What are the keys to successfully performing research while in medical school?
Whether you plan to apply for a residency in ophthalmology, orthopedic surgery, pediatrics, or any other specialty, you will likely want to be involved in research during medical school. In a 2012 survey of 1,960 program directors from 21 specialties, 51% reported evaluating applicants based on a “demonstrated involvement and interest in research.” The importance of applicant research, however, varies considerably between specialty–71% of orthopedic surgery program directors based interview invitations to at least some degree upon involvement and interest in research, compared to just 38% of pediatrics program directors. Regardless, an application replete with research experiences, publications, abstracts, poster presentations, and grants will be a notable asset to any residency application.
So, while trying to survive the preclinical years, frantically working hard on clerkships, and trying to have a semblance of a life, how is it possible to successfully perform research during medical school?
While by no means an expert, allow me to share what I believe are the top five keys to successful medical student research.
1 – Use your talents, interests, and skills to contribute to a research team
Do you enjoy writing? Do you speak a foreign language? What was your major in college–Chemistry? Statistics? Economics? Graphic design? If you made it this far, you likely have some fairly impressive talents. The first key to medical student research is to use these talents, interests, and skills to contribute to a research team. Find a project that needs your unique skills. Perhaps they need someone to speak Spanish to enroll patients for a study or a graphic designer to prepare tables, graphs, poster presentations, or illustrations for the final manuscript. Maybe there is a public health study that needs your skills in economics or statistics to perform an economic analysis of various healthcare initiatives. Look for ways to use your skills to fill a need on the team. Your expertise will be appreciated and using your talents, interests, and skills will help ensure that you have a positive research experience.
Pardon the anecdote, but allow me to share my experience. While in college I studied business management and took courses on statistics, database management, and writing. As a first year medical student I realized the most competitive specialties required research, but was concerned that my lack of experience working in a basic science lab would be of detriment to my pursuit of research experiences. Fortunately, as I began to search for research opportunities, I immediately gravitated toward clinical research projects in which my skills could be utilized. Within months I was involved in several projects using my talents, interests, and skills – I helped build a database of over 10,000 patient records, performed basic statistical analysis and trend identification using parameters in the database, created graphs and tables, and assisted in writing and editing several manuscripts. I mention this anecdote only to demonstrate that with little to no background in basic science or medical research, I was able to find a use for my talents, interests, and skills. Research is a team-game, and there is a team at your medical school that undoubtedly needs you. The challenge is finding that team.
2 – Find your program’s prolific publishers
As you begin to search for a project and find the team to which you hope to contribute your skills, seek to identify your program’s prolific publishers. Those that publish often tend to often publish, and you will get the greatest bang for your buck by working with these researchers. The nature of academic medicine is publications. “Publish or perish” is an oft-cited colloquialism which describes the importance of published research in academic medicine. If you look hard enough, you will find the handful of researchers within your program that publish frequently. These mentors will simultaneously oversee several research projects, will have a well-oiled machine of team-members upon whom they delegate much of the work, and will appreciate the extra set of hands you may provide in contributing to the research team. Once you demonstrate your ability to make significant contribution to a project, your research mentor may invite you to work on other projects, and soon enough, your name will be listed on the published manuscript as a co-author or you may even be asked to present a poster describing the project at a national meeting.
So how do you find the prolific publishers?
Talk to former medical students that have since matched into your desired specialty. They will know which researchers welcome medical student help on projects and which consistently have enough projects that you might be able to start and complete a project in time for the manuscript to be submitted, reviewed, and accepted prior to submission of your residency application. Ask these recently-matched students for an introduction to your program’s prolific publishers and once you have expressed interest in helping with their projects, get ready to work.
3 – Work well with those that do the work
Once you have found your program’s prolific publishers, you will quickly learn that they likely have little time to work with you. Don’t be discouraged when they seem too-busy for your questions or rarely respond to emails. Down the road a bit you will be grateful for how busy they are…chances are they are involved in many projects and, if you perform well and work hard, they will likely invite you to help with future projects, providing you with increased responsibility, increased learning, and increased growth. The reality is that busy researchers do not actually perform much of the work themselves, but instead serve as administrators, mentors, and final-manuscript reviewers for their team of fellows, residents, and medical students that actually do the work. Learn to work well with these team-members and help them in any way possible. Your success will be largely based upon your ability to work well with the rest of the team. Trust that your hard work will be communicated to the principal investigator (PI), and though you may feel your interaction with the PI to be limited at best, what they “hear” about you from their fellows and residents will comprise much of their impression of you when they finally sit down to write your letter of recommendation.
In my years of performing research, I estimate that at least 75% of my time has been spent working with fellows. Fellows have completed residency, often have more free time than the residents, and are expected to prepare multiple manuscripts for submission during their 1-2 years of fellowship training. As long as you do good work and make their lives easier, they will likely welcome an extra set of hands. Their clinical experience is similar to that of a junior attending, yet they are close-enough to you in terms of their recent completion of medical school and residency and understand your schedule, time constraints, and limitations, enabling them to serve as wonderful mentors as you prepare your residency application. Furthermore, the fellows whose names are next to yours on the published manuscript will become part of your academic pedigree. These future-attendings, program directors, and chairpersons will quite possibly be those whom you will call in a few years when you complete residency and apply for fellowships and jobs. Once you find your program’s prolific publishers, learn to work well with those that do the work.
