For third year medical students gearing up to apply to residency, this is the perfect time to reflect on areas of potential improvement in your residency application. There are still five months or so left before you have to hit submit on your ERAS application and this is just enough time to take on a substantive new project or have longitudinal contact with a faculty member in your specialty of choice. Come July or August, it will be too late to start something that will add meaningfully to your candidacy. Below are some suggestions for ways to strengthen your application and give you something to talk about on interviews, while also gaining skills and experience that will be relevant to residency and beyond.
1) Research: If you haven’t done research yet, this is the area where you stand to get the highest return on your investment of time in terms of improving your application. There is not be enough time to start a research project from scratch, but you could contribute to an existing project, do a secondary data analysis on an existing data set, or help a person farther along in training get a project off the ground. As busy as you are now, everyone above you in the medical hierarchy is even busier, and most would be grateful for the help. If you click with a particular attending, ask about their research work and let them know you are looking to get research experience. Don’t be shy about telling them that you are hoping to do work that leads to an abstract or paper, but emphasize that you are also willing to work on a piece of a larger project. The goal here is not only to learn about research and potentially be involved in a publication, but also to develop a relationship that might lead to a letter of recommendation from a research perspective. If you research involvement does not lead to an abstract or publication by the time your application is submitted, you can still list it as “Research Work” and it will be excellent fodder for interview discussion. We know people who have continued their medical student research work well into residency, leading to papers, presentation at national meetings, and successful fellowship applications.
2) Write up the work you have done: If you have done research, run a volunteer program, or done anything else novel during medical school, now is the time to write it up! It’s amazing how many people get busy with clinical rotations and overlook this important step in the process. Even if you didn’t discover a cellular protein or cure cancer in mice, the work you have done may be relevant and interesting to others. There are many journals and meetings that consider abstracts about medical education/volunteer programs. Ask your dean for advice on appropriate venues. If you have participated in research, ask your mentor if there is a small piece of the work that you could write up in an abstract and submit to a national meeting.
3) Write a case report: If an interesting case comes your way on a clinical rotation, ask your intern, senior resident, fellow, or attending if they would be willing to work with you on a case report. Case reports should represent a new contribution to medical knowledge: a rare disease, a rare presentation of a common disease, a diagnostic dilemma with a strong teaching point, a novel treatment, an unusual adverse reaction to a drug, and so on. Case reports can be submitted to national meetings in your specialty of choice and can also be submitted to journals for publication. This is a particularly good route if you have not done research, as it is a way to demonstrate your commitment to scholarly work.
4) Serve your school and be an innovator: As a rising fourth year, you are in a position to contribute positively to your medical school. You are the experts now – no students know more about your institution than you and your classmates. Serve on the admission committee and help shape the future of your community. If there is a gap in your education, form a committee and work to fill it. We know of a group of rising fourth years who started an intern-as-teacher curriculum, engaging faculty members to teach them and their fellow students how to be effective teachers as interns. Another student designed a fourth-year elective pairing medical students with nurses and other hospital staff for a more comprehensive understanding of hospital-based care. Yet another fourth-year designed a medical writing elective for incoming first-years. This is your chance to be creative and make your mark.
5) Seek out a longitudinal experience with a particular attending: If you work well with an attending during a clerkship in your specialty of choice and you have elective time (or vacation that you don’t mind devoting to this purpose), see if they would be willing to have you spend a week or two with them in clinic or on a consult service. You’ll get to see what life will be like once you are finished training and they can get to know you better, which will lead to richer letters of recommendation and a mentoring relationship that could continue as you start residency.
6) Volunteer work: This is last on the list because, in our opinion, this is the hardest kind of work to do in a short time frame, especially during the clinical years. The kind of volunteer work we are talking about is not a one-time thing, or even a four- or five-time thing. In order to make a difference in the community—and on your application—you have to form true connections with individuals and organizations. Ideally you would work in a leadership capacity to grow a project that can be sustained once you leave. That said, if you feel committed to working on a weekly or biweekly basis over the next five months for at least forty hours over that time, it is something to consider.
A note of caution: Clinical rotations are busy. Be realistic about the amount of work you can take on during this time. If you have doubts about your ability to follow through on a particular project, better to pass and pick something more manageable.
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