I know everyone hates the "what are the best EM residency" posts and I agree it really depends what you are looking for. So... specifically if I'm interested in research what are the best programs to look at? Is looking at NIH funding useful or misguided?
best research focused EM residency programs
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If you're interested in research, dont go into Emergency Medicine.
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deleted720339
MS4 here interested in academics/research. Can you elaborate? Thanks!
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deleted547339
Respectfully disagree. EM is relatively under researched. There's a lot of room for research in EM.
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I think what a lot of people fail to realize is that you can be an EM doctor and do research in things that aren't explicitly EM related.
Example, myself. I did a lot of burn research before med school and during/after residency I want to keep doing it. Every residency I've spoken to about this (except a few, that don't really have the ability to support me) is ecstatic to hear this from me. It's all basic/translational science, not clinical or explicitly ED related.
Personally, ED research isn't terribly exciting, IMO. But there's a bigger world out there...
Example, myself. I did a lot of burn research before med school and during/after residency I want to keep doing it. Every residency I've spoken to about this (except a few, that don't really have the ability to support me) is ecstatic to hear this from me. It's all basic/translational science, not clinical or explicitly ED related.
Personally, ED research isn't terribly exciting, IMO. But there's a bigger world out there...
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deleted547339
You say that, but most things are at least tangentially related to EM. Ok, so you want to study basement membranes in melanoma? Yea, you probably can't convince the EM chair to fund that. But you want to study trauma, ACS, sepsis, vent management, CHF, intimate partner abuse, febrile seizures, drug abuse, smoking cessation? You can easily convince somewhat that is EM research.
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burns are related. Again, PD's I spoke with that had the $$$'s were happy to talk about it.
I'm not you. All of those things are boring imo. The ED, of course, it interesting to me from a clinical standpoint but none of those fields sound interesting in the least from a research perspective.
Again, I'm not you. Congrats on all of that exciting you though.
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Really, there is no reason to be snide.
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Sounds like those PDs would be lucky to have you!!!
I also have to respectfully disagree with this statement. Sure, if you look at the IM and EM residency programs at an academic center, you will probably find more research-oriented folks in IM. EM tends to attract people who have a lot of interests outside of medicine and academia, but those are by far not the only types interested in EM (and there are of course people who are research-minded, but also have other interests). However, EM can actually be a great specialty for researchers. Most academic EM departments value research as much as any other department in the hospital, but they may have fewer people doing actual research (beyond some "we changed our curriculum and added an OSCE and we found that our residents like it" kind of stuff). That translates into the researcher being much more valuable to the department, and also less competition. More importantly though, the schedule is much more research-friendly. Imagine you work as attending where full-time means 12 8-hr shifts a month (with residents). Even with the usual meetings and committees, that still gives you a bunch of free time during which you can do research. And you can schedule conference calls, research meetings and the like to take place before or after a shift without having to sacrifice a day off (as opposed to a 12-hour shift as a hospitalist or 36-hr call as acute care surgeon). That is relevant in particular for new faculty, because it means you have a reasonable amount of time available even if you aren't (NIH-)funded yet (and thus no significant amount of protected-time).
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I was going to start my post with "respectfully disagree" as the others have, but I changed my mind. You made a ignorant and unhelpful point, probably parroting something someone told you once. No respect for something like that from me.
Its nice to see a lively discussion regarding research itself, and I think you must be misinformed if you think research and EM cant mix.
Getting back to the topic at hand, if anyone has specific programs they think are especially research focused or are good at preparing residents for a career in research I would appreciate it.
Getting back to the topic at hand, if anyone has specific programs they think are especially research focused or are good at preparing residents for a career in research I would appreciate it.
It depends a little bit on what you are looking for: is it great and structured training in research methodology with the actual content area being less important or known to you at this stage? Or are you looking to build on your existing research in a particular area? For the first option any academic four year program is likely to be a potential fit. For the latter, you should look at what particular places are good at. There are few departments that have more than one expert on every topic in EM research, from health outcomes to stroke to ARDS to massive transfusion. And you want to have the option to have more than one mentor and so on.
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I disagree on four-year programs. If your intent is to have research time, the best way to get it is via a fellowship. And if you're going to do a fellowship, then spending an extra year in training won't help. Yes, some 4 year programs allow you to have months of electives, but you get the same amount or more dedicated time and get attending level pay in fellowship.
You can definitely do a research fellowship (though the pay is often only around 100k) coming out of a 3 yr program. If you are good, you can also pull of some significant research in a 4-yr program and get a true faculty job and a K01 straight out of residency. I think both a reasonable options depending on your goals and on what the institution has to offer.
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The path to a research career is best defined in IM, Path, and pediatrics. And yes, there are relatively few researchers in EM. The ticket is to find mentors who can get you the skills to transition from resident->researcher, and to have a department that is supportive (provides start up grants, encourages grant writing, etc.). There are a number of places around the country that have the critical mass needed to develop new physician-scientists in EM.
And while we're in the worst research funding environment in US history, we have an advantage as emergency physicians: you can apply to just about any NIH institute since you have clinical experience with any disease that comes through the ED.
I will say that there are a ton of EM folks who "have an idea", but have no concept of how to develop that idea and convert it into a publishable product. But that comes back to EM being a relatively new field with few researchers, but that makes the few researchers more valuable.
