Residency Interview Question: Academics or Private Practice in the Future?

Introduction:

 
There are several curve ball questions which the interviewer can ask during a residency interview that often leaves the candidate perplexed as to what will be the implication of answering it one way or the other. There are unfortunately no straight answers to such questions and one such commonly asked but important question is: what do you plan to do in your future as a physician? Do you plan to stay in an academic setting or do you plan to have a private practice? The problem that an applicant faces when posed with this or a variation of the question is that – one is never sure what to say! If you say you want to do private practice, then there is a chance that the faculty interviewer or program director may look at it unfavorably (they themselves may be academicians) or if you say you want to do academics but have no skills or experience to back it up, you may look unprepared. 

Method: 

Using data from program directors survey (2012), one can glean some important information as to how to answer this question. The programs (specialties) were placed on the x-axis based upon the emphasis a program places on academic career of the applicant (in the order of increasing importance, from left to right), This is displayed by the green line with yellow circles in figure 1. Also included is the effect of having some prior research experience on the likelihood that a program will invite an applicant for interview (blue circles, trend line).

Figure 1: Perception of programs for career in academics (source NRMP)

Results and discussion:

Based on the ‘program interest in applicant academic career’ (which is an almost linear graph), the area is divided into 3 zones:

1.    Programs with < 30% importance (low): Med-peds, family medicine (FM), PM&RS, Pediatrics, Anesthesia, Obstetrics and gynecology.
2.    30-39% (medium): Internal medicine (IM), Orthopedics, ENT, Emergency medicine (EM) and Neurology.
3.    >40% importance (high): Psychiatry, dermatology, General surgery, Pathology, Child neurology and neurosurgery.

Thus, for those applicants who have applied to med-peds, family medicine or pediatrics, it may be better received if you indicate a non academic job in future. You can use this answer during the interview or imply in your personal statement, that your future plan is going to be practicing medicine in the community in a non-academic setting. For applicants to Internal medicine, they can chose either answer depending on your perception of the interviewer and the program. For neurology applicants, even though it would be a zone II program, it may be better to indicate that you would like to pursue an academic career post residency. Finally, for pathology and neurosurgery, which are the at the end of zone III, choice of academic career may be better received.

I have to point one important thing, regardless of what the interviewer leans towards, it should not affect what you really feel like when the answer the question, because ultimately you will do what is best for you. There are many things that affect the outcome of the interviews and this result only indicates, how your answer may be received by the programs possibly affect your chance of interview and being ranked into a program. If you wish to be in touch and get the latest posts and updates, join me on Facebook or follow me on Twitter. Also Scroll below ↓ for the most popular articles this week!

Reference:
National Resident Matching Program, Data Release and Research Committee: Results of the 2012 NRMP Program Director Survey. National Resident Matching Program, Washington, DC. 2012.

Influence Of A Gap In Medical Education - Cv On Residency Application

Introduction:

Very often, there is a question of how much does a gap in your medical education affect your residency chances?  Though there are no predetermined definitions or rules to describe what constitutes a gap in medical education, common understanding dictates that any period of your life where you are not involved in medical training or carrying out your duties as a physician are called ‘gaps’

Gaps can be small from few days to weeks time, moderate (few months at a stretch) or long gaps (years). Some common examples of small gaps in CV are taking time out to prepare for exam after graduation for medical school or even few weeks spent for personal reasons. The most common cause of moderate sized gap in your CV is actually related to the effort of applying for USMLE itself! Many applicants are done with medical school and are then preparing for steps 1 or 2 CS/CK and take a few months off to make sure everything that needs to be done is done. These moderate gaps have some influence on match chances but the most damaging of all are long gaps where the applicant has been out of medicine for years at a time. On common theme in this scenario is an applicant who has failed multiple times and takes years to get ECFMG certified or an applicant who decides to focus on other career or personal life (kids, spouse etc).

It is important to distinguish an old graduate (applicant with old year of graduation) from someone who has a gap in CV. Not all old grads will be considered as having gaps especially if they have been productive in other medically related fields (residency applicants doing PhD, masters etc). Thus old year of graduation in itself is not a bad thing but having breaks in education or profession is. 

Motivation: 

For an international medical graduate, minimizing the amount of gaps in CV is ideal. However, there are extenuating circumstances where there will be gaps nonetheless. In view of this inevitability, I have analyzed data from NRMP to see which specialties are lenient when it comes to gaps in your CV and which ones are more strict.

