Collaborate with Others

Doing research the summer between my first and second years of medical school, I was filled with a competitive spirit to get as much research done as possible. I wasn’t sure what field I wanted to go into at that time, but I knew that more research would be better.  There was also an unwritten sentiment that research projects were to be the efforts of one medical student. Effectively, my colleagues and I experienced an anti-collaboration culture. This was largely influenced on the way our funding was secured for the summer. Funding was only granted for one student per project. Thus, each student had to have her or his own project.  I remember a friend of my saying, “I don’t want anyone else on this paper.  Just my name and the attending’s.”  After burying my head that year into individualistic research, one of the most influential mentors I have had opened my perspective. We were eating breakfast at the Southeastern American Urological Association Meeting in Orlando, Florida.  We had just attended a poster session on a smorgasbord of topics that didn’t fit well into any other category.  He was advising me to look back through the abstracts from that session, find topics that might require a greater sample size to make the project more suitable for publication, and reach out to the presenter to gauge their interest in potential collaboration.

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No collaborations came to fruition from those efforts, but he had instilled in me the spirit of collaboration in research.  This completely revolutionized the way that I did research moving forward.  The next project I started, instead of being the only student collecting data, I realized that I could bring a fellow medical student on board and divide up the data collection.  We were then doing half the work at double the pace.  Of course, we had to spend some time discussing who would be first author and ensuring that the contributions were equitable between us.  This one experience ushered in a new mentality for me.  The tide of success raises all boats.  Since this project, I have continued collaboration with numerous medical students, residents, and attendings.  This has allowed for exponential growth of my research activity and productivity and helped yield success for all parties involved.  Seek out opportunities to collaborate with your peers and see your research output accelerate. 

Other ways to maximize research on your residency application:

Are you wanting to increase your research volume as a medical student? Consider collaborating with peers for a win-win situation.

Back to more research resources.

Get Credit for Everything that You Do

I was reviewing the curriculum vitae for one of my friends as we neared the due date for submitting our residency applications.  He was very well-accomplished in medical school: strong grades, involved in various student activities, and had some research experience.  He and I had collaborated on a couple of research project during medical school.  In reviewing his CV, I realized that he was missing multiple mentions of where this paper had been presented.  I pointed this out to him and he was able to add three lines to his CV!  That is substantial and it was for work he had already done.  This is one reason why regularly updating your CV throughout medical is so important, so that you don’t forget to include your experiences and successes in your application portfolio.

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For your ERAS application, be sure to get credit for everything that you do!  If you presented a poster at a medical student research day at your home institution, that counts just the same on your ERAS application (in terms of quantity) as giving that same poster at the biggest and best cardiology conference in the world.  Many departments at my institution had resident research days.  I had the opportunity to present my work (or others presented work my name was on) at those events.  Be sure to list those; other medical students already are.

If someone else presents your work, you still get credit if your name is on the project.  If you are unsure where a project may have been presented, reach out to the first-author on the paper or the senior author so you make sure to get credit where credit is due.  You worked hard on that research and sacrificed your time when you could have been doing anything else.  Reap the full benefits of your labor.

Other ways to maximize research on your residency application:

Are you getting credit for all of your hard work in medical school? Perform a full review of your experiences and make sure that you are listing all of them. 

Back to other helpful research resources.

Research: Quantity versus Quality

Participating in research as a medical student is a time intensive undertaking.  Despite the required effort, it can have a significant impact on elevating your CV above your peers and fellow applicants.  No matter where you are in your medical school career, if you are engaging in research activity (and you should be), it is important to consider the question of quantity of research versus quality of research.

“More is better. No one faults the applicant for the quality.”

Dr. Joseph X. Robin, Contributor, Med Student Edge

In answering this question, I like to think about the returns on investment.  Quality is always good, but it comes at a cost: time.  Being part of a prospective randomized control trial that merits publication in the New England Journal of Medicine or the Journal of the American Medical Association as a medical student would be a beyond astonishing accomplishment regardless of where one’s name falls in the authorship list.  Given the time constraints of medical school being only four years (and the fact that you only have three years before applying for residency), it is difficult to produce such a high caliber paper.  Of course there is plenty of other high quality research that gets published across all levels of journal impact factors, and the journal in which an article is published is by no means a metric of the quality of an article.  A large portion of my research has been dedicated to studying the quality of the academic medicine literature.  Generally speaking, there are a lot of low quality studies that get published (a lot more than high quality papers).  While you want to ensure that your research is high enough quality to be published in peer-reviewed journals, that is all you really need.  Wait until residency or until you are an attending to start those large sample size prospective RCTs.

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For your residency application, quantity of research is the key.  I attribute most of my success in securing interviews and matching at one of the best programs in the country to my research output and productivity.  Most residencies for competitive specialties take place at academic institutions where faculty members value scholarly activity and research contributions to the field.  Having products of your research (i.e. abstracts, presentations, publications) signals to programs that you have initiative, determination, execution, and the ability to see a project through to its completion.  More research further solidifies those characteristics and longer CV’s seem more impressive just by their sheer length.  In plastic surgery, there is evidence that medical students with more research do better in the match.  That makes intuitive sense.  Controlling for all other facets of an application (i.e. board scores, grades, letters of recommendation, etc), an applicant with more research has a better application.  A high research volume is also one of the only effective buffers for lower board scores.  Now, that does not mean that you have to take a research year to achieve a significant research volume.  I went straight through undergrad and medical school with no time off and achieved a research productivity in terms of abstracts, presentations, and publications that is likely higher than most applicants in any specialty even if they had taken a research year (or two).  Producing the volume required to be at the top of your applicant class is very achievable given you are willing to put in the effort.

Quantity should be your goal.  Here are basic tips on achieving the volume you desire:

What questions do you have about research? Are you ready to start generating a level of research output to edge you past your peers?  Leave a comment below or contact us directly.

