How to publish as a medical trainee

With all this talk about medical student, resident, and fellow burnout, I thought we might take a break to discuss the small delights that sprinkle throughout medical training. This is not a “You should publish as a trainee” manifesto. It’s more of a DIY guide for those who are interested but can’t find the time or the mentor. And after a decade of rejected manuscripts, unfortunately, I’ve got plenty to say on the matter.

Problem 1: “I don’t have enough time.” 

Not only is medical training physically, mentally, and socially grueling, it feeds on the hours of your day and the days of your week. In working with medical educators and trainees, the most common problem cited by trainees is their lack of time. And this doesn’t get any easier once you become a physician. So how can I encourage you to conduct research or write papers while you battle this time vacuum called medical training?

The secret is, you don’t have to write up a full-length research manuscript like you did in college or while you were working on your PhD. This would take months or years, and let’s be serious, everyone knows you’re struggling just to get the laundry done. As a medical trainee, nobody expects you to conduct a randomized controlled trial—but if you happen to be a part of one, more power to you! There are other, innumerable opportunities to publish papers in peer-reviewed scientific and non-scientific journals. For example, a co-resident of mine recently published the cautionary tale of her honeymoon in the Amazon in the New York Times last summer. (It’s really worth the read.)

For those of you with a hypoplastic right brain, like me, there is also the case report or editorial. This is one major advantage of seeing dozens of patients every day in your clinical rotations—somebody has got to be interesting! And these kinds of papers don’t require the months of preparation, IRB application submission (…for most case reports), periodic research meetings, data gathering, and statistical analysis required of a research paper. Just sit down and write it up. Often these papers are much shorter: <1,000 words, <10 references, 1 figure kind of thing. And some are even more condensed than that! In the Neurology journal’s resident and fellow section, for example, you can submit a Teaching NeuroImage for under 100 words and 1 figure. The Journal of Graduate Medical Education also publishes trainee work in their Perspectives, Educational Innovation, On Teaching, and Letters to the Editor sections for fewer than 1,200 words each.

Problem 2: “I don’t have a mentor.”

Having a mentor is not the same thing as having a strong mentor. In a recent article on KevinMD, Jackie Olive hit the nail on the head by identifying the vital role played by an educator here. Granted, Jackie’s instructors seem more the exception than the rule. No doubt inducted into the DeBakey cadre of surgical mentors, these professorial anomalies should by far surpass any standard you may have for mentors. (No mentor of mine ever bought me breakfast after rounds.)

When selecting a mentor, I’ve found that the most rewarding qualities for you — as the pupil — are the mentor’s 1) productivity and 2) accessibility. And, like building a house of cards, you need both elements of this foundation if you want to keep the house up.

By productivity, I mean their track record. Do they have experience in publishing at all? If not, they are probably not the most dependable people for getting you published. You can find your potential mentor’s track record on a 2-second PubMed search, but I would pay particular attention to the number of papers he or she has published in the last year. Zero might as well be a negative number here. One … meh. Two or more, and you’re in business.

Accessibility refers to availability and mentoring qualities. If your mentor spends 80 percent of his/her time giving lectures at other institutions (because they really nailed that first quality), I would advise against getting too attached. You need face time. Ideally, a good mentor would be someone you might run into in the hallway from time to time, or someone whose office door is kept open. The quality of the mentoring also relates to accessibility. Although we are talking about publishing as your new modus operandi, you really should want to learn something from this process. What can the mentor teach you? If this promising mentor is potentially ineffective as a teacher, it does not matter how many papers he/she published last year. It’s not worth the risk of donating your limited time to a precarious mentor-mentee relationship. The unstable house of cards may topple.

James E. Siegler is a neurologist and is an editorial board member, resident and fellow section, Neurology.

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