What will it take? Pathways, time and funding: Australian medical students' perspective on clinician-scientist training

From hesitation to participation: a narrative review of facilitators and barriers for healthcare professionals' engagement in medical education research

BACKGROUND

Medical education research plays a critical role in improving patient care and advancing medical practices, yet the engagement among healthcare professionals remains limited. This study aims to explore the factors that influence participation in medical education research and provide recommendations to foster a research-inclusive culture within healthcare institutions.

METHODS

A comprehensive literature review was conducted across four databases: Web of Science, MEDLINE, Scopus, and Airiti Library. The search focused on studies published between 2002 and 2024, utilizing keywords related to 'medical education research,' facilitate,' 'engage,' and 'involve'. The initial search yielded 814 records. After removing duplicates and conducting a thorough screening process based on predefined inclusion and exclusion criteria, eight studies were selected for in-depth analysis. These studies were evaluated to identify key facilitators and barriers that influence research participation among healthcare professionals.

RESULTS

The analysis, guided by the Ecological Model, revealed a complex interplay of facilitators and barriers affecting research engagement. At the individual level, opportunities for professional development and career advancement emerged as significant facilitators. The interpersonal level highlighted the importance of leadership, mentorship, and peer support in fostering engagement. The environmental level, including institutional policies, funding availability, and protected research time, were identified as critical influences on participation.

CONCLUSIONS

The findings suggest that a holistic approach is needed to promote participation in medical education research, addressing factors at the individual, interpersonal and environmental levels. Recommendations include developing targeted strategies to improve intrinsic motivation among healthcare professionals, strengthening mentorship and peer support programs, and implementing supportive institutional policies that allocate dedicated research time and secure financial resources. By fostering a culture that values and facilitates medical education research, healthcare institutions can drive innovation in medical education, ultimately enhancing the quality of patient care and safety.

Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals

Importance

There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.

Objective

To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.

Design, Setting, and Participants

This retrospective cohort study of patients admitted to general medicine at 28 hospitals in Ontario, Canada, was conducted between April 2015 and December 2021. All patients admitted to or discharged from general medicine during the study period who were older than 18 years were included. Data analysis occurred between February 2023 and June 2024.

Exposures

Patient admission to a general medicine inpatient service at an academic or community hospital.

Main Outcomes and Measures

Demographic and clinical characteristics (age, sex, modified Laboratory-based Acute Physiology Score [mLAPS], discharge diagnosis, Charlson Comorbidity Index, frailty risk score, and disability), social factors (neighborhood-level markers of income, material deprivation, immigrant status, and racial and ethnic minority status) and clinical outcomes and processes (patient volume per physician, in-hospital mortality, length of stay, readmission rates, and intensive care unit [ICU] admission rates).

Results

There were 947 070 admissions, including 609 696 at 17 community hospitals (median [IQR] age, 73 [58-84] years) and 337 374 at 11 academic hospitals (median [IQR] age, 70 [56-82] years). Baseline clinical characteristics were similar at community and academic hospitals, including female sex (307 381 [50.4%] vs 168 033 [49.8%]; standardized mean difference [SMD] = 0.012), median (IQR) mLAPS (21 [11-36] vs 21 [10-34]; SMD = 0.001), and Charlson Comorbidity Index score of 2 or greater (182 171 [29.9%] vs 105 502 [31.3%]; SMD = 0.038). Social characteristics, including income, education, and neighborhood proportion of racial and ethnic minority and immigrant residents were also similar. The number of unique discharge diagnoses was similar at academic and community hospitals. Patient volumes per attending physician were higher at academic hospitals (median [IQR] daily census, 20 [19-22] vs 17 [15-19]; SMD = 1.086). After multivariable regression adjusting for baseline factors, mortality (adjusted odds ratio [aOR], 0.96; 95% CI, 0.78 to 1.17), ICU admission rate (aOR, 1.20; 95% CI, 0.80 to 1.79) and length of stay (β =  -0.001; 95% CI, -0.10 to 0.10) were not significantly different, while 7-day readmission (aOR, 1.25; 95% CI, 1.10 to 1.43) and 30-day readmission (aOR, 1.25; 95% CI, 1.10 to 1.42) were significantly higher at academic hospitals than community hospitals.

