How To Publish Papers as a Medical Student or Resident

First and second year medical students often are anxious about the “need” to publish but have trouble finding details about the process and goals of writing. Yes, it’s true. If you are going to be applying in a competitive specialty, you need to have at least one (but maybe a few more) publications. BUT (and this is really important, so please pay attention) there are two important things for you to know:

It’s called academic medicine because we are part of the academy! That means that we are trying to teach and change outcomes for the future. Don’t look on these papers as a “check box”. Find a meaningful question and learn from a mentor how to answer it. You will make a difference!

Secondly, you do NOT have to publish in the field you will ultimately choose. Publications are really a surrogate for being able to think, work in a team, and write. It’s showing that you can take a complex task and actually complete it. No one expects a first or second year student to know they want to be an expert in the pathology of Hodgkin’s disease! The key is to find a mentor who will teach you the process and show you how meaningful and fun it is to study something in depth and then share what you learned with others.

So how do you do this? It starts with a blank form:

So let’s break down the five steps from starting to publishing a clinical research project…. The times in parentheses are my estimates for how long this takes for a student who is on clinical rotations. If you are doing this full time as an month long research elective, it will take less time for each step. (But – note to self – you need to get the IRB request in 2 months before your research elective starts!)

Store your PDFs in Zotero – you can attach it as a file if it doesn’t automatically download. Don’t forget to add the Zotero plugin to Word if it doesn’t automatically install.

This last step is the key step (my opinion, others may have other strategies). My goal is to read each article ONCE.  Therefore, I put EVERYTHING I think might be of interest from each article as I create my outline. It’s a lot easier to edit things out than add things in…

I start with an outline in Word that has headings something like this….

  • Introduction
  • Epidemiology
  • Pathophysiology
  • Natural history of the disease
  • Presentation
  • Treatment
  • Outcomes
  • Complications

So, I might read this paragraph in an article written by Smith et al in 2015 (I’m making this up – don’t quote anything written below!)

Pyloric stenosis was first described in 1886.  Prior to the introduction of surgical treatment, the death rate was 50%.  Surgery, which started in 1923 has now led to an almost 100% success rate with no mortality.  The typical patient is male, and 4-6 weeks of age.  They present with projectile, non-bilious vomiting and do not appear ill between episodes of vomiting.

So – using the outline in Word and Zotero I would do this…..

You then go on to subsequent articles and – even if they mention the same detail – you put it into the outline. For example, if you found 4 articles that said the typical age was 4-6 weeks, it would look like this: Typically 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)

Next, use your outline to start actually writing about the information you have gathered. As an example, switch to the “text” setting to change your note about age at presentation from “Typically 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)” to text that says “The average age at presentation is 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)”

How to save yourself hours by using Outline View properly

The Institutional Review Board is responsible for protecting patients participating in research.  Even if you are “only” reviewing charts, they must be protected with respect to confidentiality, etc.  This is not usually true for case reports, but since many journals require IRB approval, you may have to submit it anyway and have the IRB letter that says it’s exempt.

It takes approximately 6-8 weeks to get the IRB approval after it is submitted.  If they require modifications, it can take longer.  You can’t (and shouldn’t) look at charts until you get this approval.

You must have IRB approval before you can submit the list of patients from the hospital with the disease you are studying. If they are treated by doctors other than the faculty you are working with, the IRB may ask you to send a letter via the hospital medical staff office to the other doctors giving them the option to exclude their patients if they want to.  (They virtually never do, but this is a required step)

The “term paper” is just what is sounds like.  Depending on the topic, it will be ~6-15 pages long with ~20-60 references. Here is where the outline and Zotero are so important.

Change the “view” in your outline to “draft”. The outline levels will be in Blue and will now be section headings. Everything that you wrote as text will be just that – text. You can write in this view or go back and forth between the draft and the outline if you want to rearrange sections.

All of the links to the references you put into Zotero using “Add/Edit Citation” will be in your draft. At this point, you click on “Add/Edit Bibliography”. It will prompt you to choose which journal you want (Yes! It knows the format of all the major journals!) and then will automatically create the bibliography. If you add new references in at the top of the manuscript, or change the order of the sections, you click this again, and it recreates the bibliography in the correct order.

As you are creating the outline, you are also designing the “data sheet” to retrieve from the charts the details you need to prove your hypothesis.

Writing a term paper is a great way to become an expert in the topic you are researching, but it also helps you later. The hardest part of any final paper to write is the introduction and conclusion – which you mostly do by writing the term paper!

Once you’ve got to this stage, you want to skim through the articles again to see if there are any “big picture” points you might have missed and then write the summary – i.e. the abstract.

It is ALWAYS better to write the abstract after the manuscript if you can.  But – many times the deadline for the abstract will be used as the motivation/pressure to write the manuscript.  Each attending will do this a little differently. 

