When a medical student approaches the end of third year and is assessing their chances of matching, multiple factors come into play: what specialty, where in the country, grades, honors, Step 1and 2 scores, letters of recommendation, away rotations, and research. The last one—research—has become more and more important to demonstrate to program directors. On average, matched US medical students produced greater than 5 abstracts, presentations, or publications in the 2018 residency cycle1. Depending on the medical school, this may be difficult or impossible to achieve. Recently, students have begun participating in research years to bolster this aspect of their application. When assessing whether or not a research year would be beneficial, there are a number of things to consider.
What Is A Research Year?
A research year is defined as a one-year period outside of the normal medical school curriculum, where a student works with a specific researcher, physician, or department to further their research by producing abstracts, publications, or presentations. The specific position can vary from being in a laboratory, sitting at a desk, or being in the operating room.
Why Take A Research Year?
For most students, research years are done to increase their chances of matching into a certain specialty or match at a specific program. Common reasons include:
- Interest in a competitive specialty, but no research experience
- A borderline application for a given specialty (low step 1, low grades, etc.)
- Interest in a specialty without a department or residency at their institution
- Applied to residency and did not match
When To Take a Research Year?
If planning to take a research year, this is traditionally done between the third and fourth years of medical school. At this point, students have the requisite knowledge and experience to participate in clinical research and also understand the hospital environment. This planned year demonstrates interest and dedication to future program directors and also allows ample time to begin projects and get them published before residency applications are due.
Unmatched students may take a research year after their 4th year before reapplying, rather than a preliminary intern year. However, the chances of matching drop precipitously after failing the first time. In orthopaedics, the chances of matching a second time drops 75%. Many research programs do not want unmatched students and program directors can see through why the year was taken. Additionally, taking a research year after 4th year only gives 3-4 months before the next application cycle, which is usually not enough time to get studies started, let alone published.
Where To Take It?
Where a student chooses to take a research year is a combination of choice as well as luck. Generally, they are done at an academic institution with an affiliated residency program. If one is available through a student’s home institution, this may be the easiest option. If there is interest in a specific residency program, it may make sense to go there. In other cases, a student may want to work with a specific researcher and that is a valid choice as well. Keep in mind that these programs usually have an application process, so flexibility is required on the student’s part as to where they end up.
How To Find One And When?
Scouring job websites or hospital postings will usually not yield these positions. Well-known institutions may have established programs with advertised spots. Specialty-specific websites2 may have these postings as well. In many cases though, research positions are not actively advertised and require the student to reach out. This can be done by asking faculty about possible research years, or cold calling programs to ask. When cold calling, contact information for a research coordinator or physician may be available through the department’s website. If nothing can be found, it may be possible to find a physician’s correspondence email listed in a publication. To do this, search for “author last name, first initial [author]” in Pubmed3. This will also give an idea of how many publications a particular physician produces. Physicians are busy, so it may take multiple emails to get a response. If there is no response after a week, it is acceptable to email them again to follow-up.
When looking for a position, it can take as little as a few weeks or as long as a few months. If planning on taking the year between years 3 and 4, starting early during third year will give ample time to find one. There is usually a flurry of positions posted in March around Match Day, but this can be risky to wait for, as it is only 1 or 2 months away from when the position starts. Additionally, the student may not get one of these positions and have to quickly adjust course and apply for away rotations, take Step 2 CS/CK, and find out how to strengthen their application otherwise. In most cases, a position can be found from October thru March the year before.
Important Details To Consider
Not all research years are created equal and it is important to vet them before taking a position. Here are some key things to consider:
Who will I work with?
Students should be working with attendings in their desired specialty. It is even better if they work with the department chair, program director, or a well-known physician within the field. Working with the residents is good as well because they usually have some say in who they want as a future co-resident.
Does this position entail basic science or clinical research?
Basic science is an important part of medical research, but it takes longer to complete than clinical research. Generally, this type of work is reserved for MD/PhD students or foreign medical graduates who will spend multiple years at an institution. As a US medical student with one year to complete projects, it is imperative that the work mainly focus on clinical research as this will allow multiple projects to be completed.
If clinical research, what type and how many projects?
If the position is focused on clinical research, figure out if it mainly involves retrospective studies, database studies, prospective studies, or randomized clinical trials (RCTs). Most likely, it will be a mix. Retrospective and database studies are the quickest to turn around. Prospective studies may be able to be finished within the year. If mainly managing RCTs, these will most likely not be done in a year and are not well-suited for a student. This may be rationalized by arguing that one published RCT is more impactful than a handful of retrospective studies. However, the metric used when assessing a research year is the number of publications. If a single thing goes wrong, that single RCT publication turns into nothing. Therefore, it is best for a student to be involved in a position where dozens of projects are being managed, increasing the chances for success, i.e., publications.
Will I get publications?
Ask about the productivity of prior research year students and their success in matching to their desired field. In the end, the position needs to provide ample opportunity to be productive and improve the student’s CV.
Paid or unpaid?
Surprisingly, a lot of positions are unpaid, and many provide a paltry stipend that does not cover living expenses. However, paid positions do exist. Financial considerations will be dependent on the particular applicant.
Letters of recommendation
A major goal of a research year is to show the attendings that they want to vouch the student and get them into residency. However, some programs may not be willing to do this. It is reasonable to ask if they have written letters of recommendation for prior research students.
Do I want to be here for residency?
Many people match at the place where they did their research year so it is imperative do it somewhere where the student could see themselves for residency.
Will this year help overcome deficiencies in my application?
Although sobering, a research year will not make up for all deficiencies in an application. If a student wants to match dermatology but has a 199 on Step 1, the research year will most likely not overcome that hurdle. This is best understood with careful introspection, guidance from medical school counselors, and reaching out to individuals with ties to a residency program in the desired field.
What to do besides research?
It is also important to see a research year as much more than sitting behind a desk. Although working at a computer is a necessary part of the job, students should try to be around the attendings and residents. Identify opportunities to attend department lectures or rounds. If in a surgical specialty, find time to get into the operating room. A student can spend time preparing for future away rotations so they are ready to shine once they leave. See this as a year to be immersed in a specialty and prepare for a future career, rather than simply being a data cruncher.
1. NRMP Charting outcomes in the match for U.S. allopathic seniors: characteristics of U.S. allopathic seniors who matched to their preferred specialty in the 2018 main residency match. 2018. Accessed 2018 December. Available from: Main Residency Match Data and Reports – The Match, National Resident Matching Program