An Introduction to Research for Medical Students
Written by Dr Chetali Patil
Hello I'm Dr. Chetali Patil, today I'm going to talk about another side of medicine that is very often not explained or sometimes neglected in medical school.
What is Research?
How do I start looking for and get publications?
How do I boost my curiosity about clinical medicine to research?
How to find research Mentors?
Are there any courses needed to get into research projects?
How do I go from ‘Oh, I want to do Research?’ to ‘Wow, I've got great publications’.
These all questions can overwhelm anyone and honestly I was overwhelmed when I achieved my very first publication. Oh well, let me break the truth to you, research just needs a little curiosity, a lot of willingness to learn and a very good mentor. I have curated this structured pathway I wish I knew as a beginner.
What is Research?
Research is a “skill”. It's a systematic approach to answer a question. Its not just reading some information on Google but reading scientific literature from resources like Pubmed, MEDLINE, Scopus, Google Scholar, Embase, NIH, Elsevier, ResearchGate, Wiley Online Library and many more.
Scientific writing can be only learnt by reading scientific literature. Formulate questions about literature - Why is this condition progressive?
Which treatment approach is better?
What is the mechanism for treatment resistance?
Is there enough data available that could support my research? What are the research gaps in a particular literature?
For example, rather than saying: ‘I want to do research.’
Ask a specific question: ‘What is the role of the tumour microenvironment in cancer progression and treatment resistance?
Research is a learning process and you can never know just enough so don't wait until you know everything. Break it into skills individually by learning many minor things like:
Finding Literature
Ask specific questions, use terms such as “AND”, “OR”, “NOT”, MeSH terms, Title/Abstract, relevant filters, population of your study, duration of your research study, clinical trials, case reports, Review articles.
For example, instead of: “tumor microenvironment”, Try searching: (“tumor microenvironment”[Title]) AND (“cancer progression“[Title] OR treatment resistance“[Title]). Such a search strategy is much more consistent and reliable.
Reading Scientific literature
Read research papers, review articles, case reports and clinical trials keenly.
Think about the most common condition, a treatment or drug mechanism you want to understand, your questions from a lecture, an interesting or rare disease, emerging advancements in treatment and research gaps you come across in any literature.
My research interests have gradually been moving in multiple areas, from Crispr Cas9 to glioblastoma multiforme, slow progression of Alzheimer's disease due to PDE-5 inhibitors, and study about low oxygen saturation rates in populations living at high altitudes.
Asking research questions
Learn PICO:
P - Population
Who are you studying about?
I - Intervention
Which treatment are you trying to examine?
C - Comparison
What are you comparing?
O - Outcome
What are the outcomes of your study?
Choose a study design
Case Report
Report about a rare or an interesting clinical case. It is very good for beginners and you can learn about scientific writing without the need of large datasets.
For example: Histiocytic Sarcoma with striking Clinical Improvements.
Narrative Reviews
It provides a detailed discussion about a topic based on existing literature.
For example: Sildenafil in Alzheimer’s Disease: Neurovascular Mechanisms, Molecular Targets, and Clinical Translation.
Systematic Reviews
A systematic review has a specific methodology to identify, evaluate and synthesize evidence-based about a specific research question. Systematic reviews have a typical approach; the Cochrane handbook describes systematic reviews as a structured way of synthesizing existing evidence while attempting to minimize problems such as selection bias. Unlike narrative review it just doesn't summarize papers they are more likely based on evidence.
It typically involves:
Question, protocol, search strategy, data extraction, data analysis, risk of bias, methodology, synthesis of evidence, scientific writing and reporting.
For example: The Role of Macrophages in Glioma Progression and Regression: Insights into Recent Advances in Glioblastoma Multiforme Treatment
Meta-analysis
It is a statistical combination of results from several studies or research articles.
For example: a combination of 10 different studies about a specific topic identified quantitatively combining its estimation can be an effect of medicine, progression of a condition or risk factors of a disease.