Use this section as a “journal” for your submission and for notes during meetings.

Good luck with your projects! I hope this helped!

Applying to Residency: Tips for Medical Students (from MS1 to MS4)

Applying for a residency starts with choosing your specialty.  The application for residency includes personal statements, curriculum vitae, letters of recommendation, transcripts and all the other components required by ERAS.  This application is then used by the NRMP to match medical students to their residencies.  It’s a fairly complex process on a relatively short timeline.

Photo Credit (You Tube video)

The prezi below was put together to walk medical students through the process – from picking a specialty to matching in the specialty and program which is the best fit for you.

 

I’d love feedback from anyone if I’ve missed something or could explain this in a better way – please comment below!

Best of luck to the students who are starting this process to match next spring – and thanks to all the faculty, administrator and deans who help them along the way!

Photo credit

 

Residency Applications: The Curriculum Vitae

Other than the personal statement, there is nothing more distressing to medical students applying for a residency than putting together a Curriculum Vitae (CV).

student at computer

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So, what exactly is a CV?

 “The original Latin meaning of curriculum was a course, but of the kind that one runs around (it came from currere, to run).   Even more recent — dating from 1902 — is curriculum vitae, literally “the course of one’s life” (from World Wide Words)

Your curriculum vitae is a document that serves as a summary of what you have accomplished as a professional.

 

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What’s the difference between my CV and what I put on my ERAS application?

Your CV and what you put in ERAS differ in two important ways – the content and the format. ERAS will generate a CV from the information you enter, but it’s not in a format that is usually used for a professional CV.  In addition, the ERAS generated CV will not have the same information you will want on your CV.  For example, ERAS “experiences” don’t translate well into a professional CV.

 

Why do I need a CV in addition to what I put into ERAS?

  • You will need to give your CV to any faculty writing a letter of recommendation.
  • You may be asked to send a CV when applying for away electives.
  • It’s a good idea to take your CV with you on interviews to provide a copy to the program, especially if you have updated it since your application was submitted.
  • If and when you send emails to programs after you interview, it’s a good idea to attach your CV if it has changed at all. Bcc yourself when you do – if there is a problem with the email or the attachment, you’ll know it quickly.

 

What do I need to include in my CV and what should it look like?

There is no absolute “standard” format for a CV, both in content and in style, but there are some guidelines. In general, in addition to the “heading” with your name and contact information, the following sections (if they apply to you) should be included in the order they are listed.

  • Education (degrees, institutions)
  • +/- Place of Birth
  • +/- Citizenship
  • +/- Languages
  • Military service
  • Work experience (this is not summer jobs unless the pertain to your application i.e. don’t list being a waiter, etc!)
  • Volunteer experience (make sure it’s significant. There is no advantage to listing 20 things that all lasted a week or two …. again, unless it’s specifically related to your application… see “don’t pad your CV” below)
  • Other training (eg BLS, ACLS, special courses to learn a skill)
  • Professional memberships (including leadership positions, committees)
  • Honors and awards
  • Publications
  • Presentations
  • +/- Personal interests (drop after you match if you include it)

 

It’s a good idea to show your CV to mentors in your specialty to get their feedback since there can be subtle differences in CVs between specialties.

mentoring brownPhoto credit

 

What should I do to avoid common mistakes in creating my CV?

  • Pick one font and stick with it. (11 or 12 font and something really standard).
  • List items in each section in reverse chronology (most recent first)
  • Number your publications and presentations.
  • Leave plenty of “white space”
  • Don’t “pad” your CV with trivial events or accomplishments – it’s more important it’s accurate and appropriate than long.
  • Go ahead and list “hobbies and interests” as your last topic for the residency application, but remove it as soon as you match.
  • Double (no, triple) check spelling and formatting. Your CV is often the first impression a program will have.
  • NEVER put any designs, photos or logos on your CV.
  • If you put your personal email address, make sure it’s a professional email address. If it’s not, it’s time to get a new one.
  • Don’t EVER lie or exaggerate.

 

Where can I find examples or templates for my CV?

Many medical schools have examples on line and all schools have help in the Office of Student Affairs or through other faculty mentoring programs.  You can also sign into Careers in Medicine to see examples of CVs, which are also here.

nrmp shes met her match

 What should I do with my CV after I match?

Remember, your curriculum vitae is a record your professional life… so it’s a “living” document that will need to be updated as new things happen. There is no one else who will every know exactly what you do and what’s really important more than you will. Keep a list somewhere of everything new that should go on your CV and sit down at least every month or so to review and update your CV. After residency when you “graduate” to having an assistant of your own, it’s still probably better to update your CV yourself. The AAMC provides a good example of a typical Faculty CV here which gives you an idea of what your future CV will look like!

keep calm and write

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