4th Year Research Project Insight

[Guest Kirsteen]

Hello,

 

I was wondering if anyone can offer some insights regarding any aspect of 4th year undergraduate medical research projects/courses. It looks like I will be undertaking one such project this year at Mount Sinai (Toronto), in order to get my feet a little further dampened in the clinician/scientist arena, and am quite looking forward to it. That being said, some aspects of the endeavour are somewhat daunting, e.g., learning the vast array of techniques and processes involved in medical research, even before you go about applying any of these skills to creating data; and a general, although very small, fear of some of the unknown(s).

 

When speaking with my pontential supervisor yesterday (was anyone else caught in the biblical-proportioned aphid cloud that besieged downtown TO?!!) one of my primary concerns surrounded ample support when in the lab, that is, having the support structure there to provide a little confidence when carrying out lab activities and directives. One of my previous lab experiences very much lacked this and as such, the feelings of being out of one's depth and lack of direction were difficult to shake off.

 

In any case, enthusiastic about this upcoming experience I'd like to make the most of it. Drawing upon some of your experiences and insights would be valuable.

 

Cheers,

Kirsteen

[Guest Sarah371]

Kirsteen,

Fourth year projects are good if you have a good supervisor. Make sure that you meet with your supervisor at least once every two weeks. This will make you keep progressing (you don't want to meet without any work done) and will allow them to provide input early if you are having trouble. Also make sure that you and your supervisor set out explict endpoints to your experiments, eg. X and Y and if one doesn't work Z and that's it!

 

I don't know how U of T works, but when I did my honours project at Acadia (about a million years ago) I worked on if for four months over the summer and through out the year. Do you have to write a thesis and do an oral as well?

 

Use the people in your lab as a resource, most grad students, post-docs and technicians are willing to help you out. Keep a bound note book for your techniques and tab the pages for easy reference. Remember that everyone knows you are just starting out and are not going to expect you to cure cancer your first week

 

To start with write down everything you do....keep your record in a bound note book....don't ever rip out any pages....get some in the lab to show you their prefered way of keeping notes but remember that often after people have been working in the lab they skip steps etc. so they may use a short hand version of notes.

 

As far as techniques it is often good to shadow someone doing the same sorts of experiments....sort of like the old med school adage of see one, do one, teach one. When you are working on your own don't be scared to ask for help. Molecular Biology (what I assume you are doing) is cook book science....easy to do if everything works but hard when you can't get your experiment to work....my best advice is to use the "red book" (binder of molec. bio. techniques) as your bible it always has good trould shooting sections. Gook luck and if you have any further questions just ask. SARAH

[Guest Kirsteen]

Hey Sarah371,

 

Thanks very much for your lengthy reply.

 

During the meeting with my potential supervisor last week, we discussed the importance of milestones and actively trying to adhere to them. It seems that he's quite aware of some of the pitfalls of fourth year courses, e.g., losing track of time and ending up with zippo on the work front. A good start!

 

Thankfully, the project (it will be of a primarily molecular biological nature) is being offered via the Physiology Dept., (specifically the Dept. of Feto-Maternal Medicine), and they apparently have stricter standards for running these types of projects than do some other departments. For example, at the beginning of the academic year, a meeting is held for all 4th year project students, and thereafter, other meetings occur which sound more like mini-defenses. That is, the student stands up for five minutes and gives an oral presentation to any members of the Physiology Dept. that wish to attend, as well as the other 4th year project students. Questions may be asked thereafter. The first oral presentation is in December, so really, not that much time to get the results churning! An important point is that the students are evaluated by the program director at that point--not the laboratory supervisor. This December evaluation, (as well as a similar one in April/May, accompanied by a paper) counts towards your final mark. Therefore, you do have to show that you have learned something and that you have been productive.

 

The initial game plan for the course is to determine which of their projects I find the most exciting, then spend September and part of October becoming familiar with the techniques required (cell cultures, microarrays, probes, vectors, blots, etc.) to generate the data. By mid-October I hope to be on the way to being surrounded by results of some sort. With respect to techniques, you mention the "red book". This sounds like it may be a makeshift binder of techniques and not a textbook? There must be some textbook of laboratory techniques that would serve as a good reference?

 

Thanks for the tips regarding the construction of a notebook. I'll definitely request some look-sees and see how the others keep theirs.

 

I hear that the lab is normally deserted during the Christmas holidays, however, since I work full-time, I'd like to use that time to really get some data churning and get a jump on the following term. During your project at Acadia did you manage to get some constructive work done during that festive time of year?

 

Last question: did you ever consider the clinician/scientist route? Was there anything during your lab experience that may have steered you away from that path?

