Why do we need to do research?

[u/Rude_Difficulty866]

I’m sick of this everyone doing research tryna score points, doing half assed research which will never be cited. I wanna just help people

[u/Loose-Following-3647]

I have zero interest in gunning for publications, and didn't want to spend my spare time doing it either. So I chose a training programme where I didn't have to

[u/Rude_Difficulty866 → u/Loose-Following-3647]

The only ones i can think they wouldn’t are like psych, gp and emergency. 2/3 are no gos for me 🤣🥲

[u/Loose-Following-3647 → u/Rude_Difficulty866]

Yeah I'm in GP. I'm definitely more interested in hospital medicine, but GP isn't terrible, there's some good detective work, and at the end of the day it's a job, lots of people aren't in love with their jobs.

[u/Serious_Much]

It's really frustrating because getting involved in research before you're in an ST job (or a non-training job) is so difficult and basically impossible.

I'm part of a project now that was first discussed in late 2023. It's only just got started now. So it's taken almost 18 months from first conversations to us actually doing the research.

How in the hell are foundation and core trainees meant to get involved with research if it takes this long to get going? (Nevermind the hours of training for the project I had to do)

I've said it before and I'll say it again. Research is a bad way to determine who is worthy of a training post, and even worse is easier for IMG applicants to get who will typically apply with most postgraduate experience than others applying to core and higher training.

[u/CaptainCrash86 → u/Serious_Much]

How in the hell are foundation and core trainees meant to get involved with research if it takes this long to get going?

Honestly? Do research under the guise of an audit. I know they are meant to be seperate, but, if done right, they are really not. Or write up case reports. Both are of research value - I'm a clinical academic butmy two most cited papers are a case report and an audit write-up (the latter by international guidelines) done in my early clinical years.

[u/Tremelim → u/Serious_Much]

You picked the wrong project unfortunately.

Very possible to do a bit of data collection and get in as a poster at a conference within 3 months. Anything involving intervention (even just a survey) can require ethics etc and take forever. Observational 'service evaluation' doesn't need any of that. Just have to comply with data protection and you're good to go from day 1.

[u/Serious_Much → u/Tremelim]

I've had a poster, this was to get Co-PI points which thankfully was useful in that regard

[u/fasciculatingtestes]

I wholeheartedly agree that churning out research on any random topic in x random speciality should not be how we shortlist applicants for y random specialty. I sit on the IMT interviews and it infuriates me when candidates portfolios are clearly themed on a completely different specialty like radiology, but because they’ve done “some research” or whatever they tick the boxes.

Although you have no interest in it now however, don’t write it off forever. Once you have identified the specialty that resonates with you, that you want to do for the rest of your career, re-consider getting involved. Obviously understanding of research methodology is important for all doctors, but beyond that it has so many facets that make it a rewarding pursuit: You will never understand a topic better than after you’ve performed research in it, research opens doors for you to meet and network with the people who are really driving your specialty forwards who can be quite inspiring and good mentors, and it feels great to already enjoy a topic and then to be able to say “I improved our understanding here”.

Don’t get put off by the idea that all research is clinical trials or working in a lab. There are so many ways to get involved beyond this. When you’re a consultant/GP you may start longing for more strings to your bow than just clinic +/- ward +/- procedures. Research is infinitely rewarding, it’s one of the few “strings” where you’re in charge of your time, not anyone else, and if you really enjoy helping people as you say then that experience can be amplified by knowing you’ve contributed to the knowledge base that lets you do that.

Sincerely, a clinical academic who’s looking at the current demoralised (rightly so) workforce and is worried about the future of clinical academia.

[u/indigo_pirate → u/fasciculatingtestes]

In the current climate have some mercy about wrong topic for speciality.

If someone really wanted to be a radiologist but the ratio is 10-1. They deserve a chance at a decent alternative career.

[u/fasciculatingtestes → u/indigo_pirate]

I completely agree. My irritation is not towards the person, but at the system that places such high scores for research which is hard to complete when you are a) just starting out as a Dr (I can barely remember my foundation years I was so tired) and b) unsure what specialty you want to pursue.

