Research Forum FAQ - Look here before posting

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RxnMan

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- Warning - this is a work in progress. I will add a number of topics as time goes on: what is research, how do you get involved, etc. It is meant to help folks in all stages of training (pre-health, health student, professional) and answer many of the general questions people have when visiting this section of SDN. Some of this will be an expansion of my re-app FAQ. I will probably miss something, and while I am somewhat experienced, I am by no means an expert. Please send me a private message (click my name and follow the prompts) and tell me what you think.

Look here for answers to common questions about research and publishing.

Contents:

What is research?
- What is clinical research?
- What is basic science research?
- What is translational research?

Publications
- What constitutes authorship?
- What do the various authorships mean?
- What is the peer review process?
- What happens after you submit a manuscript to a journal?

Undergrad research opportunities
- How to set one up
- Will I publish?

Medical student research opportunities
- How to set one up
- Will I publish?
- How do I choose a project?

Year-off programs for medical students
- Links to various programs and their descriptions
- Interview experiences <- New (5/24)
- Some reviews by people in these programs

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- What is research?

For most of the people reading this forum, "research" refers to the application of the scientific method to expand human knowledge. Wikipedia calls it a harnessing of curiosity. At the very least, this requires a hypothesis, an experiment that tests that hypothesis, and either the rejection, or acceptance of that hypothesis.

With respect to the health fields, this can range from detecting signaling molecules in cell culture, determining the efficacy of treatments in disease models, surveying patient populations for clinic usage statistics, injury threshold testing with cadavers, NIH funded Phase 3 clinical trials, and so on. The house of medicine is huge and there is a place for nearly every interest. Many different techniques are used and nearly every discipline can bring some new insight.
 
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- What is clinical research?

Clinical research generally refers to research with human subjects. Many definitions will focus on testing the efficacy of a drug or treatment, and this encompasses a large part of the clinical research literature. But many cohort and cross-sectional studies don't generally involve treatments, but they are considered clinical research. I feel that if the project requires human subjects and IRB approval, then it can be considered clinical research. Much of the work is done in hospitals or clinics.

- What is basic science research?


Basic science research deals with the most fundamental components of observable phenomena. Just like Galileo rolling cylinders down inclined planes, basic scientists try to find the exact reason why something happens, and what parameters affect the outcome. It is effectively on the other end of the spectrum from clinical research. The drug used in a clinical trial is the product of years of work discovering and characterizing a cell receptor: How that that receptor is generated in-vivo, it's function, what increases it's function, what decreases it's function. These are the questions a basic scientist pursues. Much of medical basic science research is done in labs (A.K.A. bench research) manipulating cells and organic molecules.

- What is translational research?


Translational research has become more of a buzzword with the NIH. This came about because while the US had developed a great deal of medical knowledge over the last 50 years, relatively few new treatments have resulted. It occupies the gulf between the extremes of basic science and clinical research. Translational research strives to apply basic science findings in the clinic. Or take clinical findings and figure out what it going on. Due to being sort of a grab-bag middle man, where translational research is conducted depends on the focus of the project.
 
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- What constitutes a publication?

Most of the posters on this board won't use legal definition of a publication; rather we're talking about a significant contribution to the scientific literature. We're talking about a full-length, peer reviewed journal article. These generally include an explicit description of a series of experiments, their results, and the interpretation of those results, showing how they relate to the field. You must also justify your experiments. There are specifics for each journal, and a guide can be found here. They are usually about 3500 words long and follow the Intro, Methods, Results, Discussion (IMRAD) format. Results and experiments must be unique, new, and generally positive. Negative results (e.g. "no correlation found," "X does not effect Y") are much more common than positive because there are many ways not to make a lightbulb, but only one way to make one that works, so they don't get the same amount of press.

- What constitutes authorship? or

- What does 1st, 2nd, etc. author mean?


Authorship means that an individual had a significant contribution to the completion of a published or publishable research project.

People starting in research are commonly frustrated by this - they will often state that they took all of the data for the project, did a lot of work, and yet, are not named an author. By contrast, the lab PI, who "didn't do anything," is given an authorship. It is understandable that this situation is frustrating, mostly because much of the work that goes into a project takes place before any data is taken. The idea behind the research must come from somewhere. In basic science bench work, there must be funding to pay for lab space, hire workers, pay for equipment, and supplies. In clinical research, you have to write a proposal and get IRB approval. The experiments must be designed to illuminate the one property you wish to examine.

With these ideas in mind, you can understand how authorships are generally awarded.

1st author:
The "man on the ground," the one who ran the experiments and managed the day-to-day aspects of the study. Often the person who interprets the results and writes the majority of the final article. They will write the proposals and get permission from the host institution and gather subjects. Hour-by-hour, they put the most time and effort into the project. As a result, they get the honor of being named first, which is reflected in how papers are generally referenced (e.g. Smith, et al, Cell). Students working towards a graduate degree often fill this role.

2nd author: If there was someone who also put in a great deal of effort, but not as much as the first author, they are named second. In two-author papers, they are actually the last author.

Last author: Generally the person overseeing the project. They make sure that #1 is doing good science. They also are the one who secured the funding to support #1. Often the PI of the lab or the graduate student's advisor. While they didn't necessarily "do all the work," they make the work possible by providing infrastructure and expert guidance, and so they deserve to be recognized on any work that is produced in their lab.

Everyone else: They are the pinch hitters, the guys called in on a afternoon to do a statistics consult or collect data. They did an important part of the work, they just didn't do much compared to everyone else involved. A lot of undergrad students will get their first publication by helping write up a project completed by someone else, and will be recognized as a 3rd or 4th author.

- What is "peer review?"