 

Thanks again--I value your input,

Kirsteen

[Guest Sarah371]

Kirsteen,

 

It sounds like you are on the right track with your supervisor! Your december presentation will probably be more on the literature surrounding your topic, why you are doing what you are doing and what type of results you are expecting.

 

The red book is actually a set of protocols that is published on a monthly basis....it is put in a binder so that new techniques can continually be added.....I think it is called "Protocols in Molecular Biology".

Don't buy any text books to start.....wait to see what your lab has in it's library and borrow from there....techniques books are notoriously expensive and go out of date really fast.

 

I didn't work over X-mas vacation on my project since my home was in Toronto (too long a commute). You should be able to get some work done over the holidays....Labs are never deserted....usually someone around splitting cells checking e-mail etc....just most people don't work full time during that period.

 

I did want to do both an MD and a PhD when I was at your stage of education. I entered a PhD program out of Undergraduate and dropped out and took a Master's after 3 years. I just got really unhappy doing research. Everyone was losing their funding (this was the mid-1990's) and it seemed like my dream of having a small lab (a couple of graduate students and post-docs), producing good scientists and good data was no longer a possiblity. I also did not want to fight for money for 35-40 years. I decided to go back and do the MD after working in a lab for four years. The MD will allow me to do both clinical and research work, whereas the PhD would only allow me to do research. I don't think that I am going to do basic science research with my clinical career because the 50% lab 50% clinic usually ends up being 80% for both, not really condusive to haveing a family. But I am considering doing clinical research depending on what field I am in.

 

Hope this helps....any more questions ask. SARAH

[Guest Kirsteen]

Hi again Sarah,

 

Thanks for the tips re: the red book. Sounds like it will become a close companion over the next number of months!

 

There doesn't seem to be that much info out there regarding the success of the clinician/scientist route. My supervisor-to-be had mentioned, similar to what you had noted, that it seemed difficult for those pursuing the clinician/scientist route to meld the two careers successfully. More often than not, it appears that many MD/PhDs go on to choose the clinical route over the scientific route simply because the money may be better, and in order to secure funding for research, you're up against a horde of people who, unlike yourself, may be devoting 120% of their time to data generation. It can be tough going, apparently. A friend of a friend has her MD/PhD and she eventually eschewed the research in favour of the clinical work for similar reasons.

 

However, on the flipside, my supervisor mentioned another guy in Mt. Sinai who has managed to run both sides of the operation very efficiently. I believe that this researcher's primary interests are in the infertility/IVF arena--which dovetail nicely with his clinical practice. He runs a successful infertility practice, but also runs a very successful lab. His key to success in the latter is hiring experienced post-docs whom he nips by to check up on, on a frequent basis. Apparently he does very well with this approach. Sounds like a busy bee.

 

Now, you had mentioned the possibility of conducting some clinical research, post-MD. Aside from those specialties which require one year of research as part of the residency, what are the options for post-graduate research programs (as opposed to the MD/PhD route)? Also, it appears that research is increasingly important for those wishing spots in competitive residencies--but how important versus some of the other factors considered? Unlike the UK where post-graduate training is conducted in piecemeal fashion, e.g., in terms of 6 months to 1 year--offering some degree of flexibility with respect to changing post-graduate career paths--we select our residencies in advance and commit ourselves to that path until, generally, the completion of the residency. That doesn't seem to leave all that much time to augment the CV in terms of research and clinical experience. Is it common for any graduates to devote some time in between graduation and residency to research activities in order to improve their chances at securing their ideal residency?

 

On a completely different note, how do you like Queen's for medicine? How are you finding the facilities, the faculty and the hospitals? I'll be applying to Queen's this year as well as three other schools in cities larger than Kingston. I'm initially a little worried about the breadth of experiences that may be available in the clinical settings of Kingston. Is this feeling on valid footing? Also, have you managed to gain any feel for the quality of the facilities there, in terms of reproductive medicine, specifically?

 

Thanks again,

Kirsteen

[Guest Ian Wong]

There's been some great discussion going on here, and I thought I'd just chip in my two bits. I don't have much experience in research other than a summer spent in colon cancer research at the basic science/molecular biology level.

 

As far as lab techniques go, I've discovered that each lab often has their little quirks. Your supervisor might use different stuff than the professor down the hall, simply because he/she has had a different background exposure, or simply because he/she owns different equipment.

 

Because of this, the best way for me to get oriented was to attach myself to different techs in that lab to see how each person functioned within the lab. You'll often find that even in the same lab, people will do things differently! What worked for me was to find someone in the lab who consistently got her work done, and then I started copying her techniques. If you can find a good teacher, and emulate their behaviour that makes them successful, you're golden.

