MD Waiting 6-7 years for residency

[sleepymonk]

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I'm a med student currently in her third year of a reputable 4 year medical program. I plan to take a couple of years (before my final year of med school) to do some basic science and clinical research in the field I'm interested in, as well as take a year to complete an MPH program.

How favourably or unfavourably do committees look at students that have taken more than 5 years to complete medical school? My step score and grades are competitive, and I trust I will receive good recommendation letters as well. Additionally, let's assume I publish a few couple of research papers.

Do I still stand behind applicants that finish med school "quickly" and apply for residency?

I'm currently interested in plastics and orthopedic surgery residencies.

 

[LucidSplash]

if you are going to take time off to do any of these things, I recommend:

1) Pick one thing
2) Have a good idea of how that one thing will help you in the specialty/field you plan to pursue.
3) Take one or two years tops
4) Take the time off BEFORE you do 4th year (MOST IMPORTANT)

Trying to match into residency, any residency, let alone a competitive one like PRS/ortho, 5 years after graduation is basically suicide. If you want to do these things, take a leave of absence to do the research or degree, then come back to do 4th year. I think best would be to do the research and then save the MPH for after residency if you still think it would be useful then.

 

[sleepymonk]

if you are going to take time off to do any of these things, I recommend:

1) Pick one thing
2) Have a good idea of how that one thing will help you in the specialty/field you plan to pursue.
3) Take one or two years tops
4) Take the time off BEFORE you do 4th year (MOST IMPORTANT)

Trying to match into residency, any residency, let alone a competitive one like PRS/ortho, 5 years after graduation is basically suicide. If you want to do these things, take a leave of absence to do the research or degree, then come back to do 4th year. I think best would be to do the research and then save the MPH for after residency if you still think it would be useful then.

Thanks for the response!

What do you mean by "5 years after graduation"?

I intend to take time before my fourth year rotations, not after graduation.

Not sure if this changes your response, but the split I'm considering is:

Yr1 + Yr2 med school
2-3 years research
1year MPH
Final year rotations
----
Giving me 6-7 years in total before I submit my residency applications.

 

[deleted480308]

It just seems like too much to me. 7rs? go to residency

 

[Sephirakra]

Thanks for the response!

What do you mean by "5 years after graduation"?

I intend to take time before my fourth year rotations, not after graduation.

Not sure if this changes your response, but the split I'm considering is:

Yr1 + Yr2 med school
2-3 years research
1year MPH
Final year rotations
----
Giving me 6-7 years in total before I submit my residency applications.

A lot of med schools require you to graduate within a certain time frame (my school is 6 years, for example). You might have to get special permission to extend your education by 3-4 years.

 

[Chibucks15]

What research are you doing that you can’t wait on for a few years and pick up after you’re in? Seems super strange. Like why didn’t you just go get a PhD if you were so interested in research?

 

[AnatomyGrey12]

If you're doing 2-3 years of basic science research you had probably better have a PhD or at minimum a Masters from it. If I were a PD I would think that was weird for an applicant to take multiple research years in medical school and not have a clear direction with it.

 

[aafisahar]

Don't forget that many states have timelines for licensure. They may have carve outs for MD/PhDs but not necessarily research years. Typically it's 7 years to get all the licensing exams done. If you are outside that window, it may be tough or impossible to get licensed in that state.

 

[Espressso]

Thanks for the response!

What do you mean by "5 years after graduation"?

I intend to take time before my fourth year rotations, not after graduation.

Not sure if this changes your response, but the split I'm considering is:

Yr1 + Yr2 med school
2-3 years research
1year MPH
Final year rotations
----
Giving me 6-7 years in total before I submit my residency applications.

So you're going to take 3-4 years off before your final year of rotations? And you plan to apply ortho or plastics? So you'll take 4 years off before starting your audition/sub-I rotations in a few of the most competitive specialities? For an MPH? and 2-3 years of "basic and clinical science research"?
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[LucidSplash]

Thanks for the response!