The process of peer review is one of science's method of self-policing, one of the hallmarks of a profession. When papers are submitted to a journal for publication, they are scrutinized by experts in the same field. In an ideal situation, these experts have no ties to, or no conflicts of interest with, the authors of the submission. In general, these experts evaluate the merits of the submission and either reccomend it for publication, reject it completely, or reject it with revisions. The required revisions can be as simple as word and graphic changes, or they can be as complex as requiring a whole new set of experiments. The authors have to fufifll these revisions (and any new data aquired) in order for the submission to be accepted by that journal. The process from beginning writing to publication can take years.

Here is an interesting thread describing some of the challenges associated with publishing in science. Another good place to look (for information about research in medicine) is the Physician-Scientist Forum and their new FAQ
 
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- What Happens After You Submit a Manuscript to a Journal?

This submission comes to us from the incomparable Tildy (the original post can be found here). You can find his Academic Mentoring thread here. You can also informally ask him questions regarding publishing, research, and academic medicine at this thread.

************************************************************

Introduction:

I've been asked to describe a bit about how biomedical articles get edited from the editor's perspective. That is, to remove a bit of the mystery from the process for those submitting their first paper(s). I thought I'd do so via a thread so that questions can be asked directly.

Below, I will trace the typical course of a biomedical research article from hitting the on-line "submit" button, to appearance. This is not about how to write a good article, pick the right journal for it, etc. This is about how your well-written, brilliant contribution to human knowledge gets annihilated by a bunch of ignorant reviewers and editors and what you should do about it to get it published.

Remember that, similar to an article about the course of medical education that talks about the preclinical first two years of medical school while ignoring the fact that the preclinical part isn't two years everywhere, this article is about the TYPICAL course used by primary journals within a discipline. In other words, not about "Science" or "NEJM" or, on the other end some 4th tier (there are no true tiers by the way&#8230;) journal, but about good primary journals that reject more papers than they accept and that practioners, physicians and scientists often read to keep up with a field. Of course, there are variations in the theme and details of the process. However, like medical education, there are more things in common than different between these journals.

1. Article goes to journal where it is logged in and screened by a technical editor.

2. If within the basic scope of the journal, close to being understandable in English, and basically follows the format of the journal, it is sent to the Editor-in-Chief of the journal.

3. The editor will either handle it as the "primary editor" or send it to an associate editor who may or may not be especially knowledgeable about the specific research topic. Journals with associate editors often have 1 to 10 of them who serve as the "primary editors" for manuscripts. They will review any difficult decisions with the editor in chief, but the workload for major journals is huge and associate editors are generally fairly autonomous.

4. The "primary editor" (henceforth, editor) will look at the article briefly, especially the abstract and decide if the article merits further scientific review. This review is based on the topic &#8211; does it really fit the journal, the scientific method &#8211; is it up-to-date, etc? For clinical studies, the editor will consider the study design. For example, some journals do not publish many or any retrospective reviews. Finally, the editor may do a scan of the literature to see if this study is novel or if the authors have published some of it before.

5. If the paper is deemed very unlikely to be acceptable for publication for any reason, most commonly it just isn't "novel" or "important" enough for that journal, the editor will send it back to the author with a rejection letter. The letter may briefly describe the reason or simply say that the study would not be likely to clear peer review. Total time from submission for this process is often about a week or two. Appealing a rejection like this is essentially futile for the authors. Move on and resubmit elsewhere. Remember that the editor is doing you a FAVOR here with the quick rejection. If they send out for peer review a paper that they have already decided won't be accepted, they are delaying you by a month or more on resubmission of the paper elsewhere. Journals have relatively fixed numbers of papers they can accept. The editors can't accept all papers even all of the good ones. So, sending out for peer review a paper that is, for example, a case report or a retrospective review that the editor knows won't be something they can accept for this journal is not being nice to the authors. You can think of analogies here to the med school admissions process&#8230;.

6. If the paper is deemed worthy of peer review, the editor will select the reviewers. This is the key step of the whole process. If the authors have suggested reviewers, these will be seriously considered. In general, the reviewers suggested by authors are not more positive to papers than non-suggested authors. If the authors have given the name of someone they do not want to be a reviewer, the editor probably won't send it to them. But, they can send it to anyone they want, with the understanding that the editor has been warned of a potentially biased review. Certainly any editor brings their own scientific biases into selecting reviewers and that is inevitable. Clearly, the editor can select reviewers that they think will be easier/harder, etc. In general though, editors are seeking the most knowledgeable and unbiased reviewers they can find. They also are going to look at the reviewer's history with their journal. Is the reviewer usually on-time with reviews, do they accept review assignments or complain?

7. Peer review occurs by the reviewers. This is the LONGEST step of the process. If the reviewers initially chosen by the editor decline to do the review, then the editor may need several tries to find reviewers. In general, it is considered nice to review a paper within 2 weeks of receiving it. But this often doesn't happen. A range of 2 to 6 weeks is common. Some journals are notoriously slow. The editors can prod reviewers, but can't force anything since being a reviewer is a voluntary, unpaid task. Reviewers are usually scientists and physicians with patients to see, their own papers to write, and grants to prepare. A thorough peer-review can take 2-20 hours for a reviewer and that is totally unreimbursed time. Peer reviewers are making a significant effort and sacrifice to look at YOUR science. Keep this in mind. A brief review is not a favor. A thorough review is best, even if it seems like a lot of work to rewrite the paper. In a sense, a good peer reviewer is acting as a mentor. Of course, some reviews are unkind and inaccurate, but most are pretty accurate and well-done.

