For medical trainees interested in practicing in a highly competitive specialty such as otolaryngology, what are the merits of taking a gap year to do research, typically between the third and fourth year of medical school?
For residents who choose a dedicated, prolonged gap year—typically one to two years of research—how does that choice contribute to their future career?
As an increasing number of students take a gap year for research, some even before applying to medical school, questions are being raised as to its merits, and the potential workforce implications such a gap year may have (JAMA. doi: 10.1001/jama.2024.19750).
Although data are lacking on the number of students taking a gap year to do research, either before applying to medical school or during medical school, the trend toward students taking a gap year is well recognized, and there is growing interest in what this may mean for medicine. As noted in a 2025 commentary published in the American Journal of Medicine (Am J Med. doi: 10.1016/j.amjmed.2025.11.021), more attention is needed to understand how the growing prevalence of gap years may affect the predicted physician shortage of 86,000 physicians by 2036, as well as the toll it may take on trainees in terms of financial debt. The authors propose questions that need to be raised to understand the impact of gap years:
Are gap years truly necessary to prepare undergraduate or medical students for their next phase of training, or could their educational benefits be adequately conveyed via existing curricula? Are there ways to identify outstanding candidates for medical school and residency that do not rely on the curriculum vitae embellishment derived from an extra year of clinical work or research?
In otolaryngology, several studies document these issues and questions as the trend in delaying entry into otolaryngology by doing research has increased over the years.
A 2024 study by Boyi et al found that 28% of otolaryngology applicant responders to the Texas STAR survey reported a gap year, of whom 40% participated in research (Ann Otol Rhinol Laryngol. doi: 10.1177/00034894241261821). Among the other responders, 41% completed a Master of Public Health or Science (MPH and MSc), and 19% completed a Master of Business Administration, Education, or other degree (MBA and MEd). The study found that applicants who completed a gap year for research or an MPH/ MSc degree received significantly more interview offers than those without a gap year or those who received an MBA or MEd. Taking a gap year was not associated with match success, however.
Another 2024 study by Smith et al on the rising trends of research production among medical students applying for residency positions in otolaryngology found a significant difference in applicants with research productivity, according to the authors, suggesting that research productivity may signal a positive bias among programs for acceptance of “research-heavy” applicants (OTO Open. doi: 10.1002/ oto2.170).
The impact this is having on otolaryngology and what program directors can tell interested trainees about the merits of research are not fully understood. But there are strong opinions by otolaryngologists with years of experience working in the field, program directors, and, importantly, trainees who have taken such a gap year and experienced its influence on their profession. All agree that what is driving this trend is the need for applicants to increase their competitive edge in a very competitive specialty, particularly with the changes in the U.S. medical licensing exam to pass/fail and the increased difficulty in differentiating applicants using the old metrics of grades (which have become inflated over the years) and clinical performance.
Views from Program Directors
Shaun A. Nguyen, MD, professor and director of clinical research in the department of otolaryngology–head and neck surgery at the Medical University of South Carolina in Charleston, S.C., who has trained more than 14 research fellows annually for 18 years with more than 100 matched in otolaryngology and 15 former research fellows now on faculty, thinks that research gap years can be tremendously valuable for the right student, but are not a prerequisite for becoming an excellent otolaryngologist.
The downsides are that a gap year is not free, delays training, and can add to debt, and the quality of research opportunities is highly variable. “Some students have access to funded, well-structured positions; others are essentially working full time without pay while taking on more loans,” he said. “That raises real equity concerns.”
He cited, for example, changes for the 2026-2027 electronic residency application service (ERAS) cycle “Publications” section that emphasizes high-quality, peer-reviewed academic contributions, with applicants highlighting their top three most meaningful projects (i.e., group-related abstracts, posters, and publications from the same project into a single collection) and describing their specific role (i.e., first author, coauthor). “These ERAS changes may disproportionately disadvantage students who do not have a home otolaryngology program who already face challenges accessing mentors, projects, and specialty-specific exposure,” he said, adding that this may compel students without a home department to take a gap year just to find the right environment and support to produce that level of work.
“But it is important to say this clearly: You do not have to take a gap year to match into otolaryngology,” he emphasized, saying that many successful residents have gone straight through using their existing school structure to do focused research and specialty exposure. “Programs are looking for potential, curiosity, work ethic, and fit with the specialty,” he said. “A gap year is one way to demonstrate those qualities, but not the only way.”
