Research dilemma

[Prometheus123]

I need some advice about a research-related dilemma.

My short-term goal with research is to create evidence that the potential benefit to society of letting me become a physician who does clinical research on the side is significant enough to admit me into medical school, despite my less than stellar stats. To that end, to gain formal research experience, I’ve been volunteering in a lab doing data entry and other grunt work for the last ~3 months. I’ve put in ~110 hours. Questions:

1. Would it look bad on my application if I stopped volunteering there now?

2. If so, would it be significantly better if I said it was more like 5-6 months? This might be possible because before I started formally volunteering there, I attended weekly lab meetings and did a journal club presentation over the summer.

I’d like to stop because the PI insists that I volunteer at least 10-20 hours a week. That would be very difficult to manage this quarter since I’ve filled my schedule with 5 classes, non-clinical and clinical volunteering, and several part-time teaching jobs to pay the bills. Also, to be honest, I’m not sure of what I’m getting out of the experience justifies the time cost.

The benefit of staying at this lab would be that they would probably allow me to scavenge through their old data to try to find a correlation to write about. In theory, if I actually find a publishable correlation they haven’t already written about (unlikely), they might let me be the second or maybe even the first author on it.

The best possibility I’ve found for this so far would a possible correlation between eating breakfast and weight loss. However, after writing a mini-review of the topic, I’ve come to the conclusion that that correlation has already been established ad nauseum, so confirming it would not be truly worthy of publication as far as I know. Most of the RCTs on this have shown that eating breakfast per se has no effect either way on weight loss. I don’t know if I could find a better correlation to write about, but I’m doubtful.

3. Instead of continuing with this lab, do you think I might be able to accomplish my short-term research goal if I write an exceptional editorial/mini-review independently?

I know that editorials and reviews are not nearly as prestigious as a first or second authorship on an original research paper, and I would only be able to publish it in a low-impact factor journal or a student journal. But, could a truly insightful/useful editorial serve my purpose as well as a first or second authorship on a paper about a redundant and clinically-irrelevant correlation? I can post a brief sketch of the top two things I'd like to write about if you're curious.

@Goro, @gyngyn, @LizzyM, @Catalystik, @meded, @gonnif, I’m tagging you because you’ve all given me tough feedback in the past that helped me become a better applicant, and a better person. Contributing is optional, of course, and sorry for the long post. If any of you or anyone else has some words of wisdom, I’d greatly appreciate it.

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[LizzyM]

Research and writing papers will not make up for a poor GPA. You need to assure medical school adcoms that you have the academic chops to do well in medical school. Papers and research and volunteerism do not provide that assurance. Only grades and MCAT scores provide evidence that you are likely to do well in medical school classes and pass the board exams.

That said, if you want to show that you are interested in academic medicine and want a career combining patient care with research (and someday supervising residents and/or med students and teaching at the bedside) then it is never too early to start developing a track record. However, if your likelihood of admission to medical school is slim, it is likely that you'll be a better candidate for a school that aims to train primary care providers and not academic super-subspecialists so research may be less highly valued and the schools will want to see more work with people in service capacities and in community engagement.

However, if your Plan B would be a career in health services research or epidemiologic research, then it would not be a bad idea to continue working in research with the hope of getting your foot in the door in a graduate program if med school ends up not working out for you (57% of all applicants don't get in to any medical school and many more fall by the wayside before they get to the point of applying).

You need to decide what is the right blend of coursework, community service, research and clinical exposure is right for you. I hope this has given you a few things to think about as you hone your schedule.

 

[Goro]

I need some advice about a research-related dilemma.
3. Instead of continuing with this lab, do you think I might be able to accomplish my short-term research goal if I write an exceptional editorial/mini-review independently?

The fact that you are asking this question shows how very little you still understand about the med school admissions process, and about how science is done in general (despite all you've been told). The whole reason fro doing research is to show med schools that you understand the scientific principal. If you wish to show that you have the shops to be an academic clinician, then work in a lab for a few years and get something productive out of it.....ie, research papers and posters. A review from a pre-med would merely tell me that you have good library skills.

Editorial????

 

[Prometheus123]

The fact that you are asking this question shows how very little you still understand about the med school admissions process, and about how science is done in general (despite all you've been told). The whole reason fro doing research is to show med schools that you understand the scientific principal. If you wish to show that you have the shops to be an academic clinician, then work in a lab for a few years and get something productive out of it.....ie, research papers and posters. A review from a pre-med would merely tell me that you have good library skills. Editorial????

