Resident Research: Perspectives of a DIO and Journal Editor David Sklar MD Editor in Chief Academic Medicine Distinguished Professor Emeritus University.

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Presentation transcript:

Resident Research: Perspectives of a DIO and Journal Editor David Sklar MD Editor in Chief Academic Medicine Distinguished Professor Emeritus University of New Mexico

Goals  Why is this important?  Why should residents do research?  What are the obstacles?  What are the facilitators?  What do we do next?

My History  My first publication came about when I complained to a faculty member about the vile taste of antacids after a bout of acid reflux in medical school. He asked me if anyone had studied taste of antacids, and when I learned that no one had, we devised a wine tasting type study for antacids. It was published as a Letter to the Editor in the NEJM.

My History  I later became interested in headache treatment because we were seeing many patients in the ED who demanded narcotics for their “migraines”. I was looking for an alternative and stumbled upon the use of intravenous ergot compounds. I decided to study them and decided to give prochlorperazine ( Compazine) as a premedication.

My history  After receiving the prochlorperazine most of the patients got better before I could give the ergot or placebo.  I was stumped. “Are you sure the headache is gone? I haven’t given you the medicine yet”  “Yup, it’s gone.”  This led to a study of prochlorperazine vs placebo which ultimately was published in JAMA.

My History  Both examples illustrate some themes about scholarship and publication that we will consider later.  Motivation- bad taste of antacids, frustration at headache treatment.  Review of literature  Study design  Mentorship

What is scholarship?  Ernest Boyer Scholarship Reconsidered-1990  Four types of Scholarship-  Discovery  Integration  Application  Teaching

Why is scholarship important?  Differentiates physician training from other health care providers  Critical thinking  Improves health care and health and maybe cost  Individual growth

Why should residents do research?  Contribute to growth of knowledge in field  Learn research skills which will help with literature analysis  Identity development  Support faculty  ACGME requirement?

What are the obstacles?  Motivation  Time  Lack of mentors  Resources  IRB  Lack of skills and experience  Conflicting priorities- training, family, wellness, sleep.

What are the facilitators?  Mentors who help design doable projects  Adequate time to accomplish project (dedicated months)  Training- CTSC, fellowships, other training  Ongoing Community of scholarship support  Incentives-financial, time, travel, promotion  Support for stats, IRB, writing and submission, research director.

Next steps  Consider broader definitions- literature reviews, case reports, quality improvement, patient safety.  Team research projects  Cost effectiveness  Health services health policy  Reconsider research requirements in ACGME based upon goals

Final Thoughts  Research can enrich residency or can be a burden.  Resident research should address individual and program goals  If a requirement, adequate time, resources, and faculty support needed.