Why do pubs make an applicant more competitive?

[DrHitchcraft]

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Why do publications make an applicant more competitive to highly regarded residency programs? Do PDs that rank research high on their list of criteria for admission into their prestigious program expect that you stay within academia?

The other reasons I am thinking of are: showing off prestige of their residents and translatable positive traits from being a good researcher (e.g. understanding medical literature).

...Just trying to get a grasp on the logic of the PDs that run these 'prestigious' programs.

 

[sobored]

Research brings in money to a university, which increases its ranking, which causes alumni to donate more, which allows it to produce more research, which helps bring in more grant money, etc.

Academic medical centers are where the boundaries of medicine are pushed to the brink in order to develop and deliver new medical treatments. Naturally, they want to attract residents who are 1) interested in research, 2) have a higher likelihood of participating meaningfully in the research going on in the program, 3) students who are more inclined to stay in academic medicine. Pretty simple really.

 

[SouthernSurgeon]

Why do publications make an applicant more competitive to highly regarded residency programs? Do PDs that rank research high on their list of criteria for admission into their prestigious program expect that you stay within academia?

The other reasons I am thinking of are: showing off prestige of their residents and translatable positive traits from being a good researcher (e.g. understanding medical literature).

...Just trying to get a grasp on the logic of the PDs that run these 'prestigious' programs.

a) the mission at prestigious programs is to train "academic" physicians. So by that measure, the best marker of future success is past success.

b) they gotta rank you somehow. More swag equals more better.

 

[DrHitchcraft]

Research brings in money to a university, which increases its ranking, which causes alumni to donate more, which allows it to produce more research, which helps bring in more grant money, etc.

Academic medical centers are where the boundaries of medicine are pushed to the brink in order to develop and deliver new medical treatments. Naturally, they want to attract residents who are 1) interested in research, 2) have a higher likelihood of participating meaningfully in the research going on in the program, 3) students who are more inclined to stay in academic medicine. Pretty simple really.

Thank you. This makes sense.

 

[DrHitchcraft]

Um, what about applicants that want to receive their education at these highly regarded residency programs but does not want to enter academia (i.e. pursues clinician path 100% after residency)...do they basically just fake interest in an academic career throughout the interview and their time in the program? Or do they come clean about their intention to NOT enter academia? (But doesn't this make their research obsolete?)

 

[VisionaryTics]

Um, what about applicants that want to receive their education at these highly regarded residency programs but does not want to enter academia (i.e. pursues clinician path 100% after residency)...do they basically just fake interest in an academic career throughout the interview and their time in the program? Or do they come clean about their intention to NOT enter academia? (But doesn't this make their research obsolete?)

In those cases, it will not be a good fit for the applicant or for the residency program. You don't need to train at a "top 5" program to be an excellent clinician.

 

[SouthernSurgeon]

In those cases, it will not be a good fit for the applicant or for the residency program. You don't need to train at a "top 5" program to be an excellent clinician.

Agreed.

I am at an academic general surgery program (i.e. most of our residents do 2 years of research).

It is astonishingly easy to spot applicants who don't have a background in or drive for research/academia. Those applicants are better suited going elsewhere. Taking 2 years off in residency comes with a huge opportunity cost, and if you aren't going to make something out of those 2 years, you really should go somewhere else - for your own sake as much as ours.

There are plenty of programs that will give you great clinical training if that is what you desire. I have no illusions that my program has some magical clinical experience (although it is very good) - what makes it "great" is the diversity of research opportunities.

 

[Silent Cool]

Because admissions committees care about the dumbest S H I T. It strokes their academic ego to see students filling out line after line of useless "ECs" fighting for a spot to their institution.

I remember when I was in college doing research, my research PI said, "It used to be that in high school you had to do a bunch of crap to get into college. Now, that's been carried over to college and you have to do a bunch of crap to get into grad school."

That just about sums it up.

 

[Frazier]

Because admissions committees care about the dumbest S H I T. It strokes their academic ego to see students filling out line after line of useless "ECs" fighting for a spot to their institution.

I remember when I was in college doing research, my research PI said, "It used to be that in high school you had to do a bunch of crap to get into college. Now, that's been carried over to college and you have to do a bunch of crap to get into grad school."

That just about sums it up.

We aren't talking about med school admissions...

Residency PD's [comparatively] don't give a damn about your EC's.

 

[Silent Cool]

We aren't talking about med school admissions...

Residency PD's [comparatively] don't give a damn about your EC's.

My logic still applies.

 

[Frazier]

My logic still applies.

What's your logic?

That admissions committees enjoy seeing pre-meds "filling out line after line of useless ECs fighting for a spot to their institution"?