Conclusions and Relevance

In this cohort study, patients admitted to general medicine at academic and community hospitals had similar baseline clinical characteristics and generally similar clinical outcomes, with greater readmission rates in academic hospitals. These findings suggest that the patient case mix in general internal medicine that trainees would be exposed to during their residency training at academic hospitals is largely representative of the case mix they would encounter at community hospitals, and has important implications for health services planning and funding.

Comparative analysis of factors and barriers intervening in research participation among romanian and international medical graduates from one romanian medical faculty across three generations

OBJECTIVES

This study focuses on the factors that encouraged engagement in research activities, as well as the barriers that restricted their involvement, until the final year of study at Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Faculty of Medicine. The main objectives of this study are to investigate potential disparities in research culture and student engagement in various research opportunities between Romanian and international medical graduates, as well as to conduct an examination of the observed patterns across various graduating years (2021-2023).

MATERIALS AND METHODS

A cross-sectional investigation was conducted among graduate students of the Faculty of Medicine at the Iuliu Hațieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania. From 2021 to 2023, all graduate students from the Romanian and international programs of the faculty were asked to participate in the study by filling out an anonymous online questionnaire. The final sample included 572 participants, of whom 392 were students from the Romanian section and 180 were students from international programs.

RESULTS

Motivation and personal interest drive research engagement, according to over half of graduates. For over one-third of graduates, institutional elements like financial support and education also play a major role, as does the desire to enhance their curriculum vitae. More than 25% of graduates value community influence, 70% of graduates attended medical congresses, 12-15% presented papers at medical conferences, 23% wrote medical articles, 10-15% published at least one scientific paper in medical journals, and 20% participated in medical school research projects. Comparative analysis showed that Romanian students start research earlier, attend more medical conferences, present posters, collect data for studies, and are more interested in publishing graduation thesis data in scientific journals. To encourage international students to participate in research, the study found that colleagues' examples were more important, and both time and funds were key barriers. The research also shows that 2022 and 2023 graduates will organize more scientific conferences. According to the study, 2022 graduates began their research earlier than others.

CONCLUSIONS

To increase student engagement in research activities, medical schools should prioritize the promotion of positive factors, minimize common barriers, offer customized support and resources, encourage collaborative research activities, and facilitate cross-cultural learning.

Challenges for trainee physician-scientists during their PhD candidature: a cross-sectional study

BACKGROUND

Physician-scientists are important drivers of research, in both knowledge acquisition and research translation. In Australia, many newly qualified physicians and advanced physician trainees enrol in PhD studies, with a view to training as physician-scientists. However, data on perceived challenges and ways to support them are limited.

METHODS

This single-centre study surveyed trainee physician-scientists undertaking PhD studies within the Monash University Department of Medicine in 2020. Following discussions with PhD students and a qualitative written questionnaire, trainee physician-scientists were invited to complete a quantitative survey that aimed to identify current and future career challenges and determine the type of enrichment and support mechanisms they value most and would most likely use.

RESULTS

From 45 eligible participants, 25 responses were received (76% female). Participants identified multiple substantial challenges (median of 6) during their candidature relating to their project, changes in roles and their personal lives. They also envisaged future challenges post-PhD in establishing themselves as an independent investigator, further changes in their identity and their personal lives. Of potential support mechanisms during their candidature, a mentoring program was the most favoured, with an online discussion forum being the least popular.

