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Residents' Research Packet

Getting Started
Finding a Mentor
Funding 
Research Design and Statistics 
Presenting Your Work 
Beyond Residency

Getting Started

If you already have a research topic in mind that you are excited about, that’s great! If not, you may be thinking “I’d like to do some research, but I haven’t got a clue as to what needs to be studied or what I could possibly do.” Take heart, because finding a study topic and developing a research plan can be one of the most enjoyable parts of doing a research project!​

Identify your general interests.

The most important aspect of starting is that you pick a research area which interests you. Doing a research project is extremely rewarding and enriching, but it is a lot of work! Therefore, it is very important that you are truly interested in your research topic, so that you have enthusiasm to carry you through. Otherwise, the project may turn into sheer drudgery. Don’t simply do a research project because someone conveniently offered an idea to you. Take a little extra time and find a research topic that is meaningful to you.

How can you be sure that your area of interest needs active research? That’s the easy part! You are a physiatrist, and very little research has been done in our field. Every area of PM&R needs a lot of good research to validate, improve, and justify what we do. Simply pick the clinical area that interests you most.

Focus on a narrow research question.

Narrowing your interests down to a particular project is a bit trickier. When picking your project, keep this in mind: Be specific. You are a busy resident and have limited time to dedicate to a research project. If your topic is too broad, it may demand more effort and detail than you have time to give. Narrowing your topic is truly an investment in your research success.

Literature review

There are a number of ways to pick a project. The most thorough method is to choose a very specific area, then perform the most thorough literature review that you can. Read current review articles, ask your attendings about original “classic” articles on the topic and read some of the most current cutting edge work. Critically read to try to figure out which data are valuable and which are not. As you read, you’ll see gaps in the knowledge of the field. You’ll also notice that for every question addressed by a research study, more questions arise than are answered in the process. Eventually you’ll find many questions worthy of study and hopefully something in particular that you want to tackle and think you can handle.

It is also very helpful to see what research questions your fellow physiatrists are asking. Talk to your colleagues and attending to get a sense of what research endeavors are in process. Evaluate posters and presentations at clinical or scientific meetings. If you cannot get to those meetings, download the programs of meetings that interest you, and look through the abstracts.

Offer Your Help

As another option, you can talk to the senior people in a field that interests you. See what both the clinical and basic researchers in your area of interest are working on. Don’t be afraid to look outside your own department or institution. If a particular researcher has a new or ongoing project that interests you, see if you can get involved. Don’t be bashful. All researchers like to talk about what they are doing, and they welcome offers of free assistance from reliable, educated people.

A caveat: If you are going to work with other investigators, especially senior researchers, be very clear about your time limitations. Don’t commit to something you may not have the time to do. Keeping your time constraints in mind, try to pick a project that allows for flexible hours. It is often difficult to do animal experiments or other rigidly-scheduled research during a residency. Also be clear about your expectations before making a significant commitment; it would be a shame to contribute significantly to an investigation only to not be a part of the process of presenting the research findings if applicable.

Finding a Mentor

No scientist can work in a vacuum. Every researcher needs other people to provide critical ears, timely advice, and an occasional helping hand. If this is one of your first research projects, it is especially important that you find someone who can answer questions for you and guide you through the research process. You need a mentor.

There are a number of places a resident can find a mentor.

  • Ask around to see what your department’s attendings are doing and have done. An attending may have worked in your area of interest in years past, and s/he might be happy to guide you through another project in that area.
  • Next, look at the other departments at your institution. Many areas of PM&R also find interest in other specialties and you may find someone in another department doing research similar or related to your interests. Physiatrists find research projects in the departments of Orthopaedic Surgery and Neurosurgery with some regularity.
  • Don’t forget the basic science departments. Basic scientists generally enjoy working with clinicians. Such interaction generates new research ideas and helps to develop insight about the clinical relevance of basic research. Teaming with a basic scientist researcher can have many advantages for a resident physician. The basic scientist should be well-trained at doing research and may be able to help with lab space, computer access, equipment, or even funding for your project.
  • Finally, don’t be afraid to look outside of your institution for help and advice. Call people who have done work similar to what you want to do. They may be able to save you a lot of trouble. A lot can be accomplished with a phone, a fax machine, e-mail (most active researchers have accounts on the Internet), or regular mail.

