If you already have a research topic in mind that you are excited about, that’s great! If not, you may be thinking “I’d like to get involved in research, but where do I start? What areas of PM&R need research? What’s a good research topic? What areas are of interest to me?” Fortunately, finding a topic and developing a research plan can be some of the most enjoyable parts of doing a research project!
Identify Your General Interests
The most important aspect of beginning your research is that you select an area which interests you. Delving into a research project can be extremely rewarding, but it takes a lot of work! When you are truly interested in your topic, you will have the enthusiasm to carry you through. The good news is, regarding whatever topic you choose, almost every area within PM&R needs relevant, quality research.
Choose a Topic
There are many ways to pick a project. The best method, after choosing an area of interest, is to perform a review of the literature. As you read, you may notice gaps in the literature which will lead you to your topic. You will also find that for every question addressed by a research study, more questions often arise than are answered. Eventually, you may find many question worthy of study.
It is also very helpful to know what research questions your fellow physiatrists are asking. Posters and presentations at clinical or national meetings, such as AAPM&R's Annual Assembly, might help you find a direction. If you don't have the opportunity to go to conferences, another way is to read physiatry journals such as PM&R Journal which is released each month - there's even an app for it! You can also utilize other resources, such as PhyzForum, to connect with other colleagues who may be looking to collaborate. Finally, if you have a specific interest in mind and want to stay up to date, you can create an alert on PubMed to notify you on a regular basis for articles published with relevant keywords.
<h2id="mentor">Finding a Mentor
No scientist can work in a vacuum. Every researcher needs other people to provide critical ears, timely advice, and a helping hand. Whether this is one of your first research projects or you have several other projects under your belt, it is especially important that you find someone who can answer questions for you and be available to guide you through the process.
There are many places to find a mentor.
If you have an idea for a project, reach out to an attending. You would be surprised at the resources they can offer, even if they will not be directly involved with the project.
A great place to start is within your department. Ask around to see what research is being done. You may discover that an attending worked in your area of interest in years past and may be willing to guide you through another project in that research domain.
Next, look at the other departments at your institution. As PM&R has crossover with other medical specialties, you may find someone in another department with active projects or research interests similar to your own.
A caveat: If you are going to work with other investigators, especially senior researchers, be very clear about your time limitations. Don't commit to something you may not have the time to do. Keeping your time constraints in mind, try to pick a project that allows for flexible hours. Be clear about your expectations before making a significant commitment.
So, I have a mentor and a topic - what's next?
Next step is to determine what type of study you are going to do, whether you need/want funding, need additional credentialing and what the Institutional Review Board (IRB) process is at your institutions. Some institutions now require IRB submission for all projects, regardless of the type of data used (this includes Quality Improvement studies, Case Reports, and freely available datasets- although this tends to get an exemption or expedited review). In general, retrospective studies will be expedited review; however, would still require review which can take 4-6 weeks so keep this in mind for your timelines.
It is important to discuss with a research physician or specialist in your department to go over methodology with you. Also, ask a statistician to review stats with you as well. This should all be done before applying for an IRB. It is a lot harder to finish an IRB and realize you didn't implement the exact research project that you had in mind than to take the extra time to perfect your methodology and statistics.
Obtaining funding is one of the most challenging aspects of the research project. The best place to start is close to home. Often, it is easiest to get relatively small sums of money from your faculty advisor, department or GME office. There are, of course, other funding agencies, but these avenues can be more difficult and more time consuming.
- Faculty Advisor: If you have a faculty advisor who is doing similar or related research, perhaps they can sponsor your project. As mentioned in the mentoring section, if you can find a mentor who works in your area of interest, they may be willing to fund your research.
- Department: The next step would be to talk to your departmental research director, program director or department chairman. Most academic PM&R departments will have some “free funds” or training grant money which can be used to support resident research.
- GME/UME Office: Another resource for internal funding would be your hospital or associated university. Some institutions have training grants or endowments designated to support research at that institution. These are often directed more towards junior faculty, but you may be able to apply for these funds under your advisor’s sponsorship. Check with your institution or talk to your department chair about these options.
- Outside Funding: If you have decided to apply for an outside grant or other external funding, be prepared for fierce competition. Funding has become much tighter over the last 15 years; currently, less than 20% of research proposals submitted at the federal level are receiving funding. You will be competing in a tough market with experienced, full-time researchers. The good news is that there are many grants specifically designed to assist residents.
- Individual societies for certain conditions i.e., spinal cord, may have grants available.
Don't get discouraged! It is normal to be rejected multiple times before receiving funding. Be sure to save each application you fill out since grant applications often have similar questions.
Foundation for PM&R Research Grants
Study Design and Statistics
It is essential to have a well-planned research design in place before data collection begins. Great care must be taken to anticipate problems and to control as many variables as possible. As a researcher, you should familiarize yourself with some basic statistical tests, terms and concepts. It is important to understand which test applies to which type of data and what the results mean. Seeking a statistician's advice when planning your study may also be beneficial. Ask your department if they have a statistician on retainer. You may find the links below to be helpful starting points:
Presenting Your Work
Once you have finished your research project, you will, hopefully, want to share your results with the rest of the medical/scientific community. There are three main ways to present your work: posters, presentations and publication.
The objective of a poster display is to present research in a way that facilitates interaction between the presenter and the audience. Poster presentations are a great way of sharing your work with people interested in your topic. For more information on the best way to prepare your poster, see the link below:
Presentations are the oldest form of disseminating research. The goal of the presentation is to present research in an interesting, accurate and thorough manner. Try to tell a story outlining the important details of your research. Additionally, visual aids can be very helpful in presenting data and keeping the talk interesting. See the links below for more detailed information on preparing oral presentations:
Publishing a paper is the most lasting form of sharing research and reaches the largest audience. Although there are many choices, consider carefully where you submit your manuscript. Make sure that the journal is peer-reviewed and well-read by the audience that you are trying to target.
Publishing in medical journals can be very competitive. When submitting your paper to a journal, pay close attention to their specific manuscript preparation instructions. These instructions can be found on the individual journal's website. Some journals require payment for article processing. Once the article is accepted which can be up to $5,000, so keep this in mind when reading the instructions. It generally takes three to four months for manuscripts to be reviewed and a couple of additional months for the revised paper to be reviewed. When the final draft of your manuscript is accepted, there is usually a six to twelve month wait before it is printed, however it can be published online within 1-3 months of acceptance.
There are several different types of publication. As a resident, you will most likely be involved with one of the first four types:
- Case reports/series
- These are generally interesting patient reports/series of several patients with similar findings.
- Retrospective studies
- These are the majority of your chart review studies.
- Systematic reviews and Meta-analyses
- These types of studies evaluate and synthesize existing evidence on a specific focused research question. If there are sufficient studies to synthesize (~10) it is possible to combine the data to make a stronger conclusion. Remember that these studies are limited by what is currently available i.e., bad existing data, bad review/meta-analysis.
- Prospective studies
- Randomized control trials
Popular PM&R Journals