Tag: Research

Combining Clinical Practice with Research: What do I Need to Know?

I was recently asked by the BMJ to offer comments for an article advising doctors how they could improve their research skills and get involved in research. Integrating research into a clinical career offers a pathway to professional fulfilment, intellectual growth, and the opportunity to influence patient care on a broader scale.

While the prospect of balancing clinical duties with academic pursuits can be daunting due to time constraints and the need for specialised skills, there are numerous entry points available for clinicians at every stage of their career. From early-career networking and trainee-led collaborations to structured fellowships and leadership roles in national trials, the research landscape is designed to accommodate various levels of involvement. By developing core competencies, seeking out mentorship, and identifying practical questions within their own daily practice, clinicians can successfully navigate the challenges of a dual career and contribute meaningfully to the future of medicine

1. I’m early in my career. What are the first practical steps to get involved in research?

Identify a clinician or academic in your department or general practice who is active in research and ask if they have any ongoing projects where you could help. Joining a collaborative research network (like trainee-led groups) is another way to get involved in research.

2. I’m an experienced doctor—is it too late to get involved in research?

Absolutely not. Experienced clinicians can make an important contribution to research because they have a good understanding of topical clinical issues that that need addressing. For example, you can contribute to projects supported by the National Institute for Health and Care Research (NIHR). These studies often require local investigators who can help identify and recruit research participants and help with the collection of data. This can provide an entry into research as the NIHR can offer training, financial support for helping with research recruitment and the opportunity to join wider professional networks in your area.

3. I’m worried I don’t have time. How can I carve out protected time for research?

This is a key obstacle as clinicians will have busy jobs and may also be studying for professional exams in their spare time as well as having family or caring commitments. The most structured way is through NIHR-supported Integrated Academic Training (IAT) pathways like Academic Clinical Fellowships (ACFs) or Clinical Lectureships (CLs) in England). If you are not on a formal research training pathway, see if you can negotiate some research time. For example, some GP Vocational Training Schemes will allow trainees to spend a block of time in a local academic department. You can also look for an Out of Programme period to focus entirely on a project without clinical distractions.

4. What kinds of research roles are there?

Roles range from Clinical Research Fellow positions (often working toward a MSc degree or developing an application for a PhD fellowship) to Principal Investigators (leading a site for a trial). Research skills can also be learned from involvement in clinical audits o quality improvement projects. Although these are not classed as research they require similar skills in areas such as evidence synthesis, data collection, statistical analysis and writing up the results for publication in an academic journal or presentation at a conference.

5. Do I need a higher degree (MSc, MRes, MD, PhD), and when should I consider one?

You do not need a higher degree to participate in research or publish academic articles, but if you want to become an independent researcher or secure an academic position such as a clinical lectureship, a PhD or MD is needed. Consider an MSc, MPH or MRes early in your career to develop core research skills, and a PhD when you have a specific project you want to work on for a few years.

6. How can I find opportunities and funding?

Networking is essential. Attend departmental research meetings as well as local and national academic conferences. For funding, look at major bodies like the NIHR, MRC, or Wellcome Trust, as well as specialty-specific charities (e.g., British Heart Foundation). Many hospitals may also have some internal grants for small pilot projects or short-term research fellow roles.

7. How can I identify a good research question or choose an area of interest?

Look for at your daily clinical practice. Is there a treatment that doesn’t work well? A diagnostic delay you see repeatedly? Also keep up to date with the academic literature to see what research has been done and what research questions remain to be answered.

8. What skills should early-career clinicians focus on?

Knowledge of epidemiology, biostatistics and writing for publication are very helpful. Obtaining a Good Clinical Practice (GCP) certificate is also useful.

9. Will doing research impact my clinical training and career prospects?

In the longer term, research can enhance your career prospects, Furthermore, after completing specialty training, a clinical academic career can be very fulfilling professionally and reduce the stresses associated with full-time clinical work.

10. What are the positives and negatives of splitting my time?

  • Positives: Variety in your working week, the ability to influence future care for patients (rather than just the patient in front of you), intellectual stimulation and professional recognition.
  • Negatives: Being a clinical academic can sometimes feel you have two busy jobs. You have to be disciplined and ensure that the work within the clinical and research roles remains contained within the allocated time.

Why Indirect Costs on Research Grants are Essential for Universities

In recent days, there has been discussion about the “overheads” or “indirect” costs that universities add on to the cost of research projects. This has been driven by a decision by the US government to reduce the indirect costs of research on grants awarded by the US National Institutes of Health (NIH) from the current 60% to 15%. Comments from people such as Elon Musk has suggested these costs are wasteful and can therefore be easily cut from research grants. In this blog, I make the case for retaining a fair amount of indirect costs on research grants.

Without the indirect costs that universities receive on government research grants, universities would struggle to provide the essential support and infrastructure required for high-quality research to take place. While direct research costs (such as staff salaries, laboratory equipment, travel and consumables) are essential, they are only part of the funding needed. Research relies heavily on a wide array of indirect resources that ensure long-term sustainability, efficiency, and the proper functioning of universities.

Indirect costs include funding for essential services, such as maintaining research facilities and buildings, providing IT infrastructure and support, managing financial systems, and ensuring compliance through administrative and monitoring processes. Without adequate funding to cover these areas, research projects would be more difficult to complete successfully.

To address this challenge and ensure that universities receive adequate funding beyond direct project expenses, the UK government introduced the Full Economic Costs model. The Full Economic Costs model is designed to fairly and transparently allocate funding that covers the full range of costs associated with research activities.

Under this system, universities are able to recover a more realistic portion of the actual costs incurred in hosting and conducting research, helping to bridge the gap between the direct funding provided by grants and the true expenses they face. This model recognises that indirect costs, although not always visible at the project level, are vital to the successful completion and long-term sustainability of research projects.

The issue of indirect cost recovery is not unique to the UK. In the United States, for example, universities receive indirect cost reimbursements through a negotiated rate with federal agencies, but this system now also faces scrutiny over transparency and fairness. Comparisons like these highlight the importance of continually refining models such as the Full Economic Costs model to ensure they remain fair value for governments, taxpayers and universities.

The successful delivery of research projects relies on more than just securing grants for individual projects. It requires a support system that includes well-maintained buildings and other facilities, appropriate technology, efficient administrative processes, and skilled personnel; all of which are sustained by indirect funding.

Research Outputs of England’s Hospital Episode Statistics Database

Hospital administrative data, such as those provided by the Hospital Episode Statistics (HES) database in England, are increasingly being used for research and quality improvement. To date, no study has tried to quantify and examine trends in the use of HES for research purposes. We therefore examined trends in the use of HES data for research. Our study was published in the Journal of Innovation in Health Informatics.

Publications generated from the use of HES data were extracted from PubMed and analysed. Publications from 1996 to 2014 were then examined further in the Science Citation Index (SCI) of the Thompson Scientific Institute for Science Information (Web of Science) for details of research specialty area. 520 studies, categorised into 44 specialty areas, were extracted from PubMed. The review showed an increase in publications over the 18-year period with an average of 27 publications per year, however with the majority of outputs observed in the latter part of the study period. The highest number of publications was in the Health Statistics specialty area.

We concluded that the use of HES data for research is becoming more common. Increase in publications over time shows that researchers are beginning to take advantage of the potential of HES data. Although HES is a valuable database, concerns exist over the accuracy and completeness of the data entered.

DOI: http://dx.doi.org/10.14236/jhi.v24i4.949