offered through the S.F. Match. Here's a for instance:

I'm quoting from SF Match about USMLE scores: "We have scores for 302 of the matched applicants: the average 3-digit score was 217. For 49 unmatched applicants the average 3-digit score was 196"

That's not a terribly difficult match. While a 217 is a good score as a mean, it's not comparable to Radiology (which, the low end on radiology seems to be 220, get above that and get an interview). Keep in mind, a 217 is very close to the national mean.

For comparison, USMLE scores for Match vs Unmatch in Neuro-Surgery are 230 vs. 207 respectively. You can see it's a much more difficult match.

Anyway...you ask about other students. None of us know how the others do in our class, except to say, it's obvious who wants to be a surgeon and who doesn't. As for me, I might be considered a person who doesn't work as hard because I'm headed for Internal Medicine and then, unless I change my mind, GI. I think I surprised some people with my Step I score, but I did pick up a lot of info the first few years, and that helped me.

Now, GI's a tough fellowship to get, but not impossible, and I'm not that worried about it.

I, like you, don't feel very comfortable with the idea of Primary Care. I want to be a specialist. I'd like to know EVERYTHING about SOMETHING, rather than know something about everything. I'd feel more comfortable.

I think you might be a year behind me, as I've already taken step I. This is good for you, because Radiology has been a specialty in flux. Five years ago, you couldn't give the positions away (there was a supposed "job shortage") while now it's one of the most difficult.

This might change again.

I know I'm going off into other directions, but let me offer one word of warning. I really respect and love to be around those people in my class that work the hardest, score the highest, and don't brag about it. Those that work the hardest, score the highest, and are constantly talking about how hard they work and how high they score, I could do without those.

You can be a "secret" gunner without flexing your muscle all the time. Do it in private. Don't show anyone else up, and I think you'll command respect.

Good luck.

Here's the Neurology Match results from January:
http://www.sfmatch.org/r-neuro/neuro_matchreport.html

 

[Future GI Guy]

I don't know why I wrote that previous response to myself. Obviously, it was intended for Impassive. I'm a big dope.

 

[Ludy]

I'm also interested in neurology, and questioned people as to why it was such an easy match. According M3s/M4s and residents in various fields, here are the negatives:
-- a lot of the intellectual challenge (making the diagnosis from the physical exam using knowledge of the pathways and so forth) that draws people to neurology is now being taken over by MRIs or CT scans, and thus the radiologists are responsible for diagnoses.
-- for many patients with brain damage or degenerative diseases, there really isn't a whole lot you can do for them, possibly making it more depressing than other specialties. I didn't really understand this until I spent some time in the neuro ICU and realized just how few patients were actually able to communicate with the doctors or their families. Of course, this would be somewhat different in an office-based practice.
-- although there are many new advances, e.g. stem cells or electrical implants for Parkinson's, neurologists will not be the ones performing these procedures; neurosurgeons will.
The internal medicine residents I talked to were particularly disdainful of neurology, and felt that they rarely learned anything from a neuro consult that they hadn't already figured out.
I still think it's an interesting field, however, and I would love to hear any positives from people who have finished rotations or are in residencies.

 

[impassivemd]

Perhaps your subconscious was trying to tell you something GI guy. I know what you mean about not wanting to be around braggarts. I have tried to maintain a humble attitude in school as much as possible.

As far as neurology, it sounds far less interesting than I imagined it. I am not interested in psychiatry, and if it is true that neurologists are losing diagnostic privileges, than count me out. I guess it is something that I will just have to experience for myself.

On the other hand, diagnostic radiology is beginning to sound much more desirable. Again, it is something I will just have to experience for myself. The only problem relates to my school and the limited exposure I will probably receive.

 

[Vader]

There are some procedures that neurologists perform such as LPs, botox injections, EMGs, etc. Neurology is not as competitive as other residencies because it does not have as many applicants applying for positions. Also, the salaries of neurologists tend to be lower than many other specialties. Then there is also the common old-school misconception that all neurologists do is diagnose. Today, there are acute stroke treatments and many more drugs available to treat various conditions, including dementia. There are also many subspecialties of neurology. I think one of the great things about the field is the potential for research. Since so much remains unknown about the brain and pathophysiology of various neurological disorders, there are many avenues of basic and clinical research available. Neurology tends to be a very "cerebral" field, so if you enjoy solving complex problems and are able to deal with uncertainty, it may be for you. Just my two cents on the subject...

 

[MikeS 78]

I'd like to state that while I don't know you GI....I know your type and I'd like to state that I can't stand your type

I have been tagged one of those "braggarts" ie Gunner.........the main reason I get this title is because I answer questions in class.....I don't interrupt or try to show up people......I just feel that if a professor takes the time to try to teach me something....i should take the time to try and answer the questions and participate......god forbid that people actually find the material we study to be interesting and worthwhile...

I work very hard to understand what I am taught and am shocked and disgusted by this anti-intellectualism that I see pervading much of the med student culture....why don't we just break out the pitchforks and burn down the damn library while we are fighting this intellectual threat


it has been my experience.....as well as many others that I know.....that the title "Gunner" is much like "witch" or "Commie" it is a way to degrade, intimidate, and humiliate people for a simply having a different approach to learning and a different form of communication as yourself......it is also used as a form of competition, for it has been my experience that the lable is typically thrown at people that you don't like...or ones who you are afraid of.......I have heard that it is not the gunners but the people who are pointing out the gunners who you should watch out for during 3rd year

I expect that you will attempt to counter and tell me there are real gunners at your school and I don't know what I'm talking about and yes somewhere there probably are people who are confrontational with how much they know....but I have yet to meet anyone who is truly trying to get in peoples faces....and I go to a very competitive school

the gist of this isn't to necessarily get on your case per se...but rather because it is this behavior....this attack on people who are passionate about the field....this intimidation.......that has left me frustrated and disgusted with the medical student culture

 

[impassivemd]

Yikes! I think GI guy was just giving me some friendly advice, not necessarily berating any particular group of medical students.