He said that if a student is genuinely excited about research and exploring academic otolaryngology, a research gap year is a great investment. If they are not and are purely keeping up with perceived expectations or new ERAS rules, “then we as a field need to rethink the pressure we are placing on them,” he said.
Saying that she is seeing a lot of interest among medical students to do research, even in their first year of medical school, Amanda Lauer, MS, PhD, the George T. Nager Professor of Otolaryngology–Head and Neck Surgery and co-director of the Johns Hopkins Resident and Student Research Program in Baltimore, sees it as a way for students to beef up their resume with research publications to be competitive. That said, she views the increased interest in research as a good thing because it allows people who don’t have PhDs to get research experience and train to be future clinician scientists. “We really need these people to inform research that translates from basic science to the clinical bedside,” she said, adding that there have been fewer and fewer surgeon scientists, particularly over the last several decades.
The program that she co-directs with John Carey, MD, provides an opportunity for students who did not train in schools with otolaryngology departments or who did not have exposure to an otolaryngology research program to gain experience in the field.
Although Dr. Lauer says she doesn’t know if research influences match success, she suspects it may influence whether an applicant is selected for an interview. Overall, Dr. Lauer thinks the trend for more trainees to do research is very important, as research, she says, informs how doctors treat patients in the clinic and can ultimately provide benefits to patient care.
Eric Dobratz, MD, the director of the division of facial plastic and reconstructive surgery and residency program director in otolaryngology at Eastern Virginia Medical School in Norfolk, Va., expressed concern that many medical students may be pursuing research not because of a sincere interest in building a research skillset and career but solely because of the desire to show superiority over other applicants. “It is concerning, as the overall goal is to identify and select applicants that will train to provide safe and effective care for our otolaryngology patients,” he said.
He also believes that the pressure to take an extra year for research places a high cost on the student by delaying entry into the workforce. “It also may theoretically delay those who complete a research year and ultimately don’t match into otolaryngology from entering the workforce in a specialty that does not fill every year,” he said.
Overall, Dr. Dobratz called this issue a difficult situation to address without clear-cut solutions. “Many programs have also become reliant on research years to help with research production in the department,” he said. “If our specialty would like to avoid creating more pressure on applicants to participate in research years, we will continue to need to find ways to emphasize other aspects of the application and counsel students on ways to highlight those areas, such as unique past experience, overcoming adversity, significant volunteerism, and service,” he said.
Views from Otolaryngologists
Michael J. Brenner, MD, associate professor in the department of otolaryngology–head and neck surgery at the University of Michigan in Ann Arbor, Mich., is one of the authors of the 2024 study that found 28% of students were taking a gap year. He observed that although research productivity affects how an applicant looks on paper, it affords only a very narrow view of what an applicant can bring to the specialty.
“Not everyone has the ability to take off time for a research gap year, especially if the experience is not funded,” he said. Furthermore, he emphasized that research experience is not a reliable proxy for the overall strength of an applicant. “Although it is widely recognized that some leaders in our field engaged in research early in their career, there is little evidence that pre-residency research independently predicts superior clinical or academic performance,” he said.
He also noted that whereas most otolaryngology residents will engage in research during their training, only a small percentage will become independently funded investigators. The incremental value of a research gap year for those applicants who do not pursue a clinician scientist pathway is difficult to measure. “A dilemma is whether current research participation models are efficient,” he said. “If large numbers of applicants engaged in research are seeking competitiveness gains and fewer are pursuing research careers, is the model achieving an optimal allocation of human effort and funding resources?”
He supports a holistic model for assessing applicants that recognizes the many ways that individuals can bring value to the field, whether from diverse life experiences, research endeavors, or other meaningful contributions. This approach preserves research as an option for medical students rather than an implicit requirement.
For those who aspire to become a clinician-investigator, the holistic model supports exploration of a research career without placing undue pressure on those whose clinical interests emphasize other areas such as education, global health, or entrepreneurship. As he explains, “that way, research years remain available and supported for those with an interest in scholarship or innovation.”
He also noted that lengthening the on-ramp workforce entry across applicants can have undesirable downstream consequences, including creating hurdles to entry, increased educational debt, and a reduction of overall years in clinical practice. Over time, such trends could affect the diversity of the specialty and overall access to otolaryngology care.
M. Boyd Gillespie, MD, MSc, professor and chair in the department of otolaryngology–head and neck cancer at the University of Tennessee Health Science Center in Memphis, Tenn., is not a big fan of the trend in increasing research among medical students, as he sees it mostly as a new metric to make an applicant competitive that doesn’t really distinguish who will potentially be the best doctor. He noted that although the volume of research has gone up, the quality hasn’t. “In the past, people did research out of an organic interest and out of a desire for discovery,” he said.
