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Chapter 1 Introduction: Developing Ways to Incorporate Scholarly Activity into Clinical Training and Practice
Lynne M. Bianchi, Ph.D. and Justin Puller, M.D.
DOI: 10.1201/9781003126478-1
Tips for Success:
- Choose a form of scholarly activity that fits your personality, interests, and resources.
- Develop projects that are attractive to you and beneficial to your field.
- Design studies that can be completed given your available resources.
- Spend time reading the literature.
Warnings:
- It takes a bit of effort to develop an idea into a worthwhile project.
- Ideas are revised multiple times before implementing a project.
Key Concept: Planning may feel like wasted time but planning always saves time and prevents frustration.
Life during medical residency includes a variety of anticipated and unanticipated activities and experiences. There is a lot to learn and master in a short period of time. Most new residents expect long hours, difficult cases, challenging supervisors, and a lack of sleep. Many know they will attend and give lectures and spend time preparing for exams. Some, however, are surprised to discover they also must engage in research. If one matches into a residency program at a large medical university known for cutting-edge research, it is likely that the person wanted to include research training as part of the residency experience. For those who select residencies in community-based hospitals, rural settings, or programs not affiliated with a medical school, the requirement to engage in research may come as a bit of a surprise, a sense of dread, or perhaps the thought, “they won’t really make me do that, will they?” Yet, participation in research and other scholarly activities is a requirement for graduation from residency programs in the United States and many other countries. Faculty physicians who train residents are also required to produce annual scholarly work.
Adding scholarship onto an already long list of requirements often feels a bit overwhelming to residents and the faculty who teach them. Fortunately, there are many forms of scholarly activity, including basic and clinical research, quality improvement projects, and educational assessments, so everyone can find something interesting to do (Box 1.1).
We designed this book to guide residents and faculty in the fundamentals of clinical research, publication practices, and conference skills. We offer advice on how to incorporate scholarly activities into your weekly routine, so the process becomes more manageable and less onerous. Suggestions for pursuing other scholarly activities, outside of clinical research, are also offered.
Remember: To be a successful scholar, one does not have to work at a laboratory bench or develop a novel clinical therapy. One does not need to publish in a top medical journal or speak at the most prestigious subspecialty conference. One simply needs to identify interesting questions, implement appropriate ways to answer them, and share their outcomes through presentations or publications.
Note: Throughout this book, discussions of “projects” and “studies” refer to all forms of scholarship, not just clinical research studies. Similarly, the terms “investigator” and “researcher” refer to those involved in any scholarly project.
Tip: Scholarly activity supports the culture of inquiry needed to advance medical knowledge and improve patient care.
Hint: If you consider scholarly work meaningless to your clinical practice, periodically remind yourself of the inherent connection between scholarly activity and patient care.
Box 1.1 The Many Forms of Scholarly Activities: Choose What Works for You and Plan Accordingly
In addition to clinical research, scholarly activities include quality improvement (QI) or quality assurance (QA) projects, and education assessments (see References and Resources).
In the United States, the Accreditation Council for Graduate Medical Education (ACGME) requires annual scholarly activity reports from residents and their faculty mentors (Tables 1.1 and 1.2). Programs in other countries have their own guidelines and requirements.
Table 1.1 ACGME Resident Scholarly Activities 1. Publications with PMID | 4. Chapters in textbooks |
2. Other publications | 5. Participated in research (Yes/No) |
3. Conference presentations | 6. Teaching presentations (Yes/No) |
| All residents and fellows must participate in scholarly activity prior to graduation. Six categories of scholarly activity are recorded for each resident or fellow annually. The identification number(s) for publications cited in PubMed (the PMID) are listed, and the total number of other publications and the number of presentations at regional, national, or international conferences are reported. Whether the resident participated in research or teaching is also noted. |
Table 1.2 ACGME Faculty Scholarly Activities 1. Publications with PMID | 6. Chapters or textbooks |
2. Peer-reviewed publications without a PMID | 7. Grants with leadership role (e.g., Principal Investigator (PI), Co-PI, site director) Yes/No |
3. Non peer-reviewed publications, item writing (e.g., board exam questions) | 8. Leadership role in international, national, state, regional medical organizations; reviewer or editorial board of peer-reviewed journal Yes/No |
4. Conference presentations 5. Other presentations (e.g., Grand Rounds, invited lectures) | 9. Coordinator of seminars, conference series, or courses for medical students, residents, fellows, or other health professionals outside of program didactics/conferences Yes/No |
| For faculty, the annual report to the ACGME includes a chart with nine categories. All PMIDs are listed in the first category. The number of other publications and presentations are then listed under the appropriate categories (categories 2–6). Faculty also indicate whether they held grant leadership, committee leadership, or peer-review roles, or coordinated formal conferences or courses outside of their residency program. Details of what activities to include under each category are listed in ACGME Common Program Requirements (see References and Resources). PMID (PubMed Identification number): the number assigned to articles listed in the PubMed database (see Chapter 2). |
Due to the nature of scholarship, no individual produces work in every category each year. For residents and faculty reporting to the ACGME, most list accomplishments in different categories annually. For example, a resident may participate in teaching in year one, start working on a research project in year two, and present a poster in year three. A faculty member might receive a grant, present posters on that work for two years, then publish a paper. Another may be involved in peer review each year, co-author a poster with residents annually, and publish a new book chapter every few years. A third might give Grand Round lectures and coordinate a course every year, and periodically present or publish on projects related to assessment of learning outcomes. Some may prefer to focus on QI projects and regularly present findings at regional meetings. Thus, there are many ways to meet the requirements simply by pursuing areas of interest.
It is always helpful to track your expected accomplishments to ensure you meet annual program and institutional requirements.
Depending on the specialty and institutional requirements, residents or fellows may be expected to present at a conference, prepare a manuscript for publication, or write a literature review.
Note: Residents and faculty should work with the program director and program coordinator to identify acceptable forms of scholarly activity and establish timelines for completion.
Tip: Check that you will have at least one form of scholarly activity completed by the eighth month of each academic year. If you discover you do not have any scholarly activities for that year, you will have four months to accomplish something relevant.
Hint: You are unlikely to complete a new scholarly activity in the final weeks of the academic year. Plan accordingly.
1.1 Turn Your Interests into Scholarly Work
The first step to developing sustainable scholarly work is to choose projects that readily integrate into your weekly routine. New investigators may overlook this critical concept and fret unnecessarily over the prospect of creating a new project unrelated to anything else they do. One of the most important lessons in this book is that successful scholarly activity arises as a natural extension of your daily work and interests. For example, if a program director is revising curricular content, projects that assess teaching methods or learning outcomes can be initiated. If residents devote several hours to a community service initiative, research or educational projects tied to that initiative can be developed. There is no need to invent extra work unrelated to your current interests and efforts.
Consider the Questions You Ask and the Interests You Have
Every week, you wonder about many different things. Simply being an engaged clinician leads you to ask questions. Think about some of your recent questions or observations. Do you question whether a newer, expensive medication benefits patients more than the older, inexpensive version? Do you believe second-year resid...