Scoping Review:
It is a review for emerging research advancements or innovations. It is more about finding out the effectiveness of a specific treatment which is upcoming or ongoing in the clinical trial or about technology that has been studied or some research gaps in a specific research paper.
For example: what is the use of artificial intelligence in cancer diagnosis?
Cross sectional studies
They are population based which means they just study one particular population at a time. Most commonly conducted through structured surveys or questionnaires.
For example: Defining Normal oxygen saturation rates among Healthy Adults living at high Altitude.
Case control studies
These studies compare the outcome of a particular disease, it's risk factors, its causes in rare conditions or diseases.
For example: risk factors of SARS covid-19 infections in healthcare workers.
Cohort studies
This study follows exposed and unexposed groups to determine outcomes that are very valuable in clinical medicine and require patient records or well established data sets and information about patients.
For example: Gender-Based Patterns in Intracranial Aneurysm Site and Rupture Risk: A Single-Center Retrospective Cohort Study from the Caucasus region
Randomized controlled trials
In this kind of study, many patients are enrolled as participants and their outcomes about the specific treatment are compared with one another to evaluate any kind of intervention performed on them. It requires a lot of experience, investigators and planning.
Choose a research topic
Is this clinically relevant?
Do I have enough data to study and write about this?
Will this study be useful enough?
Can I have an appropriate mentor?
Can I realistically complete it?
Is it ethically acceptable?
All these questions are very fair and make a huge impact in your research project.
Look for a Research Mentor
A good mentor can really accelerate your research education and make a huge impact on your knowledge. You should look for your professors, any clinicians, doctors and hospital research units as mentors. Reach out to students who are in higher classes or in final years if they can help you.
If you like a specific study from a doctor write them an email showing a genuine interest in their study - please do not use AI generated email templates. Your communication is the key here. Do not hesitate to ask for help, attend conferences, try working with doctors, professors you meet there and ask them if they are interested in mentoring a research project.
Use the following affirmations:
I am interested
I know a topic but I need help in going in a specific direction
I am willing to learn
I really want to work on this project with you Can you supervise a research project for me?
Approach doctors or researchers professionally and be very specific with what you want to write. They are least interested in reading your long emails and try to be short and specific.
You can write about following things for example:
Write about you
Which medical school you belong from and the year you're studying in
Why are you contacting them
Don't forget to write about any kind of relevant experience you have
What can you contribute to their research or study
And of course don't forget your CV
Please do not write a very very long email or a story, researchers and doctors are very busy - make it easy for them to understand.
Data extraction and analysis
Use multiple search and databases.
Define an inclusion and exclusion criteria.
Do not use identical or similar search engines.
Extract and analyse your data from trusted search engines and not just Google or AI. It is very important to gather proper data because that's how you will reference your research paper.
Here's a quick suggestion: try and make different folders based on different topics of keywords that you have used to search, use tags and notes for the same.
Scientific writing
As I mentioned earlier, scientific writing is a very important skill. You should be very clear about whatever information you are writing, so structure a paper in your mind throughout the process.
Structure: introduction, methods, results, discussion and conclusion.
Reporting the literature
Well, there are multiple reporting guidelines according to study designs. EQUATOR is a large searchable library of reporting guidelines and recommends guidelines that match your study design.
For example: PRISMA for systematic reviews, SANRA for narrative reviews, CARE for case reports.
Publication
The most tricky part is finding the right journal. It is not an easy job. You have to consider a lot of things like the scope of your study, the audience, study time, indexing, methods, publication, timeline, article processing charges, open access requirements, acceptance rate and any other concerns related to publication.
Before you submit your manuscript to any kind of publication please make sure to read a section called authors instructions. Be aware of journals that guarantee acceptance rate and promise rapid publication, use misleading journal names, send aggressive invitations in your spam, do not have proper information about editorial boards, hide their publication fees and have suspicions in indexing claims.
Research publication is a very long process. You have to be patient, you might face multiple rejections before you get that one acceptance.