8. The reviews are sent back to the editor who must make a decision. With some variation on the theme, one of three decisions is possible:
a. Accept the paper (very rare to be accepted at this point for original science papers)
b. Accept the paper if the author can respond appropriately to the reviewers comments/criticisms.
c. Reject the paper​

Of these, within the middle category, there can be various ways by which the editor can indicate the likelihood of ultimately accepting a paper and convey this information to the authors. The editor could send the author a decision letter saying "This is the best thing every written about the topic, but answer the reviewers about why you did X,Y and Z before I can accept it." They could send the author a letter saying "This is awful, but maybe we are missing a key point, so look at what the reviewers say and tell us why they are wrong." Or, most commonly, they'll simply say "Respond to the reviewers and we'll relook at it."

9. The editor will send this letter back to the authors, potentially adding their own personal comments and/or note some technical issues (e.g. please double space) that need to be fixed on resubmission. The editor may point out the most important points they need to have answered or they may provide some commentary to help the author with the revision. Pay very close attention to what the editor says in their letter. It is not inappropriate to communicate with the editor directly on these points, although this is uncommonly done. You may not, as the author, gain direct access to the reviewer except for those journals that do open review (few at present time).

10. The authors must decide if they are willing to revise the manuscript based on the reviewers' and editor's comments. They must respond with a revised manuscript, specific rebuttals, and a very nice letter that ALWAYS starts with (give or take a few words) "We appreciate the reviews sent to us regarding our paper. We have enclosed our revised manuscript in which we have responded to each comment by the reviewers." Do not ever, ever send a hostile letter back to the journal. Even if you (or the PI) decide not to revise the paper for that journal, you may submit to that journal a different paper sometime and don't want to make enemies.

After your first Nobel Prize you can become a prima donna and blast the reviewers for their ignorance of your brilliance. For now, eat crow and respond nicely to each point the reviewers' make, even the ones that are clearly based on a lack of understanding of what you've done and written. That doesn't mean you MUST agree with the reviewers and make EVERY change they suggest. You can decide not to make any given change the reviewer wants. But, you must explain to the editor clearly why you disagree with the reviewer. Remember the reviewer will see this again, especially if you pick a battle here. If the reviewer wants small changes that you don't think are worth it, generally, do what the reviewer wants. Save the battles for key issues. If there are (as there almost always are) multiple authors on your paper, make sure that the co-authors see both the revised manuscript and your letter of response before submitting these. Above all, ALWAYS respond professionally to EVERY point in EVERY review. Don't just ignore a comment by any reviewer &#8211; give a response to everything that is said. Please, remember to keep it polite and collegial. The reviewer could be your future boss, colleague, or mentor. Express your anger at the unfairness of the review to your friends and teddy bear.

11. The editor will look at the authors' response and make a new decision. The choices are:
a. Accept the paper
b. Accept the paper IF the authors make a few more small changes
c. Send the paper BACK to the original reviewers to see if they agree or at least will accept the authors responses
d. Reject the paper.​

12. In theory, the cycle of 7 through 11 can be repeated a few times. In general, it is not done more than twice (two revisions) except in rare circumstances or related to some trivial changes that lead to a third or fourth revision. Typos and the like can usually be handled after acceptance. It is uncommon for an unsolvable conflict between author and reviewer to exist. Usually reviewers will accept the authors' answers but may ask for some "hedge words" or explanations of the limitations of the study in return. These types of trade-offs make editors satisfied that a balance of perspective has been achieved. In the uncommon situation of a true stalemate, it is up to the editor to make a decision. Don't worry, they won't be afraid to do it. But, they would much rather that the author and reviewer are in reasonable agreement. As a last resort, the editor may offer the reviewer the option of writing an editorial commentary or a letter to the editor in rebuttal of a paper. This is unlikely to occur for studies done by post-docs and junior faculty.

13. Eventually, the paper is accepted by the editor and the author is sent a letter that includes the phrase "Your manuscript has been accepted". At this point, and not before then (e.g. not when the letter says "we expect to accept" or "if you respond to these minor issues we will accept") can the authors list the paper as "In Press" on their CV.

14. The manuscript as accepted is now sent to the publisher and leaves the hands of the editorial office. Whether it is technically edited by hand, by computer, by the journal, or by the publisher for grammar, style and spelling is highly variable, but somehow it will get edited and your typos fixed. It is the publisher that will determine when the paper actually appears and send out page proofs.

15. About 2 months before the paper appears in the written journal, you will be sent, usually electronically as pdf files, what are called page proofs. This is the paper as it will look in the journal with everything except the actual final page numbers since they don't know them yet. You will be given 48 hours to review these. It really behooves you to spend a few HOURS poring over these. Have someone who isn't familiar with the paper do this too. Amazing how often tables are messed up (data columns transposed!), words and sentences deleted, etc. Much better to catch these mistakes now than after publication and be forced into a correction. You cannot rewrite anything in the paper now except for making corrections of mistakes. You could be asked to pay if you insist on substantial changes. Your paper could be delayed as well. Rarely, if you ask to make a real change, the editor could be informed and decide if they agree to this change. Be cautious here. Fix actual mistakes but don't try to change what you've written based on more recent data, new publications in the field, etc.

16. Finally, the paper is published. If an on-line version was published earlier, it will usually be replaced with the final version which will now appear in pubmed as a final version.

17. Congratulations! Now, just do this another 20-50 times and you're ready to be promoted!
 
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- How do you set up a research opportunity as an undergrad?

Talk to your professors. If you have a favorite, ask them after class if they are looking for help. Most profs will be receptive and see it as a compliment. If they can't take you on, they may be able to give you the name of some one who can. Many profs will offer class credit, work study, or an hourly wage in exchange.

