Starting Research in Residency: Finding Mentors, Projects, and Purpose

Introduction

Hello future Penn IM Resident,

If you’re here, you are probably looking for advice on how to get started on a research project or looking to see how you can further expand your research skills. This reflection is broken into several sections, with advice from my research experiences. Penn is an incredibly well-resourced institution and can offer as much as you hope to gain.

A little bit about myself. I went to Penn State for college and was at Jefferson for medical school. In college, I worked in a wet lab studying enzymology and had some exposure to the scientific process as well as manuscript writing (mainly literature review for introductions, writing methods, helping revise manuscripts). I primarily was assisting the graduate students with growing cell cultures and purifying protein. Knowing that research was important for residency, I sought out opportunities for more "clinical research" in medical school, appreciating that publishing in basic science was challenging and time consuming. Jefferson was an institution with a heavy clinical focus and research opportunities—particularly in GI—were more difficult to find. I got involved with research with a transplant surgeon at Penn who introduced me to statistical analysis and utilizing large datasets. Starting residency, I felt like I had a fair grasp on drafting a manuscript and a basic understanding of using statistical analysis software. My initial goals were mainly to continue working on projects and obtaining publications with the purpose of matching into GI fellowship.

Finding a Mentor

Based on my prior research experiences, I knew that the research process can sometimes be lengthy and if I wanted to have publications by the time I applied for fellowship (end of PGY2 year) I would need to start early. Finding the right time to start looking for research mentors and start projects should be individualized. Official recommendations are that in the first 6 months, you should focus on learning how to be a good intern and feeling comfortable with managing patients clinically. I personally think that depending on your prior medical school experiences, some people may feel comfortable with general intern responsibilities as soon as 2–3 months. I would encourage you to reflect on how aggressively you want to seek out research while balancing clinical responsibilities.

Finding a "good" mentor can be challenging. The time you have in residency is limited and if you have other responsibilities outside of work—your time may be restricted further. An ideal mentor should help you identify suitable projects that can be completed in a reasonable time frame. While running a clinical trial would look great for fellowship, these often take years to complete and would not be suitable for a residency timeline. It's also important to think about what you want out of the research experience. If you're looking to participate in a few projects to help strengthen your CV, you may just need to assist in ongoing projects—either in a writing or chart review role without the need to actually lead a project. This contrasts if you're looking to aggressively build a research career in which case first-author publications become more important. Again, this requires some introspection and will vary from person to person.

For me, I had researched some people in the Division of Gastroenterology who were actively publishing via PubMed. The transplant surgeon I previously worked with also gave me some names to reach out to, which is how I met my current research mentors—Dr. Bitterman and Dr. Mahmud.

"Finding a 'good' mentor can be challenging ... An ideal mentor should help you identify suitable projects that can be completed in a reasonable time frame."

Starting a Project

Now that you have a mentor, you can begin discussing projects! As mentioned, depending on what you want out of the research experience, the projects and level of involvement may vary. If you're mainly looking to just be involved on a project to help with CV building, seeing if there's ongoing projects your mentor has that you can help with (e.g., doing chart review, lit reviews to help with manuscript writing) may be sufficient. If you're looking to be more involved and lead projects, the mentor may ask if you have any areas of interest and ask you to pitch research ideas. Depending on your research background, coming up with a good research question can be difficult since you want something that's novel but also not too big/unachievable. This is also something that I've personally struggled with. Hopefully as you identify an area of interest, your mentor can help refine that into a particular question.

In my experience there are several ways to generate a question: 1) review of the literature in your area of interest and identify any knowledge gaps or current unknowns (conferences are a great way to see what's being done in the field and what needs to be done), 2) based on your clinical experiences—see if there is a question about management or presentation of a condition that has not been investigated, 3) if you have access to a database, you could screen for any interesting associations or relationships and then see if it would be interesting to investigate. Options 1 and 2 are probably your best bet in generating a novel, interesting question that is clinically meaningful.

Working on the Project

The hardest part of doing research during residency is time. With the increase in elective time, hopefully you can use research blocks to work on your projects. However, your mentor may be unavailable when you're free or the data may not be available. To maximize productivity, it's probably best to work on projects whenever you have free time and bandwidth. If you're interested in being more involved in research, now may be a good time to try and learn how to do some statistical analyses independently. To help with the writing process, modeling off prior manuscripts for the overall flow can be useful. Journals generally have specific requirements on formatting, word counts, table/figure limits that you should pay attention to.

For example, by the time I started working on the project looking at post-transplant weight change, I had felt comfortable with dataset manipulation in STATA and performing basic regression analyses. Your mentor should help provide feedback along the way with how you're designing your analyses. To better capture post-transplant BMI difference, my mentor recommended transforming the variable to a cubic spline model. Circling back to what makes a "good" mentor—they should be responsive and available to help guide you through challenges or areas of knowledge deficit. At this point, I had enough experience writing manuscripts that I drafted the paper in its entirety and sent it to my mentor for revisions with plans for publication. Scientific writing can be challenging and my drafts often came back completely red with revisions, but like any skill it gets easier the more you do it.

Why Do Research?

Motivation to pursue research varies. For some, research is simply a barrier to overcome to proceed to the next phase of training and that's okay. The most important thing is demonstrating interest and passion in whatever project you're working on, in whatever capacity you're contributing. For me, I knew I wanted to pursue GI fellowship at a large academic center, so some research would be required. Research for me was an opportunity to take a deep dive in a niche area and learn about the latest medical treatments or management. During my research experience at Penn, I came to understand that you could pursue a research-heavy career even with interests only in clinical research. You did not need to run a wet lab to be a researcher per se. A few transformative moments came through my clinical experiences with Dr. Serper and Dr. Kaplan who are established researchers. When thinking about management, not only were they familiar with the guidelines or the landmark studies, but also understood nuances in the study approach, including design or analysis flaws. Beyond just quoting findings, they had a deep appreciation for the quality of a study and how it fit in the overall landscape of the known literature. This was not something I had seen before, and it was a skill I wanted to be able to incorporate in my own clinical practice.

Another factor that sparked interest in pursuing a research career was attending medical conferences. Residency was the first time I had opportunities to attend medical conferences in person. The atmosphere at national meetings was incredible. Passionate speakers gave interesting lectures on how they manage rare conditions or extreme cases of common conditions. You could attend abstract sessions and learn about the future directions a field was heading in. I wanted to be someone who was contributing to progressing the field forward and finding ways to improve patient outcomes.

Conclusion

At the end of the day, research is time-consuming and often challenging. However, it can be incredibly rewarding to be at the forefront of medical sciences and make contributions that impact patient care on a larger scale. These factors inspire me to continue conducting research.