The majority of prestigious residencies are academic-focused. Their mission is to make successful physician investigators.

They care about publications because it is a metric that allows to observe outcomes...

You are a med student that graduated with 10 publications. Awesome. You can get it done. In the research department, you would make a good addition to our program.

You are a med student that graduated with 0 publications but 3 research "experiences". Hmm. Can you get the job done? Who knows. Should we risk our residency spot on you? No, unless something else balances it out.

What should they measure by? How bad you want to be able to wear a Harvard t-shirt?

 

[surgok]

My logic still applies.

At residency level, pubs aren't "useless EC's". It's an objective measure of your research ability.

 

[Law2Doc]

What's your logic?

That admissions committees enjoy seeing pre-meds "filling out line after line of useless ECs fighting for a spot to their institution"?

The majority of prestigious residencies are academic-focused. Their mission is to make successful physician investigators.

They care about publications because it is a metric that allows to observe outcomes...

You are a med student that graduated with 10 publications. Awesome. You can get it done. In the research department, you would make a good addition to our program.

You are a med student that graduated with 0 publications but 3 research "experiences". Hmm. Can you get the job done? Who knows. Should we risk our residency spot on you? No, unless something else balances it out.

What should they measure by? How bad you want to be able to wear a Harvard t-shirt?

Agree with you but would suggest that having a research position that doesn't lead to a paper isn't necessarily a negative. The better research projects can take years, and it's not unheard of to start on a Project that may get published after you are in residency. It's also the nature of research that not all studies will net publishable results. So having a research position and getting a good letter from a PD isn't always the worst thing. If the research is important it's still going to look better to an academic PD than some case review in a No name journal.

 

[KnuxNole]

Is it really that common for people to want to be physician investigators? I thought it was the minority?

That was one of the big reason I didn't like programs that emphasized or pushed research. I despise the thought of having to do research and don't want any part of it. 🙁

 

[Frazier]

Agree with you but would suggest that having a research position that doesn't lead to a paper isn't necessarily a negative. The better research projects can take years, and it's not unheard of to start on a Project that may get published after you are in residency. It's also the nature of research that not all studies will net publishable results. So having a research position and getting a good letter from a PD isn't always the worst thing. If the research is important it's still going to look better to an academic PD than some case review in a No name journal.

Yeah, some projects do take a really long time to be completed. Definitely agree.

 

[NickNaylor]

Is it really that common for people to want to be physician investigators? I thought it was the minority?

That was one of the big reason I didn't like programs that emphasized or pushed research. I despise the thought of having to do research and don't want any part of it. 🙁

I have no interest in doing research in my career, yet the field that I'm most interested de facto requires it. I actually enjoy the research process but there are other things I'd rather do once I reach that point of my life. I think many, many people are in situations like that, though there definitely seems to be a huge portion that do love the work and want to make it a career focus.

 

[alpinism]

Is it really that common for people to want to be physician investigators? I thought it was the minority?

That was one of the big reason I didn't like programs that emphasized or pushed research. I despise the thought of having to do research and don't want any part of it. 🙁

At very research oriented programs, yes.

However, at the average non-research oriented program its often only a small minority of students and residents.

 

[KnuxNole]

True, some fields almost make it an unwritten requirement. However, it must be tough to fake liking research if you would not want to spend 2 secs doing that crap :/

I know that with med school, research was nothing I ever wanted to spend time with whatsoever, and the thought of that would make me cringe. I was worried since I did no research in undergrad it would be bad, but like alpinism said, for the ones who love research, it's a big deal. However, I never thought of non research places as bad. I mean...it makes it sound like doctors are required to do it or else they are terrible.

 

[Johns Spangler]

You are a med student that graduated with 10 publications. Awesome. You can get it done. In the research department, you would make a good addition to our program.
You are a med student that graduated with 0 publications but 3 research "experiences". Hmm. Can you get the job done? Who knows. Should we risk our residency spot on you? No, unless something else balances it out.

 

[SouthernSurgeon]

True, some fields almost make it an unwritten requirement. However, it must be tough to fake liking research if you would not want to spend 2 secs doing that crap :/

I know that with med school, research was nothing I ever wanted to spend time with whatsoever, and the thought of that would make me cringe. I was worried since I did no research in undergrad it would be bad, but like alpinism said, for the ones who love research, it's a big deal. However, I never thought of non research places as bad. I mean...it makes it sound like doctors are required to do it or else they are terrible.

Unfortunately we live in a world where the perceived prestige/value of a residency program is inextricably tied to academia. Thus the research powerhouses are widely perceived as the "best" and most sought after residency programs...even if the applicants have no illusions of doing research in their careers.

