Doing research as a trainee in Geriatric Medicine

Part 1: The benefits of doing research, and finding a project

Alasdair MacLullich, Lecturer, University of Edinburgh
Miles Witham, Lecturer, University of Dundee

The process of moving from clinical work to enter the less structured world of research can be confusing and a little daunting. To address this we are producing a series of articles on ‘Doing research as a trainee in Geriatric Medicine’. In this first part we discuss the reasons for doing research, and then give some suggestions on finding a suitable project.

Why do research?

Benefits to Society
Research, whether basic or applied, is the most important means of adding to our knowledge of ageing, disease and the individual. Consequently, if you do good quality research you will have a real influence on clinical practice - even if this influence seems several steps down the line. Additionally, as a research-trained clinician, you have the opportunity to make sure that ongoing research is useful and relevant to the care of older people.

Personal Benefits
Doing research also brings many personal gains. You become an expert in your subject and for some this is the start of a lifetime’s special interest. You also develop several generalisable skills: public speaking, scientific writing, statistics, running projects, organisation, computer literacy, evaluation of published papers and presentations at research meetings, and the knowledge to supervise or give advice to junior colleagues interested in research. All of these skills are fundamental whatever consultant job you end up doing.

Another plus is that taking an extended break from day to day clinical work allows you to stand back and look at medicine from a different perspective. Part of this comes through working with non-clinical scientists and technicians, as well as senior academic clinicians.

Finally, knowing that you have made a contribution to your area is tremendously fulfilling. And many researchers find that publishing in journals read by their peers worldwide is quite a thrill!

Career Benefits
An MD or PhD is very important, even essential, if you want to be a clinical academic. However, publications and/or an MD or PhD thesis undoubtedly help in competing for all posts, particularly in centres active in teaching and research. This is not just because you have specialised knowledge but also because completing a research degree or publishing papers demonstrates that you have multiple transferable skills, as well as no small amount of tenacity.

Finding a project
Geriatric Medicine involves all organ systems in the context of ageing and disease. Geriatricians also have a strong interest in improving the quality of health care of older people. Therefore, the research possibilities in our specialty are unusually diverse, from lab-based molecular biology projects to health services research. Because of this, collaborations with researchers from other medical specialties are common.

There are several routes to setting up a project. Often trainees are offered a research opportunity by a senior colleague who has a project in mind. Otherwise, with some ideas of the kind of research you might like to do, you need to find someone with research experience in your desired field to speak to about it. If there is no one locally, perhaps a senior colleague has contacts elsewhere. You could also make contact with key researchers, perhaps at a BGS scientific meeting. A Medline survey can reveal researchers active in your field: virtually all would be delighted to hear from those with an interest.

Once contact with a potential supervisor has been made, think through the following key components of a successful period of research before committing yourself:

(1) The project: this should fit with your areas of clinical and scientific interest and also the kind of research you think you’ll enjoy doing. For example, you might prefer patient-based investigation to lab work. You should also think about the final outcomes of the project. By definition any scientific investigation involves uncertainty, but some projects are heavily based on methodologies which are not properly developed. In our opinion, inexperienced researchers should aim for a project which will yield interpretable results (negative or positive).

(2) The supervisor: this should be someone who has an established track record of successful publications in respected journals (check on Medline) and grant applications. Your supervisor should also have a good reputation with research students - speak informally to as many researchers as possible – and should be someone with whom you will get on.

(3) The institution: aim for a centre with an established track record and with the infrastructure to support your work.

Funding
Next, you and your supervisor (usually with other collaborators) usually need to write a grant application to provide your salary and other research expenses. Funders include the Medical Research Council, the Wellcome Trust, Research into Ageing, the Alzheimer’s Research Trust, and the British Heart Foundation. Virtually all require the applicant to have passed the MRCP or equivalent, but a training number is not necessary. You need to think ahead: writing the application takes weeks and funders take months to reach a decision. Therefore, the application should be submitted about a year before your intended period of research. Overall, it’s a painstaking process but it’s a wonderful feeling when you receive the award letter.

Please feel free to email us if you wish to make any comments or ask any questions about the issues raised in this article.

Alasdair MacLullich: Email me
Miles Witham: Email me