Tell me about yourself

My first interview for residency was at the University of California San Diego.  It was an anomalous rainy morning in San Diego that had dampened my suit and sufficiently ruffled my hair.  After a light breakfast and presentation on the program, we were divided into two groups.  One group would begin interviewing while the second group would tour the hospital and educational facilities.  My name was called for the interview group, and my stomach cringed.  I immediately began sweating profusely and had acute onset of dry mouth, nausea, and fulminant anxiety.  My thoughts were racing.  It was finally happening.  I was finally interviewing for residency.

Over the course of the morning we would have six 15 minute individual interviews with the chair, faculty members, and chief residents intermixed with breaks.  There was a secretary helping keep the interviews on schedule and escorting us to the correct room at the appropriate time.  With a last name that appears early in the alphabet, I was up in the first cohort to interview.  Nerves and anxiety skyrocketed. I took a deep breath and walked into the room.  I was met by two faculty members sitting behind a desk.  I shook their hands and they asked me to take a seat.

After brief pleasantries, they opened up a manila folder.  I could see my official ERAS photo printed on the top page.  One of the faculty members, scribbled some notes while the other began the interview.  “Carter, why don’t you tell us about yourself?”

I’ll pause here in the story to really dive into this question.  From my experience and preparation for interviews, this was by far the most commonly asked question in interviews.  Even more common than why I wanted to be a plastic surgeon!  I was asked it in all six rooms at UCSD that day, and over the course of all of my interviews answered some rendition of this question around 100 times (including 14 times in one day at the University of Southern California…talk about exhausting).  Based on cursory advice I had received, I knew it was coming.  But that did not make it necessarily any easier.  It is an open ended question and there are so many directions that you can spin this into.  That is what makes this question so daunting as an applicant, but also so valuable to interviewers.  Can a student succinctly summarize who they are, where they have been, why they are here, and what they want to do?  Your first step in interview prep should be to write out how you would want to answer this question.  You can update and refine the answer to this question throughout the course of your preparation.  After you have an initial draft, have friends or family look over it.

Here was my initial notes/draft that I wrote when preparing to answer this question:”I’m an MD/MBA candidate at UAB School of Medicine. Grew up in Shreveport, LA and went to Notre Dame for undergrad. At UAB, I’ve done well academically and been involved in numerous organizations including student senate and the diversity advisory board. I’ve been fortunate to have great mentors and have had the opportunity to be involved in numerous research projects. Initial interest in urology, but throughout all this, really fell in love with plastic surgery as a discipline and am looking for a high-volume center to train for residency and a place where I can be exposed to all aspects of the field.”

General Tips

This ended up being very similar to the response that I gave in interviews when posed with the prompt, “Tell me about yourself.”  I certainly didn’t memorize and recite this response.  I don’t recommend that for interview prep.  Reciting a memorized response comes out too rigid.  Your answers will seem more natural if you give your answers spontaneously.  But preparation and thoughtful consideration of what you will say beforehand helps the spontaneous and natural flow of your answers to be direct, succinct, and on message for showing them why they should rank you to match at their program.  Think about answering this question like it is the synopsis on the back of a book or an abstract to a research paper.  You want to draw the listeners in, provide some substance that can be expounded upon later, and keep them enticed for what is to come.  All that being said, you don’t want to spend 10 minutes talking about yourself.  Most individual interviews are 10-15 minutes.  I would aim to keep your response to this question below two minutes erring more on the side of one minute.  Many of the points you mention, you will likely have the opportunity to explain in more detail later in the interview and can get more into the specifics then.

I am going to break down my response to this question into four parts, and this can serve as a guide to you when devising your response to this question.

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Introductory Statement

“I’m an MD/MBA candidate at UAB School of Medicine.”This is your introductory statement.  While they know that you are a medical student already, tell them where you go to school.  This may help remind them of faculty members or contacts they know at your home institution).  One point I also wanted to highlight in my interviews is that I did a dual degree program receiving my MBA while in medical school.  If you are a dual degree applicant, I think this is a great place to bring it up.  If there is another defining quality or experience that set’s you apart or makes your application unique, have it in your opening line.

Contextualize Your Experience

“Grew up in Shreveport, LA and went to Notre Dame for undergrad.”Tell them where you have been.  This should be very succinct, but gives them an idea of your journey through life and contextualizes your experience as an applicant and human being.  Many people would ask me directly if I knew a plastic surgeon that practices in my hometown whom they were friends with.  I also discovered several connections by mentioning my undergraduate institution.  I also learned that a lot of faculty members in the plastic surgery community have quite strong opinions about Notre Dame football which were shared with me and discussed.  While I went directly from undergrad to medical school, if you took time off in between undergrad and medical school, that might be something you want to briefly mention.  They will likely ask you about gaps in your educational career, so be proactive and address it directly. 

Medical School Performance/Activities

“At UAB, I’ve done well academically and been involved in numerous organizations including student senate and the diversity advisory board. I’ve been fortunate to have great mentors and have had the opportunity to be involved in numerous research projects.”Give them an idea of what medical school was like for you.  This is really the substance of your answer to this question.  This is your opportunity to set the tone for the remainder of the interview by highlighting what you think were the greatest experiences or accomplishments in medical school.  For example, I wanted to emphasize my academic success in medical school.  Now I never told an interviewer in answering this question that I was 98th percentile on  Step 1, Junior AOA, and had received various other academic honors, but instead I just mentioned to them that I had been very successful academically.   I think more important is how I framed that statement.  I have been very successful academically, but haven’t just been sitting in the library 24/7 during medical school.  I’ve also been super involved with leadership on top of all of this.  Building a response like this demonstrates to interviewers many qualities in one mega-packed sentence: intelligence (strong academic performance), time management (balancing coursework and activities), leadership (being involved in student organizations).  This is what you want to do in answering this question.  Let your words not only tell of your accomplishments and journey, but also let them suggest the qualities that programs are seeking out in future residents at their programs. 

