A. Case
Reports - Case reports should usually focus on unusual outcomes or
therapeutic responses, especially when individual has been rechallenged or in
cases in which the timing of the responses to a discrete intervention yields a
clear pattern. Reports of unusual sign or symptom complexes (“fascinomas”) may
be considered but the causality in such cases in often confounded. It is
anticipated that case discussions will be submitted for publication in an
appropriate clinical journal.
B. Critical literature reviews - These projects depend heavily on an
exhaustive review of the literature by the resident and the skill and
experience of the mentor. The format of such reports may vary from traditional
editorial reviews to simple forms of meta-analysis.
2. CLINICAL INVESTIGATION
Specific projects leading to reports given by residents at appropriate local,
regional, or national scientific conferences are highly encouraged.
Mentor requirements: Faculty advisors can be chosen from the Research faculty
list and are expected to have significant prior clinical investigative
experience. Because of the short time available for the completion of such
investigator-initiated projects and the experience necessary at the faculty
level to identify and monitor projects of appropriate scope, mentors can be
chosen only from a list of approved clinical research investigators. Mentors
must file a project description prior to project initiation. Advisors without
prior experience may be chosen with approval of the Chairman or Vice Chair for
Research. It is expected that such novice advisors will seek advice from the
Vice Chair for Research or an approved senior faculty mentor.
Scheduled elective time requirement: Up to 3 modules.
Approval: Program Director and Vice Chair for Research
Specific examples:
A. Formal meta-analyses -
Relatively rigorous weighting techniques have been developed to allow the
combination of results of a series of clinical studies of roughly similar
design. Slight variations in methodology exist and experience in database
analysis and advanced statistics are required.
B. Database analyses - An important part of health services research is the analysis of databases for
prevalences and trends of health-related indicators. This form of research is
often part of ongoing quality assurance programs and may involve the use of
multiple databases. Examples of indicators are accepted health standards or
intermediate endpoints such as glycosylated hemoglobin in diabetics, use of
beta-blockers in post-MI patients, or occurrences of drug combinations
suspected to cause adverse effects.
C. Outcomes studies - Similar to database analysis, outcome studies tend to predictors of discrete
endpoints such as myocardial infarction or health indicators. These studies
may be prospective or retrospective in nature and require appropriate
pre-analysis statistical analysis.
D. Clinical physiology studies (“Proof-of-concept trials”) - These studies in small groups of human volunteers are designed to identify
specific physiological principles. They may be performed as
investigator-initiated studies or as parts of large multicenter pharmaceutical
trials and often involve the measurement of hormone concentrations or
responses, physiologic variables, or intermediate phenotypes. These studies
are sometimes “hypothesis-generating” and sometimes “hypothesis-testing”.
E. Genetic profiling studies - Many types of designs exist but the basic principles involve the association
of particular genetic markers with corresponding intermediate phenotypes in
affected and unaffected populations.
F. Multicenter clinical trials - As a rule, resident participation in multicenter
trials is not encouraged because value of the exercise is severely limited by
the narrowness of the protocol hypotheses. In addition, resident duties in
such studies are often more service-oriented (e.g. screening physical exams)
than scientifically driven.
3. BASIC INVESTIGATION
For selected individuals with prior basic science research training and
experience, carefully selected laboratory investigation projects may be
considered. Examples include experiments necessary to finalize a publication,
advance degree, or equivalent. In rare cases, development of new topic areas
is possible.
Mentor requirements: Faculty advisors must be chosen from the Basic Research
faculty list and are expected to have ongoing laboratory investigation in the
designated area and prior experience in working with residents with limited
research time. Mentors must file a project description prior to project
initiation. Advisors without prior experience may be chosen with approval and
ongoing monitoring of the Chairman or Vice Chair for Research.
Scheduled elective time requirement: Up to 3 modules.
Approval: Program Director and Vice Chair for Research
PRECEPTOR QUALIFICATIONS
A list of approved faculty mentors and the types of research they conduct will
be maintained by the Office of Research of the Department of Medicine. All
Departmental faculty are strongly encouraged to participate in research
activities. If a chosen preceptor has not performed extensive research or
wishes to move into a new research discipline, a conference with the Vice
Chair for Research is required before his/her preceptorial role is approved.
