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Careers

Contributing to medical research as a trainee: the problems and opportunities

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h515 (Published 09 February 2015) Cite this as: BMJ 2015;350:h515
  1. Veeru Kasivisvanathan, National Institute for Health Research doctoral fellow1,
  2. Priyan Maleuwe Tantrige, radiology year 2 specialty trainee2,
  3. Jeffrey Webster, consultant urologist3,
  4. Mark Emberton, professor of interventional oncology4
  1. 1Northwest London Hospitals NHS Trust, London, UK
  2. 2Department of Radiology, King’s College Hospital, London
  3. 3Northwick Park Hospital, London
  4. 4University College London
  1. vk103{at}ic.ac.uk

Abstract

Veeru Kasivisvanathan and colleagues discuss how trainees can contribute to medical research, the difficulties they face, and some opportunities for the future

Research is the means by which our understanding of disease, and ultimately the quality of care that we give to our patients, can be improved. Being involved in research as a doctor can be a fulfilling and stimulating experience. It can add variety to daily clinical workloads and satisfy intellectual curiosity.

Contributing to research is also important for career progression. Applications for medical posts at all grades give recognition for publication in peer reviewed journals and presentation of scientific work. For doctors in senior posts, contribution to research is an important measure of performance, appraised annually, and in some cases may lead to salary increments through clinical excellence awards.1

Participation in research is encouraged at many medical schools through the opportunity to do an intercalated BSc. Undergraduates can also join medical student research clubs2 and contact research teams in academic departments to help with projects and present at national and international scientific conferences. However, the generic requirements of medical graduates in relation to research set out by Tomorrow’s Doctors3 result in different medical schools placing varying levels of emphasis on the importance of training in research methodology. As a consequence, many graduates are underprepared for doing postgraduate research. Only a third of medical undergraduates in the United Kingdom do an intercalated BSc, and few go on to further academic training.4

A limited number of academic foundation training posts are available for junior doctors. These posts offer protected time for supervised research alongside clinical work. After foundation training, those interested in integrated clinical and academic work can apply for one of the limited number of National Institute for Health Research academic clinical fellowships, which offer 25% of time protected in research.5 These fellowships are designed to put trainees in a position to apply for doctoral fellowships and to complete an MD or PhD. Trainees who wish to continue on the academic pathway can then apply for clinical lecturer posts or clinician scientist awards, with the aim of becoming a clinical academic consultant.

The integrated clinical academic pathway allows trainees to deliver high quality research while maintaining clinical career progression. Only a small proportion of trainees will be able to enter this pathway. For those who do, an even smaller proportion will become clinical academic consultants.

Most trainees have never taken part in undergraduate research, have no allocated time or funding to consider such opportunities as a postgraduate, and have no designated research supervision. However, all trainees can be supported by incorporating formal training in research methodology into medical school and foundation training curriculums.

Junior doctors can attend taught courses in research methodology. Such courses can be expensive,67 but free high quality distance learning courses teaching research methodology, such as the statistics course offered by Stanford University, are available.8 Including research methodology as part of the compulsory teaching programme for trainee doctors may also encourage and support trainees to take part in research.

Providing trainees with information about the funding opportunities for fellowships available, the deadlines that must be met, and what is entailed in such applications can help trainees to take time out of clinical training to complete doctoral degrees with experienced supervisors. Some university departments, such as University College London’s division of surgery and interventional sciences, offer such support through workshops.9 Common funding sources for fellowships include the National Institute for Health Research,10 the Medical Research Council,11 and the Wellcome Trust.12

A promising recent development that may benefit a larger proportion of trainees is the opportunity to work as part of trainee led research collaborative groups to contribute to larger scale studies.13 This type of research can involve the whole clinical team, from consultants to foundation doctors, and has resulted in excellent recruitment and completion rates of potentially practice changing clinical trials.14 The next step would be to incorporate dedicated time into trainees’ timetables for these research activities, though balancing this training need with other requirements can be difficult.

Footnotes

  • We thank Harold Ellis, clinical anatomist, department of biomedical sciences, King’s College London, for proofreading the original manuscript. Veeru Kasivisvanathan is funded by a doctoral research fellowship from the National Institute for Health Research.

  • Competing interests: We have read and understood the BMJ’s policy on declaration of interests and have no relevant interests to declare.

  • The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, or the Department of Health.

References