by Alap Patel, MS4, and Alicia Billington, MD, PhD (@MedicalAdvocacy)
Participating in research and scholarly activity is an essential part of becoming a plastic surgeon. The fundamentals of research inquiry begin for most during medical school, and as the learner advances through residency the complexity and involvement in research projects evolves. Understandably, the goals for residents and students are different. Residents may conduct research to answer questions pertaining to clinical cases encountered, whereas the goal for students is often to develop a relationship with the plastic surgery team. Since both students and residents have unique approaches and driving factors to perform research, the authors, a 4th year medical student and a chief resident, each separately answered from their perspective on how to best to collaborate on research projects. Our aim is to describe tangible ways the resident-student research relationship can be fruitful for both individuals!
1. Study Design
Resident: The resident likely will lead study design and development by offering thoughts from their clinical exposure and/or discussion with attendings. It is important to be clear with the medical student about authorship and plans for the project (grants, abstract, publication) so there is no misunderstanding down the line. Outline what each authorship position will entail (i.e. the 2nd author on this paper will need to complete x, y, and z).
Student: Including a student in study design allows them to be exposed to the questions that need to be initially asked. Students should attend preparatory meetings with the resident and attending, and take notes on study components. It’s helpful to review existing papers before the meeting so you can offer some thoughts on study design.
2. IRB Protocol Development
Resident: Guide your student through your institution’s IRB approval process (i.e. navigating the online submission system). This is a great part of the research process to give the student some autonomy. Review the IRB Protocol document before final submission.
Student: Residents are busy so it’s helpful if the student can facilitate the submission process and attend to the IRB’s requested revisions. Depending on your institution, this process can be very arduous. This is an area that a medical student can shine and set themselves apart from other applicants at that institution by being vigilant with responses to the IRB.
3. Data Collection
Resident: Data collection depends entirely on the study design. In some instances, having more hands on deck can be helpful. For retrospective studies design a spreadsheet to which the student can add data. If the study requires in-person enrollment, consider utilizing other internal research resources (i.e. research coordinators) or communicate with the student to determine who has time to enroll patients.
Student: Follow the lead and direction of the resident. If retrospective, do your best to be clear about turnaround time. Yes, the sooner the better but residents will understand if you have exams coming up so long as you communicate clearly.
4. Data Analysis
Resident: The resident should be intimately involved in the decisions regarding the statistical evaluation of the data. At some institutions research personnel or statisticians are available to perform the necessary calculations. If the resident does not have a strong background in statistics they should at least meet with the statistician to answer any questions regarding the data to ensure the most appropriate tests are chosen by the statistician.
Student: Students should familiarize themselves with the type of data collected (ex: nominal, categorical, ordinal), the distribution of the data (parametric vs non-parametric), and types of tests performed. Students should ask “Why this test?” and “Are there alternative tests that could be used?” Students should also learn to be proficient in Microsoft Excel as many databases are created using this software.
5. Abstract Development and Meeting Presentations
Resident: Decide with the attending (and student) which meetings are appropriate for submission. Depending on the project, it might be possible to create two unique abstracts so both the resident and student have an opportunity to present. The resident should determine financial assistance from their institution for presenting and rules regarding time off for presentations. Many residency programs have requirements each year for publications/presentations so it is important the resident is familiar with these rules. The dates for presenting should be discussed with the residency program well in advance to ensure appropriate coverage.
Student: As a student, the goal should be to learn how to conduct sound research. Thus, being second author on a project is fantastic. Don’t worry too much about author order at this stage. While the resident may be chosen to present at national meetings, see if you can present at state meetings or your medical school research days. If you have the opportunity to travel for your presentation, check with you medical school to see if there are any discretionary funds available for financial assistance.
Resident: Assign parts of a publication for the student to work on and review all parts of publication with the attending before any final submission. You can decide what part of the paper is appropriate but often the introduction and part of the discussion would allow for both student learning and contribution to significant parts of the paper.
Student: Offer to take the lead on actively submitting the paper to the journal. This is again a tedious process the resident may be unable to attend to daily. The student can organize the submission and follow up on any required formatting changes from the journal. Follow up with your resident regularly because some journals can take months before getting back to you. Make sure to meet all submission deadlines.
We believe following these guidelines will enhance the research experience for both the medical student and the resident. The goal is that each person mutually benefits and adds to their understanding of the field of plastic surgery. Clearly defining goals and good communication are pillars to excellent research projects and happy teams. We wish you all success in your future submissions!