@Goro, as usual, thank you for be willing to tell me what I don’t want to hear. At least I know how much I don’t know. I hear what you’re saying that working for several years in a lab is the best way to prove my interest in research. I will consider that.

 

[Prometheus123]

And here is the data to show why this isnt a good idea

In a 2013 AAMC survey* where 127 medical admissions offices responded, found research experience is only of medium importance at private schools and of low importance to public schools as an experiential factor in offering both interview invitations and acceptance. Healthcare experience, community service/volunteer experience, experience with underserved populations, navigated through cultural barriers or challenges, leadership experience were considered of higher importance in factors for interview invites and offers of acceptances. This was further borne out in the 2015 AAMC Survey** where 130 medical school admissions found that both community service or volunteer in both medical and non-medical settings ranked higher in importance than physician shadowing

*https://www.aamc.org/download/434596/data/usingmcatdata2016.pdf#page=7
see page 3 (pdf p7) Table 1. Mean Importance Ratings of Academic, Experiential, and Demographic Application Data Used by Admissions Committees for Making Decisions about Which Applicants to Receive an Interview Invitation and Offer Acceptance (N=127)

** https://www.aamc.org/download/462316/data/mcatguide.pdf#page=10
See page 4 (pdf page 9) Table 1. Mean Importance Ratings of Academic, Experiential, Demographic, and Interview Data Used by Admissions Committees for Making Decisions about Which Applicants Receive Interview Invitations and Acceptance Offers (N=130)

@gonnif, thank you for your evidence-based reminder that research is a bad strategy to try to get in. The research angle is meant to be a redundant backup strategy, so I could let it go as an admissions strategy.

Maybe I should try to double my weekly non-clinical volunteer hours? The problem is my weekly ESL class only lasts 1-2 hours. Maybe I should try to find another class to teach as a volunteer in addition?

 

[Prometheus123]

Research and writing papers will not make up for a poor GPA. You need to assure medical school adcoms that you have the academic chops to do well in medical school. Papers and research and volunteerism do not provide that assurance. Only grades and MCAT scores provide evidence that you are likely to do well in medical school classes and pass the board exams.

That said, if you want to show that you are interested in academic medicine and want a career combining patient care with research (and someday supervising residents and/or med students and teaching at the bedside) then it is never too early to start developing a track record. However, if your likelihood of admission to medical school is slim, it is likely that you'll be a better candidate for a school that aims to train primary care providers and not academic super-subspecialists so research may be less highly valued and the schools will want to see more work with people in service capacities and in community engagement.

However, if your Plan B would be a career in health services research or epidemiologic research, then it would not be a bad idea to continue working in research with the hope of getting your foot in the door in a graduate program if med school ends up not working out for you (57% of all applicants don't get in to any medical school and many more fall by the wayside before they get to the point of applying).

You need to decide what is the right blend of coursework, community service, research and clinical exposure is right for you. I hope this has given you a few things to think about as you hone your schedule.

Yes, it does. Thank you, @LizzyM. Truth is, I have no idea what my chances are for next cycle. Maybe ~60%, based on that GPA and MCAT chart. My story is that I did terribly during my first two years of college, so my GPA is a permanent wreck. I then took six years off and returned to college to pursue pre-med three years ago. I’ve gotten consistently good grades since then. Based on my current trajectory, here’s where I will probably be next cycle:


· Strong trend of improvement
· cGPA: 3.38
· BCPM: 3.44
· GPA since transferring to current college: 3.93
· Senior year BCPM: 4.0 sustained over 35 hours
· MCAT: 519
· 325 hours of hospital volunteering
· 64 hours of non-clinical volunteer teaching ESL to day laborers (this isn’t enough hours, is it?)
· ~60 hours of shadowing
· Better essays and letters than last cycle, I hope

If I can’t get into an MD or a DO school next cycle, my plan B is med school in the Caribbean or India. I really don’t want to, but I will hack the Caribbean if I have to. Yes, I would like to become a subspecialist (possibly a neuroimmunologist or an endocrinologist) and maybe teach residents and med students one day. I’ll describe the kind of research I want to do in my next post.