“Now, because research has become a metric for competitiveness, it is a lot more about checking a box, and I don’t see a lot of joy in discovery in many of the students who are now doing research,” he said, adding that he sees it as unfortunate that students feel pressure to do research.
Dr. Gillespie would like to see assessment of trainees return to a more composite evaluation based on grades, board scores, clinical performance, interview, and research if involved. He says research, unfortunately, has become a proxy for intellectual ability.
He also said the pressure to add a research year during medical school puts an extra financial burden on an already hefty debt load. As more people delay entering the workforce with an increased financial burden, he thinks that may make people more focused on financial concerns than they should be for their first job, given that they feel they need to maximize income sooner.
Perspectives from the Applicants
Nneoma Wamkpah, MD, MSCI, assistant professor in the department of otolaryngology–head and neck surgery at Stanford Medicine, in San Jose, Calif., who just started her first position as a facial plastic surgeon, chose to do a two-year research program during residency to enhance her chances of getting a fellowship in the subspecialty of facial plastic surgery—a career goal she had since medical school. “From the beginning, I had a plan of what I wanted to do,” she said. “I think it was helpful to do the research for matching, but there are plenty of people who don’t do research and have successful matching as well.”
Coming from a clinically intensive medical school, it was important for her to gain research experience during residency. Essential to that was finding mentors in her subspecialty. In her current position, she is pursuing opportunities to incorporate research into her clinical duties.
She emphasized, however, that every trainee’s situation is unique, and for those who take time to do research but don’t want to pursue it in their career, she understands why it might feel wiser for them to go straight through medical school or residency without taking extra time for research.
Her one piece of advice is for trainees to check out multiple residency programs and hopefully get the opportunity to meet mentors in those programs. “You have to take a look at the ones you can go to and see if they have the resources that will be a good match for you,” she said, adding that everyone has their own individual goals and motivations, and there is no right or wrong way of working toward a medical career. “When you’re on the path you are on, you make the most of what is in front of you. If you have a strong belief in what you want to do, odds are you will end up in a place that fits your goals,” she said. “You may not see it right away, but you will get there.”
Alexandra Berges, MD, a resident in the Johns Hopkins otolaryngology– head and neck surgery department in Baltimore, said she took a research gap year between her third and fourth years of medical school, given her interest in translational research, and that the timing coincided with the reduced clinical load during COVID-19. During that time, she worked in a laboratory studying inflammatory, genetic, and molecular factors involved in laryngotracheal stenosis and iatrogenic tracheal injury. She also shadowed head and neck oncologic surgeons to deepen her understanding of the field. The gap year also provided a way to delay application for an otolaryngology residency during a year when 13 people were applying for such a position in her medical school. “I felt there was a benefit of delaying a year to make myself more competitive,” she said, emphasizing that the gap year also gave her added time to develop relationships with mentors.
She said she thinks it is increasingly uncommon for students to go straight from college to medical school, or from medical school to residency, because many of the experiences (community service, clinical exposure, research) needed to be competitive are hard to fit into college.
Dr. Berges said the problem for trainees is that there is so much competition and not many ways to distinguish oneself, especially in the era of pass/fail grading systems and United States Medical Licensing Examination scores. Adding research is one way. But, she emphasized, it comes at a cost, both figuratively and realistically. “Many residents in my cohort are older, so taking additional time inevitably delays future earnings, which plays a factor in deciding to take a gap research year,” she said.
Arifeen Sylvanna Rahman, MD, is a resident in otolaryngology–head and neck surgery at Stanford University in Stanford, Calif. Her program includes an integrated research component that allows her to dedicate two fully funded years to research without interspersing other clinical responsibilities with her clinical training. She said prolonged research time as an option in residency is an overall beneficial option, as it provides protected, funded time to focus on research in the area that they may later specialize in and create foundational work.
“The downside is overall prolonging medical training, which over the years has become more and more filled with the pressure to add additional years of research time at various points to optimize one’s chances of academic success for those who may not be genuinely interested in research,” she said. Another downside is that some applicants do it to increase their odds of matching at a particular program.
By doing research, Dr. Rahman said she hopes she can make a difference in changing the conversation about what is important and warrants more focus and investigation in various fields, adding that many of her published studies are rooted in advocacy about particular issues in health policy or the process of medical training. She said she’s trying to give voice to topics that are not openly discussed.
Mary Beth Nierengarten is a freelance medical writer based in Minnesota.
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