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Osler
Survival Guide to Research During Residency
How much research can I realistically expect to accomplish during residency? What defines a good research mentor? Why have more than one mentor? Making initial contact with a mentor Tips for interacting with mentors Sample timeline for getting research done during residency
Research is traditionally
divided into two types: basic science and clinical.
However, the more recent view places research activity on a spectrum with
“translational research” in the middle. What defines translational research
is still somewhat nebulous. In a nutshell, it encompasses activities that
translate basic science discoveries into clinical application and, in turn,
activities that use clinical observations to refine or generate new research
questions for basic science. An example of this would be a gene therapy proven
to work in vitro and in animal models
that then gets tested in a small clinical trial involving human volunteers.
Another example would be reanalyzing the biochemical compound of a drug that is
found in clinical trials to cause an unexpected benefit very different from its
originally purpose. Translational research also includes activities that
investigate in a larger population any therapies that have been proven effective
in a smaller population. The aim of research is to
contribute unique knowledge to the field of medicine. This unique knowledge can
be presented in the form of a published article or a presentation at
professional conference. Research can be reported in different ways: a case
report, a topic review, or an original article describing the results of a new
study. The prototypical research
project is a unique study that answers a previously unanswered question in
medicine. The classic research study is an experiment (in the bench science
sense) or a randomized clinical trial (in the clinical research sense). However,
there are also many other ways to study an important question in medicine and
thereby offer a unique contribution to medicine (e.g. observational studies,
meta-analyses, etc.). A research study generally
includes the following basic steps:
How much research can I
realistically expect to accomplish during residency? This
depends on a number of factors: your previous research experience, the type of
research activity you are interested in, the kind of opportunities provided by
your mentor, and how much time you can commit to the project.
The
type and amount of research previously accomplished by housestaff is varied. In
the past, some residents have chosen to focus their time primarily on reviewing
the literature in a new area of interest and formulating research questions that
they plan to later explore during fellowship. A few of these residents have
written up and published their findings in a review article. Some residents have
attended the meetings of a research group to learn how research activity is
conducted and organized for a large study. A few of these residents have taken
the opportunity to contribute in a small, well-defined way to the larger project
and subsequently become a co-author on a publication. Some residents spend time
working on their own small, well-defined project – from concept through
analysis and write-up. A few of these residents have completed their projects
during residency, or shortly after graduation, with their results presented at
national conferences and published in major journals. What defines a good
research mentor? The type of mentor most
suitable to work with a house officer depends on the house officer’s
individual interests, research background, and specific goals for the type of
research experience they want to have during residency. Overall, a good mentor is
somebody who is professionally established, has experience successfully
conducting the type of research you are interested in, is able to give their
trainees good research opportunities, and has a track record of seeing trainees
through to the completion of their own research projects. There are a few ways to do
this. The traditional way of
finding a mentor is word of mouth. Once you have a general idea of the area of
medicine you are interested in researching, start talking to multiple people in
this area. Talking to multiple people about your interests is a way to make
contacts, generate ideas, and find out who is doing what kind of research. After
talking to multiple people, you may notice that a few of the same names are
mentioned over and over again as good possible mentors – these are the people
who are well-regarded in their area. Performing a Pubmed search on
a potential mentor is another way to get a sense of how established he or she is
and what their track record of mentorship looks like. An established researcher
not only has an impressive publishing record but is often also listed as the
last author (also known as “senior author”) on multiple publications. Another good resource is the
NIH CRISP database, which you can use to identify researchers with active
funding in your area of interest. Researchers with ample funding will have more
resources at their disposal to provide their trainees with appropriate
opportunities and support. You can also make an effort
to talk to junior people (including other housestaff) who have worked with your
potential mentor to find out what their experience was like (e.g. was it
rewarding? frustrating? etc.). Why have more than one
mentor? You should know that while a
well-known and established senior research mentor may be the gateway to a world
of opportunities, he or she may be difficult to schedule meetings with and will
probably not be easily available to answer a lot of small questions about your
research project on a frequent basis. Therefore, it is often helpful to also be
working with a junior mentor, somebody who may not be as established but who
also does work in your area of interest and who can provide research guidance at
the micro level. Having more than one mentor
is also helpful when it comes to timing and opportunity. Not everybody will be
able to offer you exactly the type of research opportunity you are looking for
at exactly the time when you are ready to put in the work. As well, interacting
with more than one mentor will lend you more than one perspective on important
issues in research and medicine.
