We pulled this piece from 12 real resident posts we read this week in the places residents actually talk online. AI helped us sift through the chatter and spot the recurring themes. Then a human editor chose what was genuinely worth your limited time, and that’s what you’re reading here.
You’ve been told to ‘do something scholarly’ during residency. Your program probably handed you a poster project or mentioned that research ‘looks good’ for fellowship. But nobody gave you a framework for choosing among real options: original research, quality improvement projects, case reports, committee work, medical education, or advocacy. They aren’t interchangeable. Each has different time costs, different payoffs, and different audiences who care about them. If you’re trying to figure out how to spend your limited non-clinical time during training, you need to know what each option actually buys you.
Original Research: Big Upside, Big Cost
Original research — prospective studies, chart reviews with novel questions, bench work if you’re in an academic center — is the gold standard for competitive fellowship applications. A first-author publication in a decent journal signals that you can design a study, work through IRB, collect data, and write it up. Fellowship directors at academic programs notice this.
The cost: 100+ hours minimum for anything publishable, often spread over 12–18 months. You need a mentor who will actually meet with you, a project that’s feasible with resident-level time and resources, and enough protected time to see it through. If your program’s research infrastructure is thin — no statistician access, no dedicated research coordinator, attendings who say yes to mentorship but never respond to emails — this path becomes significantly harder. You can still do it, but you’ll be doing it with limited help.
Best for: residents targeting competitive academic fellowships where publications are counted. Less valuable for community job applications, where hiring committees care more about clinical competence and personality fit.
Case Reports and Reviews: Lower Bar, Lower Signal
Case reports and literature reviews are easier to complete. A solid case report takes 20–40 hours. A narrative review might take 60–80. You can often get these published in specialty journals without a heavy mentor lift.
The tradeoff: fellowship directors know the difference. A case report shows you can write and get something across the finish line, but it doesn’t demonstrate research chops the way original work does. Reviews are similar — useful for demonstrating knowledge synthesis, but they won’t substitute for data-driven research on a competitive application.
That said, if you’re applying to community fellowships or planning a non-academic career, case reports and reviews check the ‘has published’ box without consuming your life. They’re also a reasonable starting point if you’ve never published anything and want to learn the mechanics of submission, revision, and response to reviewers.
Quality Improvement: Underrated for the Right Audience
QI projects — reducing central line infections, improving handoff documentation, decreasing readmission rates — get dismissed as ‘not real research’ by some academic purists. But QI work has two strengths: it’s directly applicable to clinical practice, and it’s often easier to complete within residency timelines because you’re working with existing hospital processes rather than recruiting patients for a study.
A completed QI project with measurable outcomes shows you can identify a problem, implement a change, and track results. This matters more than you’d think for community hospital jobs and for leadership-track positions. It matters less for traditional academic fellowships that count publications.
The catch: QI projects can stall when they require buy-in from nursing, administration, or other departments. If you’re going to do QI, pick something you can control most of the variables for, or where you have an attending champion who can push through institutional resistance.
Medical Education: Building a Skill, Not Just a Line
Curriculum development, teaching workshops, simulation design — medical education work produces CV lines, but more importantly, it builds a skill you’ll use for the rest of your career. If you’re the PGY-2 who suddenly finds themselves teaching interns and wants to do it well, leaning into med ed isn’t just resume padding. It’s learning how to teach, which matters whether you end up in academics or community practice.
The limitation: medical education as a CV category carries weight mainly if you’re pursuing a career that involves teaching. For fellowship applications outside of med ed fellowships, it’s a nice-to-have, not a differentiator. It won’t substitute for research if research is what the program wants to see.
Committees, Societies, and Advocacy: The Overlooked Channel
Resident sections of specialty societies, GME committees, hospital quality committees, union involvement — these don’t produce publications, but they produce something else: access to how decisions get made. If you’ve ever written a ‘Dear Program Director’ letter that you knew would never be read, you’ve felt the frustration of having no channel for change. Committee and council seats are that channel.
Serving on your program’s resident council or your specialty society’s resident section gets you in rooms where policies are discussed. You learn how institutions work. You build relationships with people who will be department chairs and society presidents in ten years. And if you’re the resident who thinks a diagnostic label is misleading or that a subspecialty track should exist, these are the venues where that kind of work actually happens — position papers, nomenclature workgroups, advocacy for new fellowship pathways.
The tradeoff: committee work takes time and produces no tangible output you can list as a publication. It’s valuable for long-term career positioning and for making change within your own program, but it won’t help your fellowship application directly unless the fellowship director happens to know the committee.
How to Choose
Start with your goal. If you’re applying to a competitive academic fellowship, you need original research — probably more than one project. If you’re heading to community practice, QI and clinical competence matter more than publication count. If you’re interested in medical education as a career, build that portfolio deliberately.
Then look at your resources. Do you have a mentor who will actually show up? Do you have protected time, or are you doing this on post-call days? Does your program have infrastructure, or are you building from scratch? The best project is one you can actually finish, not the most impressive one you’ll abandon at 60% completion.
Finally, consider what you’re frustrated about. The resident who thinks bipolar II should be renamed has the seed of a review article or a society position paper. The resident who notices a gap in maternal mental health training has the seed of a curriculum project or a fellowship advocacy effort. Real frustration, channeled into legitimate work, produces better output than assigned projects you don’t care about.
Whatever you choose, choose deliberately. The default — accepting whatever poster your program hands you — optimizes for nothing. Your non-clinical time is limited. Spend it on work that moves you toward the career you actually want.
P.S. PhysEmp has job opportunities and salary reports by specialty — handy now, handier when the job hunt actually starts: physemp.com. And DocCommons is building a community for residents and attendings who’d rather not do this alone; the waitlist is open at doccommons.com