Methods: 

The line graph demonstrates two parameters, importance of gap in CV for obtaining interview (INTERVIEW) and importance of gap in CV as regards ranking the applicant (RANK). The individual specialties are depicted on the X-axis with increasing order of importance that the programs place on gap in CV. Since interview precedes the process of ranking, the subjects were ranked according to influence on interview invitations and then the influence on ranking was overlaid.  The ‘interview’ and ‘rank’ factors were different metrics and were normalized using min-max algorithm to allow for appropriate comparison.

Fig 1: Importance of gap in medical education (CV) per program specialty, source NRMP

Result: 

As can be seen in the figure, the subjects of pediatrics, surgery and Ob-gyn placed the least importance on having a gap in your CV when it came to offering an interview. On the other end of the spectrum, emergency medicine, pathology and psychiatry placed the most importance.  Radiology, internal medicine and neurology were in the middle. Most subjects except for emergency medicine had narrow range of fluctuation regarding the importance of gap in CV when it came to ranking applicants for match.

Implications: 

1. Applicants with multiple or long gaps in CV may be better off applying to pediatrics, surgery, Ob-gyn or anesthesia residencies. However, since only pediatrics is IMG friendly, it would be a better choice amongst others.
2. Those interested in pathology and psychiatry have to make sure that there are no big or multiple gaps in their education to increase the chances of matching to their favorite specialty
3. Family medicine was surprising result where in it seemed that programs in FM placed a fair amount of weight on your continued medical education/profession. 
4. When it came to ranking applicants, there was not much inter-subject variation on the importance of gap in CV except for emergency medicine.

Conclusion: 

Having a break in your medical training or profession as a physician can have an important effect on your chances of interview and matching to a residency program. There are significant inter-subject differences, which warrant careful selection of subjects if an applicant has gaps in CV. However, there may be other things in your resume which could make a positive impact in your application and compensate for the negative influence of having a gap in your CV. If you wish to be in touch and get the latest posts and updates, join me on Facebook or follow me on Twitter.

Difference between CV and resume for residency applicants

Resume is typically short (less than 2 pages)

Why you need a short version:

For many applicants who do not have lots of accomplishments, the difference between CV and resume is not much. However, if you are very accomplished with many abstracts, posters presented or volunteer work done, then writing all of your accomplishments in a list format can be tedious. It is very easy to lose the most important accomplishments in a sea of other not so important things you have done. Hence it is imperative that you have a document not more than 2 pages long which includes all of your important undertakings

When to use it:

The short resume version is a good version to use during your residency interview. When you are called in to interview with the program director or faculty, you can always break the ice by saying something to the effect that – “I know you have my ERAS CV and may have looked at it, but I would like to present to you an updated brief resume of my most important accomplishments”. This is a great way to make a robust impression on the interviewee and you can leave a copy with them in case, they want to get in touch with you or even help them remember you and put a face to the name.

How to make one:

This point is not as easy as it seems but usually a good resume is not more than 2 pages long. Make a list of all the things that are on your CV and then pare down the list by order of importance. Do not have any redundant data on your resume that may already be in the system or in your file, for example you do not need your USMLE step scores in there as they will already have that information. No need for any visas status or hobbies as well.

resume versus CV: residency application

CV is more in-depth, lengthy (2 pages +).

Why you need a long version:

This is the back bone of your professional life and chronicles all the things you have done, things you have accomplished and participated in. CVs of very illustrious scientists, clinicians and professors often run in 10-12 pages with type 10 font! (with a line in the end – please get in touch for full list of references, publications etc). For a newly graduated medical student the CV may be 2-4 pages long. This will include your home address, contact information, positions you have held, presentation, grants and funding source etc. Talks and posters you have presented will also be included here, including volunteering efforts. Do not hold back in writing all you have done but be careful as to not appear frivolous. Writing that you were the secretary of the local playing card club may look pretty silly

When to use a long version:

The long version is automatically made for you by the ERAS CV applet online. This CV will be sent to all programs and will also be copied to be distributed to all your interviewers. One good time to send the long version to PD or PC is in January. Giving them an updated CV will help them remember your name and get back into the memory spotlight. For this you need to have your CV that is updated, sending the same CV multiple times just looks silly. You don’t really need to send a free form CV to anyone, but it will definitely come in hand in many situations later on in life (visa applications, interviewing for jobs, 'green card' application etc).