What do you mean by "5 years after graduation"?

I intend to take time before my fourth year rotations, not after graduation.

Not sure if this changes your response, but the split I'm considering is:

Yr1 + Yr2 med school
2-3 years research
1year MPH
Final year rotations
----
Giving me 6-7 years in total before I submit my residency applications.

Your initial post prior to editing made it sound like you were considering doing this after graduation. Hence my emphasis on taking time off for things prior to graduation.

But otherwise, my advice stands. Pick one thing. Unless you plan to get a PHD, take 1-2 years tops. 5+ years is too much and will be questioned by residencies wondering what you were dicking around doing without something more than a few papers to show for it. Make sure whatever you pick will be helpful to you in your career plans beyond residency.

 

[sleepymonk]

So you're going to take 3-4 years off before your final year of rotations? And you plan to apply ortho or plastics? So you'll take 4 years off before starting your audition/sub-I rotations in a few of the most competitive specialities? For an MPH? and 2-3 years of "basic and clinical science research"?
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View attachment 296107

Lmao, it's not as bad as you say. The 2-3 years includes my third year, which is meant for basic research to begin with. The MPH is purely optional and something I'm currently interested in. I would, however, like to take an additional year or two for research. So that brings (without the MPH) the grand total to 6 years of med school.

Ty for all of your thoughts on this!

 

[Dr G Oogle]

What exactly are your career plans? Are you doing this research because of later career plans like trying to be chair or a PI in a lab or is just to land residency spot? Or out of personal interest. Obviously if for competitive residency don’t take more than 2 years off like everyone else said. If it’s out of interest or higher career aspirations then do it in residency or felowship many surgical residencies esp GS and most fellowships but especially those in cancer will not frown and probably encourage research sabbaticals

 

[Espressso]

This is honestly a bad plan, no matter which way you look at it. MPH should be held off until fellowship or beyond. That many research years is just too much.

 

[star.buck]

The one thing you're not factoring in, and I didn't see mentioned - is that Step 1 is becoming P/F. There is unconfirmed talk it will be made P/F retroactively for those not already matched as well. If you wait, that nice score you achieved MIGHT be reduced to a 'pass'. You'll be different from nearly everyone else applying for that same residency, make sure it's a "good" different. If it's something you have to explain or justify it may not be perceived as such and set you at a disadvantage.

 

[sleepymonk]

What exactly are your career plans? Are you doing this research because of later career plans like trying to be chair or a PI in a lab or is just to land residency spot? Or out of personal interest. Obviously if for competitive residency don’t take more than 2 years off like everyone else said. If it’s out of interest or higher career aspirations then do it in residency or felowship many surgical residencies esp GS and most fellowships but especially those in cancer will not frown and probably encourage research sabbaticals

Motivation for research is personal interest, and wanting to build a competitive residency application.

The MPH is purely out of personal interest, which I can pursue later, if needed.

 

[Cawolf]

Might as well try to apply into your school's MSTP/MD-PhD program and get a stipend and less debt if you are wanting that much research time.

 

[Dr G Oogle]

Motivation for research is personal interest, and wanting to build a competitive residency application.

The MPH is purely out of personal interest, which I can pursue later, if needed.

If personal interest strongly recommend waiting until residency fellowship or after training to pursue. Taking that much time will make you a lot less desirable to a residency because you may be perceived as having lost some of the “preparedness” that someone who just graduated may have: unless you do all your research in the department where you want to do your residency and come to some kind of arrangement. We do this in the urology department but it’s mostly for FMGs

 

[ciestar]

Go see if you can go MD-phd, nobody would question your length of medical school then. Otherwise, this plan is really risky as you describe it.

Either way, plenty of people take research years between M3 and M4 (at least at my school) for more competitive residencies. A friend of mine is doing this for derm. My school requires that step2 be taken before a certain time, though.