The Association of Academic Physiatrists (AAP) offers a unique program for residents interested in pursuing a career in research that provides structured education and guidance throughout residency in preparation to competitively apply for a K12 training grant. Find out more here: Rehabilitation Medicine Scientist Training Program (RMSTP)

Helpful Links
Foundation for PM&R Mentor Search Tool

Funding

Obtaining funding may be one of the most difficult aspects of the research project. The best place to start is close to home. Often it is easiest to get relatively small sums of money from your own advisor, department, medical school or university. There are, of course, other funding agencies, but this approach is more difficult, more time consuming, and more prone to delays than are internal grants.

  1. Your advisor. If you have an advisor who is doing similar or related research, perhaps s/he can sponsor your project. As mentioned in the mentoring section, if you can find a mentor who works in your area of interest, s/he may be willing to fund, as well as supervise, your research.
  2. Your department. The next step would be to talk to your departmental research director, program director or department chairman. Most academic PM&R departments, at least the bigger ones, will have some “free funds” or training grant money which can be used to support resident research.
  3. Your institution. The last hope for internal funding would be your hospital or associated university. Some institutions have training grants or endowments designated to support research at that institution. These are often directed more towards junior faculty than residents, but you may be able to apply for these funds under your advisor’s sponsorship. Call the Office of Research Development at your institution or talk to your department chairman about this possibility.
  4. Outside funding. If you’ve decided to apply for an outside grant or other external funding, be prepared for fierce competition. Funding has gotten much tighter over the last 15 years; currently, less than 20% of research proposals submitted at the federal level are being funded. The bad news is that you’ll be competing in a tough market with experienced, full-time researchers; this may be a battle you want to put off until after you’ve finished your residency. The good news is that there are a number of grants specifically designed to encourage new young researchers. Furthermore, granting agencies tend to be receptive to clinically-oriented proposals.

Helpful Links
Foundation for PM&R Research Grants
AAP Listing of Research Grants

Study Design and Statistics

It is essential to have a detailed and well-thought-out research design in place before data collection is started. Projects developed “on the fly” tend to get bogged down, develop big holes, are often more biased and often lead to poor research. Great care must be taken to control as many variables as possible, limit bias, and anticipate problems.

Research studies can be designed in myriad ways.  Many books and articles have been written on the subject, and you may find the links below to be a helpful starting point:

Fundamentals of Experimental Design
AAP Experimental Design and Analysis Article Database
Rehabilitation Measures Database

As a researcher, you should have an understanding of some basic statistical terms, concepts, and tests. You should understand which test applies to which type of data and what the results of the test mean. Fortunately, you do not necessarily need to know how to perform any of the tests mathematically as a computer will do this for you. However, most research projects will need the advice of a statistician, preferably one who has acquired some medical background by working with other clinicians. You should seek a statistician’s advice when planning any study so that your sample size is adequate to prove your hypothesis (a process called “power analysis”). In addition, the statistician may be aware of more sophisticated techniques which can be used to analyze your data. Appendix D contains a review of basic statistical concepts. A number of useful articles and books are listed below in the reference section.

If you wish to do your own statistics, you will need a computer program to assist you. Ideally, the computer you use should have graphical capabilities to allow you to look at histograms, scatter plots, and graphs with your data. Many easy and excellent statistics programs are now available for use on personal computers. There are probably several programs available for your use within your department. Ask around before you buy one for yourself.

Basic Measurements and Statistics

Presenting Your Work

Once you have finished your research project, you will, hopefully, want to share your results with the rest of the medical/scientific community. There are three ways to present your work: posters, presentations and publication.

Posters

The objective of a poster display is to present research in a way that facilitates interaction between the presenter and the audience. Poster presentations are a great way of sharing your work with people interested in the topic, as well as learning what others are doing in similar fields. In general, it is easier to get posters accepted at meetings than platform presentations; this makes posters a good avenue for presenting pilot data.

Posters should be simple and easy to read from a distance of ten feet. A large title with type about two inches tall should be at the top of the poster, and general text should be about one half inch tall. Try to make the content of your poster flow from top left to bottom right so that it is easy to scan. Some people choose to make their posters in outline form for the sake of simplicity. Bold sub-headings and simple figures with clear concise legends are useful. At least 50% of the poster area should be figures or tables. Text should be reserved for essential points in order to maximize your poster’s impact.

