Aiming for a competitive specialty? Here is how to approach research in medical school
This post is part of How to med school for competitive specialties, click the hyperlink to see my other posts in the series
If you are applying to a competitive specialty, research will be an important aspect of your residency application. When I started medical school, the prospect of diving into research was daunting and I didn’t exactly know where to start. In this blog, I will share my learnings throughout medical school as a surgical subspecialty applicant.
First, make sure you can manage your course load
Research productivity is just one component of a successful residency application. Take the below figures taken from the 2021 Program Director Survey for Otolaryngology applicants.
Beyond the importance of research in both deciding which applicants to interview and rank, you need to make sure that you have the grades to be considered for an interview. Step 1 was the board exam that held the most weight before the transition to pass/fail grading in 2020. Now Step 2 carries the most weight. To successfully match into a competitive specialty, you are going to need to score above average (sometimes high above average). Scoring well on USMLE board exams requires that you create effective study habits during your preclinical years of medical school. Thus, it is my recommendation that you focus your time and efforts on your courses for the first 2–3 months of classes. Aim to start reaching out to attendings to get on research projects in October or November (more on that later).
Look at previous match data
Look at the Charting Outcomes reports (2016, 2018, 2020, 2022) from previous years for the mean number of abstracts, presentations, and publications for matched applicants in your preferred specialty. Keep these numbers in the back of your mind throughout medical school as a metric you will ideally reach. ERAS limited the total number of experiences you can list in your application from unlimited to 10 in 2023, so the mean number of research experiences is no longer relevant.
How to find a research project
Talk to senior medical students interested in the same specialty
Medical school and training is an interesting beast given the sheer volume of information you are required to learn each year. In addition to medical and clinical knowledge, there is a huge gradient between what medical students in different years know. Leverage this. Senior medical students are often easier to approach than attendings and residents since they are closer in time to being in the same boat that you are. Join the student interest group for the specialty you are interested in and reach out to the people in leadership positions. They will be able to give you insights about information specific to your school that will help you get your foot in the door in the specialty’s department. Ask them which attendings are good for medical students to work with for research. In addition to research, these students will be a great resource for you as you progress on your journey. To give two personal examples, one of the members in the ENT interest group at my school had a guide on how to match ENT that was specific to my home department. Another member acted as a resource for me to navigate Epic and the hospital when I started shadowing an Otolaryngologist. Make friends with your future colleagues!
Identify attendings you are interested in doing research with
The department at your home institution will have a webpage with a profile of all of the attendings. Based on what your senior classmates told you, or if you have a specific subspecialty of your specialty that you are interested in, find the attending’s email and the email of their secretary, if applicable. Rather than asking them if they have any research projects available in an email, I found it better to ask attendings if you can shadow them for three reasons. One, it allows you to determine whether or not you are actually interested in the specialty. Two, it allows you to determine if you get along with the person. Three, it allows the attending to put a face to the name of the person they will be doing research with. One of the best pieces of advice I received in medical school was from the faculty advisor assigned to me by my school. In one of my meetings with him, I was talking about trying to find more people to do research projects with when he told me, “You are correct in knowing that research projects are important and that residency programs place weight on research productivity. However, you also need to consider the impact that research mentors will have on your application success.” You want to get to know the people you are doing research with since they are someone that you might one day ask for a letter of recommendation (LOR). Instead of trying to cast your net wide and shallow, aim to go narrow and deep to develop a relationship with the people you are working with. The proof is in the pudding. Scroll back up to the figures from the program directors' survey and you will find that LORs and prior personal knowledge of an applicant have a higher mean importance than research (at least for ENT). That being said, make sure you find someone to do research with that is productive.
If the attending doesn’t respond to your email, set a reminder to yourself to follow up in one week. If they still don’t respond, move on to another attending. You want to find people that are receptive to medical students and while it is important to be persistent, you don’t want to come off as annoying. If you feel like you vibe with the attending while shadowing, ask them if they are currently working on any research projects that you could help with. If they don’t currently have any, ask them if they know of any other physicians in the department who could use medical student help.
No research projects available? Make one
I found myself in a situation where I shadowed a doc and vibed but they didn’t have any research projects in the works. I had an idea for a research project (not of the caliber that would become a publication), did a lit review, created the methods, and pitched it to the attending, and they were willing to run with it. I got a poster presentation out of it, ideas for follow-up research that resulted in posters, and when the attending had a new research project come up, I was the first person on his list to reach out to since I had shown him that I was capable of carrying out a study. Put in the work and you will be rewarded!