But it's what USNews tells us is best, so everyone keeps chasing the same thing, despite the fact that there are probably tons of programs that would give outstanding clinical training.

 

[DrHitchcraft]

At very research oriented programs, yes.

However, at the average non-research oriented program its often only a small minority of students and residents.

I thought that this was the case in all residency programs (research and non-research orientated). There are certainly many people who have pursued pubs in medical school but have no intention to pursue research/academic path after residency - more or less to fulfill an unwritten requirement for their particular specialty-of-interest and/or program(s)-of-interest.

How would this conflict of interest between the PD and these type of applicants would play out? Surely, all of them do not get screened out during an interview...right?

It would also be interesting to see a study that really shows how many residents are retained in academia after completion of these highly-regarded (research-oriented) residency programs.

 

[DrHitchcraft]

Unfortunately we live in a world where the perceived prestige/value of a residency program is inextricably tied to academia. Thus the research powerhouses are widely perceived as the "best" and most sought after residency programs...even if the applicants have no illusions of doing research in their careers.

But it's what USNews tells us is best, so everyone keeps chasing the same thing, despite the fact that there are probably tons of programs that would give outstanding clinical training.

Thanks for pointing this out. Too bad these programs don't get a lot of recognition on internet forums or in the public eye.

 

[BurghStudent]

So, are we saying that all these ECs in med school, like small leadership roles have little bearing on residency apps?

 

[BurghStudent]

Unfortunately we live in a world where the perceived prestige/value of a residency program is inextricably tied to academia. Thus the research powerhouses are widely perceived as the "best" and most sought after residency programs...even if the applicants have no illusions of doing research in their careers.

But it's what USNews tells us is best, so everyone keeps chasing the same thing, despite the fact that there are probably tons of programs that would give outstanding clinical training.

Instead of Primary Care rankings, USNews or whoever should publish clinical education rankings. I'm certain those would not parallel the research rankings. It's amazing how much an artificial, third-party ranking system affects our decision making in terms of med school and residency apps.

 

[mcloaf]

So, are we saying that all these ECs in med school, like small leadership roles have little bearing on residency apps?

That seems to be the consensus around here.

Instead of Primary Care rankings, USNews or whoever should publish clinical education rankings. I'm certain those would not parallel the research rankings. It's amazing how much an artificial, third-party ranking system affects our decision making in terms of med school and residency apps.

Would you really trust US News to evaluate the quality of clinical training?

 

[SouthernSurgeon]

So, are we saying that all these ECs in med school, like small leadership roles have little bearing on residency apps?

Very small.

I just finished interviewing and evaluating about 10 candidates this week. My eyes glazed over trying to read through the ECs. I doubt most faculty even read them.

Would you really trust US News to evaluate the quality of clinical training?

Agreed. More rankings is not the solution.

 

[surgok]

Agree with you but would suggest that having a research position that doesn't lead to a paper isn't necessarily a negative. The better research projects can take years, and it's not unheard of to start on a Project that may get published after you are in residency. It's also the nature of research that not all studies will net publishable results. So having a research position and getting a good letter from a PD isn't always the worst thing. If the research is important it's still going to look better to an academic PD than some case review in a No name journal.

I agree with the last part that doing a meaningful bench research work would look better than an overnight case review. But if the research took years to produce meaningful results, perhaps that wasn't the best choice to begin with. Considering we only have 4 years, it would be smarter to pursue multiple projects that can be completed in short term than a large-scale project that may or may not be published in Nature or Science. My PI who also selects and interviews residents at a very research-oriented program, tells me number of pubs matters more than its quality unfortunately...unless of course the said manuscript is published in Science, Nature, or NEJM.

 

[surgok]

So, are we saying that all these ECs in med school, like small leadership roles have little bearing on residency apps?

From what I hear, PDs could care less about leadership roles or volunteer experience. I'm sure this isn't set in stone though.

 

[Dmr6186]

From what I hear, PDs could care less about leadership roles or volunteer experience. I'm sure this isn't set in stone though.

I think it all depends on the PD.

I went to an event this month where med students could ask PDs what they look for in an application. The PDs were from many of the major inner-city Philadelphia hospitals, like Jefferson for example. They all unanimously said board scores, clinical grades (especially in the field you want), and SLORs matter the most. However, some say research doesn't matter per se (one did say he believes it's a red flag to have something blank on your app, but another more seasoned PD who is very heavy into research actually disagreed with him), but they would really like to see you have a passion for something and show some development/growth with it over time, and research could be one of those things.

