On Monday, January 27th at 8:00pm Eastern, please join your colleagues on Twitter for an #AASChat on How To Choose A Research Path.
So, you’ve decided that you want to do research. You’ve come to the same conclusion as many academic surgeons – research is a rewarding part of a surgical career. Yes, surgeons like to ask questions. We like to act, to investigate, and to witness progress… and research allows us to do just that. Then, there is this vibrant community that you become part of, as demonstrated by the Association of Academic Surgeons. You meet colleagues, collaborators, and many times, lifelong friends. These people will challenge you, cheer you on, and all along the way, will make you a better doctor, scientist, and leader. And of course, don’t forget the gratification of academic achievement as one presents, publishes, and, if lucky, makes practice-changing discoveries. Doesn’t it sound so good? But wait, deciding to dedicate part of your career to research is just the first step. How do you decide which path to follow? Today we are fortunate to have many research disciplines available to surgeon scientists, such as basic/translational science (BTS), health services research (HSR), global surgery, and education, to name a few. In this article, we hope to address some of the opportunities and obstacles encountered in two of these paths, BTS and HSR. This is just the beginning of a discussion that will be continued in real-time during the #AASCHAT on Monday, January 27th, 2020.
First, let’s start with health services research, which can serve as a meaningful and rewarding research path. There are several advantages to pursuing health services research. Probably, the most obvious is that it offers significant flexibility and heterogeneity. Unlike bench science and thanks to advances in computing, it can often be accomplished remotely, which can increase productivity, especially when traveling. Additionally, essentially any field of surgery is amenable to health services research which allows clinical, teaching, and research interests to be aligned. Hopefully, the challenges encountered while caring for patients can translate into questions that can be answered in your research. Identifying a specific area of clinical interest that overlaps with research efforts allows for a niche to be filled, which facilitates papers being accepted and grants being funded.
While health services research is one of the more “accessible” forms of surgical research, there are some significant considerations to be had. While not essential, it is highly encouraged to engage in formal training, such as a masters of clinical science or public health. Knowing how to run chi-square tests does not make you a health services research. Training beyond basic statistics not only allows for more sophisticated research but allows for improved communication with collaborators who have the advanced knowledge. Health services research is not a solo sport. The most impactful health services researchers build a team of statisticians, economists, programmers, and other clinicians to ensure that the question is being answered as thoroughly and accurately as possible.
Next, let’s talk about the basic and translational science research path, which is the historically traditional path to a successful academic surgical career. This has changed over time, given some of the obstacles that we will discuss, but many BTS surgeon-scientists choose this path for the same reasons as our predecessors. You cannot underestimate the excitement of having an idea from something you observe in the clinic or operating room leading to laboratory testing with the hope that you will witness your findings making it back to the clinic someday– the ultimate bench-to-bedside victory. The great thing about BTS is that as a community, scientists celebrate each other’s small discoveries by using them as building blocks for further scientific discovery. Similar to HSR, BTS is a community endeavor. Team science is not only fun, rewarding, and efficient… but many grant mechanisms love multi-center, multi-PI proposals that bring together expertise from a variety of disciplines and institutions.
Basic science and translational research requires passion, resilience, and persistence. The time commitment is real and necessary. Spending many months trying to get a new technique to work or having a three-month experiment fail and have to repeat it is frustrating. Having to wait for two years in order to get enough reproducible, valid, and sound data to write a manuscript while your HSR colleagues have been pumping out the database papers can be aggravating. In today’s culture of academic surgery, finding institutional support for the time and money needed for basic science is challenging. Yes, there are obstacles, but we are in a promising time when many universities, organizations (NIH), and associations (AAS/SUS) are bringing attention to the value and importance of BTS surgeon-scientists and working towards ways to improve the downward trend.
Overall, whichever path you choose, you need to choose the one that is aligned with your clinical interests, brings enrichment to your career, and most of all, you need to choose the one that excites you and makes you happy (since you will be dedicating your precious time). Use your resourses when making your decision. Reach out to your mentors, attend research talks, meet with professors… and join us and your fellow AAS members on Jan 27th at 8:00 pm EST to continue this discussion.
Question #1: What’s the most convincing reason to choose a HSR career?
Question #2: What’s the most convincing reason to choose a BTS career?
Question #3: Should the difference in the potential number of publications influence my decision between HSR and BTS?
Question #4: Oops! I thought I wanted to do HSR/BTS but I’ve finally come to the light and I want to switch…now what?
Question #5: How do I negotiate successfully for the resources I need to do HSR/BTS?