At this stage, you don't have many skills to offer the PI, so you will probably wash a lot of glassware and/or work with a lot of mice. Or rats. It's boring being a lab monkey, but you have to start somewhere. Just like any job, if you're hard working, attentive, and enjoyable to work with, you'll be given more responsibility, namely allowed to run some of the experiments. This may sound cool, and sometimes it is when you're doing SEM or using a motion-capture suite, but all of that is window dressing to the real crux of research: learning how to refine a hypothesis, design an experiment that tests that hypothesis, and including good controls. Being able to critically appraise your results is also important. A good mentor and PI will introduce you to these concepts.

- Will I be able to publish as an undergrad?

Do not expect to publish - most undergrads don't. However, it is feasible to present some results at a local/college research conference. The most important things are to learn and to see if the field is a good fit for you.
 
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- How do you set up a research opportunity as a medical student?

The only real time for medical students in regular MD programs to do research is during their first summer (~10 weeks) after MS1. Their next summer is filled with USMLE prep, MS3 runs through the summer after that, and the summer of MSIV...you're either moving, sleeping, or waiting for intern year to start.

Similar to undergrad, talk to your professors. Many profs will present aspects of their research in their lectures, so if you like a particular lecture, talk to them. Many schools have summer research fellowships which can get you a stipend for the summer. Most run $2500-5000 for the 10 weeks.

There are a number of formal summer research programs that medical students can apply for. Click here or here for a list of opportunities. Scroll down to see opportunities outside of IL.

There are a number of exciting year-off programs that are available to medical students. I will list a few of these in a later entry.

- Will I be able to publish as a medical student?

Yes and no. Most med students can get a few results if the spend their summer doing research, which may be enough for a poster, but most won't have enough to publish. Everyone will know someone who does - a buddy of mine got 2 papers for a summer's effort, but he was motivated and happened to join a very productive lab.

To publish something as a medical student, most folks will have to work over several years (maybe extending their summer work) or they will get some clinical research time during their 2nd two years. Your attendings will likely have several projects going at any time, so just ask to get involved. Many schools also allow for research rotations, which are prime time to get something written up or conduct a brief project.

- I like ortho, but there's no ortho research opportunities where I go to school - will it look bad to do research in a different field? OR

- How do I choose which research project to do?


Like most things, it will help if your interests all line up nicely together. Yes, it could help your chances of matching if can talk about your biomechanics research with the ortho attending during your residency interview. That being said, this is an unlikely scenario for most medical students since:

1) Many students don't know what they want to specialize in when they matriculate, and
2) Most will change their mind while earning their MD/DO.

Given this, it is unlikely that an ortho attending will look poorly upon the neurology project you did during you MS1 summer. If this is the first time a student has done any research, I urge you to treat it as a learning experience and use the opportunity to see if research is right for you. At this point you're 'kicking the tires' of the career path, and a mentor's job is to clear out the red tape so that you have as rich and educational experience as possible. Learn whatever tools you need to conduct your assays, or studies, or whatever, but focus on the process of refining a hypothesis, designing an experiment that tests that hypothesis, and including good controls. Knowing what your results mean (both what you expect to happen, and what your controls confirm or deny) is also very important, especially since it is excellent material for any subsequent interview. Other things like stats and protocol design sort of shake out of the process from there. So I suggest you choose a project based upon the interpersonal skills and mentoring ability of the project's PI. More important than a big name, or flashy project is doing quality work, and a good PI will get you there.

- But I still don't know what project to do!

If you're really stuck on a place to start, yet you're undecided on your career, then start by looking at diseases that effect systems. Examples include hypertension, inflammation, and diabetes. These are also extremely common conditions, and there is not a field of medicine that does not deal with these problems in some way or another. You can spin a project in hypertension, for example, to support an application to any residency.
 
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- What are year-off programs for medical students?

There are a few well-known programs that will allow you to take a year off from your MD studies and conduct research. They vary in competitiveness, stipend/compensation, type of research, qualifications, and location (and be a US citizen). You must complete their application and interview for all of these. With the exception of HHMI Research Training Fellows, you must move to the institution awarding you the fellowship. Note that there are many Doris Duke sites, and several others (Sarnoff, Fogarty) allow you to determine the institution you want to work at.

As time has gone on, several SDN users have participated in these programs. I asked them about their experiences and posted their responses below their respective program.
 
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Doris Duke Clinical Research Fellowship

The Doris Duke Clinical Research Fellowship (CRF) program, established in 2000, is designed to encourage medical students to pursue careers in clinical research by giving exceptional students the opportunity to take a year to experience clinical research first hand.

From Optimally Prime's post on his time with the DDCRF program:

- Where are you now in the program? Midway through a DDCRF year.

- What was the the series of events that made up your application process, with respect to both the NIH and your 3rd year rotations? (or tell us the time line if you went MS2 -> DDCF) I put together all three applications over my holiday break. I knew I'd be applying for a year off by October of my third year, so I had the foresight to ask my dean and attendings/PI's for LORs before I began writing my PS and filling out the apps. Doris Duke interviews at multiple schools began rolling in late January. I interviewed at both CRTP and the Cloister, so I heard from them in early Feb for a combined interview weekend in the first week of March.

- How did you identify who to work with? Dug through Pubmed. Read bios. General word of mouth/mouf.

- Are the clinical aspects of the program worthwhile, or are they a waste of time? The DDCRF has been AMAZING so far. I'm interested in being a clinician-scientist, so the appeal of a "protected" year of clinical research time was undeniable. I have a great mentor who is probably more of a friend than a boss, awesome techs and grad students who help me navigate in my lab, and the other DDCRF fellows in my program are really chill people to boot. We have a didactic component so we get to take public health/epi classes in our public health school most afternoons of the week. All the fellows usually have a weekly or bi-weekly luncheon to discuss topics in clinical research (or to just take a break from lab if the mood strikes).