How to make a long version:

There are 2 ways to make the long version; the first one is fairly easy with the ERAS online template the CV is actually made for you in a format that is uniform and acceptable by programs. The other one is the free form CV which you make in MS word or any other word processor software. There are several examples of long CV online but the one I prefer is linked here – see the image.

In conclusion, know the difference between a CV and a resume, Spend some time working on both, use each of them to your advantage. Also, if you applying to different specialties try and tailor your resume. For example if you have experience in both pediatrics and psychiatry, then put the pediatric experience above the psychiatry experience and vice versa. If you like this site and wish to be in touch and get the latest posts and updates, join me on Facebook or follow me on Twitter.

Keep your CV ‘Rolling’ – Augment Professional Success

Studying, exams, scores, applications. For a residency applicant, this turns out to be a frequently repeating occurrence like the soak, wash, rinse cycle of a washing machine. This is true not only for a second time applicant but also is a sad reality of a first timer because there are multiple steps with similar motions on the way to get a residency in medical field. In the busy schedules of medical students or physicians one often overlooked but exceedingly important thing is your resume and CV. Websters dictionary defines CV as a short account of one's career and qualifications prepared typically by an applicant for a position. The difference between resume and CV according to about.com is that a resume is typically short (less than 2 pages) while CV is more in-depth, lengthy (+2 pages). To be professionally successful, one must work towards accomplishments and have a ‘rolling’ CV

What is a rolling CV?

Simply put, keep adding meaningful accomplishments to your CV every 6 months. The additions have to further your professional development and make your application stronger. Why 6 months, would you say? 

Half a year is a reasonably good length of time to do things in a dedicated manner. 

Anything shorter than that is not enough to produce quality work and longer than that is a bigger gap. Rolling your CV as opposed to having a static or stagnant CV very important. Every one who is a success does it in a way applicable to their situation. Top scientists, keep publishing. Developers keep innovating new ideas.

When should you begin ‘rolling’ the CV?

It is a continuous process of progress and advancement of your self. The sooner you decide to set this goal, the better the results will be at the end of the year. It can be as simple as setting a few minutes aside from your day to decide what else can you do to improve yourself. 

Set some time aside to figure out what you can do that matters to your application

Figure out a good thing and then get working on it. Also, remember to make the additions to your CV before applying for a job or residency, so that the programs receive the most current version of your profile.

Professional advancement requires an evolving progress

How can you keep your CV rolling?

There are many ways to keep your CV moving forward and have been dealt with in detail in other sections of the site. Briefly, you could sign up for some courses or get some extra degree credits. There are also options to add to your list by showing you are productive in writing and publishing. This can be in the form of case reports, journal articles, letters to editor, critical review, critique, original submission or even a personal commentary on hot topic issues. Do not be disheartened if your entry does not get accepted, this happens – all the time. Even the best of physicians get their manuscripts returned. The idea is to keep trying by sending to another journal or medium (website etc) or trying again with revised better content. 

Never say no to opportunities that may come you way. 

But to make those opportunities you have to work for it. Other additions like volunteer work,working in charity hospitals or free clinics are also valuable additions to your CV.

Finally, why should you do this?

The very fact that you want to pursue residency and post gradate training in US indicates you have a desire to further your professional careers. Having a evolving improving CV shows many of the attributes that potential employers are looking for in a candidate. They want to hire someone who is industrious and innovative. Some one who has versatility and is able to validate the mission of the institution. This issue is very important for so called ‘old grads’, if you have graduated from medicine years ago and are now applying for residency, what you  have done in between becomes the single most important factor aside from scores. If you have not been doing much, it is not late to start. Do a critical appraisal of your self and decide what you can do to improve your application.

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sample letter asking for research experience

This is a sample letter asking for a chance to obtain research experience. Many applicants have good scores and USCE but may still fall short of matching because their resume is not well rounded to appeal to the programs they applied. Not all graduate medical education programs place emphasis on research but certain institutions or specialties do like applicants who have research background are not just scores and more scores. 

After you have decided on what kind of research you want to do, the next step is to prepare a list of faculty and institutions that you will correspond with. The basis of this list may be geographical (only places close to where you live in US), topical (research topic that you are interested in) or contextual (dependent on your CV or contacts).

Dear Dr. John Doe,

Medicine is an ever changing science and each change rests on newer scientific discoveries improving on the previous technique or method. I recognize the fluid nature of medical discoveries and comprehend that for a physician to excel in clinical care, firm rooting in scientific thinking is a must. Realizing this need to hone my scientific skills and to consolidate my fund of knowledge, I plan to purse clinical/basic/translational research in (your favorite subject here).

