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April
2002
Volume 66 |
Number
4
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RESIDENTS'
REVIEW
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| Research
in Residency? How to Pull It Off |
Kayode
A. Williams, M.D.
"The
intelligent person is always open to new knowledge. The wise person
seeks it out." – Proverbs 18:15
The prospect
of attempting to do research during residency is daunting given
the academic and clinical workload required. However, it is possible
to tackle this task and to turn it into an exciting opportunity
and experience. Given the current need for academic anesthesiologists
and the availability of training grants, now is the perfect time
to get involved with research.
Several key
elements are necessary to pull together a great project. First,
work in an environment where there is an infrastructure that fosters
research. This makes it easy to join an ongoing study or to develop
a spin-off from a larger grant. This does not necessarily require
a large academic center. There are many smaller programs with
an active research base. Second, it is vital to identify a supportive
and research-orientated faculty mentor who will be willing to
help navigate the experience and avoid potential minefields. This
makes the journey from idea to publication more feasible and less
arduous. Third, approach all clinical work with an inquiring mind,
and remember to ask the question, "Why?" Fourth, be
ready to do the extra work that research will require. To deny
the sacrifice in terms of time and energy required would be to
trivialize the challenge, however modest it may be. Fifth, find
a supportive forum in which the completed work can be presented
and critiqued. Local, regional and national meetings such as poster
presentations within your institution, the Midwest Anesthesia
Residents' Conference and the ASA Annual Meeting provide opportunities
to present, articulate and defend your ideas.
The most difficult
step is always the first one – getting started. Irrespective
of the level of training, it is often simplest to start with a
clinical base. The average CA-1 resident has a caseload of 750
to 1,000 patients during the year. This offers a tremendous resource
in terms of interesting case reports and/or small case studies.
One example is a case report on the use of a novel drug or technique
in a unique patient population. From the CA-2 year through fellowship
training, the increasing complexity of cases makes it easier to
identify problems and questions that may be readily answered.
How to
identify a question: First, think through all the processes
and procedures you have ever performed from your first day in
residency onward. As you learn methods of topicalizaton for intravenous
cannula placement and difficult airway intubation, methods of
induction and securing the airway for floor codes, methods of
placing central lines, arterial lines or epidural catheters, think
about how to improve the technique. Second, make a note of all
interesting patient management problems and how you solved them.
Third, identify a mentor who is conducting interesting research.
Fourth, read to identify gaps in the knowledge base. So many decisions
in medicine are made without clear evidence.
How to
design a project: After selecting an interesting clinical
issue, it is critical to define a clear question and a testable
hypothesis. Talk with as many faculty as possible to clarify your
question and decide on the best way to approach it. The data generated
should produce a conclusive result within the short time frame
of your residency.
How to
find support: More than one mentor may be required. The faculty
or staff with whom the interesting case was done may not have
the inclination to get involved with all aspects of the project.
Identify faculty who demonstrate an interest in research and who
will be willing to give advice regarding data collection and data
presentation. If necessary, look outside the anesthesiology department
for mentors who will be able to offer support in alternative research
techniques. Many of the subspecialty divisions of ASA have committees
interested in promoting research. For larger projects, the Foundation
for Anesthesia Education and Research (FAER) sponsors several
grants, including the Research Fellowship Grant, the Education
Research Grant and the FAER Resident Scholar Program. These can
be reviewed on the FAER Web site at .
How to
carry it through: Give yourself ample time. It is easy to
underestimate the extra hours required to complete a project.
Collect as much data as you can during working hours in order
to make the most efficient use of your time. Share the load whenever
possible; two or more heads are better than one. Data collection,
presentation and success are all best shared.
In conclusion,
research during residency should be viewed as a valuable learning
and career development tool. Research encourages creative and
independent thinking, enhances time management skills, develops
the ability to take an idea from concept to publication, improves
presentation skills and refines interpersonal skills. Regardless
of whether your ultimate career goals lie in academia or private
practice, this experience can only enhance your residency and
your practice in the future.
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Kayode
A. Williams, M.D., is a fellow in Pain Medicine, University
of Michigan, Ann Arbor, Michigan. |
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