<p>For several of the competitive surgical specialties, research years are considered a virtual necessity (probably not required if you have straight honors 3rd year and a 250+ Step 1), let alone a chance for an improvement. They want to see that you’ve gone into these fields in depth, and a couple weeks on electives usually doesn’t satisfy program directors unless you’re brilliant. Many of these students often thought they were going to do something else earlier in med school and then had a change of heart. Then as mcat is talking about, there are people who want careers that are not 100% clinical practice and the research years make them more competitive to residencies that specialize in that.</p>
<p>There are 2 other reasons I hear frequently for research years
just need a break from the grind before residency eventually starts (I don’t know if I genuinely believe this reason though. I think it’s probably just a way to avoid saying “my application is weak even for a less competitive specialty and I want to be strong enough to guarantee I end up in a decent hospital in the city of my choice at least”)
Sync up with a partner the year below you to couples match</p>
<p>I appreciate plumazul’s critical thinking skill, that one-extra year needs to have “quantifiable benefit”. For said specialties that value research year shall be upfront, make it mandatory. For the goal of pursuing academic medicine, can you obtain equivalent credential by heavily involving in research with smaller patient load while being a attending in early years? In “grand scheme of things”, aren’t you losing a prime and productive year, if the goal is simply matching to certain specialties? </p>
<p>I can only speak about surgical residencies, but having a reduced patient load to engage in research won’t work since a several surgery subspecialties are moving towards requiring a minimum number of various specific types surgeries in order to qualify for board eligibility. Already surgeons-in-training in some programs are having trouble meets those minimum numbers during their normal length residence. Having a reduced patient load would increase the length of a surgical residency by at least one and possibly several additional years.</p>
<p>Academic faculties are hired on the basis of their past research (and ability to attract funding), not for their potential to engage in significant research in the future. I will also mention that academic faculties already have a reduced patient load if they are actively engaged in research/teaching activities.</p>
From this parent’s POV, I think it would be good for DS if he could have a break between the MS3 year and the even more brutal residency years ahead.</p>
<p>For the two requirements listed by iwbb for not having to have a research year, DS has met one of them but not sure about the other (so far it has been good, but it is still ongoing and there will be any “oops” anytime as it is really not under each individual’s control unless, just as a joke, you really have the charisma of being a successful President of US like JFK.) Also, I have not heard from him that he has an interest in pursuing any highly competitive specialty. He said once that if he continues to be interested in what he has been interested in so far, he has a relatively good chance to stay where he is at even if he skips the research year (likely due to the inbreed phenomenon?) Will he choose to stay put? I have no idea.</p>
<p>Another topic, DS said that the life style of being an emergency room doctor is good. The only potential downside, as it is rumored, is that other physicians may “look down” upon the emergency room doctor. Is it just a myth (in an academic teaching hospital environment only) or does it have some truth in it?</p>
<p>BTW, he said he had seen many (at least 3 that we have heard of) deaths since his first MS3 rotation. It is a fact of life for people in this kind of job to have this experience (seeing patients dying or dead. It is especially emotionally challenging to see a dying teenager or even a child.) Also, one very old, somewhat illusional patient would punch anybody who is dressed or look like a doctor because she thought the doctor prevented her from going home. So even the lowly MS students were asked to take off the white robe before they need to go near her.</p>
<p>The lifestyle of an EM doc is good, but as I used to remind D1— working rotating shifts when you’re 35 is fine; rotating shifts when you’re 59----not so much much fun. </p>
<p>And yes, in some settings and at some hospitals, EM docs do get looked down on. (They get called glorified triage nurses or Dr. Passalongs since they don’t provide the definitive care for most patients, but either discharge the patient or send them on to other medical departments for treatment.) But I have to say if I were ever on a plane and got seriously ill or had a heart attack, I’d much rather have a EM doc on board than say a dermatologist or Ob/Gyn.</p>
<p>MCAT2- son is delaying residency by a year as well, instead of a research year he will be getting his MBA…dual program. Many in is class take that year (his school allows 2 years) or 2 and do a research year, other dual programs (MD/MPH is VERY popular at his school) some are having babies, others are traveling. A very large percentage of the classes do this…the school encourages it. Son only applied to schools that offered the dual MD/MBA program so he knew it would be in his future!</p>
<p>There is the added benefit of more time to prep for residency and line up what he wants in the future. And honestly his concern isn’t about losing a year to earn more money. If he wanted that, he would have taken the i-banking job offered to him right after his first undergrad. He knows how busy life can get after you are working in the real world and just how difficult it can be to go back to school. So he is truly placing a priority on his educational experience in an institution and knows how priceless it can be. He sees is fellow alumni and sees their struggles in wanting to go back after being in the workforce relying upon a sizeable income and their finances based on that income. He knew getting it done now, mitigating his loans as much as possible was the best answer for him.</p>
<p>So far, no gap year in D’s plans, she did not mention any of her friends who are planning on a gap year, but who knows. She had 4 moths of Research so far, does not look like she has a plan on doing more. She will focus on several “specialty” rotations as well as more IM rotations in AI capacity and thinking about 'away" rotation, this one is still up in a air (very competitive place, she might not get a spot any way). Still not sure about number of residencies to apply, but more or less has a list of minimum number of places. I feel that she likes talking to me, she says it clears her head. I am glad to be helpful, trying not bother her. I make myslef think that “no call” means “no problem/no issues”. </p>
<p>mcat2 - what is your son’s stated reason? I am not certain IM and EM are very competitive (unless aiming for MGH for iM) and from what you have mentioned, he seems to have mind bogging Step scores.</p>
<p>Kat - thanks for bringing up various reasons for extra years, getting another degree, having babies are perfect justification for a timeout. Traveling ???, are they burnt out in med school? I’m very familiar with I banking world, applaud your son’s desire to become a doctor, we could use a good doctor than a banker.