In my search for a research program, I came across your institution as a significant heavy weight in the areas of research in (your favorite subject here)[1]. I have had the opportunity to read up about the recently published work done by your team in __abc____ (pub med search the author or faculty, use this if they have published in the last 2 years, if not, DO NOT use this line). The results and conclusions in this report are relevant to my interest in __abc__ . In order to familiarize myself with the nature of research and to be a part of scientific community, I would like to offer my time and effort as a research apprentice/assistant. I am skilled in data mining, tabulation and representation [2] of data with familiarity in statistical methods [3]. I work well in a team and would be able to train and work with your graduate student/post doctoral research fellow without intruding on your time, their progress or laboratory workflow.

The benefit I bring to your team would be my clinical training and expertise in human disease and therapy. Though compensation for my time and effort would be a helpful incentive, lack of such will not preclude me from pursuing this opportunity. Your team is helped by more manpower and I receive research exposure. I can guarantee that after seeing my work ethic, scientific rigor and professional discipline, you would have no hesitation to draft a letter of recommendation on my behalf in your capacity as the research mentor.

Also, I am very interested in continuing this association by applying to your institution for residency starting in 20__. In this manner, we can continue to collaborate should I match in (your subject – medicine, peds, pysch, neuro etc) at (name of the institution). I am attaching a one-page resume for your perusal at this time [4], I will be more than happy to send a detailed CV, if you wish to consider extending me an offer to work with you.

Thank you,

First Lastname, MD (use MD, do not use any other degree unless the faculty is a physician himself and knows other medical degrees like MBBS etc)

1. Before you compose your email to the faculty do some background reading and home work regarding the work they do. This will make you sound exceptionally interested and make you appear a serious candidate.

2. If you don't know how to use excel or similar software, spend some time learning it. It will be the most useful skill set to learn in research data analysis. There are several videos on youtube and tutorials online on this topic.

3. Again, if you did biostats as part of PSM (preventative and social medicine) or epidemiology in medical school, now would be a good time to brush up on it.

4. Remember to have both long and short versions of your CV. 

If you like the example above, feel free to change it as suited to your needs. Dont forget to join me on facebook or follow on twitter! 

sample letter asking for observership

As a response to my past article, On writing to the department chief, I had several folks ask me what kind of letter should one write when initiating communication with physicians. The following is an example of a letter, which you can use to ask for observership opportunities.  

 DON’T copy the letter verbatim because you may find that your credibility will be called into question using cookie cutter templates. The idea of showing the below example is to allow you to formulate a channel of correspondence that gets results. 

This template letter may be applicable to you in most cases but if background is unique enough, the letter may be molded to support your intent. Also make sure to read the foot notes to different points that are touched in this letter paying careful attention to the topics brought forth. Also, the italics are special directions, that you can modify as needed to suit your purpose.                                                    

 

Name: residency applicant

two lines of your current address

can go here

phone number

Sub:

Seeking a possibility for shadowing[i] in Dept. of (your favorite field here). This line will be an explanatory heading unlike the email subject, which has to be attention grabbing.

Dear Dr. Dept. Chair[ii] (personalize by using name),

(Introduction, paragraph). The purpose of my correspondence with you is to explore opportunity to shadow in your department. As you may be aware, one of the silent requisites prior to being accepted into a US program is familiarity with the US health care system[iii]. I am determined to understand the nature and workings of health care delivery in US and for that matter would like to shadow a medical team.

(Why I chose you, paragraph). The reason I chose your department is because, it is one of the busiest programs with illustrious faculty, and a training program[iv] that seems to uphold the six core values of the ACGME curriculum[v]. The breadth of patient care issues and the depth of involvement of your physicians are worth learning from.

(Why you should choose me, paragraph). I am driven and ambitious to achieve a level of professional excellence, which I see in action at your program. The testament to that statement comes from ______ (insert your best accomplishment, or recognition, it has to be good!)[vi]. Also, I am very interested in continuing this association by applying to your program for residency starting in 20__. This engagement will allow the faculty to evaluate for themselves a potential asset for the program. I am attaching a one page resume for your perusal at this time[vii], I will be more than happy to send a detailed CV, if you wish to consider extending me the offer. 

Thanks

First name

ECFMG number

---

[i] Avoid using and abusing the word observership. Letter should sound fresh and crisp.

