Weighing your options: Should you pursue a research year?

In 2022, USMLE Step 1 and COMLEX Level 1 both went pass/fail. While it has been argued that the goal of this transition was to relieve the perceived pressure of examinations and enforce a more holistic review, the reality is that medical students no longer have an early litmus test of their future competitiveness for residency.

Additionally, more and more medical schools are moving to pass/fail curricula. In 2018, one study showed that 58.3% of surveyed medical schools reported a pass/fail curriculum, compared to a 2021/2022 study that indicated 83.2% of LCME (allopathic) schools had a pass/fail curriculum.

The data demonstrates that we are seeing a shift in medical education evaluation from objective to subjective measurements. This raises the question: “If I want to attend a competitive residency, how can I stand out amongst my peers?”

Enter the “research year” conversation

During research years, medical students take a hiatus from coursework and instead focus on producing research with a specific department or PI. Typically completed between the third and fourth year of medical school or following the fourth year after an unsuccessful match season, a research year (also called a fellowship) may include publications and abstracts, presentation of findings at conferences or clinical duties.

Suitability

Competitive specialties are those with residencies that have a lower rate of applicants who match into the specialty for which they applied. An analysis of data from the 2022 NRMP match showed that dermatology had one of the most competitive match rates at 10% for MD seniors compared to 7% for DO seniors. Among the more competitive specialties, there is an increasing focus on research.

Based on data from matched U.S. seniors, the top five specialties that emphasize research are plastic surgery, neurological surgery, dermatology, otolaryngology and orthopedic surgery. The average number of publications, abstracts and presentations for plastic surgery was 28.4, compared to internal medicine at 6.9. However, in a survey of PDs across medical specialties, 45.4% agreed that leadership experience would be emphasized, and 57.8% strongly agreed that Step 2 CK would be emphasized.

While research is growing in importance due to the advent of pass/fail board exams and medical education curricula, it is not the be-all and end-all of a successful applicant.

Advantages and disadvantages

To gain a better understanding of research years and the advantages and disadvantages they provide, we sat down with Tyler Williamson, OMS IV. Williamson applied for orthopedic residencies in the 2023 Match and has had an impressive interview season thus far. However, Williamson decided to apply for orthopedics late during his third year, which left him only six to seven months to improve his ERAS application.

In addition, Williamson knew that although he had the benefit of a strong score on Step 1/Level 1 that put him within striking distance of orthopedics, he lacked orthopedic-related research that showed commitment to the specialty and a network of professionals in the field who could vouch for his aptitude.

When asked about the pros and cons of his research year, Williamson said, “The most beneficial [element] was the networking and the people I was able to put myself in front of.”

Williamson gained a tremendous amount of research experience and networked with PDs, presented at conferences, worked with residents and made a name for himself by demonstrating a strong work ethic. From these interactions, he garnered contacts who were willing and able to speak to his character, knowledge and ability to succeed in an orthopedic residency.

Williamson’s research year also presented drawbacks, such as having to coordinate logistics with a school that was unfamiliar with the benefit of research years and managing the process with limited finances. Sadly, taking a year for research also meant Williamson did not graduate with the class that had provided a support system through his time in medical school. With a slight catch in his throat, Williamson stated, “Those are some of my best friends that I have ever made in my life.”

Although research years are becoming more common and gaining favor within competitive residencies, each individual student must evaluate for themselves if the opportunity is right for them. Fellowships can provide a springboard to develop a network and the time to make it impactful. However, nothing is guaranteed, and there are no handouts in the process of residency applications. Students who already have substantial research experience or who don’t enjoy research might not reap the full rewards of a research year.

Final thoughts

When considering a research year, ask yourself: “Do I have people to vouch for me within the specialty I want to apply? Do I have a CV that demonstrates a commitment to research? Am I committed to a research-heavy and competitive residency specialty?” No one but you can answer these questions. There is no secret formula (or algorithm) to match into your preferred specialty.

However, a research year is one tool that could help improve your application and make you a stronger residency applicant. The key to many opportunities is being in the right place at the right time. To this, Williamson adds, “How can you be in the right place at the right time? You be there every time.”

Related reading:

Making the move from the second to third year of medical school

Overcoming obstacles as a medical student: A journey of resilience