To me, it felt like "applying to med school anxiety" all over again when I was there.

 

[alpinism]

I thought that this was the case in all residency programs (research and non-research orientated). There are certainly many people who have pursued pubs in medical school but have no intention to pursue research/academic path after residency - more or less to fulfill an unwritten requirement for their particular specialty-of-interest and/or program(s)-of-interest.

How would this conflict of interest between the PD and these type of applicants would play out? Surely, all of them do not get screened out during an interview...right?

It would also be interesting to see a study that really shows how many residents are retained in academia after completion of these highly-regarded (research-oriented) residency programs.

Many of the most prestigious residency programs (esp in non-primary care fields) expect their residents to perform research (scholarly projects) and in some cases even have it as a requirement for graduation. These types of programs are interested in turning out not only good clinicians, but also future leaders in their respective fields. One important aspect of leadership includes advancing the field through research.

One of the main benefits of going to a highly regarded (research oriented) residency program is the ability to perform cutting edge research (lots of available opportunities and funding) while also making connections for a future job in academia.

 

[KnuxNole]

I guess that's the difference with me, I would HAte that environment. Being forced to do research would be highly depressing, especially when there is zero interest in it by a longshot.

I feel like the minority who wants nothing to do with research, advancing the field, being a leader in the field or academic discussions. I don't enjoy the research process or being an academic person 🙁

 

[Law2Doc]

I agree with the last part that doing a meaningful bench research work would look better than an overnight case review. But if the research took years to produce meaningful results, perhaps that wasn't the best choice to begin with. Considering we only have 4 years, it would be smarter to pursue multiple projects that can be completed in short term than a large-scale project that may or may not be published in Nature or Science. My PI who also selects and interviews residents at a very research-oriented program, tells me number of pubs matters more than its quality unfortunately...unless of course the said manuscript is published in Science, Nature, or NEJM.

Your research career doesn't end with getting into residency. It can be valuable for your CV even if it gets published well after you are in residency. So no, it wasn't really a poor choice to begin with, it just means you have broader horizons then the "just want to get into residency" approach. If you are going into academics this is really not a bad thing. You will be applying for fellowships and academic jobs subsequent to residency and those put even more weight on the quality of your research.

 

[surgok]

Your research career doesn't end with getting into residency. It can be valuable for your CV even if it gets published well after you are in residency. So no, it wasn't really a poor choice to begin with, it just means you have broader horizons then the "just want to get into residency" approach. If you are going into academics this is really not a bad thing. You will be applying for fellowships and academic jobs subsequent to residency and those put even more weight on the quality of your research.

I'm not saying it was a poor choice, just not the best. I see what you're saying, and I don't disagree with your rationale. But from a practical point of view, it's wiser to optimize your research experience under given circumstance (i.e. medical school). For instance, if you spent 3 years working on a project that has yet to be published while you're in med school, even if it will eventually get published in residency and it laid out a solid research foundation, it still won't look as good as someone who put in equal amount of work and produced several publications in specialty journals with IF around 3-5 WHILE in med school.

All I'm saying is that if one has a choice between a long-term project and multiple short-term projects, as a medical student, it is probably wiser to go after the one that yields the most number of publications. Higher quality research can be done in residency, when you are more capable and when there's more support.

 

[BurghStudent]

Well, I'm glad to hear there are less hoops to jump through, or at least, the hoops are more meaningful.

I agree with the last part that doing a meaningful bench research work would look better than an overnight case review. But if the research took years to produce meaningful results, perhaps that wasn't the best choice to begin with. Considering we only have 4 years, it would be smarter to pursue multiple projects that can be completed in short term than a large-scale project that may or may not be published in Nature or Science. My PI who also selects and interviews residents at a very research-oriented program, tells me number of pubs matters more than its quality unfortunately...unless of course the said manuscript is published in Science, Nature, or NEJM.

That is unfortunate. I just spoke with a PD in a competitive field. He said that what he looks for is if you excelled at whatever you tried your hand at, i.e. if you were a research hound but published 10 papers that were all 3rd or 4th author in low quality journals, that's not as good as publishing 3 more or less first author papers in specialty journals. Meh.

 

[gregoryhouse]

I like the idea of research but I really only like very specific research that I find interesting which is often hard to find a PI with similar interests, especially cuz im at a relatively small school.

However, I cannot stand bench work. I did it in undergrad and refuse to ever go near a lab bench again. Since I plan on going into a competitive specialty, I plan on doing research but mainly clinical, short projects. I'm working on a clinical anatomy related project right now, and Im expecting to get it done within a few months.