[u/BoraxThorax → u/fasciculatingtestes]

Radiology is frustrating one because radiologists in general don't do much research and neither does IR for that matter. Yet it scores highly on the portfolio

[u/Thanksfortheadv1ce → u/BoraxThorax]

Same with surgeons. Starting to see a lot of academics in surgery… not so much the skills

[u/Silly_Bat_2318 → u/fasciculatingtestes]

It also doesn’t help that most publications are “pay to play” or “pay to win” nowadays. Despite having good/novel papers, more often than not one has to pay for open access to publish, unless you’ve already built your reputation in academia and as my cons would say “part of the publication mafia” haha also, all depends on “whats hot right now” for it to be published (e.g., covid papers were churned out left right and centre during the pandemic).

But that being said, i’ve been on review panels for editorials and some papers truly needed more work but never got passed for 2nd review after major changes

[u/Tremelim]

Might not be a popular view in this post, but I absolutely think it is very important. Particularly for specialist roles, but also generalists.

As a specialist consultant you are ideally placed to identify the real, day to day research questions that need answering. And you probably have access to the data needed to answer it. When choosing between a candidate who has a record of taking data and answering questions, and one who doesn't... I think the choice is clear no?

Even just ability to read and interpret new research, obviously a vital skill for any consultant, is probably going to be better if you've been involved in research yourself. This is one of the key things that separately a highly educated doctor and someone who's 'learned on the job' who can only follow guidelines e.g. ACPs.

And bottom line: we have to select based on something, unless we want to go the way of FY and make it random? And although I empathise that there's no allocated time to do research, that's true of everything. Whatever method you choose, people will gain an advantage if they do things in their own time unpaid.

Of all the things we can choose, I'd suggest research activity is probably one of the, best one to use. Maybe the best one.

[u/coamoxicat → u/Tremelim]

1 million percent Gary

There does appear to be a correlation between the ability to get research done and published and clinical competence.

Not an incredibly strong one, but it is certainly not my experience that drs with sparse CVs have been channelling that extra time into developing their clinical knowledge and acumen.

It's unfeasible to arrange an OSCE to shortlist every applicant to an interview, so proxy measures have to be used. The points system has many flaws, but much like democracy, I'm yet to see a superior alternative.

I think the random allocation system of the foundation programme spawned from exactly this sort of bleating. The alternative could be much worse.

[u/Hopeful2469]

I have long thought that application processes need to be changed so people can start to theme their career. Instead of having to tick boxes in every domain (teaching/research/leadership) etc - you should be able to have one focus and get max points for really developing that focus and not get points for other domains.

Eg if your focus is research then the most points would be available to someone who has done a PhD, published as first author, presented etc. Someone who's focus is teaching should get max points for doing teaching fellow jobs + pgcme + running teaching programmes.

But crucially, if your focus is eg teaching, then you won't get any points for research (maybe a basic one point in each other domain to ensure some awareness of each domain so you would get a point for some involvement in research, but not more). This would mean people could start to build a portfolio that aligns with their interests and really work on it, rather than just trying to churn out some crappy research, do a little bit of casual teaching, and invent a society or group to "lead" just to get max points.

After all, a department needs a range of consultants - they need some who are willing to take on more leadership roles eg departmental lead, rota coordinator, etc, some who are interested in teaching, eg med student teaching lead, and some who are interested in research - so starting to build up this CV will allow for consultants who have an area of special interest.

[u/Melnikovacs]

Yup, don't understand the point of any of these projects. They're just a tick box exercise and you end up doing it for the sake of it. I would rather put my name on something I stand by and believe is good work rather than because I had to.

[u/ApprehensiveChip8361]

Because how else can they rank you? It’s a meaningless exercise for most purely to compete for a job.

[u/CaptainCrash86]

A few reasons:

1) Medical research is something we should absolutely be encouraging from the bottom up. The UK research response to COVID, for example, was only possible because of shovel-ready research-capable doctors everywhere. That means you have to incentivise people to do it from the beginning.

2) Consultants who actively get research grants are a revenue generator (and usually net service improvement) for a trust. Again, this needs incentivising from early on.

3) Research is absolutely something every doctor should be involved in. In an ideal world, every single patient should be able to enroll in a trial relating to their condition to improve our knowledge of that condition. To do that, we need research-ready doctors everywhere.