The Department’s Office of Research will attempt to provide support and
guidance in these instances to allow faculty to develop expertise in new
disciplines. Non-departmental faculty preceptors may also be chosen with
approval of the Vice Chair for Research.
PROJECT DEADLINES
Compliance with intermediate deadlines is essential to ensure project
completion by the end of 36 months of internal medicine training. Accordingly,
project deadlines are as follows:
PGY2—ALL RESIDENTS
- September 1 or before: Research Mentor must be identified
- January 1 or before: R1 summary form must be filed
PGY3—ALL RESIDENTS
- June 1: Completed written report or presentation
RESIDENTS REQUESTING RESEARCH ELECTIVES
Those individuals requesting a research elective (1-3 modules) may do so only
after filing, together with the individual’s mentor, a written summary of the
project to be completed. Residents may choose mentors from the approved list
of investigators or may suggest an additional mentor, subject to approval by
the Vice Chair for Research or Department Chair.
RESEARCH REPORTS AND PRESENTATIONS
Analysis, collation, and final preparation of data are essential features of
the research curriculum. The research requirement will be considered complete
only when a full presentation has been given or an appropriate written summary
is received.
The final report may take one of several forms.
1. Manuscripts
A final manuscript satisfies presentation requirements and is the most
desirable form of report and will be deemed sufficient, whether or not the
resident chooses to participate in a formal presentation (poster or oral).
Participation in local, regional, or national scientific conferences is
encouraged. Manuscript supervision is a major responsibility of the individual
mentors and papers should be prepared according to the instructions found in
the individual scientific journals
2. Scientific conference presentations
Residents and mentors are encouraged to submit research projects to
professional societies. Residents are also encouraged to present their works
at a local or regional (American College of Physicians or equivalent)
conference. Two standard presentation forms are recognized:
A. Oral presentations
1. Abstract presentations. A standard 10-minute presentation (with 5 minutes
of questions/answers) is the standard format for scientific meetings. National
presentations are strongly encouraged but, at a minimum, a presentation may be
made at the annual Research Day for the Department of Medicine or the annual
University Research Day.
2. Clinical Conference Presentations. For the 2001-2 academic year, the
research responsibility can be discharged by preparing a 1-hour clinical
conference for presentation to the Department of Medicine. This conference
must be approved by the Program Director and must: (1) include a handout that
contains a thorough literature review (see 1B above) and (2) be formatted in
PowerPoint, and (3) be of sufficient academic quality to be archived for
future use faculty or residents. These projects can only be mentored by
previously approved senior faculty with extensive teaching and presentation
experience and a thorough knowledge of educational methods.
B. Poster presentations
Residents may elect to present material in the form of a standard scientific
poster. Residents and mentors should be prepared for standard poster
discussion during national or local scientific sessions. Supervision of poster
preparation is a major responsibility of the individual mentors.
COLLABORATIONS AND MULTIYEAR PROJECTS
In order to support projects of major scientific merit, it may be desirable to
foster collaborative efforts between residents. In general no more than 2
residents will be assigned to a single research project to avoid dilution of
the experience. Projects may also be initiated that cannot be completed within
a single year or by a single resident. In such cases, teams of PGY3 and PGY2
residents should be considered so that ample time is available for project
completion. In the case of a planned multiyear project, it remains the
responsibility of the graduating PGY3 resident to complete a presentation or
to write a full progress report using the same style as the complete report.
RESEARCH AWARDS AND TRAVEL
Travel and other expenses for residents to present projects at major
scientific meetings are the primary responsibility of the individual mentors.
In the event that sufficient funds are not available, the Department Chair may
consider providing supplemental funds.
Annual Departmental research prizes will be given for meritorious projects
that may include monetary rewards. Winners will be selected by a committee of
the research faculty based on the following criteria.
1. Clarity and novelty of the hypothesis
2. Quality of the scientific methodology
3. Evidence of effort expended
4. Potential clinical or scientific impact of the findings
5. Quality of the presentation
