EBM… I know it is important. I am bitter because my residency forces us to do "research". They give you no protected time, no resources, and the attendings themselves aren't very interested in doing research. We only do it at our program because it is an RRC requirement. Obviously, I have some huge chips on my shoulder. One of the numerous chips is that I feel like I have wasted hundreds of hours doing research. First, as an undergraduate, trying to get into medical school. I worked as a lab rat, doing my professors bidding and getting paid a pittance. My research never went anywhere. My professor was brand new and we helped him getting him get his new big project underway. I never published, and I never contributed anything other than being a cog in the wheel.
In medical school, I was involved in 2 different failed projects where I spent hundreds of hours pouring through patient records extracting data. The attending didn't have enough time to help us complete the project and ended up tabling it. In residency, I spent dozens of hours pouring through articles and carefully building my own research project. The IRB rejected the application 3 different times, and finally asked that we get together and talk. We finally came to an agreement on how exactly they would allow me to proceed, but it took literally 18 months to get to that point. With 14 months left in my residency, I thought I still had time to get it done and do a good job, and finally contribute a kernel of knowledge to the Holy Grail of EBM. My attending told me, "I think that it would be a sign of wisdom and maturity if you abandon that project and help me do this other project." A few days before, I had asked him for a letter of recommendation, so I wasn't in a position to not be anything other than, "wise and mature". I helped him get his lame little project done that I didn't quite see the point of. I wrote it up and submitted it to the SAEM comference, thinking, "What a piece of trash, this will never get accepted." It got accepted and I went, in shame, embarrassed to be a part of the publication, but going through the motions so that I could just graduate from residency. My attending wouldn't let me present all of the data because he wanted to break it up into separate parts and get multiple publications out of one project. This made my presentation even more worthless and pointless.
Luckily, as I sat and listened to the other research presentations, they were, by and large, equally lame. I came to the conclusion that I never wanted to be a part of another research project for the rest of my life. There was however, an amazingly dynamic speaker, who is one of the guru's of emergency medicine research. He presented an overview of his history of research and gave recommendations to programs of what they needed to do to promote research. One of his central beliefs was that we need to not force residents to do research. He reasoned (and I was convinced the next day as I listened to embarrassingly meaningless presentations) that when you force residents to do research, you get tiny little projects that come to nothing, waste everyone's time and in the end, are meaningless. I know, I know, "Do I want some cheese with my whine?"
The real reason why most ER "research" gets done is because it is an RRC requirement. Attendings want residents who are interested in research because they are under huge pressure to publish. Three ridiculous papers that are meaningless are more important to some attendings than one solid paper every 4 years that means something. At least at our program, bonuses are figured out, in part by number of published papers and presentations at regional meetings. Again, I don't dislike Evidence Based Medicine, I am irritated by a broken system that largely churns out crap. I know I'm being a troll. But the purpose of this website is to give medical students an idea of what residency is really like and what ER in general is like. I just wanted to present a different face to academics and fellowships in general. Usually, on this website, it is kind of a rosy faced, "Gee williker guys, lets go do some research and fellowships. That would be swell and exciting!"