 

[odyssey2]

Whatever you want to do, I wouldn't take more than 2 years off of your regular curriculum. 1 year is very common, 2 years is on the high side, more than that may make you stand out in a bad way.

 

[NickNaylor]

Taking that much of a break is going to be a hindrance unless you are extraordinarily productive during your research time. If you're not going into an extremely competitive specialty, I would suggest deferring doing these things until later on. Depending on what kind of setting you work in, you might even be able to get your MPH at a significantly reduced cost as part of faculty benefits (if you're at an academic setting, for example). Everyone who reviews your application is going to be concerned about you being out of clinical work for 4-5 years. The other concerns with respect to timing of step exams, completing medical school within a certain time frame, etc. are also worth considering.

 

[odyssey2]

Thanks for the response!

What do you mean by "5 years after graduation"?

I intend to take time before my fourth year rotations, not after graduation.

Not sure if this changes your response, but the split I'm considering is:

Yr1 + Yr2 med school
2-3 years research
1year MPH
Final year rotations
----
Giving me 6-7 years in total before I submit my residency applications.

How are you planning to do a research year during your third year of med school? Does your school have a different curriculum?

 

[GoSpursGo]

I'm not sure, but I think there's some misunderstanding of your timeline here.

Years 1-3=MS1-3
4=basic research
5=MPH?
6=MS4

I really don't think there's anything that outlandish about this timeline, and I wouldn't flatly say it's a "bad" idea. Plenty of people do a research year to become attractive to some of the more competitive programs out there. A few thoughts:

1) Just do one year of research, and decide now if you want it to be basic vs clinical. If you decide basic, then yes, the longer you're in the lab the more productive you'll be and the more likely you are to actually see a project through, but unless you're doing a full MSTP/PhD I don't think that should be your goal. 2 and probably even 3 years won't be enough time for you to complete a high-impact project. You should latch onto an existing project and be responsible for one piece of it. If clinical, one year is plenty.

2) I'll echo what others have said, I don't see where the MPH fits into the picture of making yourself competitive for residency. It won't be seen as a negative, but I just don't think it's helping you, and if it's something you really want you can pick it up later.

 

[wysdoc]

Might as well try to apply into your school's MSTP/MD-PhD program and get a stipend and less debt if you are wanting that much research time.

Yeah, I was wondering if this OP is trying to do a DIY MD/PHD program??

 

[sleepymonk]

Yeah, I was wondering if this OP is trying to do a DIY MD/PHD program??

Kinda -- i was originally not sure about research, but got interested in it after working with a basic science lab during my third year. Thinking about pursuing that for a bit before I move on to life in residency.

 

[sleepymonk]

How are you planning to do a research year during your third year of med school? Does your school have a different curriculum?

My school allows up to 2 extra years for research before the final year.

 

[CyrilFiggis]

This sounds like something you should talk to your student affairs office about. You say you’re at a “reputable” USMD, I can guarantee they’ll look at your stats and resume and tell you what you need to do. A single gap year after MS3 is enough for the vast majority. Leave the personal interest crap for during or after residency. Why jeopardize your career goals now for something that you’ve worked so hard for??

 

[Tenk]

None of the things you listed are worth taking even a single gap year, let alone multiple. The only three reasons to take gap years are: personal reasons, PhD, or you can make a crap ton of money doing something else. If you aren’t doing it for one of these three things it’s a complete waste of time and money. (I personally also think PhD is a waste of time and money but I’ll concede it for those who are really into research so I don’t have to be).

 

[odyssey2]

None of the things you listed are worth taking even a single gap year, let alone multiple. The only three reasons to take gap years are: personal reasons, PhD, or you can make a crap ton of money doing something else. If you aren’t doing it for one of these three things it’s a complete waste of time and money. (I personally also think PhD is a waste of time and money but I’ll concede it for those who are really into research so I don’t have to be).

If you're applying for a competitive specialty gap years can be very helpful, even necessary in some cases. Research is expected in some fields and it's difficult to get a lot done during the normal med school curriculum.