Build a Research Portfolio:
Now I know this might sound a bit too extreme but honestly if you are planning for future residency in USA or UK or any other countries it is important that you do not just have to have a collection of certificates or some random publications, you really need a proper research portfolio. Make sure that your research is aligned with your interest that you want to apply in future in your residency or fellowship.
For example: if I am interested in oncology my CV should talk about research, posters, abstracts or presentations related to cancer.
Your research CV should have the following things: education, orchid ID, research experience, publications (manuscripts that are published or under review), abstract posters presentations, conferences , research courses certificates and any relevant skills.
What are research skills?
● Scientific writing
● Reference management
● Search strategy
● Data analysis
● Biostatistics
● Research ethics
● Identifying research gaps
● Research methodology
● Study design
As a beginner, you can consider a research training program. There are many free research training courses available online by WHO or NIHR. You can also look for research internships, clinical practice, research ethics and journal clubs at your university. Start with one research project now, this is very important. You can never say to yourself that “Oh, I want 10 publications by the end of this year”. Research is very vast and to understand the topic you need to invest your time in it so take it one project at a time and then things become easier.
Structure of Research:
A systematic approach towards your research will make a huge difference. I know it is very underrated or might even sound a bit old school but create a folder for every project, label the folder with following names: introduction, protocols, search strategy, database, results, figures, main menu script, discussion, conclusion, submission, peer review comments, and the Final Draft.
You can also keep a record of what you contributed to the Research from your side, what problems you encountered, what you learned and how is this relevant in your medical career.
Use AI very carefully, it is a very useful tool but it cannot replace your personal perspective.
You can use AI for following things:
● To brainstorm research questions or ideas
● Structuring or organising your research paper
● Explaining concepts that you do not understand from the data
● Improving grammar
● Help understand the scientific terminologies
● Create a timeline for research paper
Use AI for help, not to find out evidence or purpose of your research.
Research Tools:
Database
Source: PubMed Central (PMC) (.gov) https://share.google/L0mZprPJ4qGM06xB1
Source: National Institutes of Health (NIH) | (.gov)https://share.google/3AuqoU32sbRsdprU0
Source: Google Scholar https://share.google/EvpHCdVfdlpHeBQfD
Source: National Library of Medicine (.gov) https://share.google/WH8rtoL2jQQHaMxrA
Source: Cochrane Library https://share.google/Bis52NWVWL79npKSS
Source: The American Journal of Medicine https://share.google/3ohP7nw7Z2i7m2mj6
Source: Wiley Online Library https://share.google/o68vBhe51CBOs5nuL
Source: ResearchGate https://share.google/YDCAX5Gc6PCTW1bjD
Source: Elsevier https://share.google/G5SAY4P1PrRrBpqbv
Tools
Source: Rayyan https://share.google/zRAcfmmhJPSpgD1em
Source: Covidence https://share.google/jW6hmdF176qIuXtQK
Microsoft Excel
Google documents
Guidelines
EQUATOR : https://share.google/n9vGZDbPMnrdY56Nz
Research registration/record
Source: PROSPERO https://share.google/cUWKtmE5B3LXpHf7N
Common mistakes to avoid:
I made this mistake of working on a project which was very interesting but with limited data, never do that.
Do not choose complicated topics right at the beginning.
Ignoring research gaps
Chasing publications or authorships
Paying for publications or expensive courses that give you publications
Ignoring the limitations of your research
Lack of evidence
Starting a research without having a well-organized plan
Remember that your research is not a competition or collectibles that you just want to keep in your house. For a strong CV every medical student needs to collect good research publications, certificates of webinars/courses, conferences and memberships in your relevant field. Also you do not need to wait until your residency to become a researcher you don't need to have advanced knowledge of statistics or scientific literature, start at the one then another, learn how to search, ask questions, find the mentor, join different projects, ask your friends, make mistakes, correct them, write, keep writing more even if you get rejections keep writing, revising keep trying and finally you will get an acceptance. And then maybe you can say oh yes I can conduct research independently.
- Dr. Chetali Patil, MD.
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