A “gap” year has different meanings in medical education, from international travel to introspective evaluation to academic research. In the academic medical community, a “research gap year” specifically refers to a year that trainees devote towards furthering their academic careers. This is a broad overview of the major factors to consider when coordinating a research gap year, especially pertaining to medical students who are applying into specialties that strongly encourage engagement in research. This piece is based on my personal experiences (what worked and what could have been improved) and is not meant to represent the wide spectrum of opinions on this topic.
The timeline (when to start, what to look out for, informing the medical school)
It is generally a good idea to begin exploring a research year approximately 6–9 months before its commencement. This is to allow plenty of time to figure out logistics, funding, mentorship, and the works, especially given that most students are on clinical clerkships while having to navigate these processes. Schools often have preferred dates by which students will inform the dean’s’ office on their research year, which may be labeled as a “research concentration year” or a “leave of absence” depending on the school. Additionally, there is usually an application that students will need to fill out explaining the focus of the research year. The reason for this is primarily two-fold: to provide the school with an explanation for the gap year and for the school to potentially guide the selection of mentorship or research institution based on prior student experiences. It would be wise to use any breaks from clerkships to explore pre-planning for the research year as it may be challenging to meaningfully plan the year amid the chaos of the wards.
Funding provides the means for students to have a productive year without accruing more loans (and some loans may not cover “leave of absence” years). Broadly speaking, there are two major categories of funding: internal and external. Internal (institutional) funding is school-specific and students should contact the equivalent of a dean of educational affairs to learn more. These funds are highly variable; for instance, a student at a medical school with limited research funding may experience more difficulty when applying for research funding through the school. On the other hand, students at a research-rich institution will usually have a more well-structured research fund and application process available. These details should be explored at least 6 months before the research year begins, especially considering variations in institutional application deadlines.
External funding comes in the form of federal grants such as the HHMI (Howard Hughes Medical Institute), Doris Duke, and NIH/NCATS (National Institute of Health, National Center for Advancing Translational Sciences), in addition to private scholarships. Duke University School of Medicine has compiled a well-rounded list of similar externally funded opportunities. here. Schools affiliated with a CTSI (Clinical and Translational Science Institute) may have a TL-1 NIH predoctoral scholarship reserved for medical students, providing funding and a research-specific curriculum to mold students into stronger researchers. Finally, there are a wide variety of privately funded external scholarships students can apply to. Many are specific to the specialty of choice, and some are available through the national specialty organizations.
Selecting an institution
While funding is often intertwined with the selection of a research institution, there are associated pros and cons of where to take a research gap year. One frequently preferred option is to take the gap year at the home institution’s specialty department because it is easier to coordinate with the school. As students are statistically more likely to match at their home institution, devoting a research year at the home institution may further increase the probability of matching there. Furthermore, there is the familiarity factor of having worked in a hospital where the staff knows the student. However, there are “away” research gap years as well.
Personally, I decided to look outward for my research gap year at a research-strong institution. First, the faculty had an abundance of experience working with students and shared a mutual understanding of expectations for the research year. Next, there was a well-established infrastructure in place to facilitate the processes of grant writing, institutional review board approval, and statistical support. Not only did these mechanisms help to streamline the turnover of my projects, they allowed me to juggle multiple academically stimulating projects simultaneously through a staggered approach. Finally, there is the added benefit that this option will create meaningful relationships which may increase the probability of interviewing and potentially matching there.
Selecting a mentor and creating expectations
This is perhaps the most important piece of the puzzle, as most students are already aware. Naturally, it is not surprising that students find this process daunting. Because physician-mentors often cap the number of trainees for a research concentration year, it would be prudent to reach out as early as possible. For instance, I met with my research mentor 9 months prior the start of my research year. The research fellow after me had reached out an entire year in advance.
There is some controversy regarding mentor selection. While some may prefer research mentors to be senior and well-established faculty members, others may recommend younger mentors who are in the active process of building their own research careers. Although this is a frequent point of contention for students, there is no correct answer. It is more important to align oneself with a mentor who has shared research interests and is strongly invested in the student’s success. This can be achieved by speaking with upperclassmen applying into the same specialty who have taken a research concentration year. It is often beneficial to seek a mentor who has a track record of successfully working with and supporting students previously.
As the research year is a considerable investment for both the mentor and student, students should meet with several potential candidate-mentors in person and decide among them. It may be more challenging to work with a mentor who is highly engaged in numerous activities, which may preclude the development of a meaningful mentorship experience. Additionally, as there will be a close engagement between mentor and student during the year, it is important that personalities match to allow for synergistic collaboration. Finally, it is important to gauge expectations during these meetings to correctly align oneself with the most optimal research experience (e.g. what the day-to-day looks like during the year, what the student’s role will be in projects, how many potential projects to work on) so expectations are met.
David is a fourth-year MD/MBA Candidate at Tufts University School of Medicine, previously a research fellow in the Department of Dermatology at Brigham and Women's Hospital. His NIH-funded research is focused on improving dermatologic care through quality improvement.