Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
PracticeUpdate: Dr. Gong, will you please discuss why research is so important to the medical field?
Dr. Gong: Why is research important to the medical field? As all of us go through our training and move into practice, we should recognize that the diagnostic tests, such as scans, the blood tests, the therapeutics that we use have been built on the shoulders of scientists, scientists who did the research, starting from preclinical, or basic science, laboratories, to translational research, to the clinic, and to the clinicians and researchers who have tested these drugs and procedures in patients. And so, although we see a lot of MDs presenting the results of breakthrough studies that are featured at the large conferences, I think it's always important to realize that it's the PhDs, those who work with students with bachelor or master degrees, those coming out of high school working in early-career research positions or assistant positions, who have built the framework for all these developments that help change the lives of our patients.
PracticeUpdate: Why is research important for a career in medicine?
Dr. Gong: In terms of how research is important for someone’s career, I think the importance could be stratified two ways, depending if a person wants an academic position or more of a private practice type of position.
Research in academic positions
If you desire to be in an academic position, academic medicine, research is important because it's one way to show that you're committed to teaching, you're committed to conducting research to help advance our field through breakthrough developments. And, sadly, it's hard to deny this, but it's also used as a measuring stick for future jobs, future fellowship positions, faculty positions. Applicants are chosen for these positions based on their academic background, their training background, but also how much research they've conducted.
This could be in the form of abstracts, presentations, and peer-reviewed publications. Research is necessary to advance your career.
Once you start publishing your research on a particular topic, you start to be regarded as an expert on that topic. This is very important; not only do you want to build your portfolio to become a key thought leader, but you're going to need funding to support more research. Grant application is very competitive, and the applications are peer-reviewed. Although the prototype is an NIH-funded research grant, foundation grants, other federal grants, and smaller internal grants are all competitive.
The groups awarding the grants like to see that applicants have a background of research on the given topic. When they see that grant applicant A, who is applying for funding to investigate a novel pathway or to develop a biomarker of response or a therapeutic for a particular disease, has published as first author, for example, it reassures them that they are funding someone who has been successful in investigating the topic, who is an expert in this topic. It reassures them that the project is feasible and will be conducted in the way it’s proposed. Applicant A has done it before. And that gives a major sense of reassurance to these funding agencies.
Research in private practice
Now in the private practice setting, I would say that, although you may not be as actively involved with research, knowing the latest research is always important. I know a lot of private practice community, oncologists and practitioners who are super busy, super hardworking, super smart; they also find the time to dive in and become up to date with the latest research developments.
By considering research as a way of keeping up to date with the latest developments and making sure that you are using and translating the latest-breaking developments that are going to really improve patient outcomes, you can make a real difference in the care of your patients. Of course, a lot of research developments are presented at the annual conferences and are published in big-impact papers. Even if you don’t attend the conferences, you often see same-day NEJM publication of these presentations, and the findings eventually get incorporated into national guidelines. And, so, they become available to all oncologists, in both academic and private practice, eventually.
I think involvement with research will just help boost your CV to make you a competitive applicant as well. You also gain experience of how to interpret the scientific findings that you read about. You gain a bit of background of how the studies are investigated, interpreted, and written up. You gain a good background of the process, the scientific method.
For your patients' wellbeing, you should be well acquainted with the latest research developments. But again — and it's kind of hard to deny this too —sometimes even when you're involved in private practice, research publications can be used as a measuring stick to separate you from your peers.
I think it's very common for interviewers or candidate reviewers to weigh candidate A against candidate B, who both came from respected institutions. They both did really well with their training. But candidate A had more publications and had done more research than candidate B. So, research endeavors could be used as one of the factors that separate you from other candidates. I always tell my residents and fellows that, if you do research early in your career, it can only help you, whether you decide to go into academic medicine, or private practice, or another non-academic setting; it can only help you and boost your CV and your resume.
PracticeUpdate: What are the different types of research opportunities that physicians can get involved with?
Dr. Gong: Research could be very basic and translational, meaning you're doing research in the laboratory. We call it the wet lab, or basic science lab. It could also be more database interrogation, and this is usually the basis for retrospective reviews. And we often call this the dry lab, where you're mining data and abstracting charts and medical records to do research that way. You can also be involved with prospective studies, which are more clinical trials. We've had fellows who have been very engaged and participate in those as well. I'm sure I'm missing a ton of other categories. There can be epidemiologic research. You could be working at risk factors, looking at prevalence or incidence of disease and causation.
There are also things like case reports, case series, and reviews where you're not really in the data-gathering phase but more in the interpretive phase, and you're doing a review of the literature. This is considered research too. And these are things that have value as well. I first learned how to write for a medical journal from working on a case series, and then I was able to hone my writing skills more by doing narrative reviews, building onto original studies. This type of research is just as important, and I think provides a tremendous learning value.
PracticeUpdate: Would you comment on the differences between first author and senior author?
Dr. Gong: Being first author shows that you took the lead and you did the bulk of the interpretive writing or the data analysis. That's what being a first author means. Then as you progress from early career to mid to late career, it becomes important to be the senior investigator, the last author on these papers, meaning that you served as a mentor to the first author or that you helped supervise the work of that first author researcher. That transition from first author to senior author becomes important as you transition from an early career faculty member to a more senior member.
PracticeUpdate: What about collaboration on research between academic and private practice physicians?
Dr. Gong: Often, we collaborate a lot with those in the nonacademic setting, those in the community who are private practitioners. We even often have affiliate sites to our main academic sites. These practitioners often serve as co-investigators on clinical trials or research studies. Oftentimes they refer patients to us for participation in research studies. That's another aspect of why staying involved with the latest research, ongoing trials, ongoing studies: it benefits our patients, even if we are not in a major academic center.
story of the week
Cabozantinib Plus Nivolumab and Ipilimumab for Renal Cell Carcinoma