I can't speak for everyone, but I agree with GI guy. I don't like to be around people with condescending attitudes, whether "gunners" or not. If you do, more power to you.

 

[AJM]

Originally posted by MikeS 78:
•I'd like to state that while I don't know you GI....I know your type and I'd like to state that I can't stand your type

I have been tagged one of those "braggarts" ie Gunner.........the main reason I get this title is because I answer questions in class.....I don't interrupt or try to show up people......I just feel that if a professor takes the time to try to teach me something....i should take the time to try and answer the questions and participate......god forbid that people actually find the material we study to be interesting and worthwhile...
•

Wow! I didn't expect this kind of response to GI Guy's very thoughtful post! I didn't think he was trying to discourage people from working hard and being intellectual during medical school. In fact, it sounds to me like he works very hard, and is probably, in fact, a "closet gunner", in the best sense of the term, of course!

I think that GI Guy was basically making the distinction between someone who works hard, does well, but works cooperatively with their other colleagues, and someone who works hard, does well, and tries to "show off" their knowledge inappropriately, sometimes at the expense of their colleagues. In medicine, which relies a great deal on cooperation and collaboration, the former type of "gunner" is much more desirable. People do tend to notice and respect the former group much more than the latter group. In clinics, many people's true personalities "shine", which is one reason, especially in clinics, it becomes much more important to make an effort to work with, and not compete against, your colleagues.

I, too, really respect my classmates who have worked very hard, scored well, and don't brag about how smart they are, or who don't try to make my other classmates feel bad about the type of student they are.

 

[AJM]

Originally posted by impassivemd:
•Regarding time off, I don't think we get much. We may get a few weeks in between electives during fourth year, but that's it. Taking a year off is unheard of at my school, though I would LOVE to do that.•

If you talk with your Dean of Students, he or she may be a little bit more encouraging about taking time off than you think. The fact that people tend not to take time off at your school doesn't mean that they *can't* take a year off. It might be a funding issue, so you can definitely try to get a grant. For example, there are Howard Hugh's grants in which you get funding for a full year doing research at the location of your choice, there are NIH grants, where you can do research for a year at the NIH. There are also other grants, such as the American Heart Association, and others depending on what area you would like to do research in. If you are interested in doing this type of thing, definitely talk with someone about the possibility of pursuing it.

I actually took an extra year during my preclinical years of med school to do research, and it really was a great experience. Now, I am in my 5th year (I just tell people I'm a 4th year...), and I'm also taking a couple of months off of clinics to do some different research that's more clinical-type stuff. It's only 2 months long (and one of those months I actually get credit for as a rotation), and I'm planning on continuing to work on it while I do my 4th-year rotations this year. You might want to think about doing something similar -- it actually doesn't take too much time out of your schedule, as long as you know what specialty you want to go into before you take clinical time off!

Sorry about the rambling! But I would bet that if you have a good reason, and can get some kind of funding, your school would let you take a year off.

 

[MikeS 78]

my claim is not that there aren't some backstabbers out there...my claim is that people who usually get the lable usually are getting it as a form of attack.....and it has been my experience that the backstabbers are usually not the folks that are labled gunners....but rather people like GI guy...the "humble type" who silently is reading up on your patients to show you up in the pimp session.....

my claim stands....I think everyone that I have heard called gunner has gotten the title usually because the person labling them is either trying to belittle them publically, or trying to intimidate them into not speaking up.....or as a form of pushing off the competition

thus while nothing GI said is overtly sickening......it is the unsaid spirit of his claim that angers me....the intolerance of the people that make such claims......and in fact the dishonesty of the silent gunner ....as they masquerade as the friendly team player.....and sharpen the knife for your back

 

[MikeS 78]

as to the origional poster....while research is always a plus....and I'm not sure where you published chances are good that what you did in biochemistry is not entirely relevent to the research done in most surgery and/or medical fields......and the fields that it would be relevent in are not competitive enough to require research.....the gist is that i would make sure that somehow I find a way to tie my experience into the translational research type fields...ie work for an MD doing bench work

 

[AJM]

Originally posted by MikeS 78:
•my claim is not that there aren't some backstabbers out there...my claim is that people who usually get the lable usually are getting it as a form of attack.....and it has been my experience that the backstabbers are usually not the folks that are labled gunners....but rather people like GI guy...the "humble type" who silently is reading up on your patients to show you up in the pimp session.....
•

Didn't GI Guy specifically say in his post *not* to "show anyone up"? I'm not trying to provoke an argument -- I totally agree with you, Mike, about the "back stabbers". However, I stand by my previous interpretation of GI Guy's comments. I think he was trying to discourage people from trying to show off their knowledge inappropriately. To me, that kind of flaunting knowledge includes things like learning about fellow students' patients so that you can show them up during rounds or pimping sessions.

Mike, I fundamentally agree with you -- I think that usually when people are labelled gunners, it is by those people who are the "true" gunners, possibly for intimidation, to make others feel bad for working so hard, I don't know. While there are a few people like this at every school, luckily it's only a handful. But I don't get the feeling that GI Guy is in this category -- I think he was just trying to give some honest advice basically saying "play nice."

 

[impassivemd]

I'm not getting into the gunner debate.

Taking a year off is certainly something I am interested in, and certainly something I will inquire about. The major disadvantage that I can see is being left behind by all of my classmates and friends. However, I am glad to hear that a medical school such as mine may not be completely opposed to the idea.