I’ll write something soon about mudphudders and the residency process. I think you suggested that a while ago and I think it’s a really good topic. But to address publication record, I strongly suspect that the clinical interviewers are more impressed by a long list of publications rather than high profile publications. For example, I don’t think many residency interviewers could explain the difference between Cell and the Scandanavian Journal of Diagnostic Techniques. Also, with regards to telling interviewers that your paper is “in review”, “accepted” or “in press”, I’m not so sure how well that goes over. There a lot of medical students whose Journal of Orthopedic Pathology articles are “pending” and I suspect applicants whose research hasn’t gone anywhere also use the “in review” or “in preparation” excuse. So I think there is a greatly diminished appreciation if it’s not on pubmed–especially in light of the fact that most interviewers don’t fully appreciate an “accepted”/”in press” high profile article e.g. in Nature/Cell/Science. However, for the few interviewers who do know about high profile journals, it is helpful to be able to say that your publication is accepted.

As far as going back to 4th year, the advice I’ve heard is to pick a “throw-away” rotation to start with, and then don’t blow 4th year off (as some med students do).