[ii] Or other faculty that you have come to know, who is in a position to influence the program.

[iii] There is no mention that you are “IMG”, it is easy to deduce that, and is implicit. Thus does not look like “another IMG seeking observership opportunities”

[iv] Do some homework about the place you are writing to. Sounding superficial is just as bad as being ignorant.

[v] Familiarize your self with these and use this if you know residents or someone who is in the program.

[vi] Don’t waste a good letter with a bad reference. If you don’t have much to sell in the first place – do not attempt to sell a poor accomplishment by garnishing or inflating your achievements. Doing so will result in instant discredit and loss of any future chances of getting anything done from there.

[vii] You are doing them a favor by not attaching a bulky 8 page resume at the first pass. They will be thankful to you for not flooding their inbox with attachments they do not need. Remember to have both long and short versions of your CV.

If you like the example above, feel free to change it as suited to your needs. Dont forget to 'recommend' me on facebook or follow on twitter!

10 ways to improve residency chances through letters of recommendation (LOR)

1. Target each LoR to the specific specialty you are applying to. For this you will have to meet with the referee to explain the nature of the LOR and its purpose.
2. According to American Medical Association (AMA), LORs from overseas schools are not very helpful since international medical school standards vary and often are not comparable to those in the U.S.
3. Get some experience working in a U.S. health care system before applying for residency so that you can get a US LOR
4. Teaching programs are better than private offices of physicians in US for point number three
5. Opportunities for USCE/observerships/externships are hard to come by but if you work hard enough, you will get a good break
6. Letter, which extols your clinical abilities in addition to other niceties, is received very well by programs.
7. Work with your letter writer to produce a well composed, personalized attestation of your capabilities as a physician and portray you as an asset.
8. Deans letter is not that important unless there are delinquencies and discrepancies in your medical education.
9. Since at least 2007, increasing weight is being given to LORs from US teaching hospitals. In same line of thought, LORs from faculty in hospitals without ACGME accreditation will be carry less importance.
10. Order of importance of LOR
1. US LOR from ACGME accredited university hospital
2. US LOR from ACGME accredited community hospital
3. US LOR from non ACGME accredited hospital
4. US LORS from university based research program
5. US LOR from non hospital based community physician
6. Non US LOR from US affiliated university hospital
7. Non US LOR from university hospital
8. Non US LOR from non teaching hospital
9. Non US LOR from private physician
10. Non US LOR from non physician

PhD as an Alternative for International Medical Graduates

In the first part of the article, I spoke about masters as an option for foreign medical graduates either before or as an alternative to getting a residency. You can read that article here, Masters programs as alternative for IMGs. As discussed before, getting a residency is getting tougher every year. The 45-50% match rate for international or foreign medical graduates is going to decrease. This is due to an increasing number of foreign medical graduates applying each year. For the unmatched applicants alternatives are an important question. Here in, I discuss graduate school as an alternative for international medical graduates with special emphasis on PhD track as an option.

The two main reasons discussed earlier as to why IMGs are attracted to graduate school programs are still the same -

• As a temporizing measure
• As a permanent solution.

As a temporizing measure, PhD program is not a good idea. Firstly, if you do drop out of your program and choose to jump ship, this will forever be a point of contention on your CV. It may appear that you do not have the conviction to finish the task and affect your chances later on in life. There is a middle option for those who do not wish to continue with PhD. At least finish your course work, appear for qualifiers and graduate with a masters in the subject (your graduate committee permitting).
 
In what subjects can foreign medical graduates can do a doctoral study.
The following lists the possible areas of study; this list is not entirely comprehensive as there may be universities that offer more specialized or unique programs that are not offered elsewhere

• Biochemistry
• Biological Engg.
• Biological sciences
• Biomedical sciences
• Bioinformatics
• Genetics
• Health informatics
• Medical pharmacology
• Medical physiology
• Microbiology-immunology
• Neuroscience
• Exercise physiology
• Nutrition
• Pathobiology
• Public health
• Special education
• Statistics

Bear in mind that even though you could apply to any program of study, it will be beneficial for your resume and chances for residency later if you apply to specific programs. The table  below shows the ideal programs and subject to apply for with specific residencies in mind. 

Fig 1. Relationship between research areas and medical specialties

Application to graduate schools

In US, persons of various backgrounds apply to graduate school, medical graduates included. In addition, you can chose to study any field for your PhD but remember to keep the choices that are relevant to your education as a physician. The list above is a good one to follow for medical graduates.