 

[GoSpursGo]

None of the things you listed are worth taking even a single gap year, let alone multiple. The only three reasons to take gap years are: personal reasons, PhD, or you can make a crap ton of money doing something else. If you aren’t doing it for one of these three things it’s a complete waste of time and money. (I personally also think PhD is a waste of time and money but I’ll concede it for those who are really into research so I don’t have to be).

This is just out of touch with the reality of applying to competitive specialties. The neurosurgery program at my current institution recommends that students who don’t have prior research experience strongly consider taking a research year, and while I think that’s a bit of the ivory tower bias, doing a year of research can certainly massively improve an application.

 

[nimbus]

Most of the medical students at Stanford take a gap year and they match just fine😉

 

[Tenk]

If you're applying for a competitive specialty gap years can be very helpful, even necessary in some cases. Research is expected in some fields and it's difficult to get a lot done during the normal med school curriculum.

Work harder, not longer. OP says they are already competitive for plastics and ortho. There’s no reason to not go straight through doing research on the side if they are competitive. As the great Dwayne the Rock Johnson loves saying: be the hardest worker in the room.

 

[Tenk]

This is just out of touch with the reality of applying to competitive specialties. The neurosurgery program at my current institution recommends that students who don’t have prior research experience strongly consider taking a research year, and while I think that’s a bit of the ivory tower bias, doing a year of research can certainly massively improve an application.

No it’s not. It’s called working harder than others. There are people in every competitive specialty who have great scores, great research and go directly from med school to residency. Why? They worked harder than everyone else. Stop making excuses.

 

[odyssey2]

Work harder, not longer. OP says they are already competitive for plastics and ortho. There’s no reason to not go straight through doing research on the side if they are competitive. As the great Dwayne the Rock Johnson loves saying: be the hardest worker in the room.

She said she had competitive grades and test scores, but unfortunately that alone might not cut it for an ortho or plastics residency these days. One year off for dedicated research is going to yield a lot more pubs and field-specific connections than trying to squeeze it in during med school. I'm not suggesting OP needs to do everything she's outlined in the original post, but saying she won't benefit from taking some time off for research just isn't true.

 

[Tenk]

She said she had competitive grades and test scores, but unfortunately that alone might not cut it for an ortho or plastics residency these days. One year off for dedicated research is going to yield a lot more pubs and field-specific connections than trying to squeeze it in during med school. I'm not suggesting OP needs to do everything she's outlined in the original post, but saying she won't benefit from taking some time off for research just isn't true.

You’ll also lose about $500,000+ of salary which at time of retirement will be several million dollars. Also, taking a gap year when you fail to match is essentially the same thing only you might just match and skip the whole lost year altogether.

 

[odyssey2]

You’ll also lose about $500,000+ of salary which at time of retirement will be several million dollars. Also, taking a gap year when you fail to match is essentially the same thing only you might just match and skip the whole lost year altogether.

Except the reapplicant match rate for certain specialties is very low (~20%). That's obviously influenced by other things but that's still taking a big risk. It also may be more important for some people to match at something you enjoy, and spend some time exploring before you make a decision, than to make a decision based purely on lifetime earnings. Someone may be seeing if they enjoy research on their own or is interested in an academic career. A student choosing a lower-paying specialty out of personal preference is taking a bigger net-worth hit than someone taking an extra year.

 

[CyrilFiggis]

You’ll also lose about $500,000+ of salary which at time of retirement will be several million dollars. Also, taking a gap year when you fail to match is essentially the same thing only you might just match and skip the whole lost year altogether.

I feel like you would oppose me ranking 4-year EM programs high for the same reason.... but that’s for another time, another thread 🙂

Anywho, there are many applicants who wish to match into competitive specialties who only decide to do so during 3rd year. If they have little research or work in the field, most PDs encourage them to take a gap year.