What if there are major weaknesses in your application? How would you go about answering this question?  Let’s use an example.  Maybe you didn’t perform as well academically as you would have liked either on your board scores or clerkship rotations.  That’s okay.  This is your chance to put yourself in control of the conversation.  Let’s consider a hypothetical scenario where a student didn’t score well on Step 1 but knocked Step 2 CK out of the park.  A good talking point to include here might be, “While I didn’t perform up to my potential on Step 1, I worked hard and drastically improved my Step 2 CK score by hard work, focus, and preparation.  That is the same dedication, focus, and level of performance that I am going to exude as a resident.”  You addressed a weakness in your application on your own terms, contextualized it for the interviewers, demonstrated why they shouldn’t worry about it when ranking you, and focused their attention to the future.  That is the key with any weaknesses that may be on your application.  Take control of the conversation and frame them to highlight your strengths.  That takes us to the next and final part of answering this question. 

Look to the Future

“Initial interest in urology, but throughout all this, really fell in love with plastic surgery as a discipline and am looking for a high-volume center to train for residency and a place where I can be exposed to all aspects of the field.”Take control of the interview and refocus it on why you are applying to this specialty and why you are interested in this program. Finishing your response in this manner gives you the opportunity to, again, establish the tone and can demonstrate to them that you are an individual with goals, vision, and purpose.  For example, if you were to read over my CV when I was applying, it read a lot like an application to urology and not plastic surgery.  I started a Movember fundraiser for prostate cancer, was urology interest group president, received an AUA research grant, and the majority of my research was on kidney stones.  I needed to explain why I wanted to be a plastic surgeon despite all of these non-plastic surgery experiences.  The reason for including it as a detail in this open ended prompt is to do so on my terms.  Oftentimes, interviewers would loop back later in the interview and ask for me to discuss in greater detail about my transition from urology to plastic surgery which I was happy to provide them.  Instead of hiding those experiences, I framed them to demonstrate how they helped me in deciding to apply for a plastic surgery residency. 

I also think that it is great to discuss what you are looking for in a program, and you may want to tailor this to where you are interviewing.  For instance, don’t say to a program with a required research year that you don’t want to do research and want to just go straight into private practice.  Also, don’t say how important research is to you if the program has zero research output.  While you want to be yourself and find the best program for you, you also want every program to rank you as highly as possible.  Blanket, safe statements are okay.  The line I used was, “I want to train at a high-volume center and a place where I can be exposed to all aspects of the field.”  It is very hard to criticize someone saying that they want to work really hard and be well-rounded. 

The “Tell me about yourself” question can be asked in a variety of manners.  “Tell me about yourself.” “Why don’t you start and tell us about your background?”  “Who is (insert your name)?” “What should we know about you before we get started?” “Do you have any remarks before we get started?”  You should be expecting this question and be prepared for it.  Write out your response to this question today and spend time thinking on it.  Your answer to this question is more times than not the first impression interviewers will have of you.  Make your words count and tell the story that you want them to hear.

What questions do you have about making your opening statement? Leave a comment below or contact Med Student Edge directly.

Finding a Research Mentor (Part 3)

If you’ve been following along, this is the third and final post on finding a research mentor.  By now we have discussed what type of research to do, what specialty to research in, and qualities that make for a good research mentor.  While those are the main initial considerations, there are several other items you want to make sure to discuss with potential research mentors as these items can have a profound impact on your experience.

What is the timeline for project completion and the likelihood of presentation or publication?

It is very important in initial meetings with research mentors to discuss your goals and their goals.  For example, if they want a retrospective chart review of 1,000 patients with 30 primary endpoints completed by the end of the week…that might not be the best endeavor to sign up for.  Similarly, if their plan is to slowly collect data over a 5 year period, that doesn’t sound like a project that you are going to have submitted for publication by the time you are applying for residency.

A great mantra for research project timelines as a medical student is to undersell and over deliver.  In my initial meeting with the endourology fellow, we determined that that my summer project would be a retrospective chart review of patients to determine the compliance and accuracy of 24-hour urine testing in the workup for kidney stones in these patients.  He told me, “Yeah, you know take your time with the database. It’ll be summer. Enjoy your break.  You’re with us for 8 weeks, 10 weeks?  Let’s try to be near completion with the data collection by the end of your time with us.”  I, of course, agreed to these goals.  But remember, undersell and over deliver.  I had the full data set to the fellow and attending for review after just two and a half weeks.  This set the tone for our mentor/mentee relationship and after seeing that hard work, they were even more willing to help me achieve success.  Regardless, do try to set a timeline initially and stick to it.

Being able to distinguish what project ideas are publishable comes with experience.  As a first year medical student, I did not have that expertise (and an area I still need help with).  I assumed, like many other medical students, that if an attending is presenting me with a project idea then that means this will end up as a publication on my CV.  That is far, far from the truth.  Looking back at my personal experience and the experience of classmates, I would estimate that 50% of projects that are started by medical students make it to a presentation and an even lower percentage make it to publication.  There are numerous contributing factors to these numbers.  Sometimes the interests of students and attendings change and they are no longer interested in pursuing a project.  Some projects are poorly designed.  Some studies it is difficult to recruit patients or achieve an adequate sample size.  Sometimes the peer-review process does not deem the project to merit publication.  And sometimes it just doesn’t make sense.  I have a research project I authored in plastic surgery that was awarded the best paper at the Academic Surgical Congress meeting in 2020, was accepted for publication in the Journal of Surgical Research, and will be featured on the cover of that journal in November of 2020.  I collaborated with a classmate and performed nearly the same study in orthopedic surgery, and after submitting it to five different journals we still cannot get it accepted.  For all these reasons, I think it is important to ask potential mentors what they envision will be the product of the research.  If they think there is a high likelihood that this project will merit presentation at a regional meeting, national conference, or a publication, then that is a project you want to be a part of.