There is definitely merit in long projects, but I like quick results. So short projects are much more enjoyable to me.

In relation to this topic, what do you guys think of "Summer research internships." Are they worth it, or is it better to stay at your home institution? Any particular good ones?

 

[Nesir]

Why do publications make an applicant more competitive to highly regarded residency programs? Do PDs that rank research high on their list of criteria for admission into their prestigious program expect that you stay within academia?

The other reasons I am thinking of are: showing off prestige of their residents and translatable positive traits from being a good researcher (e.g. understanding medical literature).

...Just trying to get a grasp on the logic of the PDs that run these 'prestigious' programs.

Besides what other people have said, I can tell you as someone who has a ton of research and is currently on the interview trail talking about research.

Most of the time, it can be used as a metric to see that you a) started a project (with guidance of course) that b) you were able to derive a hypothesis and prove a hypothesis in one direction or another and c) took the time to reflect upon your work and create a meaningful document (have you tried writing an intro and/or discussion section of a paper? its crazy hard and takes a lot of time to do). Sure all the stuff about ranking is true, but at an individual level to have gone to the extent to do a proper lit search, generate a hypothesis, and experiment the hypothesis shows an extreme amount of dedication and ability to work hard (surprisingly just like their other metrics measure as well, Step 1, clinical grades, etc)

 

[Nasrudin]

There are pointless excesses to the publish or perish model in the context of residency training. For example is everyone applying to derm interested in becoming an academic physician or do they all have it on their CV just because they all have it on their CV and so on. It can be an arms race in some sense. Also, it's based on a model of indentured servitude. From the time we're undergrads these opportunities are constructed around a willingness and an ability and an inclination to work for free. If you're a minority student you can just apply and be coddled along in such environments as well. So it's not exactly an enterprise free of racial, institutional, or socioeconomic predilection.

There are also ridiculous expectations in the cultures of certain fields for this type of servitude. I've heard of ortho residents being expected to do publishable work in the context of "80" hour work weeks. You can have that. I'll be moonlighting with that time in a much more hospitable field that is luckily less conducive to this hysteria for largely recruitment reasons.

That said I understand why it's a metric for academic programs. Anyone who gets published has done an incredible amount of independent work and should be rewarded for this. It's a fact that our clinical guidelines are developed from the hard work of tens of thousands of such individuals. And they have my respect and gratitude, if not willingness to follow.

 

[NickNaylor]

There are also ridiculous expectations in the cultures of certain fields for this type of servitude. I've heard of ortho residents being expected to do publishable work in the context of "80" hour work weeks. You can have that. I'll be moonlighting with that time in a much more hospitable field that is luckily less conducive to this hysteria for largely recruitment reasons.

Completely agree - any whiff of that sets my alarm bells ringing.'

And great post overall.

 

[Etorphine]

For some reason everyone seems to ignore this point that was only made by you and NickNaylor. Derm, Plastics, Ortho, ENT, Ophtho all essentially require you to have a pub or two under your belt to even get a look in the field even though the majority of those residents are going to be clinicians first and foremost. It's not just the "academic programs" that want publications, but in this case it's more to weed people out than to ID who wants to do research.

Anybody ever see the paper about the amount of "pubs" that weren't able to be verified in ENT applicants? Probably holds true for most of the other competitive fields too.
http://www.ncbi.nlm.nih.gov/pubmed/22422816

Edit: Apparently it's a problem in plastics too.
http://www.ncbi.nlm.nih.gov/pubmed/22421486

Unbelievable! I think institutions should place a greater emphasis on fact-checking these types of things. It is almost analogous to cheating, and is a practice that should be categorically rejected.

 

[Starry]

Unbelievable! I think institutions should place a greater emphasis on fact-checking these types of things. It is almost analogous to cheating, and is a practice that should be categorically rejected.

The crazy thing is how many people think they can get away with it... and how many people do. I completely agree with you.

 

[fullfavor]

Those applicants are better suited going elsewhere. Taking 2 years off in residency comes with a huge opportunity cost, and if you aren't going to make something out of those 2 years, you really should go somewhere else - for your own sake as much as ours.

 

[sonofva]

Pubs don't automatically make you more competitive. You have to know how many beers to drink to hit that sweet spot where your test taking ability actually improves.

 

[Staradmiral]

Unbelievable! I think institutions should place a greater emphasis on fact-checking these types of things. It is almost analogous to cheating, and is a practice that should be categorically rejected.

No surpise there, cheating occurs at every stage of the process, pre-med, med-,residency, jobs. Even if the publication is real, there are plenty of med students who "know someone" and get their names slapped on papers without stepping foot in the office.