research in residency

[tortuga87]

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Just wanted to post some thoughts here as I move onto residency. Wondering if anyone can relate or disagree:

Going from MD/PhD to residency has been a strange experience. The MD/PhD program was very research heavy and intensive as expected, so I always had the impression that medicine had lots of impressive research underway. Medical school also emphasized evidence-based.

As I interview for residency though, I cannot help but notice that the research quality in clinical departments is much lower than research departments (to a surprising degree). When you become a semi-descent clinician and then actually read many of the original papers of the so-called evidence base, you realize that they are... not that quality evidence-based... Also, only a small number of institutions seem to have quality research. It seems that only a handful of people (<100) are really pushing the field forward; I didn't really expect such a small world for important issues that affect huge portions of the patient population.

Everyone keeps on talking about how research is important but in reality very few clinicians actually do serious research. Research is kinda just seen as some bonus hobby at most places. I suspect research as an MD/PhD might be a lonely career after the MD/PhD program, where I will have to fight for research time and be the odd-ball researcher in a room of full time clinicians.

I can now really see why the MD/PhD program was started, but I did not expect medicine to be so similar to the wild west...

 

[eteshoe]

Hey @tortuga87 - glad to hear that you’re almost done and best of luck on the interview trail!

I’m still a few years out from residency but I agree with most of those sentiments. As I’ve gotten better at evaluating logically executed science, I really wonder how some of the articles in clinical journals really count w/ uncontrolled experiments, biased approaches, and weak/incorrect statistical analyses.

Even though I’m at a top tier medical center, when I go to some grand rounds I still see flawed studies being referred to as “evidence” for clinical management. Which is kind of a disservice to the patients IMO.

But yea I can imagine it will be a lonely path. Yesterday, I was talking to one of the Hem/Onc fellows (an MD/PhD) who’d just finished up his faculty job search and he really highlighted the importance of securing funding at that level because the income potential is so high that even research powerhouses aren’t really pushing to support early career investigators bent on building up a rigorous research program.

Though the reality is a bit more stark to me than when I had just started, I still feel a level of “excitement” about my prospects. For now I just gotta keep grinding.


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