Getting Involved in Research

Opportunities To Do Research

Finding The Right Project

Finding The Right Mentor

Defining A Research Question

Designing Your Research Study

This chapter will introduce you to research. It will give you an idea as to what opportunities are available to develop as a researcher, and how to take advantage of such opportunities when they arise.

OPPORTUNITIES TO DO RESEARCH

Academic medicine is a broad term for a variety of career paths with differing degrees of clinical and research involvement. Opportunities are wide-ranging, from writing a case report to obtaining an academic medical post or completing a PhD. Broadly speaking, those who want only occasional or relatively short-term involvement in research should focus on finding an appropriate small project and mentor. Many people will just approach a mentor and work on a small research project in their spare time. For those with an ongoing interest in academic medicine, finding a way to obtain allocated time to engage in longer-term research may be best. This chapter considers the more formal opportunities to engage with research.

There are many different opportunities to do research at various points throughout your career, and many questions are asked about the "ideal" time to do research. Unfortunately, there is no simple answer to this question. The answer varies considerably between countries, and it also depends on taking advantage of opportunities as they arise.

COURSES AND RESEARCH DEGREES

Table 1 below summarises different options for formal research qualifications. It is important to explore and consider these carefully as they are a significant commitment and will slow your progression through clinical training. Nonetheless, they are valuable opportunities that may allow you to gain skills and experience throughout your career.

POST-GRADUATE MEDICAL TRAINING

Post-graduate medical training varies considerably between different countries. Opportunities for doing research during this training vary even more, and entry into academic medicine has often been described as a convoluted and unstructured process. Here, we will explore the research opportunities available to trainees and interns around the world, including in the UK, the USA, and Canada. Similar principles apply to other countries across the world, like Australia and New Zealand.

United Kingdom (UK)

Once qualified, UK career pathways allow for academic work to be integrated into clinical training from the first year as a junior doctor until a substantive (consultant) post is gained. These academic training pathways have considerable flexibility and account for those who may discover their aptitude for or interest in research only later in their career (Figure 1). Similarly, it accounts for those who had an early interest but have come to realise that the pursuit of academia is no longer appealing.

At the time of writing, this integrated academic training pathway consists of the academic foundation programme (AFP), academic clinical fellowships (ACF), and clinical lectureships (CL) before attaining the certificate of completion of training (CCT). After the CCT, a joint clinical and academic senior post may be applied for. Candidates may enter or leave this pathway at any point to return to full-time clinical training.

The AFP is designed to give interested junior doctors an opportunity to experience academic medicine. Officially, previous research experience is not required. Unofficially, applicants for the AFP are expected to have extensively engaged with and enjoyed formal research as an undergraduate. Therefore, students without any formal research training should seek out their own opportunities throughout medical school to gain experience before applying for the AFP. The structure of the AFP varies between deaneries, but generally consists of either a 4-month block allocated to research in the second year, or dedicated academic day releases scattered throughout the year. In the research world, this is a fairly limited amount of time. Ideally, the AFP should help you identify your research interests, and allow you to present your work or publish a paper. Many deaneries also provide a teaching or management-oriented AFP. In summary, the AFP gives junior doctors an opportunity to explore their interests in research, and will serve as an indication of interest and commitment for those who wish to apply for an ACF.

ACFs are open to anyone who has completed foundation training in the UK. This does not have to be an AFP. The ACF is a 3-year post (or 4 years for trainees in general practice), and includes allocation of a national training number (NTN), meaning that successful applicants are simultaneously enrolled in specialty training. During an ACF, 25% of your time is allocated to research, and the remaining 75% to clinical training. These posts are usually specialty specific, but can be tailored according to your particular interests. Again, the division of research time varies significantly from post to post, with some allocating 1 day per week to research, and others blocks of 2 or more months at a time. There are advantages to each approach. For example, a cohesive stint of research time may allow for a more uninterrupted focus on your project and greater involvement in the laboratory, whilst increased division of the time may allow less disruption of clinical training.

The primary aim of an ACF is to identify a suitable project and gather preliminary data for a PhD. During the ACF, the majority apply for a Research Training Fellowship to complete a higher research degree, such as a Doctor of Medicine (MD) or Doctor of Philosophy (PhD). Those who are unsuccessful at obtaining a research fellowship at the end of an ACF post, or those who wish to continue with their clinical training before undertaking a higher research degree, will return to the standard specialty training routes. Higher research degrees may also be undertaken as an out-of-programme experience anytime during clinical training.

After completing a PhD, trainees may apply for clinical lectureship posts. The posts last for 4 years, during which trainees are expected to balance postdoctoral research commitments with completing specialty clinical training. The amount of time allocated to research is usually around 50%. After clinical lectureships, clinician...