 

[Mass Effect]

I'm a med student currently in her third year of a reputable 4 year medical program. I plan to take a couple of years (before my final year of med school) to do some basic science and clinical research in the field I'm interested in, as well as take a year to complete an MPH program.

How favourably or unfavourably do committees look at students that have taken more than 5 years to complete medical school? My step score and grades are competitive, and I trust I will receive good recommendation letters as well. Additionally, let's assume I publish a few couple of research papers.

Do I still stand behind applicants that finish med school "quickly" and apply for residency?

I'm currently interested in plastics and orthopedic surgery residencies.

Your peers don't graduate "quickly." They graduate on time. What you're suggesting would make you uncompetitive, imo.

 

[Tenk]

Except the reapplicant match rate for certain specialties is very low (~20%). That's obviously influenced by other things but that's still taking a big risk. It also may be more important for some people to match at something you enjoy, and spend some time exploring before you make a decision, than to make a decision based purely on lifetime earnings. Someone may be seeing if they enjoy research on their own or is interested in an academic career. A student choosing a lower-paying specialty out of personal preference is taking a bigger net-worth hit than someone taking an extra year.

None of this is applicable to OPs situation. If OP is truly a competitive applicant currently then they should double down and work twice as hard rather than twice as long. That’s my opinion but I’m always one of the hardest workers in the room.

 

[Tenk]

I feel like you would oppose me ranking 4-year EM programs high for the same reason.... but that’s for another time, another thread 🙂

Anywho, there are many applicants who wish to match into competitive specialties who only decide to do so during 3rd year. If they have little research or work in the field, most PDs encourage them to take a gap year.

I actually ranked a 4 year program #1 because it was my home city. I am very thankful I did not match there but that’s quite different from this. At least in a 4 year residency you have a residency salary and can moonlight. You’re not losing anywhere near as much money as this situation which is an obscene amount every year.

 

[Dr G Oogle]

Kinda -- i was originally not sure about research, but got interested in it after working with a basic science lab during my third year. Thinking about pursuing that for a bit before I move on to life in residency.

Unless you really can’t wait to scratch that research itch I strongly encourage you to try to establish yourself as a researcher in residency/felowship or after. I became very productive in research as a fellow and continued to do so in as faculty. I really wanted to do research in residency but managed to eek out just one paper. You can still get involved as a student, get on some projects get more experience it will only make you more competitive but to get a decent basic science paper in 1-2 years is pretty difficult and I’m not sure the effort is worth the cost unless you have some inside scoop. An MPH in school could probably only help you.

 

[GoSpursGo]

No it’s not. It’s called working harder than others. There are people in every competitive specialty who have great scores, great research and go directly from med school to residency. Why? They worked harder than everyone else. Stop making excuses.

Sure, the neurosurgery program at one of the top schools in the country recommends a gap year just for fun 🙄

I actually agree with your idea that if you're relatively competitive, you can just apply, see what happens, and if you don't match then you delay graduation and consider that your "gap year." I've said that several times in other threads, you can look them up if you feel like it. The problem here is that we don't have a ton of context--if to the OP "competitive" means that they have a step 1 score near the median for their intended specialty and good grades, but no research chops for a specialty where the median number of pubs is 10+... then when we're in February of 3rd year it doesn't matter how hard your work, you're not churning out 10 pubs in the next 7 months, and there's a real cost associated with applying through ERAS twice. Or if this is someone who aspires to be some academic bigwig at a top 5-10 institution for his/her specialty, there may be value in taking the time now to get into one of those top programs for residency.

Again, I don't know the OP's specifics or career goals. But there are absolutely some students where taking a research year makes sense.

 

[njtrimed]

The one thing you're not factoring in, and I didn't see mentioned - is that Step 1 is becoming P/F. There is unconfirmed talk it will be made P/F retroactively for those not already matched as well. If you wait, that nice score you achieved MIGHT be reduced to a 'pass'. You'll be different from nearly everyone else applying for that same residency, make sure it's a "good" different. If it's something you have to explain or justify it may not be perceived as such and set you at a disadvantage.