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Is there potential for future projects with this mentor?

This consideration really gets at longevity of the mentor/mentee relationship which is particularly important when you are applying for residency and need letters of recommendation.  When I came back to the chair of urology and endourology fellow with the data collection of my summer project complete in two and a half weeks, they had three to four additional projects in queue that I could start on.  They weren’t scraping the barrel to come up with new ideas.  Together, they had tons of ideas but just needed data collectors (i.e. medical students) to make those research projects come to fruition.  There was an abundance of opportunity.  These qualities of inquisitiveness and innovation may have been one of the most important advantages that they provided me as mentors.  No matter how hard I worked, I was never going to run out of projects.  From that first summer of medical school, we established one of the most productive mentor/mentee relationships I have been a part of that lasted throughout the remainder of medical school.

What support staff does the mentor have in place?

I did not realize how much of a difference this could make and honestly took it for granite in my time researching with the urology department.  The urology department had dedicated, paid staff to write and submit proposals for Institutional Review Board (IRB) approvals. These individuals also helped with setting up my ethics trainings, getting remote Electronic Medical Record access, generating patient lists for chart review projects, and recruiting patients for participation in our studies.  They also had departmental relationships with statisticians that could provide counsel for study design and statistical analysis.

In contrast, when I began actively pursuing research projects with the division of plastic surgery, I had to do the majority of this work for myself.  I had to learn how to write and submit IRBs (a valuable skill, yet very involved and time consuming) on my own.  I had to talk with hospital IT support to set up trainings and access for other medical students helping with data collection.  I didn’t have contacts within the hospital to assist in generating patient lists based on patient encounters or ICD-10 codes.  There weren’t dedicated statisticians for the division, requiring me as a medical student to seek out and find statistical support elsewhere in the school of medicine.  While these are relatively small issues in the grand scheme of things, they are important to consider in your process of selecting a research mentor.  The more time you spend on administrative activities setting up your research experience, the less time you have to collect data and write manuscripts. 

If you’re reading this, you’ve made it to the end of our three part series on finding a research mentor.  If you missed part 1 or part 2, be sure to go back and visit those.  Equipped with this information, use it to help pick out a research mentor that will be the right fit your you. 

What other considerations do you think students should be considering when selecting a research mentor? Comment below or contact us.

Finding a Research Mentor (Part 2)

This is part 2 of our series on finding a research mentor.  This segment will be dedicated to what qualities make for a good research mentor.  In part 1, we outlined how to determine what specialty to select for performing research and points to consider when deciding on what type of research you would like to become involved in.  Part 3 will outline various other small considerations that can have a dramatic impact on your experience and productivity.

What qualities should I be looking for in a mentor?

Academic physicians are extremely busy and are pulled in so many directions with their time.  Many split their time between clinical responsibilities, teaching duties, administrative tasks, conducting research, and securing funding for their research activities.  Still, there are some individuals that despite all of the other demands for their time and attention, spend an extraordinary amount of time mentoring and working with medical students.  These are the type of mentors that you want to work with throughout your time in medical school.

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One quality that I took for granite initially was accessibility to the mentor.  In trying to secure research mentors during my first year of medical school, I found out how incredibly difficult it was just to make initial contact with and schedule a meeting with some physicians.  The first mentor I tried to reach out to was an orthopedic surgeon.  Making initial contact with him took three emails.  After making contact and scheduling a meeting, he ended up canceling our initial meeting four times despite making myself available to meet with him at any time and at any location.  I trecked from the medical school library to attempt to meet him at the main hospital, in an affiliated surgery center, at the VA hospital, and at his office all to be stood up.  After four cancellations, he set me up with a meeting with a medical student research fellow working for him.  The research fellow vaguely discussed a project idea and told me to get started without any instructions or direction.  In contrast, I reached out to the chair of urology at my institution about a month later.  He responded directly to my initial email within 48 hours.  He said he would be happy to meet to discuss opportunities and already had numerous project ideas ready for me.  He mentioned that he was out of town that week, but carbon copied his endourology fellow to meet with me that week and discuss the various projects opportunities.  I met with the fellow that week, and met with the attending upon his return.  I probably don’t have to tell you that I chose the urology mentor for my summer research experience.

Another important component to investigate before even deciding to contact a potential mentor is to look at the physician’s research output.  You want to work with someone who is publishing a lot.  Don’t take just sheer number of publications as the only indicator.  Determine when those articles were published.  For example, an attending nearing the end of his or her career may have amassed a substantial number of scholarly publications.  However, if the last one was 10 years ago, then that mentor may not be a good mentor for you.  On the other end of the spectrum, attendings right out of residency or fellowship often carry some risk.  In my experience, these attendings are more than happy to mentor and work with medical students as they remember what it was like being a medical student.  They also are eager to start accelerating their own career and building an arsenal of medical student researchers is a great way to do so.  While they may have good intentions with project ideas, I have found that they can lack the experience to know how likely a project is to be published and may struggle with study design and implementation.  Of course there are exceptions, these are just some points to be cognizant of before signing up with a particular mentor and diving into a project.  I tell you this so you can learn from my mistakes: I can’t even tabulate the number of hours I have spent working on projects that have amounted to nothing.

Enthusiasm of the mentor is another helpful gauge.  If they are excited to work with you, that makes the entire research experience more enjoyable.  They will be more willing to meet with you, more willing to help teach you, more likely to encourage you to present and publish your work, and more helpful in securing you funding to pursue those opportunities.  If working with you is a burden to them, that creates for a less productive, enjoyable, and educational experience for all parties.