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It takes most people six months of dedicated effort to put together a K award application. The structure of the grant is such that you have to identify a mentor team and construct a career development plan, which are specific to whatever institution you will be at. Which is why every person I know who has submitted a K, did so in the first 2-5 years after graduating residency, after they got a job as an assistant professor. Logistically, would be nearly impossible to arrange this as a resident, even if it was at your institution, even if you were a MD/PhD.
And the NIH award cycle is such that it will be at least 8 months after you submit before you get your first grant dollar, assuming you get funded on the first try (only ~20% of all K-award applications get funded). Resubmitting would push back that start date another 8 months. Which means that nobody is going into a K right out of residency, even in a four-year program, unless you apply in PGY-2 (unheard of).
K's also require a publication record. It is hard to take a single paper from conception->publication before you graduate residency, let alone the multiple papers needed for a K. In our three year program, 90% of pubs coming out of our resident-initiated projects are accepted and published ~1yr after they graduate. Bottom line: most work done during residency won't be on the CV in time for someone to graduate with a K award.
And are you sure you mean K01? Because most clinicians submit K08s or K23s. I recall the K01s being primarily for PhDs or for people who are coming back to lab after leaving for a few years, not clinicians.
So, if you're "Deb Houry good," you might be able to get a K out of residency. But I think it would be unrealistic for anyone to plan their career that way. A much more common pathway is to do residency followed by protected time in fellowship.
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I did a research associate program at HCMC as part of my field experience requirement for my MPH in epidemiology. They seem to have quite a few different and interesting projects going on and a goid set up for it. So I'd suggest checking that one out.
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This + 1. I thought I'd already posted this actually-- HCMC is a research machine, has the infrastructure in place to get a lot done quickly, and is politically very powerful at their institution. (It helps that the leading academic expert on exemption from informed consent is former faculty there and that they have crews of medical students and undergrads recording everything always.) Brigham is stepping up in this regard, Brown has been doing a lot lately, Harbor-UCLA has a very research oriented group, UW Madison is looking to develop one and has the funding and leadership to do so. UCSF has some incredible researchers with a lot of grant funding, especially in policy areas.
It really depends on what you want to work on. I went into EM focused on an academic career, and interviewed at most of the "top" programs in terms of research productivity and ended up at one I like a lot-- PM me with any questions or post them up here, I'm sure there's a lot like me. Ignore the haters.
The number one priority of a residency is to create a clinician. Anything else should ideally be pursued in fellowship or during a year off, if possible. As far as which programs are the "best"? Tough to say. But, you can probably get an idea which programs perform a lot of research by using involvement with print journals as a surrogate (at the editorial and review levels). Also, keep in mind that a program's involvement in research is going to be influenced by faculty interests, so a departments involvement in research could change drastically if just one person were to leave. (An old program in the Northeast used to do a lot of research, but key members either left or died in the late 90s, thus that program doesn't do as much as it used to.) Some places have specific topics that they tend to focus on - e.g toxicology, EMS, cardiac arrest, etc. So, depending on your interest one program may be more enticing than another.
I don't think I'm knowledgeable enough to name names, but you will see some programs are highly represented when you look over the editorial staff of Annals, JEM, and AEM.
I agree with you that this is definitely not the standard. But it's also not as impossible as you make it sound. But hard to see someone pull this of in a 3-yr program. Regardless of that though, I would disagree with your statement that "it is hard to take a single paper from conception->publication before you graduate residency, let alone the multiple papers" - I worry that this would discourage residents from doing research. If one starts early, it is certainly possible to pull of more than project (and get it published during residency).
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The Dunning-Kruger is strong in this one.
Do what you like, but NIH Ks are nigh impossible to get from residency. The mechanism wasn't designed for residents and I would never tell one of my residents to apply for one while in training.
Do what you like, but NIH Ks are nigh impossible to get from residency. The mechanism wasn't designed for residents and I would never tell one of my residents to apply for one while in training.
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Are you saying it is NOT difficult to take a paper from conception to publication before graduating residency, and maybe even multiple papers? If so you and I either had VERY different residency and/or research experiences.
I agree with Hair. It is difficult for a novice researcher to take any paper from conception through study design, IRB approval, execution/data collection, data analysis, manuscript submission, review, and publication in 36 months.
Where I did residency, we had several residents publishing somewhere between more than one paper during their training.
Novice researcher - probably more difficult. Many residents have been able to gain significant research experience prior to residency though, particularly MD-PhDs.
You are entitled to your opinion. Never said I'd advise anyone to do so, just that it has happened before. A research fellowship isn't a guaranteed pathway into funding either, just one of many different options.
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Again, no one says it is impossible, but your previous post denied that it was difficult. Clearly MD-PhDs are not representative of the typical EM resident. They have an advanced research degree already. Most residents do not. I would classify most graduating med students, even if they have some research experience and a 'publication' or two on their resumes as novice researchers as they likely have never taken a project all the way from conception to publication. They will find it challenging to do that for the first time in 3 years while in residency. It happens, but more often they end up getting an abstract or two and their first 'real' publication happens shortly after graduating residency. At least that's what my experience has been at my academic 4 year residency, but I doubt many other programs would be way more advanced.