Application to graduate schools is on an individual basis and you will have to fill in online applications to the university programs of your choosing. You can choose your graduate schools and narrow down the list that suits your needs, gradschools and princeton review offer excellent resources. Many programs have deadlines in September through December and early applications are encouraged. There are specific requirement of each program including minimum cut off scores for GRE and TOEFL. Some institutions may waive the requirement for TOEFL if you have passed the step 2 CS but this is an extremely rare occurrence. You will also need a statement of purpose (like a residency personal statement, but geared towards research – graduate school). Programs also require 3 to 4 letters of reference for admission process. An independent agency verification and conversion of your transcript (medical, junior college degree) to a GPA system may be required in some cases.

Graduate school modus operandi

If accepted to graduate school, approximately first 2 years involve taking courses and classes to prepare you for doctoral study. Most programs especially those involved in science research will also allow rotation in different labs and with different mentors to help choosing the desired project. These rotations usually are 3-4 month blocks with about 2-4 faculty members. At the end of the rotations, you chose a mentor, join the lab, and start work on topic of your research. Work on research topic usually goes on for 3-5 years depending on the faculty, motivation of the graduate student and facilities available. In the second, third or fourth year you will have to a comprehensive examination which is a mock dissertation. Defending your thesis work is the biggest presentation you will have and will lead to a culmination in completion of your PhD work. Thesis defense or final oral exams are theoretically open to all including all the faculty members of the department, related departments and committee members. Any person in the audience can challenge or ask questions regarding the work and defending your ideas, concept or reasoning leads to a successful ‘thesis defense’.

At the end of a successful completion of doctoral program, you are awarded a doctoral degree (PhD) in the major that your research topic falls under. This is certainly a long road to get to residency and has some advantages and disadvantages

Advantages

• You can study for your USMLE exams and prepare well
• Expense can be borne easily as you are paid a stipend or fellowship during your PhD research work
• You can make contacts and enhance your professional network
• You can collaborate with physician faculty and thus get into more clinically oriented research on the side.
• Getting US letters of recommendation is a breeze.
• You can find opportunities to obtain US clinical experience/ observerships since you are working with in a university system. It is almost unheard of that a graduate student who request shadowing with a university physician is refused without genuine reasons.
• Even if you do not match – there is another option open for you (teaching, academia, industry or scientist are all pathways that are wonderful alternatives to residency-fellowship-physician pathway)

Disadvantages

• Time consuming process, there is a wait period of 4-5 years till you can be ready to apply
• You are automatically and old graduate by the time you apply for a residency position
• Again – because of the gap – policies may change over the years and foreign grads may have tougher time getting a residency.

Hopefully, this article provides some information regarding the PhD track as an alternative for those medical graduates who are looking for other options. Also read up about physician assistant as an alternative for those seeking alternate options.

On publications

Publications!

This is a touchy subject. Some applicant have them and others don't. It is encouraged to have at least some publication to enhance your resume. 

A publication can be in the form of abstract, poster submission to a meeting, or articles in peer reviewed journals. 

Scientific writing: Amazon

Abstracts 

Abstracts are short summary of your work and are usually submitted to meetings and  if accepted evolve in posters or talks at meetings. Get in touch with faculty who are involved in clinical or bench research. They will be your big ticket to getting some publications. Talk to more than one scientist as you may have a project that does not succeed. 

Posters 

These can be case reports, clinical scenarios or research articles in poster format.

Peer reviewed articles - precious commodities

Finally, there are peer reviewed articles which are tough to secure but if you have them then do not fail to proudly display them. Getting publications take a lot of hard work and networking. You have to find the right connections and then do a lot of hard work. Be clear before you embark on a project regarding the ownership of work. I have heard of horror stories where a student did the hard work while someone else took the credit. 

Another good source of publications which is independent of research or faculty is 'Letters to journals'. 

Letter to the editor count as publications too.

In NEJM, JAMA or other articles of repute, there is a section called letters to the editor. If you have a good command over English and have a unique perspective that was not addressed in the original articles published in these journals then it is worth considering submitting your letter. This can be response to article published or in rarer instances can cover 'humanities' aspect of medicine. Stellar articles will be accepted to journals of high impact, and these will be your own 'publication'.

In conclusion, research and publications add to a resume. Check how to obtain research experience if you are interested in enhancing your CV.