Medical students are very busy. The demands of studying medicine are extraordinary. Why then is it so important, on top of all there is to learn, to bother engaging in health and medical research? It is particularly important to consider this question at a time when, nationally and internationally, medical schools are including a research project as either a requirement of their program or a highly encouraged option. In fact, the Australian government is now supporting research by medical students with a specific category of scholarship funding from the National Health and Medical Research Council (NHMRC) available to students undertaking in a combined MBBS/PhD or MD/PhD program. [1]
As a Dean of Medicine, and passionate advocate of health and medical research (HMR) in Australia, I support the inclusion of research in medical programs. Research training and experience are not just ‘nice to have’ but a ‘must’ for our doctors of the future. Increased research training in medical programs is beneficial for a student’s professional pathway, their evolving practice and, most importantly, for the health of the patients and communities they serve. [2,3]
Demonstrated research experience at medical school is increasingly important in obtaining positions in training programs post-graduation. [4] Recognition of the importance of HMR in developing and applying the skills and knowledge acquired in their medical studies has seen many of the specialist colleges including research training and productivity (for example publications) in their approach to selection of trainees. Competition for vocational and advanced training places is fierce, and a professional resume that includes research productivity and qualifications is and will continue to be important. Some colleges may even move to requiring a PhD for entry into advanced training.
A research experience may be the first time a student has had to write and record what they do, think, and find coherently, concisely and precisely. This can contribute to developing lasting habits of critical thinking. In a landmark and classic essay, C. Wright Mills commented that there was never a time he was not thinking, reflecting, analysing, and writing – he was always working on an idea. [5] This is the mindset that research can build up, and this is surely the mindset we want in clinical medicine and population health, where continuing critical appraisal of new evidence and engagement with new ideas is vital. In addition to stimulating ongoing interest in learning, this intellectually curious mindset contributes to a sense of personal satisfaction and eagerness to engage in discovery and learning as part of a team. [3,6] Research achievements are rarely made by individuals in isolation. Developing a mindset of critical inquiry in individuals and teams clearly encourages research productivity in grants and publications in the longer term, [3] which can ‘future-proof’ careers at a time when research performance is important in professional esteem and progression. Even more importantly, involvement in research appears to improve clinical practice. Research-active healthcare providers appear to provide better care and achieve better patient outcomes, [7] making the investment of time in research training for medical students potentially very important to building a healthier society in the long term. Given the potential benefits to early career clinicians and to patients, it is important to expose recent medical graduates to research as well, and successful postgraduate training programs are also taking steps to include research training. [3,8]
So, what is the best way for medical schools and postgraduate training programs to provide research training that maximises these benefits? It is clear from the literature that the most important thing is to have protected time to pursue research. Whether the research is a programmed experience as part of a course (as is increasingly the case), or something pursued independently by the individual student or trainee, giving as much time as possible is key to getting the best quality outcomes. For recent graduates, hospitals need to allow time to do research. [8] For students, time should be set aside within the program. [4] Students and trainees also need to be mentored by experienced researchers to get the best results. [3] Research experiences for students and trainees that combine mentorship and protected time can deliver the biggest benefits to our future clinical leaders and society as they are most likely to result in high quality outputs that are published and improve knowledge and practice. Where possible, trainees without research degrees should try to enrol in these at the same time as pursuing their research experiences, through a university that offers flexible research training and options to submit theses by publication, as earning a research degree such as a PhD is increasingly becoming a prerequisite for obtaining research funding that can support a clinical research career.
In summary, more than ever before, being a doctor in the 21st century is a career of lifelong learning. The combination of continued, rapid growth in knowledge and advancing technology bringing that information to your fingertips, have brought both a richness to the practice of medicine as well as a challenge. There is a growing appreciation that researchers make better clinicians. Research exposure increases understanding of clinical medicine; facilitates critical thinking and critical appraisal; improves prospects of successful application for post graduate training, grants, and high impact publications; develops teamwork skills; and increases exposure to the best clinical minds. The government is lifting its investment in health and medical researchers like never before. The establishment of the Medical Research Future Fund by the Australian Government, for example, offers the promise of continued durable investment in HMR and innovation, and the NHMRC’s substantial investment in research training scholarships for current students and recent graduates signals the Government’s commitment to developing clinician researchers for the future.
I encourage all students to make the most of research opportunities in medical school and beyond, not only for the personal and professional benefits, but in contributing to the health of their patients and to the Australian community.
References
[1] NHMRC Funding Rules 2015: Postgraduate Scholarships – 6 Categories of Award – 6.2. Clinical Postgraduate Scholarship. 2015. https://www.nhmrc.gov.au/book/6-categories-award-3 (accessed Nov 2015).
[2] Laidlaw A, Aiton L, Struthers J, Guild S. Developing research skills in medical students: AMEE guide no. 69. Med Teach. 2012;34:754–71.
[3] Lawson PJ, Smith S, Mason MJ, Zyzanski SJ, Stange KC, Werner JJ, Flocke SA. Creating a culture of inquiry in family medicine. Fam Med. 2014;46(7):515–521.
[4] Collier AC. Medical school hotline: importance of research in medical education. Hawai’i Journal Med Public Health. 2012;71(2):53-6.
[5] Mills, CW. On intellectual craftsmanship. In: Seale, C. Editor. Social research methods: A reader. London: Routledge, 2004.
[6] von Strumm S, Hell B, Chamorro-Premuzic T. The hungry mind: intellectual curiosity is the third pillar of academic performance of university. Perspect Psychol Sci. 2011;6(6):574-88.
[7] Selby P, Autier P. The impact of the process of clinical research on health service outcomes. Ann Oncol 2011;22(Suppl 7):vii5-vii9.
[8] Chen JX, Kozin ED, Sethi RKV, Remenschneider AK, Emerick KS, Gray ST. Increased resident research over an 18-year period – a single institution’s experience. Otolaryngol Head Neck Surg. 2015;153(3):350-6.