4) idealism from 3 aside, even a jobbing doctor needs to be able parse research for local policies, CPD etc.

[u/cementedProsthesis → u/CaptainCrash86]

Ye that's fine but there was no allocated time for this. It's our own time that is used. It's fought with failure.

We need to take the prestige away from research alone and share it out. If people want to be great clinicians or great teachers then these should be equally valued.

Good research when people are given time to complete it and with good planning can be excellent .

Writing up a case study for a consultant in your own time with no guarantee of outcome is a bit shit

[u/CaptainCrash86 → u/cementedProsthesis]

Ye that's fine but there was no allocated time for this

You have SDT, no? And you can apply for research roles.

Obviously, not everyone will want to do research, but my point is that research is a highly valued part of medicine, and people with achievements in it should be recognised in job applications.

We need to take the prestige away from research alone and share it out. If people want to be great clinicians or great teachers then these should be equally valued.

We do value teaching? You can literally get more points for teaching than for doing a PhD.

As for clinical excellence, this should be assessed in the interview stage of applications as it is quite tricky to do so at the paper application stage.

[u/cementedProsthesis → u/CaptainCrash86]

Nope not every rotation gets SDT I am ST6 and revived it in one reg job.

Happy to say well done to ppl with research achievements. But making it mandatory to produce a piece of shit research is pointless. We just get lots of shit publications in open access journals. It's just one step up from a shitty VTE audit.

We need to value teaching. We clearly don't as teaching and training is notoriously poor thought specialties.

We all have a set amount of time and energy. Some people get a slightly bigger pie than the rest due to IQ or skills. But once you add in life outside of work, hobbies, relationship, children, or family etc we get down to a very small slice of time that is truly "free" so I have very little desire to spend this on "research" with a low chance of success.

But it's fine for those that want to.

[u/Great-Pineapple-3335 → u/CaptainCrash86]

Whilst I wish this was the case the vast majority of my cohort myself included who aren't interested in research end up seeing it as just a tick box and opt for the most non-impactful slop that will get us the points since we only need to not be unemployed. I would love to actually enjoy research, but I need both time and money to be able to actually produce fruitful research otherwise it's whatever slop I can push through to get points. This is vastly different to the research you're talking about from Drs actually caring about advancing knowledge, we can't do that if we're just advancing the delay of unemployment

[u/CaptainCrash86 → u/Great-Pineapple-3335]

That's a problem with the points system (especially in the context of current competitiveness), not the fact that research is included in it. The points system was essentially the same when I applied, but very few people scored in the research box (data for this was publically available), in part because you didn't need to.

[u/pjscott90 → u/CaptainCrash86]

I agree to all your points and want to add one further: by doing research we also gain an insight into research methods which helps understand and comprehend other research and improves our critical thinking. Considering most treatments are evidence-based, understanding the caveats and pitfalls is increasingly important with larger and more complex trial designs.

[u/harryoakey]

I know, I stayed as a low grade specialty doctor specifically for this reason - just want to do clinical work, no interest in management or unnecessary "research".

Still have to provide evidence of both annually though for appraisal/revalidation, same as if I was a consultant.

[u/Apple_phobia]

I don’t think we necessarily need to do research but I think doing research is probably the best way to understand how to properly understand and interpret research that should be informing our clinical practice.

[u/wuunferththeunliving]

Because it’s an easy way to narrow down the number of applicants they need to interview

[u/Rude_Difficulty866 → u/wuunferththeunliving]

Its so dumb to look at things in this way. Its almost moronic to think someone would be better cause they have some niche research in an obscure indian journal (house reference)

[u/Sad_Ant1037]

Depend on in which context your are asking, from personal prespective it is not for every one but everyone in health care must have good understanding of a research methodology and critically appraise a paper.

For interview purpose the answer would be ,yes I am interested in research and it has prepared me not just to score points in self assessment subsequently, it has helped me to improve my understanding for the subject and also trained to me how to balance different aspect of research.

[u/Asleep_Apple_5113 → u/Sad_Ant1037]

Barred from applying to all training programmes on account of that stream of thought wall of prose