Preparing and Presenting Effective Research Posters​

Presentations

Presentations are the oldest form of sharing research. The goal of the presentation is to present research in an interesting, accurate and reasonably thorough manner. Try to tell a story outlining the important details; do not just read a scientific paper. Audio-visual aids can be very helpful in presenting data and keeping the talk interesting. They can also be confusing and tedious if not used well, so try to keep them simple. For text slides, shoot for no more than 6 lines of text apiece. Similarly, tables should be used to highlight specific points, not present reams of data. Figures should be clear and well labeled. Slides are the most commonly used visual aids. Type should be 24 to 60 points in size to ensure readability.

Communication for Scientists

Oral presentation structure

Ten simple rules for good oral presentations

Giving a good scientific presentation

Publications

Publishing a paper is the most lasting form of sharing research and reaches the largest audience. There are usually a number of appropriate journals for any type of research, but be careful where you submit your manuscript. Make sure that the journal is peer-reviewed and well-read by the audience that you are trying to target. Ask around to see which are considered to be the better journals in your area of interest. If you have done research in a very small field without obvious journal choices, do a literature search to see where similar work is being published. And you should always turn to your research advisor, mentor, or faculty to get additional advice.

Publishing in medical journals can be very competitive. You need to write a good paper to show off your good research. When submitting your paper to a journal, pay close attention to their specific manuscript preparation instructions. These instructions can be found in the individual journals. The instructions are often listed monthly; thus, the weekly journals will include their instructions every fourth issue, the monthly journal in each issue, etc., so flip through the most recent issues once you decided where to send your paper. Writing in the proper format is of utmost importance; otherwise, the journal will just have another reason to reject your paper. And always remember to submit a cover letter to the journal’s editor(s) stating the title of your paper, listing all of the authors (if more than one, each has to sign this letter indicating they have read the manuscript), and indicating that your paper has not been accepted for publication elsewhere.

Getting research papers published can be a long and difficult process. When a paper is submitted to a journal, the editor usually has two and sometimes three “experts in the field” review the paper. They will write comments about the paper and rank it. Depending on these reviews, the editor will either accept the paper, accept the paper with revision or reject the paper. The better journals accept fewer than 50% of manuscripts submitted and, of those accepted, almost all are accepted with revision. It generally takes three to four months for manuscripts to be reviewed and a couple of additional months to have the revised paper reviewed. When the paper is accepted in final form, there is usually a six to twelve month wait before it is finally published. Be patient and be persistent. If revisions are requested, do only what you think is appropriate (some of the comments or requests by the reviewers may simply be wrong) and write a very thorough letter addressing each reviewer’s comments in detail. If your paper is rejected, don’t feel bad. Most papers are rejected on the first submission. Read your reviews and see how you can improve your paper. Then try again. Consider your first manuscript submission a learning process; you will learn a lot. Good luck!

Communication for Scientists

How to write your first scientific research paper

How to write a scientific article

Writing a scientific research article​

Beyond Residency

During your residency you are, hopefully, only just starting a long a productive research career. If research is something you would like to pursue, additional training would probably be helpful. One option is to do a fellowship.

Fellowships run the gamut from being entirely clinical to exclusively research. Most lie somewhere in between and are quite accommodating to the individual’s goals. Fellows are in high demand so be choosy. Remember that the goal of a fellowship is to advance your education well beyond residency. It should not be to pay dues, provide cheap labor or get an “in” to a program. Be sure the program you choose has good mentors and good facilities to allow you to achieve your goals.

Websites

AAPMRAAPACRM​, and AMA​ have websites that provide information on clinical as well as research fellowships.

EMG Fellowships

The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) has an excellent listing of EMG fellowships available in the US and Canada. It contains information on over 50 positions. Although most of the positions list completion of a neurology residency as a prerequisite, they may consider PM&R residents as well. You can obtain a listing of electrodiagnostic medicine fellowships by visiting the AAEM website at www.aanem.org/Education/Resources/Fellowships.aspx.

The NIH

The National Institutes of Health support fellowships in many ways. They give grants to academic institutions to support fellowships. Many of the positions listed in the “green book” are supported by NIH funds. They also give grants to individuals with a number of different awards. For more information, call the NIH, or see the NIH Guide book listed in the funding section. Finally, the NIH supports a number of fellowships at the NIH campus in Bethesda, MD. See:grants.nih.gov/grants/index.cfm for more info.