There are also different styles of mentoring.  After working with the chair of urology, I soon learned that he was a very hands-on mentor.  After drafting a manuscript for my first project, I sent it to him for review.  Instead of just sending back edits or completely rewriting the paper, he scheduled a meeting for us to go through my draft.  We sat in his office and went line by line through the paper addressing the content and style of my writing.  After a lengthy discussion, he told me to go home and rework the paper based on what we had discussed.  After re-drafting the manuscript, we again met and went line by line re-writing and editing the paper simultaneously sitting down together looking at the same computer screen.  This was an invaluable experience and after repeating this process with other projects, he helped turn me into a confident academic writer.  Another urology mentor that I have worked with extensively has nearly the opposite mentoring style.  He was about as hands-off as a mentor could be.  The first project I did with him, he sent me a paper from a study published in another field and told me to figure out how to replicate it in urology.  He had provided me with the idea, and it was my role to design the study, collect the data, perform the statistics, and draft the manuscript.  When I sent him the manuscript draft, he made edits and sent back the paper for me to adjust it.  From the start of the project to the end, I don’t think we ever met or discussed anything in person, but instead had a couple brief phone calls when questions arose.  Both of these individuals were excellent mentors, despite their stark differences in how they mentored.

Many of the qualities that make for a great research mentor include general qualities that make for a successful individual in any field of work.  Good organizational habits, professional etiquette, and timeliness.

When you are meeting with various research mentors about potential project ideas for longitudinal research during medical school or for a dedicated research period, look for these qualities in a mentor to discern if the physician will make for an encouraging and supportive mentor for your research endeavors.

What qualities do you look for in a research mentor? Comment below or send your thoughts to Med Student Edge directly.

Finding a Research Mentor (Part 1)

One of the most frustrating and time consuming processes for me during the first year of medical school was selecting a research mentor to work with during the summer between the first and second year.  At that point in time, I had nearly zero research experience outside of working for a virology lab in college one summer, but I knew that participating in research and generating products of that work (presentations and publications) were highly valuable for building a competitive residency application portfolio.  This is the first of a three part segment on discovering the right research mentor for you.  This post will discuss the basic considerations of what specialty to chose for your research and what kind of research is best for your goals.  In part two, we will discuss several qualities to look for when identifying potential research mentors.  Part three will cover other miscellaneous considerations that can have a substantial influence on your research productivity and success.

Image by Pete Linforth by Pixaby

I remember during medical school orientation being provided with a document that provided help for finding a research mentor.  Perusing this document, all it did was list nearly every attending with an affiliation to the school of medicine, their specialty, and an email address.  After emailing a couple of attendings and receiving no reply, I decided that I needed to be more systematic in my approach.  I first needed to answer several questions.  What specialty should I perform research in?  Did I want to participate in basic science or clinical research?  In conjunction with these questions that I did ask, looking back I realize that there are several additional considerations that I wish I would have accounted for.  These include the qualities I should be looking for in a mentor, the timeline for project completion, and potential for future projects.

What specialty should I perform research in?

As a first year medical student, very few people know exactly what specialty of medicine they want to eventually practice.  And that is okay.  I received several pieces of advice when discerning the answer to this question.

All research is good and more is better.

Dr. Carter J. Boyd, Founder Med Student Edge

All research is good and more is better.  Program directors and individuals that sit on resident application review committees know that it is not common for medical students to know from day 1 what field they will apply to for residency.  They also know that research takes a long time and that projects that you start as a first year medical student may take several years to move from an idea to published paper.  Later in your medical school career, as you begin to move towards choosing what specialty you will apply to for residency, you should try to identify a research mentor within the field you will be applying to.

While all research is valuable, if you think you may have an inclination towards more competitive residencies (i.e. surgical sub-specialties), it makes sense to do research in a more competitive specialty initially.  There is a seemingly unwritten bias among surgeons to favor research activities and experiences that were affiliated with other surgeons.  This may be better understood with an example: it is easier to have an application filled with ENT experiences and change at the last minute to applying for family medicine than it is to have a family medicine application portfolio and decide to apply to ENT near the application deadline.  Experiences in more competitive specialties transition to less competitive specialties with greater ease than the reverse scenario.

All that being said, try to pick a specialty for research in a field that you like or want to learn more about.  If you know that you do not want to be a neurosurgeon, then look for opportunities outside of the neurosurgery department.  Research is a great way to learn more about a specialty and an excellent way to become an expert on an individual topic in that specialty based on your project topic. 

Should I participate in basic science or clinical research?

There are several important points to consider when answering this question.  First, determine your own goals and preferences.  If you are interested in academic medicine and particularly in helping direct a lab as a part of your career, working on basic science research may help give you a background in this arena and assist you in building the skill set needed for eventually serving as a principal investigator in a laboratory.  Instead, if you are interested in policy, patient outcomes, or medical education, clinical research may be a better fit for you.

For my decision for the summer between the first and second years of medical school, I used a cost-benefit mentality to decide.  I had 10 weeks of dedicated protected research time with no other commitments.  If I were to choose basic science research, I would require extensive training on the procedures and experiments I would be performing, have limited access to the facilities, be subject to sharing equipment with the normal workflow of the laboratory, and may encounter delays or mistakes that require troubleshooting beyond my expertise.  Additionally, at the end of 10 weeks it was going to be difficult to find time to complete experiments or projects as medical school coursework commenced in second year.  By comparison for clinical research projects, I could obtain remote access and work from any location, work at my own pace, and hypothesized that it would be much easier to continue projects into the school year if I did not finish them within my 10-week period of protected time.

In terms of volume, it takes basic science researchers months to years to take a project from idea to publication, oftentimes a very arduous process.  As a medical student, this timeline does not align well with the aim of having as much research on your CV as possible.  It is much easier to produce a considerable volume with clinical research, particularly with collaboration on data collection and outsourcing of critical components of research such as statistical analysis. 