4 – Learn to juggle
Have you ever heard someone that is extremely busy say they feel like they are “juggling a lot right now” or have “a lot of balls in the air.” The fourth key to medical student research is to learn to juggle multiple projects at once. A few of my medical school research projects were completed in just a few months, but the majority represent several years of consistent effort and work. If you hope to have several publications by the time you apply for residency, seek out projects at various stages until completion. Consistently beginning new projects will provide time for unforeseen yet inevitable delays in IRB approval or funding and seemingly endless revisions prior to acceptance for publication. A consistent influx of new projects will ensure that the challenges of the day-to-day grind of research will be frequently rewarded with the enthusiasm and excitement of publishing and sharing your work with the research community. Keep your ears perked up to other projects that your classmates, residents, fellows, and attendings are working on. Perhaps you can join a team that is beginning a research project and will need help with preliminary data acquisition, IRB application submission, or grant writing. Projects such as these may take months or even years to complete, but don’t be discouraged by such projects, as your involvement in these early stages will help you learn skills needed in the future when you want to author an IRB or apply for a grant. While working on these long-term projects, be on the lookout for projects that may be completed sooner, and soon enough you will be juggling multiple projects all at once.
Learning to juggle is the fourth key to medical student research. Yes, you will need to juggle clerkship learning, shelf studying, family/life balancing, and any other balls that you have in the air, but when referring to this circus act of juggling, I refer primarily to juggling your various research projects and their respective deadlines. Ideally you will have enough balls in the air that you will always have a project that you are working on. Just like trying to finish the various appetizers, main entrees, side dishes, dessert, and freshly-baked bread at that perfect moment when your significant other sits down for dinner, try and time your juggling such that by the time your application is submitted, your projects will be “accepted for publication,” “in press,” or “published.” Any of these comments included in your application will hold several times greater impact on your residency application than “pending” or “preparing manuscript for submission,” which often translates to “not done” or “who-knows-when-we’ll finish” in the eyes of the residency application review committee. For this to be the case, you must involve yourself in not just one, but several projects, delicately juggling all of the projects at once, being careful to keep them all in the air and progressing forward toward completion. Try to keep your projects near the top of the research team to-do list, avoiding at all costs the demotion of your project to lower and lower on the list until gradual death and burial in the coffin of unfinished projects–only to be resurrected once you are long-since graduated and forgotten. When the data acquisition has been completed and results are finalized, move that project to the very top of the to-do list. Offer to write the introduction, methods, and results sections, locate citations for the discussion, and do anything you can to get the manuscript completed. In my experience, it typically takes 4-6 months from the time a manuscript is first submitted until the time that it has gone through rejection, acceptance with significant revision, conditional acceptance, and finally acceptance for publication. And even then it will probably be another six months until the article is finally published! Successful research during medical school (and beyond!) is largely a matter of learning to juggle several projects all at once.
5 – Keep a long-term perspective
In my first year of medical school, my perspective was anything but long-term. I was entirely focused on surviving next week’s exam – frantically memorizing muscle origins and insertions, dermatomal distributions, and courses of nerves and vessels. I was merely trying to swallow the Super-Duper Big Gulp volume of information of gross anatomy, histology, embryology, and pathology. At some point in that first year, I realized, somewhat discouragingly, that despite my best effort I was little more than an average medical student with dreams of matching into a residency that was anything but average. Having taken the ACT three times, the SAT twice, and the MCAT twice, I recognized that my slightly above average performance on standardized tests in the past might quite possibly foreshadow the future, and that I could anticipate a slightly above average performance on the father-of-all-standardized-exams, Step 1 of the USMLE board exams. Knowing that the most competitive specialties often use Step 1 as a screening tool, I realized that my perspective needed to change, that I needed to develop a long-term perspective and a long-term strategy to help differentiate my application from the other hundreds of applicants with average or slightly above average Step 1 scores. I began to seek out multiple research opportunities, was fortunate to work with amazing mentors, published a few papers, and even presented our research at several national meetings, all while many of my classmates were busily studying for next-week’s exam.
Perhaps the most important key to medical student research is to keep a long-term perspective. Will the time and energy you spend doing research as a student take away from studying for Step 1, shelf exams, or clinical rotations? Yes, absolutely. However, I believe this time will do as much for your residency application as that 260+ Step 1 score of which you have dreamt since beginning medical school. As long as you do well enough on Step 1 to keep the doors to your dream residency from closing, a strong research application will not only get your foot in the door, but will help that door swing wide open when you receive an invitation to interview. Strong research will set the stage for an enthusiastic, interested, and engaged interview experience, and will help you stand out when compared to your classmates with higher scores on Step 1 or clinical rotations.
And what about after you match, how will the research performed while in medical school help you achieve your long-term career goals? Highly competitive fellowships look for individuals with academic potential, grant-funding committees give greater consideration to grants authored by those with evidence of research experience and a CV replete with publications, and academic and private practice employers will be thrilled to hire you as an expert in your field. Your long-term perspective will not only help you match into the specialty of your dreams, but will continue to help you achieve your dreams during residency, fellowship, and beyond.
In conclusion, as you consider implementing these five keys into your medical school journey, remember that your consistent and strategic efforts now, while exhausting and at times overwhelming, will prove to be of tremendous value throughout your career. Regardless of where you are in this journey, there is still time for you to strengthen your application with research through application of these top five keys to successful medical student research: