Let’s Chat RESEARCH!

Session 490

Let’s talk about research! Joining me today are Dr. Tiffany Chan, Assistant Clinical Professor in the Department of Radiology at UCLA, and Dr. Matthew Grace, Assistant Professor of Sociology at Hamilton College. We talk about the research we are going to be doing, along with Dr. Elaine Reno, an emergency medicine physician here at the University of Colorado School of Medicine.

We will specifically look at the impact of COVID on premed students. For more information, go to premedsurvey.com and see how YOU can get involved! Complete the survey and you’ll be entered to win either a $100 gift card to Amazon or one of five 45-minute sessions with me.

For more podcast resources to help you with your medical school journey and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[01:06] The MCAT Minute

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[01:32] Dr. Tiffany Chan’s Research Background

Tiffany explains that while she does like research, she didn’t necessarily always like it.

Research is always something that you’re told needs to be on your application at any stage, whether you’re trying to get into med school or trying to get into residency or fellowship.

And so, Tiffany started off by doing research during undergrad. She worked in a molecular biology lab working with C. elegans. She didn’t really know what she was doing, but she was doing the things that people were telling her to do. She was trying to get involved in the papers. But it wasn’t really her passion.

In other words, she was just checking the boxes. She knew that having publications in well-known journals and being the first author or last author can really help. To this day though, she believes it’s still very important.

Being an attending now, Tiffany gets to choose her research interests, specifically around her passion for medical education. These are things like quality improvements, workflows, and things that have a tangible result or benefit for herself, her colleagues, and her patients.

As a Biology and English double major in college, Tiffany enjoys writing and communicating. She actually enjoys things that are more scientifically oriented.

'Research is a way to explore these questions and to really provide a solution to day-to-day things, and to really impact patient care.'Click To Tweet

What started off as checking boxes has actually turned into something she’s passionate about.

Tiffany adds that selection committees do not want to hear about your million projects that are half-completed. They want to see you go through an entire project to completion because that shows a lot about you as a person and how you do in academics.

[07:09] Dr. Matt Grace’s Background

During undergrad, Matt worked on independent research and parlayed that into a research assistantship. From there, he went to graduate school.

Matt gradually developed an admiration for premed students having had the opportunity to work with them. He has also been interested in the thought processes of premed students and the challenges they face. He was amazed at how an 18-year-old student could realize that they want to go to medical school and do medicine at an early age.

Matt also mentions the scarcity of studies available around premeds. And so, he thought this is such an under-studied area that needs to be looked upon. Specifically, what types of factors – social, academic, or otherwise – either lead people to persist or fall away from that academic track?

[12:08] Where to Start: Choosing a Topic

There are different ways to go about identifying a research question. It can be academic or it could be something that’s happening in the world that can be related to medicine, health, or health care. Maybe you’ve come across it on the news or social media and it generates interest in you. Oftentimes, this touches your personal life or maybe the lives of family members or close friends.

If you’re a consumer of information or the news, that can be a great place to look for inspiration. Another great place to start is to identify the things or topics you’re passionate about and would want to take a deep dive into.

'We are so fortunate to live in this day and age where vast amounts of information are just instantaneously accessible at our fingertips.'Click To Tweet

Researchable Questions

Matt also recommends looking at researchable questions. Try to get a footing in terms of what the literature is on that topic. Identify a topic of interest then identify what has been written on that topic by folks in the field and its adjacent fields and do some deep reading.

Look for some gaps in the literature or in our knowledge base on that topic. And think about whether you can generate a question, which is potentially research-worthy.

Lastly, simply ask yourself if it’s an interesting question on a human level. This is the reason it’s useful to be part of a research project with a team where you can bounce ideas off of one another. That way, you can figure out if it’s just an idiosyncratic interest or if it’s something that touches other people’s lives.

[15:58] The Value of Research Outside of a Wet Lab

Regardless of your research, Tiffany says that gaining the experience early on is valuable. In her case, her research on C.elegans didn’t necessarily and directly affect too much of her life or her profession for that matter. But it gave her a very solid foundation for which she could start looking at research projects.

The challenge for a lot of students is finding some good topics because there are questions that could feel overwhelming.

The Value of Shadowing

Tiffany’s advice on where to start is to shadow a mentor, or for instance, message the endocrinologist at your institution. Tell them that you’re thinking about the field and ask if you can come by and hang out with them in the clinic for a day or so.

Once you establish that relationship, then you can look to your attending with regard to some ideas around the disparities in healthcare that they see day to day. Ask them what could be useful for further investigation. Because they’re the ones who are going to know more about the literature and what’s happening in society for their specific field.

A mentor doesn’t even have to be an attending either. It could even be a resident or another med student, or a senior med student.

Tiffany also agrees with what Matt said that thinking in a group is certainly useful. She has been an attending for three years, and she still looks to her senior colleagues for guidance.

Considering the Practicality of Your Research

Tiffany also suggests asking yourself these questions when choosing a topic: First, what’s the whole point? Second, what’s the practical aspect of this? Can you get this project done using the resources you have?

For example, you are in your third year of med school, and you really want to get a project done. But it might take three or four years to complete. Those are kind of the practical aspects that you have to consider when embarking on a project.

[20:19] Different Research Tracks

Research is not only limited to benchwork because that’s what PhDs spend most of their time doing. And so, it doesn’t mean you cannot do research if you’re an MD.

'There are many tracks where you can do MD/Ph.D. or you're an MD who does a lot of clinical trials. There are so many opportunities for a fusion of both.'Click To Tweet

Then you can also look at the more human aspects of research. Tiffany’s most recent publication in general breast imaging was literally about social media and how we have been using virtual shadowing for her specialty, breast radiology. It’s not a very typical research topic. But Tiffany adds, who knew that you can make a project out of Instagram?

Tiffany was able to create a project that is not a traditional science sort of thing. But it still got accepted in a scientific journal because it affects people.

[22:13] About Our Current Research

During the pandemic, there were not that many in-person opportunities for people to learn. And so Tiffany explains that they drew another project based off of their foundation asking – how does COVID affect premed perceptions of what it’s like to be a doctor?

We are curious about the baseline perspective of being a physician and that whole path, and then how COVID has affected them, if it has, at all.

COVID has put a huge strain, especially on frontline health care workers. It has affected all physicians, even those who are not in the emergency room and not working in the ICU. For instance, Tiffany has seen how COVID affected her patients because they were skipping their screening mammograms.

'Our goal with this project is to see what you have experienced as a result of COVID. Everybody's experience is different, and that's what we want to learn from you.'Click To Tweet

[24:10] Figuring Out Which Questions to Formulate

In general, our research will look at how does the pandemic affect their mental health? How does it affect their academic performance? We will look at the variety of ways in which people have been impacted by this pandemic.

The Impact of COVID-Related Death

Over a million people in this country alone have died. If you look at research around who’s been most affected by loss, it’s basically young adults who fall into the age bracket of being premed students.

The Impact on the Economy

We also have people who are experiencing economic hardship for the first time. These are the middle class, maybe even lower middle class, and certainly working-class people. Then all of a sudden, the unemployment rate spikes to 14% in the first month of the pandemic.

What does that mean if you’re a premed student who’s trying to check all these boxes in the background and you’re worrying about where to get your next meal? Is my family going to be okay? Do I need to scale back academically and pick up a job to help my family? These are questions that are greatly impacting the world right now.

The Impact on Mental Health

At the same time, we’re also worried about the mental health and well-being of our medical workforce. There are many people who have been very burned out by what they’ve had to endure the last two years for a variety of issues. Whether it’s policy failures or otherwise, and just the nature of the pandemic.

The Impact on Career Choices

Thinking about the people who are entering this profession, what are the challenges they’re facing? How is that leading some people who otherwise are qualified and would make excellent physicians to maybe have second thoughts about whether or not it’s a possibility for them?

As somebody who studies inequality and who cares very deeply about these issues, especially as they relate to medicine, Matt thought there was no way could pass up the opportunity to be part of this whole research.

[30:17] Numbers to Measure

Tiffany points out that there has to be some element of quantitative data here, and you can get numbers by asking for more qualitative comments.

In fact, there are many projects out there that literally use free text comments as part of the research as well. That’s something that you can’t put a numerical value on. But those could provide a lot of value for projects. And so, it goes both ways.

Pre-Testing

For instance, if you’re doing an online survey, does it just end once you click on a button? Is there a flow that doesn’t work? Are there any typos?

In pre-testing, you also look at whether the questions flow together or are the different modules arranged a certain way.

Pilot Study

Sometimes, you’ll pilot a study with a smaller sub population of the larger group that you’re interested in. Typically, you would administer it to the population that you’re interested in.

[35:21] Recruiting for a Research Study

In the world of medicine, we use randomized controlled trials. And if you don’t need as big of a population in that instance, the closer you can get to a real experiment, the smaller your sample size generally can be.

But Matt explains that the social world is complicated and complex. Your experiences are different from other people’s and even if we might share some commonalities, there might be all these other ways that we’re different.

He adds that the notion of proving causation in the social sciences is often very much overstated. But there’s still a lot of utility and looking descriptively at correlation.

If you’re trying to figure out the sample size you need, Matt recommends pretesting a survey to identify the effect size. Then calculate how many people you would need to survey to see if that’s a true effect size.

For a social science type survey like this one, you’re hoping for a few thousand people to take a survey. This is harder to accomplish in this world where we’re constantly being bombarded by requests to take surveys.

[38:00] The End Goal

'Whenever you start a project, you should have an idea of what your goals are.'Click To Tweet

Tiffany explains that not every project needs to be publishable. Some will make a big effect with your faculty or with patient care. And that’s really enough for this project.

Ultimately, our goal is publication. There are a lot of medical education journals, of which this could be great for. There are also some social sciences that would be very well-versed in helping us with.

When you’re starting a project, have a goal of what journal you want to submit it to, assuming that publication is your goal.

You can always aim for those journals. But if you get rejected, do not give up because it happens to all of us. There are many other journals that are also of excellent quality that will accept your research.

Moreover, you can always reframe something as a letter to the editor or as some sort of case series. And so, there are many different ways to get your work out there.

That being said, this research is not just a selfish endeavor to get something published, but to really make a difference.

We hope to share this information to those that are in this tumultuous time, where many things are being demanded of them. You’re probably trying to meet other requirements and you don’t know if this is the right field for you. And so, we want to help you guys out!

[45:14] Get Involved!

Again, if you are a premed student and would like to take part in our research, go to premedsurvey.com.

We want to hear from your perspectives, about how you deal with stress, and what causes you to worry about going into med school? What’s your experience with the MCAT, with the preparation, and how do you see yourself compared to your peers?

All these are things that are not necessarily captured in the medical school application, but are so vital and important to your development as a person.

Ultimately, as a medical professional, we want to hear your thoughts and your perspectives.

Once you complete the survey, you’ll be entered to win either a $100 gift card or one of five 45-minute calls with me.

Hopefully, this study can also inform ourdecision makers and policymakers and give them a better sense of what it is that students have been dealing with over the past few years.

At the end of the day, the whole medical school world is about questions and thinking about answers. Hopefully, this opened up your mind as to how to ask those questions and potentially think about how to start answering those questions.