Med student wanting to do Neuro research

[berrypie]

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Hi All,

I am an M3 doing my rotation in Neurology, and I'm absolutely LOVING it!

I had planned to take the year off between 3rd and 4th year to devote mostly to research (as well as other clinical activities), and I have decided that it would be a great idea to do some Neuro research while I've got the time.

I would like to spend about 4 months full-time doing research, but I'm having a hard time finding the right path. It seems that most of the neurologists I work with in the hospital do some publishing here and there, but don't have projects that are substantial enough for me to spend 4 months on. On the other hand, most full-time researchers are PhDs in neuroscience, and they seem to take mostly MSc and PhD students for their labs.

Does anyone have suggestions on what type of Neuro research project I could accomplish in 4 months? And what type of people/places should I contact?

Any advice would be greatly appreciated 🙂

 

[typhoonegator]

4 months just isn't enough time to do anything that isn't already in some state of readiness for you. Your question is very hard to answer because we don't know what research resources are available to you.

Med students tend to think of a research project like its a class they are taking, with a defined start and end date. Unless you are writing a case report and you already have all the data you need, this model usually doesn't work. Your gels will fail, your momma rats will eat her babies, and your reagents will get left unrefrigerated in the mail room overnight. Research is hard and unfair. This is why PhD students develop motor tics and a thousand-yard stare sometime into their fourth year.

With all that said, you need to sit down and pow-wow with one of the senior researchers at your institution. Your neurology chair might be able to help as well to point you toward someone who can help you. Tell them what your time constraints are, and what you are interested in. Have a concrete interest in mind going in.

You probably won't be able to pull off much of a bench project in 4 months, because it would probably take you that long just to learn the procedure/methods. If most of your faculty is really clinical and do hobby-research, they might have patient series that you could write up. Neurologists tend to squirrel-away interesting cases or patients with a particular disease that interests them. A case-series project could potentially be done in a few months, depending on the data and documentation.

Make sure you read up early on the institutional review board (IRB) policy of your institution, because if you need IRB approval for your project, it takes a while to move through review. You'd want to get that going long before your actual start date.

 

[berrypie]

Thanks for your reply, typhoonegator.

I agree that the research world does not fit into neat 4-month packages, which is a big part of what makes this so hard! Perhaps the solution is to do a number of smaller case-reports (like you mentioned) or something of the like, in which I can step in and not have to worry about IRB approval and all that jazz.

Food for thought...!

 

[tbo]

I'll try add some info that I've gathered as I'm a medical student interested in research opps but I'll also add a question.

I think assuming a solid work ethic, you can get a retrospective clinical research project out in 4 months. Indeed, assuming you're not reviewing more than 200 cases, 4 months might even be excessive (again, assuming you bust your butt). Caveats to this are accessibility of records (not old-school paper records you have to visit the archives in the basement for. If your institution has electronic records over your study period, then this will speed things up considerably). One should not downplay the tedium of retrospective clinical research, though. Be sure to pick something that interests you at least somewhat. That will pull you through when you've sat at the computer screen for hours on end, wondering why you've only gotten through 8 patients that day. Last caveat is IRBs and such. I might suggest that if it's well written (find a good mentor that's done a few of these), retrospective review IRB submissions can usually be expedited. Assuming at worst 1-2 revisions (which is conservative), it shouldn't take more than a few weeks. I'd be sure to get this squared away BEFORE your 4 months start, however.

My question is on the value of case reports for medical students. Is there a substantive drop-off in accomplishment from a clinical study (case-control or whatever) to a case report? Do residency directors or attendings care?

 

[typhoonegator]

There is an enormous difference between case-reports and case-control or cohort studies, or clinical trials, or multi-tiered bench projects. HOWEVER, to answer your question, a case report or series can be very helpful to a residency application. You do not need to land on the moon, cure cancer, or prove the existence of god to get a neurology residency position. You really only need to prove a dedication to scientific rigor and an interest in the field.

A case-control study, clinical trial, or cohort study requires a hypothesis, a huge amount of advanced planning, funding, IRB approval, dedication to data collection, skill in data analysis, luck, and and dedication to the research. Believe me, it isn't easy. It takes multiple years and a great mentor.

A case report requires a unique and interesting case, access to PubMed, and someone who wants to write it up. That's about it.

When I applied to residency in 2004, I had bench research from medical school which had provided one low-level poster at that point, and one published case-report. I talked up the case-report during interviews, described how it reinforced my interest in neurology, and matched at a good program in which 50% of my class had MD PhD.

Most applicants will not have a high-level publication on their application. Some MD PhDs will, but in general they are not compared directly to pure MD candidates during ranking. If you can get a middle spot on a 25 author paper published in PNAS, then great -- good for you. But you'd better be able to describe every detail of the paper to me. If you cannot, then you'd be better off writing a case report in journal I've never heard of and know every bit about the case and how the experience fortified your interest in neurology. I don't care if you're able to finagle your way on to a paper you know next-to-nothing about -- I want to know if you understand and care about research in neurology. If you can demonstrate that in a case-report, then that is more than fine with me.

Sorry for the long post. Again, I mean in no way to denigrate case reports...they are simply very, very different from a case-control studies, GWAS, or clinical trials.

 

[tbo]

HOWEVER, to answer your question, a case report or series can be very helpful to a residency application. You do not need to land on the moon, cure cancer, or prove the existence of god to get a neurology residency position. You really only need to prove a dedication to scientific rigor and an interest in the field.
...
If you can get a middle spot on a 25 author paper published in PNAS, then great -- good for you. But you'd better be able to describe every detail of the paper to me. If you cannot, then you'd be better off writing a case report in journal I've never heard of and know every bit about the case and how the experience fortified your interest in neurology. I don't care if you're able to finagle your way on to a paper you know next-to-nothing about -- I want to know if you understand and care about research in neurology. If you can demonstrate that in a case-report, then that is more than fine with me.

Thanks for the eloquent context. I don't think I've ever heard anyone really go beyond the achievement of a publication or an abstract and talk about what accomplishing something in research actually represents. 👍

 

[PhakeDoc]

...One should not downplay the tedium of retrospective clinical research...

While everything stated in this thread is useful, pay special attention to this, especially if dealing with paper charts, or charts from OSH as well. If an attending says "oh yeah, this quick case review will take you 1 week at most to gather all the data", RUN RUN AWAY as FAST AS YOU CAN! Don't say you weren't warned....

 

[tofurious]

If you are at an academic center, most neurology attendings have a list of "to write up when there is a medical student around" projects. These may not be that sexy (no curing anything), but you should be able to get a manuscript or abstract out of it (depending on your effort). There are some case reports that are more meaningful than others (n=10 is always more useful than n=1, and some people may even consider case series to be significantly better than a case report). Most academic centers also have neurology attendings who double as neuroscience investigators, and they always have student projects for summer students or rotating graduate students that can be completed within 3-4 months. I would not let the residents and fellows discourage you from pursuing this. Alternatively, you could go for the Howard Hughes training (http://www.hhmi.org/grants/individuals/medfellows.html) which gives you more structure. When I was in school, they also paid for year 3 and 4 tuitions or something...