Finding a Mentor
Research Design and Statistics
Presenting Your Work
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 get involved in research, but where do I start? What areas of PM&R need research? What’s a good research topic? What areas are of interest to me?” Take heart, because finding a 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 select an area of research which interests you. Delving into a research project can be extremely rewarding and enriching, but it takes a lot of work! Therefore, it is very important that you are truly interested in your research, so that you have the 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 the extra time and energy to 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 specialty within PM&R needs relevant, quality research to validate, improve, and justify our position within medicine and the care we provide to our patients. Start the process by selecting the rehab field that interests you the most.
Focus on a Narrow Research Question
Narrowing your interests down to a particular project is a bit trickier. When selecting 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.
There are many ways to pick a project. The most thorough method is to choose a very specific topic, 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 more current literature. 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 attendings to get a sense of what research endeavors are underway. Evaluate posters and presentations at clinical or national meetings such as AAPM&R’s Annual Assembly and AAP. If you cannot attend those meetings, download the programs of meetings that interest you, and peruse through the abstracts. Also utilize other resources such as PhyzForum on www.aapmr.org to connect with other colleagues who may be able to help in your search.
Offer Your Help
As another option, you can speak with the senior leaders in the field that interests you. Learn what 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 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 a helping hand. Whether this is one of your first research projects or you have several other projects under your belt, it is especially important that you find someone who can answer questions for you and be available to guide you through the research process. You need a mentor.
There are many places to find a mentor.
- A great place to start is within your department. Ask around to see what attendings in your department are currently working on and have done in the past. You may discover that an attending worked in your area of interest in years past and may be willing to guide you through another project in that research domain. A good place to start is with your chief residents. They usually have an idea of ongoing projects within the department.
- Next, look at the other departments at your institution. As PM&R has crossover with other medical specialties, you may find someone in another department with active projects or research interests like your own. Physiatrists can find research projects in the departments of Orthopaedic Surgery, Neurosurgery, Prosthetics and Orthotics with regularity.
- Don’t forget about basic science. Collaborations between clinicians and basic scientists generate new ideas for translational research projects. Undergraduate medical education departments are generally open to collaborating ideas and providing resources. Teaming up with a basic science researcher can have many advantages for a resident physician. Bear in mind, however, that these mentors may have limited experience working with clinicians in training.
- Finally, if all else fails, don’t be afraid to look outside of your institution for guidance. Seek out others who have done work like what you want to do. An email or phone call is all it takes to start the conversation.
- If you have an idea for a project, reach out to an attending. You would be surprised at the resources they could offer, even if they can’t be directly involved with the project. Sometimes all it takes to get a project started, is a fresh set of eyes a few new ideas.
The Association of Academic Physiatrists (AAP) offers a unique program for residents interested in research careers that provides structured education and mentorship throughout residency in preparation to apply for competitive multi-year K12 training grants. Note: Participation in the program at the resident (“pre-application”) level is not required to apply for the grants. Find out more here: Rehabilitation Medicine Scientist Training Program (RMSTP)
Foundation for PM&R Mentor Search Tool
Obtaining funding is 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 faculty advisor, department, GME office, or medical school. 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.
- Faculty Advisor: If you have a faculty advisor who is doing similar or related research, perhaps they can sponsor your project. As mentioned in the mentoring section, if you can find a mentor who works in your area of interest, they may be willing to fund, as well as supervise, your research.
- 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.
- GME/UME Office: Another resource 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.
- Outside Funding. If you’ve decided to apply for an outside grant or other external funding, be prepared for fierce competition. Funding has become much tighter over the last 15 years; currently, less than 20% of research proposals submitted at the federal level are receiving funding. 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 many grants specifically designed to encourage new young researchers. Furthermore, granting agencies tend to be receptive to clinically-oriented proposals. If you have a team of resident researchers on your project, then this becomes an easy task to delegate.
Don’t become discouraged. Receiving funding is the most difficult and time-consuming part of research. It is expected and normal to be rejected multiple times before receiving funds. Save each application you fill out. Grant applications often have similar questions and you will learn to quickly tailor your answers to each, saving more time with each additional application you fill out.
Foundation for PM&R 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 various 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 understand 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. Ask your department if they have a statistician on retainer. Other researchers within your department have needed a statistician at one point, guaranteed. This may be a resourceful allocation of funds, too. Many 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 3 ways to present your work: posters, presentations and publication.
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 10 feet. A large title with type about 2 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 to maximize your poster’s impact.
Preparing and Presenting Effective Research Posters
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
Publishing a paper is the most lasting form of sharing research and reaches the largest audience. There are usually many 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 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 the authors (if more than one, each must 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
Residency enables exposure to a plethora of research opportunities. If you find yourself allured by research, then seeking a fellowship may be the next step in your career path. Available fellowship opportunities can range from clinical to research. However, most will lie somewhere in between and can accommodate everyone’s goals. Remember that the goal of a fellowship is to advance your education 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 well-trained mentors, stable facilities, and opportunities that will allow you to achieve your goals. To find fellowship opportunities available, network with colleagues, visit local and state meetings, attend national conventions and utilize the websites below.
The following websites will provide valuable information to aid in your search:
The AAP has constructed a Rehabilitation Medicine Scientist Training Program (RMSTP) with funding from numerous organizations (including the NIH) to support and develop those physiatrists who are committed to research in physiatry. Please be aware that this program occurs through three phases beginning during residency. For more information visit, http://www.physiatry.org/?page=RMSTP.
The National Institutes of Health support fellowships in many ways. Namely, they support ACGME accredited, non-ACGME and jointly sponsored programs. For more information on available programs, visit https://www.cc.nih.gov/training/gme/programs1.html. With a competitive compensation package and Loan Repayment Program, it is well worth investigating.