- Did you think it is worth it? That is, what were your goals in participating in the program, and have you been able to achieve them so far? Yes. I would do it again in a heartbeat. And given that I'm probably going into a demanding residency, this year has been perfect for a mental recharge after M3. I'm finally getting back into the shape I was before medical school!

- What was it about your application and interview that you feel got you a spot? Not sure really. My board scores/grades are pretty good, but I know people who had just as good, if not better, stats that weren't even interviewed. In retrospect, it was probably strong letters that may have been the difference. Aside from my research dean, I had a PI who knew me and my ability really well and an attending from my medicine rotation I was close with write on my behalf. My personal statement was also very clear about my goals to be a clinician-scientist and outlined my areas of research interest. The key to any good PS is weaving an interesting story/plot with your future goals.
 
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Howard Hughes Research Training Fellowship

The goal of the HHMI Research Training Fellowships for Medical Students is to strengthen
and expand the nation's pool of medically trained researchers. The fellowships provide
funds to support fellows and meet their research- and education-related expenses.
HHMI awards the fellowships through an annual competition. The fellowship provides support for one year of full-time research training in fundamental biomedical research. It includes a stipend, a
research allowance to meet a fellow's research related expenses, and a fellow's allowance to
be used for health care and tuition and fees. Fellowship research must be conducted at an
academic or nonprofit research institution in the United States, excluding the National Institutes
of Health (NIH) in Bethesda, Maryland.

Here is Pinkertinkle's experience with the HHMI Research Training Fellowship:

- Where are you now in the program? I am half way finished, fellowship ends in 6 months.

- What was the the series of events that made up your application process, with respect to both the NIH and your 3rd year rotations? For fellowship between MS2/MS3: during MS1 to first half of MS2, locate mentor at your own institution or another institution. Complete and submit application with their support by January of your MS2 year.

- How did you identify who to work with? You need to find a mentor on your own. I had worked with my mentor during the pre-MS2 summer and during MS2 year.

- Are the clinical aspects of the program worthwhile, or are they a waste of time? HHMI fellowship focuses heavily on basic science. No clinical time is required or expected.

- Did you think it is worth it? That is, what were your goals in participating in the program, and have you been able to achieve them so far? Worth it if you can publish at least 1 first author paper.

- What was it about your application and interview that you feel got you a spot? No interview is required, I think having worked with my mentor for a while already helped a lot.
 
Howard Hughes Cloisters

As a Research Scholar, you become part of a special research community at the NIH. You spend a year working as part of a research team in a laboratory at the NIH's main campus in Bethesda, conducting basic, translational or applied biomedical research under the mentorship of an NIH senior investigator, or preceptor.

I have HHMI/Cloisters experiences from ramblinwreckie, TrojanDoctor, and gclax30. Note: glax30 has a non-traditional viewpoint as both a DO and a re-applicant to HHMI Cloisters. In addition, he has decided to stay on for a second year:

- Where are you in the program?

Ramblinwreckie (RR): I am midway through the cloister program. I applied during my clinical year (MS2 at Duke). On that note, I would highly encourage people to apply after their clinical year, since so many career decisions are dictated/altered during clinical year.

glclax30 (g30): Finishing my first year at the Cloister in Bethesda, MD. I plan to stay for a second year and continue my project.

TrojanDoctor (TD): I completed the Cloister program last year, after my second year of medical school. I am currently finishing my third year (first clinical year).

- What was the series of events (e.g., the timeline) that made up your application process, with respect to both the NIH and your 3rd year rotations?

g30: I applied in January of 2nd year and was rejected. I was undecided about reapplying as I finished school and got ready to take step 1 boards. But I called the program over the summer (beginning of 3rd year rotations) and discussed my application with one of the program directors and felt that I had a decent shot. I worked on my application throughout the fall months on weekends off from rotations, and worked especially hard to develop my personal statement. I reapplied January of 3rd year, interviewed in March, accepted in April, and began in August after finishing 3rd year rotations and taking step 2 boards. I highly recommend taking boards before you get here! You don't want that stress hanging over your head as you try to finish up your research project and get back on rotations.

You have several start dates to choose from in either July or August of your fellowship year. It is probably better to show up earlier and have first crack at the good labs. There are A LOT of summer students, CRTPs, post-bacs, etc. and the good ones fill up fast. However, I arrived in early August to take advantage of the 5 week gap in my schedule to study for step 2.

I don't know the required length of the program but you typically work from July/August to late May, depending on when your school requires that you go back on rotations.

TD: I started my application process early in my second year. I talked to faculty members about options in taking a year off for research and was told about the different programs (Doris Duke, NIH CRTP, NIH HHMI, Sarnoff) offered at different universities and a "post sophmore fellowship" in pathology our school offered.

- How did you identify your mentor?

RR: I basically knew who I wanted to work with long before coming to the NIH, mainly because there is only one person in my field of interest at the NIH. However, for most people, they choose a mentor after coming to the NIH. You spend the first 2-4 weeks meeting with a whole bunch of PIs and getting a feel for their labs.

g30: You typically spend the first 2 weeks at the NIH meeting with investigators in different labs to identify a project in which you are interested. I began browsing through the NIH website (under intramural research) early in the application process to get an idea for what I might want to study. After I arrived, I basically cold emailed on-campus investigators and set up "interviews" for those first two weeks. I averaged about two meetings per day for two weeks and had decided on my lab by the end of week 2. Some people take longer to decide, some shorter. The program admins don't push you to make a decision but again the earlier you start the process, the better. To get though the mountain of paperwork and required safety training, orientation, etc. takes up a lot of time so get the ball rolling as soon as you make a decision.

TD: I identified my mentor by clicking through the NIH website and help from an advisor. In the Cloister program, a scientists is assigned to each scholar based on research interests to help identify a lab.

- How do you feel about the clinical aspects of HHMI?

