I have a couple of questions I hope you guys can help answer. The primary one is lets say you want to go into the R.O.A.D. specialties for whatever reason. After spending 3 years of medical school working your tail off (I heard 4th year is not that bad) what do you do if you can't get into the specialty you want? What options exist. Lets say you want to do derm, and after acing your pre-clinical grades you fail to score that 240 you need for derm on Step1. If you end up with a 226, what then? Do you just give up on derm, and enter something else? How do medical students deal with the blow not matching into their specialty? My other question is that I know a ton of medical students do research between MS1 and MS2. Most end up doing research in the field that they eventually want to go into. If an MS1 and MS2 student does research in Derm, cranks out a publication or two in that field, but fails to match into Derm, what then? Is that research experience considered a waste? Do publications in undergrad count? Lets say a student will be a 3rd/4th author in a REALLY high impact medical journal (New England Journal of Medicine, JAMP, Nature, etc) and that article will be cited roughly a couple hundred times (roughly 500) . If this research work is not related to the field of medicine the student wants to go to, is it still helpful on residency apps? I heard the saying that "Publications, especially in HIGH IMPACT Journals (Impact factor greater than 7) will stay with you for life". My final question is why is Anesthesiology included in the notorious ROAD specialties. I have been looking at step 1 scores for Anesthesiology and they seem to be much lower than Orto,Derm, Radio. Is it because nothing else is even remotely competitive for US MD grads?