Clinicians doing research during their postgraduate training

Blog Post by Ben Creagh-Brown, Clinical Research Fellow, Royal Brompton Hospital, London, UK

Who does research and why? Historically, trainees often did research purely as way of improving their CV so they could obtain a registrar post, particularly in the most competitive fields like neurology, cardiology and cardiothoracic surgery. However, there have always been those who did the research out of genuine interest and/or the desire to pursue an “academic” career. Since modernising medical careers, and the changes introduced to streamline higher training, it is more difficult to take time out from your programme to do research unless you are already on an academic track. Depending on your specialty and your location, it may still be advisable to undertake research in order to be competitive when it comes to applying for consultant posts.

What does it involve? Generally research is either predominantly laboratory based (basic science) or focused more around patients (clinical research) or a combination of the two. Lab-based work will usually involve working with a team of scientists and using laboratory techniques to generate data that helps answer questions relevant to your hypothesis.

Clinical studies vary widely in their scope but may include development or evaluation of novel therapies or investigations. It is usual to spend at least 2 or 3 years on your research project. It is essentially to register for a higher degree at the university affiliated with your research group as soon as you start. The university will charge you to be a postgraduate student and this can be prohibitively expensive if you are not a UK national.

It is absolutely essential to write up your research and submit the work as a thesis in order to obtain a higher degree. This involves a vast amount of work and should not be postponed until you have completed your time out of clinical training. Completing a period of research and not obtaining a higher degree is seriously frowned upon as it may be considered to show a lack of commitment.

MD or PhD? If you have spent sufficient time (usually ~3 years) and your work is of sufficient quality you may submit for a PhD. An MD, or MD(Res) is a similar higher degree but, unlike a PhD which can be obtained by scientists and clinicians alike, an MD can only be obtained by holders of a primary medical degree. An MD can be obtained after a shorter length of research, typically 24 months. A PhD is an internationally recognised qualification whereas an MD is a British institution. Therefore an MD is likely to be underappreciated by your international colleagues.

When to do it? You must have enough experience to know what area interests you but not be too close to finishing your training. Generally, people start their research after they’ve been a registrar (or specialty trainee nowadays) for a year or more. However, research funding can take 1 or 2 years to organise so start looking well ahead of when you want to start.

Where do you find a research post? Posts are regularly advertised in the BMJ (careers.bmj.com), alternatively ask around or find out where they do research most relevant to your interest and contact the head of department. If you go for a meeting with a head of department – prepare yourself by knowing about the research they’ve done and about what you’d like to do. Attend conferences for inspiration.

Funding If you’re lucky you’ll find a post that doesn’t require you to source funding. However, most posts require you to apply for grants. This is a very time consuming and stressful process that frequently results in failure! Grants are highly competitive.

How to choose the best research post It is vital to pick a supervisor, or supervisors, with experience of supervising clinicians successfully. The department should have a good reputation, an excellent record of obtaining funding and of achieving higher degrees for their research students. If you don’t pick a subject that sincerely interests you then it will be a miserable endeavour. The advantages of having clinical commitments at the same time as pursuing the research are financial and experiential. The disadvantage is that you’ll feel torn between competing priorities and one of your obligations may suffer.

Why do it? There are many reasons: to gain a thorough understanding of your subject, learn how difficult scientific research is, to gain appreciation of the trials and tribulations of performing experiments / conducting a clinical trial / writing a systematic review etc., get a reputation in the field, gain experience of a technique/methodology, work with professionals from other backgrounds, receive training that you wouldn’t otherwise get, take time out from busy clinical work allowing you to reassess your goals, to question your knowledge, and gain in confidence…

In summary, I would advocate spending time in research for anybody interested in gaining in-depth knowledge about any aspect of their chosen clinical field. I would recommend spending a long time planning your research post and having found possible departments, speak to current or former postgraduate students to learn of their experiences.

Readers may be interested in Research in Medicine: Planning a Project – Writing a Thesis, by Juliet Usher-Smith, George Murrell, Harold Ellis and Christopher Huang, which provides essential advice to guide the beginner through the processes involved in selecting, organising, funding, undertaking, evaluating and publishing a biomedical research project, and completing a postgraduate qualification. The third edition is due to be published in 2010 and the second edition is available now.

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