Making initial contact with a mentor Getting in touch with a potential mentor for the first time can be intimidating, but it doesn't have to be.
Before your first communication, you should take the time to find out what their areas of interest and expertise are. Do a Pubmed search to see the kinds of articles they have published and with whom they have collaborated on these projects. Go to their departmental web site(s) to see what titles and positions they hold at Hopkins and read any available biographical sketches. A general internet search (e.g. google) or Hopkins web search may also reveal something about projects they are currently involved in. Think carefully about which part of their work overlaps best with your own research interests.
The first communication is often email. Keep this brief and to the point. Mention upfront who you are (intern, JAR, etc.) and who may have referred you to contact them (e.g. Charlie, Mike Weisfeldt, another faculty member). Briefly outline your interest area(s) and mention any relevant personal background (e.g. Masters or PhD training, previous research experience). Finally, express that you are interested in setting up a first meeting, at their convenience. Some mentors may ask you to email a copy of your resume or bring a copy of your resume to your first meeting. This is simply a way for them to learn more about you, your background, and any previous research-related experience (e.g. knowing that somebody was a psychology major in college might prompt a mentor to ask about helping to run a quality-of-life study).
Before your first meeting, prepare to talk a little bit about your background and what led you to your research interests. Also prepare to talk about the kinds of research projects you are interested in participating in, at what level(s) you hope to participate, and what your end-goals are for the experience.
At your first meeting, you will hopefully be able to learn and ask questions about the different types projects that you could be involved in by working with a particular mentor. You may also learn about other potential mentors who are doing work in this same area. Before making any firm commitments, consider and discuss what the timeline for accomplishing tasks would be and how this could coincide into your rotation schedule. Ideally, the times when a project requires the most work from your end is when you are on an elective or case block. Before your meeting ends, confirm when and how the next form of communication will take place.
Tips for interacting with mentors Frequent and timely email is
how a lot of researchers collaborate on projects. However, there are still many
senior researchers who like to collaborate frequently in person. Try to set up from the
beginning a tentative schedule of meetings to help keep the project on track. At
the very least, meetings should take place at certain critical points during the
research process (e.g. going over a project proposal, discussing an analysis
plan, reviewing results, etc.). Be as organized and as prepared as possible
before each meeting. Plan an agenda of issues to discuss and have a prepared
list of questions. The more you have done to prepare before each meeting, the
more momentum you bring to the process and the more able your mentor will be to
help you keep your project on track. Sample timeline for getting research done during residency
The process of achieving
success in medical research is very different from the process of achieving
success in the practice of clinical medicine. In research, there is no defined
curriculum, no set path, and no predictable outcome. A lot of what makes people
successful at research is simply hard work, diligence, and luck. Therefore, if
your first project (or two or more) do not work out for some reason, don’t be
discouraged. You should know that many successful researchers in academic
medicine have faced the same hurdles and challenges – and the majority have
had to endure through multiple failures before achieving their successes. Advice to a Young
Investigator. Book by Santiago Ramon Y Cajal, 1898. Reprinted by the MIT Press,
this book is a classic that is available at your local online or brick and
mortar bookstore. “[The] wisdom contained in this slim, elegant volume is
almost a century old, it is as fresh and useful today as it no doubt was
then.”
American College of
Physicians: Effective Clinical Practice Primers This web site provides links
to quick, accessible overviews of commonly used terms and concepts in
evidence-based medicine.
Clinical Research
During Internal Medicine Residency: A Practical Guide. Article by Kendal Hamann
et al., 2006. Am J Med.
2006;119(3):277-283.
Designing Clinical
Research: An Epidemiologic Approach, 2nd Ed. Book by Steven Cummings
et al., 2001.
Epidemiology in
Medicine. Book by Charles Hennekens et al., 1987. This book is a standard,
manageable introduction to basic epidemiology.
How to Be a Good Graduate Student. Paper by Marie des Jardins, 1994. |
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