I still have doubts though about that, kids are encouraged to take extra years to ready themselves for matching into certain specialties at certain place. This reminds me how college professors enticing their PhDs to “labor” as long as possible under them. Somehow I felt, the whole med-education process heavily favor the institutions at kid’s expense, “gap year”, “research year”, etc. On the other hand, I believe residence training is the real training that shall be extended, emphasized to get them ready, guess congress is not giving any more money for that.
I’m just an outsider looking in, it’s not that “extra year income” matters, don’t you think at end of this process, the older you are, the heavier you debt load is, the narrower your choice will be? </p>
<p>I can see from the listed reasons, that D. has none of them. No desire to have another degree, baby (at this point) or travel (she has done probably much more and of greater variety than 99% of Earth population). I do not know what would be plan if god forbid that she does not match. I have no idea what people do. Do they take a gap year and apply next year? But she is planning to be in Transitional year residency anyway. I have no clue what they do if say they match to Transitional year and do not match to their specialty. She clearly prefers to be in some kind of clinical setting dealing with patients over research (unless it is clinical research). The part of research she enjoys the most is to be in charge of it. to be an expert in the project, the one who others consult.</p>
<p>Examples of the specialties I am referring to are ENT, ortho, urology. I have also heard Derm benefits a lot from research years.</p>
<p>I’m sure this topic is routinely discussed on SDN and you’ll get input from people who have actually been through the process (unlike me, but my former MD classmates are going through it now)</p>
<p>PCB- in son’s case he took into consideration his debt load for the dual program. Since he was awarded a tuition+fees+stipend for med school his debt load is low for med school. The MBA part is being funded by his full fellowship+ from the b-school. His “research” year allows his to save the additional year of tuition for the MBA (the MBA is much pricier than the MD) and the additional year of an MBA program. As I mentioned upthread, he knew he wanted an MD/MBA when applying and the schools knew as well, so when decision time came around he weighed all his options and all the factors…location vs. COA vs. COL vs debt/loans vs. scholarships vs. total out-of-pocket vs. time. Location as far as COL and future residency. Some programs “like” their own grads or locals, areas close by. He also focused on that when making his med and b-school decision.</p>
<p>A surprise factor was the input and influence of his undergrad mentors and alum. Didn’t see that playing a role but it really has.</p>
<p>Pcb1604, you mentioned something that brought back memories. During my residency the ICU attendings did everything they could to entice surgery and anesthesia residents to do a fellowship in the ICU. At Johns Hopkins, it was intimidating enough because the attendings were brilliant but we couldn’t get over the obvious fact that we would be labor. Q2 call for the whole year at paltry pay. Obviously this disparity lead to only the career students taking the fellowship opportunities and everyone else “cutting the cord” as soon as they could.</p>
<p>This phenomenon of students taking extra years off for research, other degrees or traveling is completely foreign to me. Other than MD/PhDs, this didn’t occur at my school during my time there almost 20 years ago. But it isn’t occurring to a great degree here in my state now. It will be interesting to see the long term outcomes when these physicians make it out into the workplace. It has already been tough dealing with the generation that came after me.</p>
<p>The 80 hour per week generation has been a challenge. That rule started the year I completed residency. So, when I joined a private practice, the hours were just as bad as residency. Over the years, I started noticing that we were having issues with our new employees. They demanded same pay, less work hours, less call, etc. These demands did not add up with the finances. I started calling my colleagues around the country and found similar reports. Private practice was more demanding than residency. For many of the new graduates, they weren’t ready for it. I used to tell one of my colleagues that the patient doesn’t expect you to stop caring at 5PM because it’s time for you to go.</p>
<p>We are having issues with this off and on even now. It’s the rarely discussed work ethic problem. Some groups have managed by dropping incomes to match the lower work load while others have sold out to large corporations who provide a shift work model. But it will be interesting to see what challenges this generation brings. </p>
<p>The generation before me was absolutely right to complain about my generation LOL! They went through these crazy pyramid residency and partnership schemes and my generation didn’t have to go through that. We brought in evidence based medicine and I know my generation made demands that were unsettling. My generation expanded the use of midlevels. And when that previous generation complains out loud to me, I just listen and give them their respect. I am so glad I never had it as hard as those who came before me.</p>
<p>But the generational gap doesn’t negate the real conflicts, the positive, as well as the negative changes that have occurred. Change is not always good. When you ask someone to work a 72-84 hour shift because a partner is suddenly placed on bed rest for a complicated pregnancy, the line seems to be drawn straight down the generational divide.</p>
<p>And so, I have to read up and be prepared for the modifications my colleagues and I will have to make for the new folks coming down the line.</p>