Considerations for research project type
For better or for worse, research is a currency for successfully matching into competitive specialties. This means that you need to have something tangible to show (abstract, poster, oral presentation, journal article, etc.) to show for your efforts. When choosing to get involved with a research project, consider the timeframe it will take to get one of these tangible results. Throughout medical school, I was involved in various study types including narrative reviews, systematic reviews, clinical trials, retrospective chart reviews, international software challenges, and database studies. In general, retrospective database/chart review studies will take the least amount of time to complete while prospective studies and clinical trials will take the longest. Coincidentally, this is mostly borne out in research on the topic [Tumin 2022]. It isn’t necessarily a bad thing to get involved in a project with a longer time horizon. It will help you build a relationship with the principal investigator (who may one day write you a LOR) and other shorter-term projects may pop up in the interim that you can work on if you show you are capable of managing them. That being said, if you find your first research project has a longer time horizon it might be a good idea to try to find (or create) a shorter-term project concurrently. I will talk about this more in the next section.
Keep in mind that you will have less time to conduct research once you start your clerkship rotations and begin studying for Step 2, especially during your fourth year when you are on away rotations and application season is looming. Below is an image of the hours I spent on research by year in medical school and here is what it led to. Try to maximize your preclinical years!
You got started on a research project. Now what?
Look up conference deadlines
Having a deadline is a great way to keep you on track. A quick Google search can be helpful to find these, but you are probably better off asking a senior medical student what the major conferences for your specialty are and then looking up the dates once you know their names (For ENT, COSM is in the spring and AAO-HNSF aka Academy are the two large meetings). Aim to have something to submit to a conference during the fall of your MS2 year.
Try to be as self-sufficient as possible
This is difficult, but it is important. Physicians and researchers are busy so you want to make sure that you respect their time. Some PIs will have meetings at intervals to discuss progress on projects. If you are in this situation, write down your questions and bring them with you to the meeting. If you don’t have scheduled meetings, get as far as you can on a project while writing down questions along the way. Once you can’t possibly get any further without assistance, reach out to your PI and try to schedule a meeting to discuss the project. If you have small questions that you feel would be annoying to ask and attending (how to use Zotero, formatting a manuscript, etc. — trust me I had plenty) try Google or ask a senior medical student (MAKE FRIENDS WITH YOUR FUTURE COLLEAGUES).
Stick to your timeline
If you have a deadline or make a promise to your PI, KEEP IT. Remember that your reputation is on the line. Try to always underpromise and overdeliver.
Be proactive
Research almost always takes longer than it is projected to. There will be roadblocks and delays. Once you have a project off the ground, start looking for opportunities to get another project running. Reach back out to that doc you shadowed who didn’t have a research project at the time, create your own project, or keep an ear open as to whether your PI has another project in the works that you can jump on. You want to try to avoid having periods during medical school when you don’t have a project that you can be working on. This needs to be balanced with making you don’t bite off more than you can chew, leading to missing deadlines or seeing your grades falter.
Manuscript Writing
I stumbled across this X thread (then Twitter) during my second year of medical school and it is absolute gold. It also touches on determining a research project and choosing a research mentor.
The only other thing I will add to manuscript writing is to write your results first, followed by an introduction and discussion. Then write the conclusion, and finally, the abstract [Hoogenboom 2012].
Departing thoughts
All research is good research. I had a long winding journey to figuring out that ENT was the best fit for me. When I started medical school, I thought I was going to be a urologist, then a general surgeon, then an orthopedic surgeon, and finally an otolaryngologist. I did research within each specialty. At the time I applied for residency, I had no articles published in ENT (I did have posters and presentations though). During residency interviews, I got very good feedback about my motivation and curiosity to dive into each specialty. It was not looked at poorly that most of my research was actually in ortho rather than ENT. Remember that interviewers want to know that you are choosing your specialty after thoughtful consideration. If you did research in a field that is not what you end up applying to, that tells them that you have taken time to consider your specialty. Program directors are just trying to find applicants who show a commitment to intellectual curiosity that will help advance their field of choice in residency and beyond.