RR: My program has no clinical bent towards it. For some, that works out just as well. However, for people like me who love the clinical side of things in addition to the research, you have to forge your own path.

g30: Most projects for Cloister students are basic science in nature so there is little clinical contact. But some bench scientists do both, that just depends on the person. My PI sees patients with malaria when he goes overseas so I will get some clinical experience this year, but that is not the norm.

TD: The Cloister program has as much or as little of clinical aspect as you want it to have. I chose to work in a purely basic science lab so I didn't see any patients. That being said, however, I used some of my book allowance for a subscription to NEJM and tried to read at least a couple articles out of each issue. Also, I attended "Grand Rounds" at the NIH, which were excellent.

- Is the program worth it?

RR: It depends on what your expectations are and what you envision your career path to be. So, it's entirely dependent on you individually. If you want this program to help you bolster your residency application even though you have no desire to do research in the future, I would be hard pressed to justify taking a year out of your life for that. But, even that, it's dependent on you.

g30: The Cloister program is absolutely worth it! I don't think there is any better year-off research program in the country and would certainly do it again (in fact, I am!) You can do great research in any one of the thousands of university/hospital labs throughout the country in the various other programs like Doris Duke. Those are all great programs. But the benefits of the Cloister go above and beyond anything you'll get anywhere else. It is more than just pipetting and running gels, this year is about research training and developing the critical thinking skills to be an excellent physician-scientist. That was my #1 goal for this year and the HHMI program definitely helped me realize it. And there are too many other "fringe" benefits to mention here but suffice it to say that you will only boost your career opportunities by spending a year here.

TD: I do fully believe it was worth it. Ultimately, I don't know if I will ever run my own lab, but I am interested in an academic career and hope I will be able to collaborate with PhDs. Obviously, everyone does these programs to be more competitive come Match time. I am still only a third year, so I cannot comment on how it will affect where I go for residency. But, from those scholars who returned to their fourth year, they all have had terrific placements. They all will be in very prestigious places next year.

- Did you state a research area of interest in your personal statement, or did you write about your desire to do clinical research in general terms?

RR: I was very specific in my interest in research. At the time I was applying, I knew what field clinically I wanted to go into (peds cards) but I did not necessarily know what research aspect of peds cards, which is impossible to know since it will change. So, I talked about my interest in congenital heart disease and tissue engineering, which are two things I've been interested in for a while. However, if you don't know what field you want to go into, there is no reason to just choose one for the sake of the application. There are people in my program who have never done research nor know what field they want to go into. So, I wouldn't worry about it too much. Speaking in general terms is fine.

- What was it about your application and interview that you feel got you a spot?

RR: I honestly think for me, personally, my strong academic record in undergraduate and medical school helped the most. Our medical school makes us take NBME subject exams in our first and second years which I did very well on. I think that helped as well. I spent the summer after my first year doing research and was fortunate enough to contribute enough to be included as an author in a paper. I also got 2 very strong (I assume from their enthusiasm in accepting my request) letters of recommendation from that summer. My third letter was (again, assumption) equally as strong from a professor at my school. Looking back, my personal statement was pretty wack, so don't stress out about it too much. My interviews were pretty typical. Simply, be able to talk about your past experiences or why you want to do the program intelligibly.

g30: I think that calling the program and reapplying showed my determination and interest in spending a year at the program. From what they tell us, the personal statement carries a lot of weight in your application package since basically every applicant is going to have ridiculous recommendation letters. I would recommend spending a great deal of time (i.e. a few months) working on the PS. Having some clinical experience in 3rd year helped me to focus my research interests and gave me something to talk about in my statement and on interviews.

- How were the program interviews themselves?

g30: The interview is an interesting experience&#8230; one interview is "soft" and they ask you about yourself, your motivation for applying, what you want to study, etc. The other is a fairly tough one in which they ask you about any past research projects and kind of grill you to see how you respond. Bottom line, don't put anything in your application that you aren't prepared to discuss in detail! For example, don't give the impression that you directed the day-to-day experiments for a big lab project if you only pipetted a few things here and there. But don't be afraid to include that experience, just be sure to get across exactly what your role was. And always be prepared for: why is that an important subject to study? They love that. Know the relevance of your lab project to that field but also to medicine/science in general.

One thing that definitely did not hurt me was being a DO student. I encourage any DO student to apply.

p.s. Don't be a tool on interview day. Don't be a snob, even if you are from one of the schools that sounds like "Shmarvard" or "Shmons Shmopkins". No one likes that. Just chill, have fun, and be friendly. (RxnMan's note - This advice holds true in all parts of life - don't be a tool)

- You mentioned you're staying on another year - what motivated this decision, and how did you accomplish this?

g30: I have been thinking about staying for a second year for several months now because my project is developing into something that could be quite important to my field. I really need that extra year to explore my research questions to the extent that I am satisfied. I may need to travel overseas as well. And honestly, 10 months is just too short to get anything major accomplished unless your lab is an absolute publishing powerhouse and you happen to fall into the ideal project. I don't think I would have wanted that anyway. I have struggled A LOT to design a proper project and to get my assays up and running, but I think that is all part of the experience and I have enjoyed it. In order to stay for a second year at the Cloister, you just need permission from your school Dean and approval for funding from your PI (which is basically guaranteed). The program automatically takes you for the second year, you don't have to reapply.

- What are the negative aspects of your program, if any?

g30: The only real negative to the Cloister (and other NIH-based programs) is that you don't experience real academic medicine the way it is done in the private sector. That is, GRANT FUNDING. Your money here is guaranteed so you don't have to write grants. While that is convenient for this one year, it doesn't prepare you for life as a faculty member at a university hospital. I wish I could see the grant writing process from start to finish because not everyone can work at the NIH!
 
