“Good morning Dr. Saasouh, I am a medical student/resident/postgraduate student/nurse anesthetist interested in anesthesia research opportunities.”
This is how a decent chunk of emails I receive from trainees start, and it gives me hope in the future of our medical research infrastructure. Despite the interest in the field, trainees choosing to pursue academic research face daunting barriers.
Before the barriers, it is important to make a relevant distinction: Some trainees feel forced to “get their name on something” in order to enhance their application for the next position. In such a case, the greatest barrier is their personal lack of real interest in the purpose and process of academic research, and that is not something we are going to tackle today.
For all others who genuinely wish to pursue academic research, here is some of what they are up against:
Clinical training overload. Training programs have a rather large curriculum to cover in a finite amount of time. Combine that with reduced caps on working hours, personal life matters, and unexpected situations, and it becomes difficult to manage additional formal responsibilities.
Research education. Or, more aptly, the general lack thereof, is a serious limitation for trainees. Apart from some of the larger academic centers, trainees in the average program often have little or no prior formal education in research methods. The result is that a trainee often cannot anticipate the workload required to get involved, and a reasonable proportion would organically drop out due to the project not being “worth the effort.”
Funding. Also known as “The Grand Obstacle,” funding is a limitation of the majority of requests you could make and affects many of the items on this list. Understandably, academic research is a considerable financial investment (and not simply an expense). But, as all investments go, along with the risk comes the potential return of accolades, reputation, advancement, and, in some cases, financial benefit. Between funding received by training programs, internal departmental advancement dollars, and the emerging “for-profit” academic structures, it is my personal belief that funding should not be as much of a hindrance. Budget owners have been conditioned to say “we don’t have enough money for that,” but the more astute managers can often find ways to at least contribute to the research endeavor should they believe in the investment potential.
Reputation. To publish in a reputable journal, you need to have a good academic track record, produce excellent science, or both. Trainees are limited by experience, which knocks them down on both of these accounts. Their best option would thus be to join a research group where those elements are already present and, in a way, ride that wave until they can make it on their own. Given that not many such groups are typically available for trainees to join, sometimes they have to take the long route of starting small and building up. That, in fact, is an admirable path that substantiates the contributions of a trainee or junior faculty, but it takes a significantly longer time and larger effort.
Infrastructure. Say you were an aspiring researcher in your training years at an institution where time and funding were non-issues. You set out to start a major research project and notice that you have no trained research coordinators, no compliance officers, no IRB training, and no manpower to collect or analyze data. Might as well think of something better to do with your time and energy! Having the appropriate infrastructure can augment the zeal of a young researcher and propel them in directions they didn’t even know existed.
Collaboration. There is only so much one can do in isolation, especially in an age where large data registries and multicenter, sometimes multinational, collaboratives are producing a staggering amount of science that tends to overshadow smaller efforts. Collaboration requires contacts, networking, and — most of all — the willingness to work with others.
Role models. Enter non-trainees. It is rather rare to encounter the enthusiastic, academic-minded trainee who had not been influenced, one way or another, by a similar-minded role model who had “made it” in the world of medical research. Role models, I would argue, have the responsibility of realizing their own value and recognizing their influence on younger minds in a way that helps guide, polish, and propel them in the academic world. I say this because not every “eligible role model” understands their own status as an academic influencer, and that presents countless missed opportunities.
Production pressure/lack of administrative time. Also known as “The Other Grand Obstacle,” this is one facet of modern medical practice that is becoming ever more pervasive and ubiquitous. I would be (pleasantly) surprised if I didn’t hear this complaint almost on a daily basis.
Fears/hesitations. Megalophobia (fear of large objects), anthropophobia (fear of people), atelophobia (fear of imperfection), atychiphobia (fear of failure), catagelophobia (fear of being ridiculed), and scoptophobia (fear of being stared at) seem to be relevant to this discussion.
While these sound extreme, there is an element of phobia in some trainees who see proper academic research as too big of a project. And why shouldn’t they? Most successful and famous researchers do, after all, work on big projects and complicated protocols requiring proper baseline research acumen, funding, reputation, infrastructure, and extensive collaboration, among other things. Does this list seem familiar? These are some of the barriers we’ve mentioned above. Hence, the timid or hesitant research enthusiast is often faced with a debilitating combination of barriers that stops them before they even start their journey and prevents them from realizing a potentially bright academic future.
Let’s band together to create, enhance, and evolve. Let’s create good academic programs, appropriate infrastructure, and reasonable support for our younger colleagues. Let’s enhance what we currently have and build on it. Let’s evolve what is currently working and adapt it into places where the status quo is not working.
Let’s also be good role models and inclusive leaders. Inspiring young minds and guiding them, not restricting access to the wealth of knowledge and opportunity available to them.
This doesn’t have to mean veering too far from our current path. We often get stuck in the inertia of things that are, rather than taking a step back and optimizing processes to realize things that could be.
How can you improve access to academic research? Share in the comments.
Dr. Saasouh completed an anesthesiology residency at the American University of Beirut (Lebanon), a research fellowship at the Cleveland Clinic Department of Outcomes Research (Ohio) where he was chief research fellow, received training in neuroanesthesiology at the Cleveland Clinic (Ohio), and is currently an anesthesiology resident at the Detroit Medical Center (Michigan). Dr. Saasouh was a 2019–2020 Doximity Conference Fellow and is a 2022–2023 Doximity Op-Med Fellow.
Image by Nuthawut Somsuk / Getty