I have heard students and some faculty members suggest that basic science research looks better on a CV than clinical research.  While I think there may be some truth that basic science research experience may receive higher clout given that it typically requires significantly more effort and time, I don’t think that a ‘research experience’ equates with a ‘research product’, namely presentations or publications.  Head to head, I would be more impressed with one basic science publication compared to one clinical publication on a medical student’s CV, controlling for position of authorship.  But I personally would place more value on a medical student with one clinical publication compared to zero basic science publications but ‘basic science research experience’.  All other things being equal, basic science research likely is more prestigious than most medical student clinical research (unless it is a New England Journal of Medicine published randomized control trial).  However, all other things are not equal because it is much easier to publish numerous clinical research projects than it is to garner one basic science research publication.  While there may be a few medical students that garner an outstanding publication in JAMA or NEJM , programs are not expecting you to do that.  The overwhelming majority of faculty members you will interview with have not published in those journals, and they don’t expect you to.  This is why I consistently emphasize research volume to medical students.

For all of these reasons, I elected to pursue clinical research during the summer between first and second year of medical school.  My medical school allowed us an additional research block in our third year of medical school in which I participated in basic science research for 8 weeks, but that decision was largely based on diversifying my research portfolio for applications as I had already generated an ample volume of publications and presentations from clinical research in the first two years of medical school.  For students who may take a research year during medical school, I think that is a great time to be involved in basic science research.  I have witnessed several friends and colleagues make substantial contributions to the scientific community and bolster their own CV‘s with basic science research experiences, presentations, and publications during a dedicated research year. 

This concludes the first of three segments on finding a research mentor.  Look for part two next where we will discuss what qualities to look for in a research mentor. 

Do you have insight to add regarding what kind of research students should perform and in what specialty?  If so, comment below or contact us directly at Med Student Edge.

How to Study for USMLE Step 2 CK

Studying for USMLE Step 2 CK can be particularly stressful during the course of busy 3rd year rotations and the 4th year application process.  Still, it is important to set aside time to adequately prepare for the exam as it is a major component of your residency application.  If you have been studying, reading, and learning during your clerkships, you are likely more prepared than you think.  The ongoing studying for the shelf exams is excellent preparation for Step 2 CK as the style of the questions is very similar to these examinations.  Step 2 CK is different from Step 1 in that CK predominantly based on applying your knowledge to clinical scenarios.  There is much less of an emphasis on extraneous memory recall and instead a transition towards application of what you know to solve novel patient cases and anecdotes.  That fact should inform the way that you prepare.  Namely, practice questions are the key.

My general advice for exam board preparation is to continue what you have been doing.  By the time you are preparing to study for and take Step 2 CK, you have taken an innumerable number of exams, quizzes, and tests throughout medical school.  And if you have made it this far in medical school, you’ve likely been fairly successful throughout that entire process.  If you happen to have struggled on clerkship examinations, you may want to try to identify any problems with your test taking strategies for clinical based questions as these tests are quite similar in content and style to Step 2 CK.  Still, strong preparation is the best way to ensure success on these exams.  Make a schedule, chose your resources, and get to studying.

While Step 2 CK resources have traditionally been more sparse in comparison to Step 1 preparation tools, this will likely change with the progression of Step 1 to pass/fail score reporting.  It will be interesting to see what new learning tools emerge based on this change as Step 2 CK scores will likely transition to the importance that Step 1 scores traditionally carried.  For now, here is the list of resources that I recommend you use in your preparations.  While there are many more resources available, those listed below are sufficient to optimize your time, money, and efforts. 

As I’m sure many of you are familiar with this question bank from Step 1 preparation, UWorld is the gold standard preparation tool for Step 2 CK.  UWorld’s team has worked extensively to augment both the quality and quantity of the practice questions available over the past several years.  The questions aren’t the only feature that make this such an invaluable resource.  The in-depth analysis provided for the questions for both the correct and incorrect answer choices is where I spent the bulk of my study time with this resource.  The descriptions break down the question and deliver the content that the question was testing you in well-polished, succinct answers.  Too many times I have seen students just focus on getting the questions right.  There is a lot to be learned by missing questions and studying the explanations is a great way to build your fund of knowledge.  They have two practice exams available for self-assessment.  I purchased a subscription for the Step 2 CK UWorld that I completed throughout the timeline of my clinical coursework and used to prepare for shelf exams.  It is worth purchasing another subscription or resetting your account when you begin your dedicated studying for Step 2 CK.  Completing the entire UWorld question bank is my most highly recommended tip for Step 2 CK preparation.

National Board of Medical Examiners (NBME) Practice Tests provide practice examinations that are useful for reviewing specific specialty subject content and also comprehensive material to prepare for Step 2 CK.  These practice exams generate score reports that can help you identify specific content areas weaknesses to guide the remainder of your studies.  They also provide a rough idea of what score your performance on the practice test might correlate with on the real exam.

In terms of books, First Aid for the USMLE Step 2 CK is a good reference guide.  I don’t recommend reading it cover to cover given the time restraints for Step 2 CK preparation, but it is good to have a quick and easy place to annotate learning points from practice questions.  I had extensively annotated a copy of First Aid for the USMLE Step 1 and ended up referencing it for several specific areas that aren’t covered as in depth in the Step 2 CK version.  Step-Up to Medicine was another great resource that I used throughout all of my clerkships (not just medicine) and I found particularly helpful for preparing for the Step 2 CK exam given the detail it provides on the fundamentals.

Image from FirstAidTeam.com

Online MedEd is a great resource for video based learning.  I used these videos to varying extent to cover certain topics studying for shelf exams throughout the clinical years.  I found these videos particularly helpful for reviewing specific content areas where I was not performing well.  They also provide for a more passive way of learning when you’re exhausted from reading or focusing on practice question blocks at the end of a grueling day.  I made a cumulative list of videos that I found particularly helpful for me to review easily confused concepts as the exam date approached (such as the Pediatric’s – Orthopedic video).  There is other content available through this site, but selecting videos to address your specific weaknesses is the most high-yield.