NIH Clinical Research Training Program

The Clinical Research Training Program (CRTP) is a year-long program designed to attract the most creative, research-oriented medical and dental students to the intramural campus of the National Institutes of Health in Bethesda, Maryland. Participants, known as fellows, spend a year engaged in a mentored clinical or translational research project in an area that matches their personal interests and goals.

- Interview Experience

Here is RxnMan's CRTP interview experience:

Travel
I took the train to Bethesda. I came in through Union station and took the Red line from there to Bethesda. No real hassles, the travel company got in contact with me well before the interview to arrange my trip.

Lodging
We were all put up in the Doubletree Hotel in Bethesda, next to the NIH campus. Everything was paid for by the travel company.

Schedule
Two days overall. Most of the first day was taken up with traveling to Bethesda, with some pre-interview meet-and-greet activities in the evening. The second day was interviews, site tours, and travel home. I was on my FP rotation at the time, so I was able to get time off without too much hassle.

The first day dinner was at the Cloisters, where we met previous fellows, NIH researchers, the director, and hung out with fellow applicants. Afterwards there was a presentation by some of the current fellows describing the different strengths of the program. Then a number of previous fellows spoke about their experiences. We joked that it seemed that all of the previous fellows matched to residencies at Johns Hopkins, but this is more due to the proximity of Baltimore than anything else. Then we went back to the hotel, with the option of going on an apartment tour.

Interviews
Three interviews, all a half-hour long. They are mostly in a conversational format, with some discussion about your motivations for applying, your credentials, your research interests, and what you want to do while at the program. They are arranged in alphabetical order, so if you're Ms Xanadu, you will be interviewing throughout the day while Mr. Douglas might be done by 1pm. The interviews take place in the Clinical Center, which is somewhat Byzantine, so give yourself plenty of time to find the appropriate room.

My interviewers were somewhat hit-or-miss: one had not read my file beforehand and was negative when he didn't "get" my research interests. The next understood my motivations entirely and was incredibly positive.

- Student Experiences

These are my (RxnMan's) thoughts on the NIH-CRTP

- Where are you in the program?

I am a little more than half-way through my research year.

- What was the series of events (e.g., the timeline) that made up your application process, with respect to both the NIH and your 3rd year rotations?

I knew that I wanted to apply within a few weeks of hearing about the program as a MS1. As the fall of MS3 rolled around, I began to gather my application materials and think about my personal essay. I wrote my essays in Nov-Dec during rotations. Actually, at one point, I was working on my essays at the nurses desk during my OB/Gyn rotation, left to evaluate a patient, and returned to find a nurse had completely erased all of my work! I was incensed, but it all worked out in the end. Moral of the story - save your work often and trust nobody!

February interview offers came out and I got time off from my rotation to do the interview in March (I told the clerkship director I was going whether he gave me time off or not). Late-March I got the acceptance, August I moved to Bethesda.

- How did you identify your mentor?

The NIH assigns you a Tutor once you're accepted. This person is responsible for hooking you up with a good lab and showing you around. After that, tutors have varying degrees of involvement. I was in pretty frequent contact with my tutor before heading down, trying to ID labs and hit the ground running. After that, I haven't met with him much. Other students, they meet their tutors all the time because of collaborations. I narrowed my list of labs down to 4-5 and interviewed around (all informal, mostly in the PI's lab) during the first week or so. Made my decision 2 weeks in. It was like deciding between great and awesome. The scientists here are really that wonderful.

I based my decision on what the lab studied, the type of work they did, and fit. I wanted to spend this year studying something related to my planned medical specialty, so I found labs that did work relevant to that field. I feel that my work should be pragmatic and as closely related to patients as possible - so looked for translational labs. And then fit. I wanted to make lasting connections during my time here. I wanted to completely immerse myself in the research experience and the culture of the NIH. I wanted to develop a specific skill set, which required strong mentoring. So I looked for these things when I interviewed labs.

- How do you feel about the clinical aspects of CRTP?

There's a lot of flexibility. There's an ongoing clinical series where Clinical Center docs bring their patients in for us to meet them. You can also make clinic as much or as little a part of your experience as you want. I know fellows who spend a day a week in clinic, and then there's me, who hasn't seen a patient in months! It depends on your mentor somewhat, but mostly your interests.

- Is the program worth it?

:laugh: Well, I've had four projects this year so far, and two of them failed. It's been hard, but your results are your results, so you move on. It will just be a little longer until I get pubs out of this year. It's been stressful, but I put that on myself.

Outside of strictly getting positive results, my answer is yes, it has been entirely worth it. I've been able to hit all of the other goals I had for this year and then some. I can literally do anything I can think of. If I need help figuring out what antibodies to use for immunohistochem, something I know almost nothing about, I can walk down the hall and a world leader can answer my question. If I need a reagent, the only challenge in getting it is finding where I put the catalog last. The biggest hurdle to starting a collaboration is the paperwork. I have access to the world's largest dedicated clinical research hospital. I have wonderful lab-mates. I wanted to learn more about grant-writing, so I am enrolled in the grant-writing class for fellows, taught by the guys who'll review my grants one day. There's always some cool conference or lecture going on. The Great Teachers series is awesome - I got to meet Robert Schrier and Jenny Heathcote.

- Did you state a research area of interest in your personal statement, or did you write about your desire to do clinical research in general terms?

I stated the disease processes I wanted to study and why I wanted to study them. At the time, I was somewhat undecided on what medical specialty I wanted to go into, and that indecision actually made my application essays weaker (another goal for this year was to figure out what I wanted to specialize in). In retrospect, I'd just pick one theme, focus on it, and run with it. Then change as needed, after I got in.

- What was it about your application and interview that you feel got you a spot?