 

[Prometheus123]

Based on your feedback, I’d like to ask a different question, if I may. Regardless of whether research helps me get into medical school, I’m committed to doing clinical research one day as a physician. What do I need to do now and over the next few years to establish enough of a track record to get grant funding from the NIH and approval from IRBs for the kinds of studies I want to do one day as a physician? Do I need to volunteer 10+ hours a week doing data entry in a lab at some point no matter what, so I might as well do it now? Do I have to work in a lab for several years? Is authorship really what I need? Would authorship on a correlational survey study serve the purpose?

Here’s an example of the kind of research I want to do. One of my main interests is the possibility of treating the inflammation that appears to drive the pathogenesis of many chronic diseases. A couple years ago, I read a great review paper called Anti-inflammatory therapies for atherosclerosis in Nature Reviews Cardiology. Based on their analysis, it seemed clear that a very promising treatment option was low-dose methotrexate. I thought “I’d love to conduct an RCT of low-dose methotrexate in patients with atherosclerosis one day.” What do I need to do to get to the point where I can do that eventually? (By the way, I recently found out that Brigham and Women’s Hospital is currently conducting a Phase III trial of this idea, so I’m not the only one who thought this.)

Here’s another example: I recently guessed that phosphodiesterase 4B inhibitors would cause weight loss and decrease food cravings because there are a half dozen ways in which their mechanism of action should do that in theory. I looked in the literature, and sure enough found an RCT showing that obese women with PCOS taking metformin lost significantly more weight with the PDE4 inhibitor rolipram than control. As a physician one day, I would like to be able to get funding to do a follow-up trial of this in a different population with a larger sample size. For instance, the PDE4 inhibitor roflumilast is FDA-approved for COPD, and patients with COPD are often obese. At some point, someone should conduct a study of obese patients with COPD taking roflumilast to see if they lose more weight than control. I’d like to be that physician. How do I get there?

 

[Goro]

Based on your feedback, I’d like to ask a different question, if I may. Regardless of whether research helps me get into medical school, I’m committed to doing clinical research one day as a physician. What do I need to do now and over the next few years to establish enough of a track record to get grant funding from the NIH and approval from IRBs for the kinds of studies I want to do one day as a physician? Do I need to volunteer 10+ hours a week doing data entry in a lab at some point no matter what, so I might as well do it now? Do I have to work in a lab for several years? Is authorship really what I need? Would authorship on a correlational survey study serve the purpose?

Here’s an example of the kind of research I want to do. One of my main interests is the possibility of treating the inflammation that appears to drive the pathogenesis of many chronic diseases. A couple years ago, I read a great review paper called Anti-inflammatory therapies for atherosclerosis in Nature Reviews Cardiology. Based on their analysis, it seemed clear that a very promising treatment option was low-dose methotrexate. I thought “I’d love to conduct an RCT of low-dose methotrexate in patients with atherosclerosis one day.” What do I need to do to get to the point where I can do that eventually? (By the way, I recently found out that Brigham and Women’s Hospital is currently conducting a Phase III trial of this idea, so I’m not the only one who thought this.)

Here’s another example: I recently guessed that phosphodiesterase 4B inhibitors would cause weight loss and decrease food cravings because there are a half dozen ways in which their mechanism of action should do that in theory. I looked in the literature, and sure enough found an RCT showing that obese women with PCOS taking metformin lost significantly more weight with the PDE4 inhibitor rolipram than control. As a physician one day, I would like to be able to get funding to do a follow-up trial of this in a different population with a larger sample size. For instance, the PDE4 inhibitor roflumilast is FDA-approved for COPD, and patients with COPD are often obese. At some point, someone should conduct a study of obese patients with COPD taking roflumilast to see if they lose more weight than control. I’d like to be that physician. How do I get there?

Become faculty at a med school.

 

[Prometheus123]

Become faculty at a med school.

I will do my best to set my rudder in that direction, sir. I'm happy to know that that is the track that is probably the best fit for what I want to do one day.

By the way, today I learned there's nothing like getting your tuchus handed to you by remedial gen chem homework to remind you that you're still at level 0, haha. So it goes.

Based on everybody's feedback here, here are my action items from this thread. Please feel free to correct me if I've jumped to any incorrect conclusions:

1. Try to find a correlation that I could do a survey study about that's related to what I wanted to write about anyway. That way, I could start establishing a track record of authorship and write and learn about what I wanted to write and learn about too.
2. Try to find a different lab to get involved in that's a little more understanding about hours, that is doing research that's closer to what I want to do one day, and that's more open to pre-meds doing their own projects. Look for MDs doing super-cool clinical trials. Ask critical questions about these issues before making a commitment, and be prepared to walk away and keep looking if it's not a good fit.
3. Try to find a second weekly ESL class to teach as a volunteer to beef up those non-clinical volunteer hours.