By the time you are taking Step 2 CK, you are already a pro test taker.  Trust the process of preparation and try to maintain a solid routine of studying so you can excel on test day.  Good luck!

Med Student Edge has no financial relationships with any of the resources that have been mentioned in this post.  Do you have other helpful resources that you’d like to share? Leave a comment or contact Med Student Edge directly.

CV Template

While I should have been excited the first time I secured a meeting with an attending to discuss a potential research opportunity, I was incredibly anxious over one line in the attending’s email.  “Before our meeting, would you mind sending me a copy of your CV?”  As a first year medical student, all that I had at that time was the résumé I used for applying to medical school, and I really didn’t have much to add to it.  Instead of preparing appropriately for the meeting by reading the attending’s previous published research articles, I spent two days learning how to build a curriculum vitae on the internet.  I was hopeless trying to decide which elements to incorporate from the various examples I read.  I pieced together a rather motley document to email him before our meeting (as fate would have it, the attending chose a different medical student for the project).

Photo by Andrea Piacquadio on Pexels.com

About a year later, I stumbled upon a model CV from our medical school.  I realized how different this version was from the examples I had seen online (largely targeted for the business world).  I swiftly constructed my CV based on this guide and over the next two years since then have tweaked the sections and formatting to better align with the Electronic Residency Application Service (ERAS) application.  This CV template will allow you to accurately demonstrate to mentors, residency programs, letter of recommendation writers, and others your accomplishments and achievements.  Copy and paste it into a word document and begin to build your CV.  The formatting may require minor adjustments.

We will walk through each section of the CV and try to clarify any ambiguity.

Heading

Use your official name, and if you go by another name consider putting it in quotations.  List an address that you (or someone) will be checking for mail.  List your cellphone number and a non-institutional email address.  I recommend creating a separate email address for going through the application process (I used my personal gmail) as some institutional email servers filter out external emails.

Education

This should include any graduate school (your medical degree, any master degrees) and your undergraduate degree.  At this point, high school is no longer relevant.  I recommend listing your USMLE scores under your degree (in my experience, attendings will ask your Step 1 score if you don’t list it).  I also recommend major medical school honors such as election to Gold Humanism Honor Society or Alpha Omega Alpha under your degrees as well.  Everything else can appear later in the Honors and Awards section. For your undergraduate degree, I think it is important to include what you majored and minored in.  I had an extensive conversation with a chief of the plastic surgery division on one of my away rotations after he noticed from my CV that I had a minor in Theology.  You never know what will catch the eye of an attending. 

Honors and Awards

General format is to list the award name, and the group that awards is gave you the award (whether that be a school, professional society, alumni association).  It is important to also list a brief description of the award.  While the award may be well known at your institution or in a given group, don’t assume that everyone reading your CV will know what it is without a brief explanation.  Keep explanations to one short sentence if possible.  This is where I would list scholarships and research awards.  If you have honors from college that are noteworthy, I would also list those here.  Any major awards from high school such as being valedictorian or an Eagle Scout (I was asked about this at nearly every institution) should also be included. 

Research Experience

In the left hand column, you want to list the time frame that you have worked with this attending.  I chose to divide research experiences by individual attending.  I have seen others divide research experience by project, but I think organizing it by an attending is best, particularly if you have worked with numerous attendings.  I used ‘research assistant’ as my title/role on almost every research experience (the ERAS application portal will ask for these items).  I also classified my research experiences by the specialty that the project was associated with (plastic surgery research).  I would list the attendings name, with his or her degrees, and academic titles (professor, assistant professor, associate professor, chair, ect.) List the attending’s departmental or divisional affiliation. Then, list a description of what research you did and what your role was.  I kept each of these down to one sentence, though I have seen many people write a full paragraph and provide extensive detail.  I think either is okay, but lean towards brevity.  

While I did not list a work experience section (I went straight through undergrad to medical school and took no time off), if you had another career or worked before coming to medical school, add this section to your CV.  Programs will ask about any timeline gaps in your application, so having it already listed on your CV allows them to focus on you and why you are interested in their program.

Publications

This is the first of many sections related to research products. This was the bulk of my CV.  I have them subdivided in this way because this will help you streamline the process for when you enter the information to ERAS.  Under this publications heading, this is where you want to list primary research articles that you have authored or co-authored in reverse chronological order (the most recent at the top).  I would listed publications here that have been accepted for publication, are in press, or are already published with a DOI or PMID.  Use a standard citation format that includes the authors last names followed by first and middle initials, the title of the article, the journal name, month and year of publication and the DOI or PMID if the article is published. If not published yet, list “accepted” or “in-press” at the end of the citation. 

Published Abstracts

ERAS allows you to specifically designate these, so if an abstract you presented at a conference gets later published in a journal, you can list that here.

Book Chapters

ERAS has you specifically designate book chapters as separate from primary research publications so I recommend listing it separately on your CV. ERAS requires you to submit all of the publishing details of the book. This was very difficult for me to determine for one of the book chapters that I helped write. I recommend getting in touch with your attending to make sure you have the appropriate information to list these citations.

Other Media

This section could include articles that you were featured in or wrote. One of my posters at a conference was picked up by a news network and an article was written on our work. I listed it in this section. I also helped to create a surgical video that was published online. I listed it here.

Manuscripts Submitted

In my opinion, this is one of the most important sections for ERAS and I think it is very important to have up to date when you give your CV to mentors or are applying for away rotations. Submitted manuscripts can be listed on your official ERAS application (this section composed 37% of all of the publication/presentation listings on my ERAS CV when I submitted my application). This is a great feature of the application process, particularly given the long duration of the peer-review process. Simply list the authors last names followed by initials, the title of the project, the journal it was submitted to, and the moth and date of submission. 