 

Scheduling and organization has to be a very important skill to master as well. I think your previous background will stand you in good stead here, but suffice it to say that I was totally unprepared for how organized I needed to be in order to make things work. In labs with money problems (read: all of them), you are often jockeying with other workers for the use of lab equipment. There's nothing more frustrating than prepping up some over-night cultures for a PCR the next morning than to discover that morning that you neglected to book the PCR machines in advance, and there's now a 4 hour backlog. If you consult another tech for advice on a new protocol, make sure you write it in your lab book, and not on the underside of a paper towel, which the janitorial staff loves to throw out.

 

Also, research seems to go in spurts and shortages, which makes it really difficult to try to schedule into a fixed time period such as Christmas vacation. You might discover a week into that period that you need XYZ reagent, which needs to be special-ordered, and until it arrives, your main experiment is cooling down. If you're like me, you might accidentally leave a crucial reagent in the clutter on the side of your workspace overnight, instead of in the -20 degree freezer that it likes to reside in. :rolleyes Or, you might simply discover that you want to try going in another direction, but can't do it without prior consultation from your supervisor, who may or may not be available.

 

Anyway, for that reason, I think research is something that is hard to schedule because of it's unpredicatability.

 

As far as residency goes, there are very few residencies where a significant amount of time off is allotted for dedicated research. I think the only specialty to do that is Neurosurgery, although I believe that General Surgery at UBC is now encouraging/requiring that. Most surgical residencies that I've checked out want research projects from their residents throughout the training period, but there is still the expectation that most graduating residents will go directly into clinical practice, or perhaps into a fellowship that then leads into clinical practice.

 

From the MD/PhD's in our class, I think all three of them are interested in combining clinical work with research. However, I think all three are quite realistic that it may not be possible to do an optimal job of both simultaneously. I also don't know how one would go about securing additional research experience post-MD and post-residency. However, I suspect it would most likely take the form of collaborating with specific researchers (either MD or PhD) that you had previously met and worked with during your residency time.

 

Ian

UBC, Med 3

[Guest Kirsteen]

Thanks for those (more than) two bits, Ian,

 

Yep, you're spot on with respect to differing techniques--even within the same lab's projects. Nonetheless, no matter which project is tackled, it sounds like they all have their own banks of requisite learning curves, techniques-wise. As to inter-lab differences, they seem to be quite massive. One group across the hall uses guinea pigs as their model, and apparently another uses sheep to investigate pre-term labour. Perhaps it's the Scottish upbringing, but I particularly enjoy sheep grazing on Braveheart-like hills, and would have one hell of a tough time comfortably incorporating them into any aforementioned lab techniques. Hence, the fact that our lab uses human tissues excised from tumours, etc., bodes well.

 

I'm all over the multi-tasking aspect of lab work, so it should prove to be fun in that regard. In addition, quite honestly, I think I've lucked out since this lab, (and the whole feto-maternity research floor) appears to be particularly well-stocked and well-equipped with beautiful, new-looking equipment (not that I'd recognize a particularly new microscope from Adam at this point, however). Compared to some of the labs that I've seen in other facilities, some of those at Mt. Sinai appear to be real beauties.

 

Thanks for the festive tips--I had considered the scarcity of bodies, but not of equipment, reagents and the like. Sounds like I'll have to gear up for organizational overdrive just prior, given all the unknowns that could materialize. Perhaps that would be a good time to have a number of alternate work plans arranged just in case reagent XYZ does head south for the holidays.

 

With respect to the MD/PhDs with whom you are in contact, Ian, are they leaning more towards the clinical side of the MD/PhD training or the research? It sounds like it's imperative once you've started your research, and if you intend to maintain it, to stay in touch in various dimensions, with the research community. I'd imagine that this would be incredibly challenging to achieve during the ultra-packed undergraduate MD years of the joint degree.

 

Back to the residency question: what factors do you guys feel are most important for securing a competitive residency position? Obviously, aptitude for the material during specific clinical training blocks is a clincher, but what else? How important is the research component? Also, regarding the specific training blocks, how are students normally assessed? Is it on an on-going basis, by a number of faculty members or hospital staff, or is it via a final evaluation, administered by one person?

