Backgroud: There was an exchange of emails before this one. They're not necessary to understand what's going on here.
Thank you for what you've shared. I was caught off guard at first when you challenged me to think about why I want a more competitive residency program. To clarify things, I am uncertain of what I should choose to practice for the rest of my life. It is a weighty and difficult decision to make. Every specialty in medicine is fascinating. Simply put, I want to be able to do it all. I want to be able to replace hips when necessary and at the same time, I want to be able to perform an emergency cricothyrotomy, repair a cleft lip, etc. Obviously, this is extremely naive and indecisive of me - I feel like a child brought to the toy store and I'm only allowed to choose one toy to stick with for the entirety of my childhood. Getting back to 'competitive' residency programs, I don't want to be a resident at the most pretigious residency program. I want to be a resident at the residency program that will train me to be the most effective doctor I can be.
I have no intention of feigning interest in research when what I mainly want is to make positive impacts on the lives of patients that I am in direct contact with. To be honest, I don't know enough about clinical research to desire it; perhaps it would allow me to do exactly what I said I wanted to do in the sentence before this one. In any case, regardless of what type of role I intend to take on as a physician, residency programs for certain specialties, both clinically- and research-oriented, expect research publication from students.
Medical students speak of the R.O.A.D. to success. It stands for Radiology, Ophthalmology, Anesthesiology, and Dermatology respectively. These are some of the specialties that require research publication regardless of future intent of applicants to pursue research or clinical medicine. In fact, even non-research oriented hospitals will want to see research experience from applicants for these specialties. There are several other specialties that students tend to place in a similar category as ROAD that hasn't been associated with a clever acronym yet. To name a few: orthopedics, plastics, neurosurgery, urology, otolaryngology, and radiation oncology.
Students who have gone before me have spent the 3 months between their first and second year of medical school to commit to an already ongoing research project relevant to their desired specialty. If lucky, the research is published and the student gets his or her name on the publication as the last author. I really liked what you suggested about analyzing where my intentions lie - strong clinical contribution or commitment to research. Right now, I am leaning towards heavy clinical involvement and am peeved at the fact that I am expected to do research to remain a competitive applicant. In fact, I'll go as far as to say that a three-month commitment to a research project probably only allows superficial exposure and probably doesn't add very much to the study. Perhaps research experience and publication is a litmus test for residencies to gauge how dedicated students are to their specialties?
I will continue to reflect on what you've sent me in your email. I feel as though 4 years of medical school is barely enough time to just superficially experience all the different types of specialties. It's just been a bit overwhelming that students are expected to have made up their minds barely into first year of medical school. The Chair of Orthopedics at Henry Ford Hospital Systems in Detroit gave a talk at school a few weeks back and indicated that future orthopedic surgeons would have had an unwavering desire to pursue the specialty even before starting medical school!
i didn't mean to throw you. my main message is that you should first know where your heart is and then you can pursue all of the steps to get what you want. importantly, everything you do from that point on should be singularly focused on that ultimate goal.
it sounds like you want to be a general surgeon and then practice in a 3rd world nation where you can perform a large variety of procedures to help people dramatically. i wonder if there are opportunities to travel to Africa or India as a medical student and assist with operations or even perform them. this experience will provide you with much more real world experience and demonstrate commitment to surgery than you can ever show by spending a few months in a lab. being a 4th author on a low level journal will not impress anyone. showing that you spent a year in nairobi and operating on children with appendicitis -- now that's something that will get you into the best clinical training program possible.
He has a point. General surgery will allow me to do many different things and I would become a very effective/high-impact doctor, provided that I'm a good surgeon. Still, I can't say that my path is clear. I thankfully still have some time to figure it out. A life of philanthropy and service sounds extremely rewarding and something that is right up my alley of interests, but a life of leisure and comfort continues to whisper from a place not too far.