It is that time of year again… the time to give thought to the question, “Are you going into the lab?” Finding a research opportunity or lab has been discussed previously in this forum and is often coupled with discussions on mentorship. Traditionally, taking time to do research has involved joining a faculty member’s basic science lab at one’s home institution– this is often the path of least resistance. However, this notion has changed over recent years, and more residents choose an individualized research trajectory. Given the heterogeneity in research options, selecting an opportunity among the many available “labs” may be an overwhelming task for many residents. Obstacles that stand in the way of finding unique research opportunities include lack of funding, ability to travel, knowledge of where to locate unique opportunities, planning for time off, or pressure to join a lab within the institution. The reality is that the reasons for taking dedicated research years varies depending on the individual’s career goals. There are many important considerations for medical students or surgical residents interested in research. We aimed to illustrate a few of the major (albeit not an exhaustive list of) considerations for anybody thinking about pursuing dedicated research years in their surgical residency.
- Why take on dedicated research years?
The opportunity to pause clinical training and focus on a research topic for a period can yield tremendous career benefits. For one, the experience of performing research will leave you with a greater appreciation and understanding for the science behind the innovations you will see over the course of your career. Performing research will give you an opportunity to network and meet colleagues in your desired field or area of interest across the country. There are several reasons why someone might choose to perform research in their residency, and there is no wrong answer.
- The early bird gets the worm.
The earlier you begin planning for your research experience, the more likely it is that you will find a position suited to your interests. Certain programs do not allow residents to take time off for research, while others mandate one or more years. Knowing that you might be interested in doing research in your residency is an important consideration when choosing a residency program. This may also impact residency rankings. Making your wishes known to your program director at an early point will allow for him or her to accommodate your career goals. Develop a written research plan early– it demonstrates initiative and puts your plan in writing.
- Clinical or basic science or something in between?
Choosing between clinical and basic science research is one of the most important branching points after deciding to spend time in the lab. Also, there are variations on these two themes, such as translational work. This is where much of the variation is starting to take place. There are different tasks that may be involved in your day to day research… pipetting under a hood vs. digging through patient charts. Ask yourself what you want your day to look like, and if you want to devote a portion of your career to research, ask yourself what you want your day to day to look like ten or twenty years from now. Consider too your prior research experience, as there will be a learning curve wherever you start.
- When should I leave?
Sometimes, this is predetermined by your program and not a consideration at all. Often a surgery resident must decide whether to leave for research after their 2nd or 3rd clinical year. There are relative benefits to both strategies. Leaving following the 2nd year, represents a natural shift in clinical responsibilities from a junior to mid-level resident. In doing so, residents leave before a point where their surgical skills really begin to develop (as a PGY-3). Leaving following PGY-3 year with another clinical year completed may be of benefit when it comes to potentially performing clinical work, especially at an away institution.
- What are your goals?
Be honest with yourself. If your goal is to match into a competitive fellowship, your main missions will be to publish as many papers and present at certain key conferences during your research years. If your interest is in spring boarding into a true academic surgical career and eventually secure grant funding, then perhaps the subject of your research and networking with leaders in that field is more important. Having an idea of your end goals will help identify the best possible position.
- Zero in on a topic or area of interest.
In general, the more closely aligned your ultimate research lab with your clinical interests, the more successful your time will be. However, this should be balanced against your reasons for pursuing research in the first place as mentioned above, and a successful research experience does not require that it be in a lab related to your clinical interests. There is much to be gained from a well-run, productive lab that may be completely unrelated to anything you envision your practice entailing. The website for the Association of Program Directors in Surgery has a link to available positions that may be worth looking at. (Link below.)
- Identify leaders in the field.
If your ideal position is outside your institution and you have the approval from your program director, then you should identify leaders in the field of interest and make contact with them about possible openings in their lab. This can be achieved in a number of ways. One of the most efficient ways is to simply ask surgeons at your institution for names of the top contributors to the field. It is not uncommon that over the course of that conversation, you might get very valuable advice on labs to consider (it is a very small world). Alternatively, you can review the recent literature in the journal of your intended specialty and see which authors have published on topics that interest you and contact the corresponding author to express interest and inquire about open positions in their lab.
- The interview.
Before you interview with a lab, have a good understanding of the recent manuscripts published by the lab. Your goal is to have as complete an understanding of the direction of the lab as possible prior to your interview. While the interview is about the lab evaluating you to see if you are a good fit for their lab, it is equally important for you to determine whether the lab is a good fit for your career goals. Ask questions about the current projects and what the day/week looks like for a typical resident. Who makes up the lab group? What is the day structured like (weekly lab meetings, daily touching base, PhDs)? Do you collaborate with other labs and have access to their resources? How is authorship decided? What conferences does the lab typically present at? Additionally, ask about the previous residents in the lab. How many of them matched into their intended specialty, how many publications (first and co-author) did they end up with and in what journals? This is a good question to ask both the principal investigators and current and former residents in the lab. These conversations are especially important if you will be a visiting resident in the institution.
- Funding.
This is often a sticking point for choosing one lab over another, as most of us have school loans that won’t go away (not to mention other financial responsibilities). Some positions are self-funded and are an attractive opportunity. Other positions require applications for grant funding or funding provided through clinical work (e.g. covering a set number of calls). You should have a clear understanding of the resources available for your position and, if applicable, your responsibility in acquiring those funds prior to agreeing to any position.
- Become the total package.
Although you will be devoting long hours to your research, in many cases the schedule is more flexible compared to that of a clinical surgery resident, and these years provide a (rare) opportunity to develop interests or hobbies outside of surgery. Whether that interest is rock climbing, learning a new instrument or language, or even geocaching, you might find a life-long hobby doing something you never considered or even heard of. Not only will you find a new activity that you enjoy doing, but you will also add an dimension to yourself that will be unique and help separate yourself from an otherwise homogenous group of fellowship or job applicants. After all, you never know when the person interviewing you is an avid whittler!
The ultimate decision in choosing a lab comes down to the answers to the above questions, along with the countless questions that are unique to each resident’s circumstance. Once you select a position, be sure to inform your program director to allow for accommodations to be made for your absence. You might even consider getting a head start on a project or doing some background research to minimize the learning curve. This is not intended to be an exhaustive list of every consideration for each student or resident considering research during their surgical residency, but we hope this will get the ball rolling and help you navigate the often-complicated pathway to choose the right research opportunity. Best of luck in your academic pursuits!
Association of Program Directors in Surgery open training positions: https://apds.org/education-careers/open-positions/
https://www.aasurg.org/blog/forging-new-pathways-creative-areas-study-academic-surgery/