Not sure why the OP is still ignoring this. If you really crushed Step 1 and it’s becoming P/F, why would you waste the chance to show this to competitive specialities? You can take years off during residency and also pursue an MPH) as everyone has mentioned. This is your best chance to match whatever specialty you want. There will be time to do the rest.

 

[Tenk]

Sure, the neurosurgery program at one of the top schools in the country recommends a gap year just for fun 🙄

I actually agree with your idea that if you're relatively competitive, you can just apply, see what happens, and if you don't match then you delay graduation and consider that your "gap year." I've said that several times in other threads, you can look them up if you feel like it. The problem here is that we don't have a ton of context--if to the OP "competitive" means that they have a step 1 score near the median for their intended specialty and good grades, but no research chops for a specialty where the median number of pubs is 10+... then when we're in February of 3rd year it doesn't matter how hard your work, you're not churning out 10 pubs in the next 7 months, and there's a real cost associated with applying through ERAS twice. Or if this is someone who aspires to be some academic bigwig at a top 5-10 institution for his/her specialty, there may be value in taking the time now to get into one of those top programs for residency.

Again, I don't know the OP's specifics or career goals. But there are absolutely some students where taking a research year makes sense.

Neurosurgeons are weird af. They are by far the most ivory tower of specialties and I actually won’t argue against gap years for that specialty because it is so ultra competitive with so few spots and so high monetary reward that I agree, you’ll need to do everything possible to match there. Actually one girl in my class matched neurosurgery and she ended up needing a gap year after match despite doing nonstop neurosurgery fun for years. All my other ortho/plastics brosefs matched straight from MS4. OP said they are interested in plastics or ortho though so I still vote for powering through.

 

[Phloston]

Rather than pandering to what various PDs think, maybe just do what you want in life and then apply back in however many years, don't match if that's the case, then take your degree and teach high school instead.

Okay, I'm half-joking. There's a lot of good/varied advice here. The fact that you're asking this Q means you already have a sense that residency chances vs time off bears a negative-slope trajectory.

My advice is to take in the input of others but ultimately make choices you think will make you most happy. Most input you'll get is of the inhibitory / hyper-cautionary mindset.

 

[mistafab]

I would recommend printing out your CV, and meeting with the plastics or ortho advisers at your school to discuss your plans.

Then, come back and report what they said.

 

[Dave1980]

Taking time off to do basic research without being in a PhD program would be a disaster

 

[odyssey2]

Taking time off to do basic research without being in a PhD program would be a disaster

Plenty of med students do this. Most of the med students in the HHMI program at the NIH do basic science research.

 

[IMGASMD]

Plenty of med students do this. Most of the med students in the HHMI program at the NIH do basic science research.

Because there are a lot of Ortho and plastic doing basic science research?

 

[nimbus]

You’ll also lose about $500,000+ of salary which at time of retirement will be several million dollars. Also, taking a gap year when you fail to match is essentially the same thing only you might just match and skip the whole lost year altogether.

I’m not sure how much of that salary young attendings actually save. Most people who make $500k don’t save $500k. Taxes will knock it down to $350k. If you go to Europe and buy a fancy car, it’s like you haven’t even made that money. It’s what you save, not what you earn. If you make $500k and save only $57k, you’ve only saved $57k.

 

[Tenk]

I’m not sure how much of that salary young attendings actually save. Most people who make $500k don’t save $500k. Taxes will knock it down to $350k. If you go to Europe and buy a fancy car, it’s like you haven’t even made that money. It’s what you save, not what you earn. If you make $500k and save only $57k, you’ve only saved $57k.

Correct but it jump starts you an extra year. So all those things you would purchase a year later are now bought now and it will push you forward faster. If you aren’t an idiot eventually you will look at investing a large portion of that money within a few years. That’s still 25-30 years of compound interest. Still multiple million in retirement.