Manuscripts in Preparation

You cannot include this on your official ERAS CV.  However, this is a great indicator to mentors, letter of recommendation writers, and program directors of projects that are close to submission.  List the authors last names followed by initials and the working title of the project.  Your goal should be to move as many projects from this category to the manuscripts submitted section.

Studies in Progress

Again, this section cannot be added to the ERAS CV.  For the same reasons as above, it serves as a nice demonstration of your ongoing scholarly activity.  List the authors last names followed by initials and the working title of the project.  Work diligently to get as many of these projects finished and submitted before the application deadline. 

Presentations

You should list these in the same general citation format.  Start with the authors last names followed by initials and the title of the talk.  List the conference or setting of the talk.  Include the city and state where the talk was given as well as the month and year.  It is also important to list what type of presentation it was (poster, oral, plenary, ect).  For abstracts that were accepted but not able to be presented due to the COVID-19 pandemic, I would also include a brief caveat statement explaining this.

Activities and Service

This will become a substantial portion of your application and CV.  List your role or title, the organization that it was affiliated with, and the city and state of the experience.  Here, it is also important to give a description of what your role was.  There may be many experiences or activities that would be well known to someone at your institution that would not be recognized outside of your school.  It is okay to go a little deeper into each of these if you would like to, however my personal style is to maintain brevity.

Professional Membershis

This is where I would list memberships to honor societies from college (Phi Beta Kappa for example) or election to honor societies in medical school (AOA or GHHS). Also, if you have become a member of a specialty organization (when I was interested in urology, I became a student member of the American Urological Association) include it here and the length of time you have been a member.

Languages

List any languages other than English that you are proficient in and indicate the level of proficiency.  Being fluent in another language is an extremely attractive quality.  But if you list it, be ready to speak it.  One of my interviews for residency was conducted completely in Spanish because the interviewer wanted to test if I really was fluent in Spanish as I had listed.

Hobbies

Some people will build an extensive list (I have seen people list 30+ hobbies).  To me, that seems like a bit much.  I would select 5-10 maximum hobbies or outside interests to include.  These are one of the most commonly asked questions in interviews.  So if you list hiking as a hobby, be prepared to discuss your most recent and favorite hikes.  If you list cooking, be ready to walk an attending through your favorite recipe.  If you list a musical instrument, you should be ready to tell the interviewers what songs you play.  While you want to show that you are an interesting person outside of the hospital, don’t list a hobby or interest if you aren’t able to speak on your involvement or interest in that particular activity.  You will be asked.

Composing a CV for the first time can be a daunting task.  This post helps you with what to include in your CV and how to organize it.  Keep these tips in mind when formulating your CV and set aside time to update it regularly.  Be sure to carefully review your CV and ask a family member or friend to give it a read over for you.  Remember, this is your way of presenting your accomplishments and activities.  Invest in the time now to organize and format your CV well and it will payoff for you later.

Do you have questions about how to compose a CV or what information to include? Leave a comment below or contact Med Student Edge directly.

Special: Away Rotations for 2020

Away rotations were a very important part of my fourth year of medical school as they are for many medical students applying to a wide range of specialties.  Audition rotations or sub-internships give students a unique opportunity to work directly with programs, meet new faculty and residents, garner letters of recommendation, and learn a tremendous amount working in their desired field.  They also are important for international medical graduates and students who may not have the specialty they are applying to at their home institution.  I will dive into the value of away rotations in later posts.

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During early 2020, fourth year medical students were preparing their applications for the Visiting Student Learning Opportunities (VSLO) program.  These plans came to a dramatic halt with the freezing of the typical application cycle due to the emerging COVID-19 pandemic.  Given the duress of the situation and realizing the broad implications of ensuring the safety of all medical students, encouraging social distancing practices, and providing equitable opportunities for all medical students, I recently was a part of a multi-institutional and multi-disciplinary team that discussed the best way for students, programs, specialty governing bodies, and the Association of American Medical Colleges (AAMC) to address the pandemic’s effect on away rotations.  We proposed several action items and opportunities that institutions and specialties could implement to provide virtual experiences for students.

It has been great to hear that despite the circumstances, the AAMC made specific recommendations that help to address many of the concerns raised across the country with away rotations and that specialty governing bodies have integrated these approaches into their guidelines for programs to use.  Specifically, many programs are working to set up virtual experiences for students.  These may range from allowing interested students to virtually attend a program’s grand rounds, virtual meet and greets with faculty and residents, or attend resident teaching sessions.  The specific opportunities differ by school and institution, but application deadlines for some are approaching soon.

While these virtual experiences serving as surrogates for audition rotations are not ideal, I encourage every applicant to take full advantage of the situation and these opportunities.  Programs and applicants alike will be chartering new territories so I would expect glitches, however don’t let that negatively impact your experience.  One item in particular that I would like to emphasize is carrying yourself virtually in video call scenarios with the same professionalism you would exhibit for in person experiences.  As interviews are going to be happening virtually (more on that to come), programs will be operating with less information than usual and be using these virtual sessions to help ultimately determine rank lists.  Be dressed well and appropriately, be well groomed, sit up straight, be attentive, and use a nice, plain backdrop.  You would hate for any pictures, posters, decorations, or other items lurking in your video feed to negatively influence your application and compromise your ability to match.  I would put away cellphone distractions and be sure to have your audio muted when others are speaking.

Most importantly, be yourself. Oftentimes on away rotations, many students feel the pressure to portray a certain image of themselves and we do that in other areas of our lives as well.  While you certainly want to be professional and respectful, if there is a discussion taking place, be a part of it if it is appropriate to be.  Prepare for the sessions and ask insightful questions when given the opportunity.

While this is uncharted territory, research and take advantage of these virtual experiences programs are offering to make the most of this application season. 

Best of luck in finding the right opportunities for you and comment or reach out with any questions you encounter with the process.  

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