 

Thanks again,

Kirsteen

[Guest fred]

hi

i don't really have time to reply to everything that has been mentioned here but maybe some thoughts..

you don't need a phd to be a clinician/scientist. one option is to do post-doctoral research in any lab (just like a phd would) and since you have an md that shouldn't be a problem. best is to make contacts in the speciality of your choice, do research electives and then have someone help to set you up for post-doc work in a top-notch lab.

that said, doing the md/phd has lots of advantages with respect to training, experience, contacts, etc.. with the combined degree future funding shouldn't be a problem (if you put out some good work) and you WILL end up with a faculty position. typically 75/25 research/clinical.

the extra 3 years of work (~ 7 years total md/phd combined plus speciality etc..) is offset by the fact that you will get to where you want to be while being finacially compensated while you are getting there. however, that shouldn't be your main consideration.

if you are looking at doing research a speciality is something you will probably need to do. familiy medicine is fine but it probably won't be what you are looking at if basic science research is your thing.

hope that helps and i recommend that if research is your desire the the md/phd program is the way to go. hope that helps.

[Guest Kirsteen]

Hey fred, thanks for your input.

 

A couple of questions for you: I would be quite interested in teaching at a future date, although more on a smaller than larger basis. For example, in one of our Physiology courses, we had guest speakers (more often than not, physicians) who would come in and give two or three lectures on their area of interest--I don't know if any of these people were deemed "faculty". Do you know what the implications are or commitments involved with a faculty position? If you do accept a faculty position, are you restricted with respect to the amount of clinical work that you can do?

 

Yes, I am quite interested in a few areas of medical specialties, therefore research could be a nice fit. It sounds like you are in close quarters with someone who may be enrolled in an MD/PhD program? If so, how do they like it? Do they have any criticisms regarding this approach to a medico-scientific career?

 

Cheers and thanks again,

Kirsteen

[Guest fred]

with regards to teaching, there are multiple roles that faculty members can take. as a clinician scientist your time commitments will be already quite restricted and as such you might not get to do as much teaching as other faculty. that said, teaching does occur. you could be a part of a team of people teaching a course or you could offer selective courses to specific graduate students. the choices are quite wide ranging. teaching also occurs in a different capacity. faculty participate in journal clubs, teaching fellows, giving rounds, supervising graduate students, etc.. that all contribute to "teaching time".

the teaching will not interfere with "clinical time" however the problem lies in the amount of "protected time" that you have for research. indeed faculty are usually torn in a battle to protect that research time. so you will never really be in a position that clinical time is threatened, it will most likely be the other way around.

 

i would say that the only criticsm (and worry) that i have about an md/phd program is the decrease in research productivity that undoubtably occurs during your clerkship and residency years. while that's a large portion of time that you will not be publishing lots, it shouldn't be a problem in your securing future grants since reviewers will look at your c.v. and realize that you haven't been "wasting" your time outside of research.

 

the other thing is time. some people want to finish and get out and make money. if that's what you want then don't do the md/phd. family med. will take approx. 2 years after med school but a specialty will take at least 5 or more years. it's a big time committment. also, when you get out you won't be making as much money as you would privately, you will make a fraction less. however, you will be a phd and, once you earn your scientific reputation, funding and jobs will be yours for the choosing.

helpful?

any more questions, i'll be glad to answer them for you.

[Guest Ian Wong]

As far as residencies go, I think in general research is useful, but it is unlikely to be the final clincher. From what I can tell, the process of getting a residency is that you will receive interviews based on the strength of your profile (eg. grades, letters of recommendation, research and pubs, etc), but your ultimate acceptance will depend on how much they like you.

 

As a result, research can be a good way to put your foot in the door, and give you an extra topic to add depth to your interviews, but you need the complete package for a successful application, which seems to mean a minimum of one elective at that institution + them actually liking you.

 

As far as your performance on electives, I've only had experience with one elective, but grading seems much less formal. I don't think you are expected to write a test at the end of an elective, but throughout that time while you are assisting doctors, you will be asked questions on the day's topics or perhaps past topics. This serves as a bit of a gauge as to your background knowledge base.

 

Also, while you are working on their service, the residents will find out whether you and them are compatible (very important if you're gonna be working side by side for the next five years), and they will also find out how you work clinically. Here, likability and your capability level count for a lot. Conversely, this is your chance to "test-drive" the program for 2-4 weeks, and decide whether YOU would enjoy working here for the five years of your residency.

 

By the end of the month, the residents and faculty have a good idea of how you stack up compared with past or present other students that have rotated through their service. That ultimately can be reflected in whether they decide to interview you, or perhaps unofficially decide that "you're the one" for them, even before the interview. In this way, I guess getting a residency is much more like getting a job from the business end. If they like you a lot, then yes, while they may still hold interviews, the job/residency might just be yours to lose.

 

Ian

UBC, Med 3