I remember sitting in my residency academic adviser’s office as I was discussing the plans I had designed for my community project at the end of my intern year. I can only imagine what she thought as I looked at her with a blank stare when she had suggested I should create an original research project around this. “What?” was all I had managed to mumble out of my mouth. The next 15 minutes were kind of a blur, but somehow I had been convinced that this was a great idea. Yes, I was capable of starting a brand new research project from scratch right in the middle of residency. Yes, I could not only create this project, but I could publish it.
I had come into residency with a small amount of research under my belt. I had been involved in a few projects while I was completing my masters, mostly related to bench science research that had allowed for me to “get published” (I was the fourth or fifth author on a few published articles). Sure! I knew how to do a research project, or so I told myself. My academic adviser had been gracious enough to connect me to a research mentor who then promptly explained to me, in a very nice way, that I had no idea what I was doing.
How am I going to do research? How do I get involved in research? What the heck is research? The first things many people think about when starting their residency training. As physicians we value research. We need research to keep medicine moving forward. But how can we actually contribute to meaningful research? How can this help us move our career forward? Will this help me get the job I want in a very competitive field? Will this help me get the fellowship I’ve been dreaming about my whole life?
These are very hard questions, and the answers are different across the board. Many residents who have an interest in research never actually start the process or finish what they started during their residency despite the fact that the Accreditation Council for Graduate Medicine Education (ACGME) has requirements for internal medicine residents that they must “participate actively in a scholarly activity.” In a survey of internal medicine program directors, it was found that only approximately 20 percent of residents in training fulfill the scholarly activity requirements by conducting hypothesis-driven research.
Now back to my journey into the world of original research. I wanted to design a small project to give back to the community and make a meaningful difference. I combined my passion for education and preventative health and designed a curriculum to address and teach healthy habits and lifestyle choices to high school students about to go to college. Again, I reiterate, I wanted this to be small!
Over the course of the next three years I ended up learning about the process of going through a full institutional review board (IRB) including scientific review committee (SRC), how to ensure you’re protecting an at-risk population, pilot studies required for survey development, how to design a curriculum that can be effectively given to high school students, and how to analyze a pre and post-test survey. What started out as a small idea turned into one that was larger than expected. With the guidance of supportive academic and research mentors, I was able to navigate this whole process. It was not easy. I wanted to give up often. I remember sitting in front of a large panel of physicians and researchers thinking, “What am I doing here?? They keep calling me the wrong name. I doubt they are going to approve my small, little project.”
After multiple revisions and multiple meetings with people I never thought I would have to meet and a long grueling process — my project got approved!! I kept a journal throughout the whole process so I could look back and think about what I went through. I learned a lot about research, and everything I took away from this is process is something I’m hoping I can to impart on other people.
Lessons that I’ve learned as a resident embarking on research:
1. Research is hard. It’s not meant to be easy. But when done correctly, it can be very satisfying. And a small study can actually lead to change that can be very important.
2. Find a good mentor both from an academic and research standpoint. They will become your cheerleader, friend, devil’s advocate, sponsor and, most of all, a sounding board in your darkest hours. But more importantly, the person you celebrate with when you succeed.
3. Keep a journal. This allows for you to reflect on what you are doing now, look back on what you have done already — and move forward to reach your final goal.
4. Success isn’t always what you first thought it would be. Once I completed my curriculum, we analyzed the data we had collected from the surveys, and there was a statistically significant difference. It was great. However, my marker of success had changed. I viewed the educational experience of learning how to conduct a research project from start to finish as one of my trophies. I had survived, learned a new skill that was invaluable and was then able to mentor residents succeed at research as well.
5. Failure can provide our biggest learning moments. In one of my journal entries, I reflected about the moment I realized I was on the brink of giving up and near failure — that I was ready to call it quits. During the next session in my curriculum, I had an experience with a student that changed my whole view of what I was doing with my intervention. A young, 17-year-old female senior pulled me aside at the end of our last session and told me she had always settled to go on one path for her future, but because of meeting me she knew she wanted more. She very kindly stated that after seeing I was from the same small town as she, and successful in the field of medicine, that she had a whole new perspective and was no longer scared to admit her real dream — of being a physician. I nearly cried.
I am grateful for those who came before me, and I hope that I may help those who come after me. Research is hard, for sure, but honestly, it is rewarding in many ways I never thought imaginable. So don’t give up and be brave. Even small projects can lead to amazing things.
Kathryn Jobbins is an internal medicine physician.
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