I have a good deal of prior research experience. Maybe my LORs.

- What are the negative aspects of your program, if any?

Some kids get caught up on choosing their mentors, but in general, good tutors should be able to help you narrow down the possibilities to some good labs.

Via PM, another poster gave her advice and experience with the NIH's CRTP:

- Application timeline: Apply in the winter online, interview in March, and hear if you are accepted a few weeks later.

- ID'ing a mentor when you get there: Some folks knew who they wanted to work with ahead of time (family, connections, past work experience, etc). Most CRTPers are not this way and will interview with several labs before they decide which one they want to work with.

- Clinical aspects of CRTP: Can be a waste, may not. Varies widely from one participant to another. Clinical work may be an aspect of your project. How the year is spent is entirely up to the student.

- What got her in: She honestly could not tell me. She did not know she had a chance when applying. She had a lot of research experience as an undergrad, and she was very forthright in her interest in doing research during the interview.
 
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Sarnoff Foundation Fellowships

During the year in the laboratory, the Sarnoff Fellow will undertake his/her own research project and assume responsibility for it from inception to completion. The Fellow is expected, with guidance, to develop the hypothesis and specific aims of the project, to participate in the experimental design, to carry out appropriate experiments, to interpret the data with the help of his/her Preceptor, and to prepare an original manuscript for submission to an appropriate peer-reviewed journal. Each Fellow presents his/her results at the Sarnoff Foundation's Annual Scientific Meeting, as well as at appropriate national meetings.

Here is ellia08's experience with the Sarnoff Fellowship Program:

- Where are you now in the program? About 6mo into my first year. I am applying for a second-year (about 1/5 sarnoff fellows do out of interest).

- What was the the series of events that made up your application process? (or tell us the time line if you went MS2 -> Sarnoff) M1. Research summer. M2. applied Sarnoff and Cloisters. Accepted into both. Sarnoff Research mentor appointed and contacted me. Took Sarnoff.

- How did you identify who to work with? I THOUGHT that I had a general idea initially but in the interview I mentioned a crazy idea that I'd been working on. My interviewers said, "Hey, do you want to do that?" I said, "Are you kidding me!!? That would be incredible. I just thought no one could make that happen." After my official acceptance, my sarnoff research mentor and I had long conversations and exchanged numerous emails on possible labs and the state of the field. I also emailed members of the Sarnoff Scientific Committee (see the website http://http://www.sarnoffendowment.org/ for who these people are because it varies by year but they are always excellent cardiovascular researchers.) I took this advice together with some of my own ideas and made a shortlist of 10 labs from around the country. I spent 1 week on the east coast and 1 week on the west interviewing and checking out labs. I made my final selection, notified everyone else and moved to Boston.

- Are the clinical aspects of the program worthwhile? There are no clinical aspects to my work however, because the program is so flexible, other fellows are in the clinic as medical students... some up to 1-2 days a week. Others are doing clinical research so... they're always around the clinic but in a research oriented way. They all seem to really love it. I have a few standing offers for some clinic days which I think I will do, however in my sarnoff plan this is more of a fun free-time activity.

- Did you think it is worth it? That is, what were your goals in participating in the program, and have you been able to achieve them so far? YES. Yes, in every way, yes. I've already submitted my first paper. I hear it only gets better in the second year... which is hard to even imagine. I am so lucky to have done this. I would do it again in a heartbeat. (Sarnoff cardiovascular pun) So... thats an unqualified, yes it was worth it.

- What was it about your application and interview that you feel got you a spot? Ha. :) This program is too individualized to make this an easy question to answer. I think that I was doing something interesting/different. I has a strong sense of generally where I wanted to be (if not specifically). Hm, this is tricky to describe. The best thing you can do is this: (1)find the field that interests you, (2)find its cutting edge where you are left saying "WHOA! thats the most ridiculously interesting thing I've ever heard", and (3) then decide, THATS what I want to do. No matter how nutty everyone else thinks you are for aspiring that high, I think that you will find a receptive audience here. Whether you're geeked out by imaging, or stem cells, or global health, or public health, or clinical research, or bioinformatics or cellular biology doesnt really matter. Sarnoff wants to give you the chance to do something you would never otherwise do. They'll send you anywhere and find a way to get you to the best people. They look to you for the vision.
 
Fogarty Fellowships

The Fogarty International Center in collaboration with the National Institute of Allergy and Infectious Diseases, the National Center on Minority Health and Health Disparities, the National Cancer Institute, the National Institute on Drug Abuse, the National Institute of Nursing Research (NINR), and the National Institute of Child Health and Child Development (NICHD) is offering a one-year clinical research training experience for graduate level U.S. students in the health professions. This is an opportunity for highly motivated individuals to experience mentored research training at top-ranked NIH-funded research centers in developing countries. If you are accepted for a scholarship, then Africa, Asia and the Americas are regions of the world that you may find yourself experiencing.
 
NIH Year-Off Program for Graduate and Medical Students:

The Year-off Program provides an opportunity for currently enrolled graduate or medical students to spend a year engaged in biomedical research at the NIH, with the understanding that they will return to their degree-granting institution within one year. U.S. citizens or permanent residents who have permission from their institution to interrupt their studies are eligible to apply.
 
Center for Disease Control Epidemiology Fellowships

Funded by a grant from Pfizer Inc, The CDC Experience: Applied Epidemiology Fellowship at CDC provides medical students with an applied hands-on training experience in epidemiology and public health. Eight competitively selected medical students from around the country who are completing their second or third year of medical school will spend up to one full year at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. While at CDC, with the guidance of experienced CDC epidemiologists, they carry out epidemiologic analyses in areas such as birth defects, injury, chronic disease, infectious disease, environmental health, reproductive health and minority health.
 
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