Please don't judge me too harshly if I fall short of my own goals. I always aim for the 98th percentile, and I never reach it, but at least by aiming high I usually get pretty close. As always, thank you very much for your input, @Goro, @gonnif, and @LizzyM.

 

[TelemarketingEnigma]

What do I need to do now and over the next few years to establish enough of a track record to get grant funding from the NIH and approval from IRBs for the kinds of studies I want to do one day as a physician? Do I need to volunteer 10+ hours a week doing data entry in a lab at some point no matter what, so I might as well do it now? Do I have to work in a lab for several years? Is authorship really what I need? Would authorship on a correlational survey study serve the purpose?

Become faculty at a med school.

Goro's pretty much right here. I can speak to this a little bit further (I'm currently involved in the other side of this process) since it doesn't sound like you quite get the scale of this: NIH funding isn't something that drops into the lap of anybody who has a cool project they want to do. Your track record, connections, and reputation can play just as big a role as the quality of your proposal in convincing reviewers and funders that your project is worth funding. The things you're naming (lab volunteering, authorship on one or two studies) aren't even in the realm of the kind of work you need to do to prove yourself on this level.

I'm assuming that you want to be the PI on your own projects and not just working on someone else's stuff. To get to that level, you need to: Get your terminal degree (MD or PHD generally), make connections to research mentors, work on their projects, publish a lot in high impact places (one or two "correlational studies" isn't gonna cut it), develop a reputation as someone who does good research, present at conferences and meetings, make more connections with peers and mentors, get a faculty position, maybe be a co-PI on some studies with bigger names attached (lots of clinical research is a team effort), make more connections, publish more... this takes years, and way more than 10+ hours of work per week.

It sounds like you're enthusiastic about research, which is great! But it also sounds like you don't have a very good understanding of the bigger research picture. That's okay - I'll admit that I didn't quite understand the scope of all of this until I started my current job. But if you've got your heart set on being a research PI, you should start trying to get a better understanding of how the process works and what you need to do to be a part of it.

Also: get really good at filling out paperwork. There's a lot of it coming your way if you want to apply for NIH funding...

 

[Prometheus123]

Goro's pretty much right here. I can speak to this a little bit further (I'm currently involved in the other side of this process) since it doesn't sound like you quite get the scale of this: NIH funding isn't something that drops into the lap of anybody who has a cool project they want to do. Your track record, connections, and reputation can play just as big a role as the quality of your proposal in convincing reviewers and funders that your project is worth funding. The things you're naming (lab volunteering, authorship on one or two studies) aren't even in the realm of the kind of work you need to do to prove yourself on this level.

I'm assuming that you want to be the PI on your own projects and not just working on someone else's stuff. To get to that level, you need to: Get your terminal degree (MD or PHD generally), make connections to research mentors, work on their projects, publish a lot in high impact places (one or two "correlational studies" isn't gonna cut it), develop a reputation as someone who does good research, present at conferences and meetings, make more connections with peers and mentors, get a faculty position, maybe be a co-PI on some studies with bigger names attached (lots of clinical research is a team effort), make more connections, publish more... this takes years, and way more than 10+ hours of work per week.

It sounds like you're enthusiastic about research, which is great! But it also sounds like you don't have a very good understanding of the bigger research picture. That's okay - I'll admit that I didn't quite understand the scope of all of this until I started my current job. But if you've got your heart set on being a research PI, you should start trying to get a better understanding of how the process works and what you need to do to be a part of it.

Also: get really good at filling out paperwork. There's a lot of it coming your way if you want to apply for NIH funding...

Thank you. You're right, I don't get the scale.
1. Would you say that little things now like a correlational study, volunteering in a lab or for an MD doing a clinical trial, etc., would likely be a good stepping stone to the progression of steps you mentioned? Or does it not really matter? Should I just concentrate all my efforts on getting into medical school for now, try to get accepted to a school with some research opportunities, and start this process then, or maybe even after graduating from medical school? That seems to be what you're saying, I just want to confirm. Put another way, would it hurt my chances of working with a research mentor in or right after medical school if I have essentially no prior research experience?

2. What do you mean by the other side of this process? What do you do, if you don't mind me asking, in general terms?

 

[TelemarketingEnigma]

Thank you. You're right, I don't get the scale.
1. Would you say that little things now like a correlational study, volunteering in a lab or for an MD doing a clinical trial, etc., would likely be a good stepping stone to the progression of steps you mentioned? Or does it not really matter? Should I just concentrate all my efforts on getting into medical school for now, try to get accepted to a school with some research opportunities, and start this process then, or maybe even after graduating from medical school? That seems to be what you're saying, I just want to confirm. Put another way, would it hurt my chances of working with a research mentor in or right after medical school if I have essentially no prior research experience?

2. What do you mean by the other side of this process? What do you do, if you don't mind me asking, in general terms?

1. They're great for getting your feet wet, and building a resume, certainly. And that in turn may be helpful for getting into med school (if that's what's lacking in your app). But the far, far more important step is getting that degree, and you need to get into school in order to do that. There is pretty much a zero percent chance of becoming a PI without an MD or PhD (There are a few fields where there are exceptions to this, but that's more like law, some public health fields, computer science, etc - not clinical research). Once you're in medical school, you should definitely be looking for research experiences. I can't speak to the process of getting into the type of residencies that'll put you on track towards research, since I'm not in med school yet (and am more familiar with the traditional PhD PI track), but research in med school will definitely help there. And I'm not saying don't do research now - just that anything you do before the degree will only be a tiny drop in the bucket, barely scratching the surface of "establishing a track record".

2. Without getting too specific, I work for the kind of people you're trying to get grants from

Edit: I should clarify that I'm specifically talking about getting on the track to being a PI on something like a large NIH-funded clinical trial, since it sounds like thats what you're interested in. If you just want to publish things like case studies, that's a different ballgame that I'm not able to speak on.

 

[deleted343839]

1. Would it look bad on my application if I stopped volunteering there now?

2. If so, would it be significantly better if I said it was more like 5-6 months? This might be possible because before I started formally volunteering there, I attended weekly lab meetings and did a journal club presentation over the summer.

I’d like to stop because the PI insists that I volunteer at least 10-20 hours a week. That would be very difficult to manage this quarter since I’ve filled my schedule with 5 classes, non-clinical and clinical volunteering, and several part-time teaching jobs to pay the bills. Also, to be honest, I’m not sure of what I’m getting out of the experience justifies the time cost.

That's a fair question. What do you have to look forward to? Possibly there is a better research experience for you than the one you're in right now, but it's typical to start new RAs on lower level tasks such as data entry and then assign them more complex/interesting responsibilities once they have shown a track record of dependability, accuracy, etc. Are there research assistants who have been there a year or more, and if so, what are they up to? Are they doing more interesting work or being offered the chance to co-author poster presentations or papers? If so, maybe you need to stay the course and be patient with the process. You can't expect to walk into a new lab and be invited to co-author a paper right away. It's understandable that someone may need to switch labs to find a good fit, but you don't want to jump from lab to lab and never stay anywhere for very long. Talk about a waste of time.

What do I need to do now and over the next few years to establish enough of a track record to get grant funding from the NIH and approval from IRBs for the kinds of studies I want to do one day as a physician?

Connect with a funded investigator at your school, volunteer to work in his/her lab, and learn as much as you can about how the publication and funding game works. More importantly, though, learn how to do research.

Don't worry about IRB approval. You don't need to interact with IRBs at this stage. Institutional IRBs typically only review studies proposed by faculty members, so you need to become faculty first. If you are working with a professor who does human subject research, you might be able to work on IRB materials to see how it's done, but in the big picture there are probably more valuable experiences to be had at your level of training.

My short-term goal with research is to create evidence that the potential benefit to society of letting me become a physician who does clinical research on the side is significant enough to admit me into medical school, despite my less than stellar stats.

At the end of the day, this is just not going to happen. Let's imagine you really did become a stellar undergraduate researcher, but your grades and GPA were not competitive for medical school. Many people would, quite reasonably, steer you toward a scientific career as an alternative (eg, if you show great potential as a scientist then pursue a PhD). If the main reason you're pursuing research so aggressively is that you think it would overcome mediocre stats (as your original post suggests), then you have some misconceptions about what is valued in medical school admissions.

If you genuinely believe that you would be happy doing research as a physician, then first and foremost focus on getting into medical school, and then you can pursue research and scientific training opportunities once there (and beyond).