CONCLUSIONS

Trainee physician-scientists report multiple challenges during their PhD candidature and envisage significant challenges in establishing their research independence after PhD completion. They valued several potential support mechanisms, particularly a mentoring program. Australian universities and their associated academic health services should consider establishing programs to support trainee physician-scientists.

What are the chances? Clinician scientist` career pathways in Germany

BACKGROUND

Germany faces a lack of clinician scientists. This problem is widely acknowledged, not just in Germany, as clinician scientists are crucial for medical translation and innovation: trained in medical practice and research they are capable of translating scientific problems into clinical application and vice versa, clinical problems into research. The implementation of nationwide clinician scientist programs (CSPs) in Germany is supposed to solve the lack of trained clinician scientists and, as consequence, to improve the translational relationship between biomedical research and clinical practice. Against the backdrop of an increasing number of CSPs, our study provides early insights into their effectiveness with a focus on what it means to become a clinician scientist and to establish a subsequent career path as a clinician scientist in Germany.

METHODS

During a research project that was conducted from 2020 to 2023 and funded by the German Federal Ministry of Education and Research, we studied thirteen CSPs. We developed a qualitative questionnaire and interviewed 36 clinician scientists in training, their program supervisors, as well as policy stakeholders. The goal of the interviews was to identify the key obstacles in establishing a career path for clinician scientists in Germany.

RESULTS

We found three types of challenges for establishing and ensuring long term career paths for clinician scientists: First, local working conditions need to allow for clinician scientists to create and perform tasks that combine research, teaching, patient care and translation synergistically. Protection from the urgency of patient care and from metrics-based performance measures both in the clinic and in research seem key here. Second, a stable career path requires new target positions besides clinic management and senior residency. Third, there is a need for cultural change within university medicine that recognizes and rewards new translation-focused practices.

CONCLUSION

We find that CSPs improve working conditions for the duration of the program and provide protected time for doing research. After the programs, however, the career paths remain unstable, mainly due to a lack of target positions for clinician scientists. CSPs support the initial development of the clinician scientist' role, but not in a sustainable way, because the separation of research and patient care is stabilized on an institutional and systemic level. The tasks clinician scientists perform in research remain separate from patient care and teaching, thus, limiting their translational potential. In order to remain a clinician scientist within this differentiated system of university medicine, clinician scientists have to do a significant amount of extra work.

One size does not fit all: an exploratory interview study on how translational researchers navigate the current academic reward system

Introduction

Translational research is a subfield of the biomedical life sciences that focuses on clinically driven healthcare innovations. The workforce of this subfield, i.e., translational researchers, are diversely specialized and collaborate with a multitude of stakeholders from diverse disciplines in and outside academia in order to navigate the complex path of translating unmet clinical needs into research questions and ultimately into advancements for patient care. Translational researchers have varying responsibilities in the clinical, educational, and research domains requiring them to split their time two- or three-ways. Working between these domains and alongside peers who do not split their time as such, raises questions about the academic reward system used to recognize their performance, which mainly focuses on publication metrics within the research domain. What is unclear is how combining research tasks with tasks in the clinical and/or educational domains effects translational researchers and how they navigate the academic reward system.

Methods

In this exploratory interview study, semi-structured interviews were conducted to gain a deeper understanding of the current academic reward system for translational researchers. Stratified purposeful sampling was used to recruit 14 translational researchers from varying countries, subspecialties, and career stages. The interviews were coded after data collection was complete and arranged into three overarching result categories: intrinsic motivation, extrinsic factors, and ideal academic reward system and advice.

Results

We found that these 14 translational researchers were intrinsically motivated to achieve their translational goals while working in settings where clinical work was reported to take priority over teaching which in turn took priority over time for research. However, it is the latter that was explained to be essential in the academic reward system which currently measures scientific impact largely based on publications metrics.

Conclusion

In this study, translational researchers were asked about their thoughts regarding the current academic reward system. Participants shared possible structural improvements and ideas for specialized support on an individual, institutional, and also international level. Their recommendations focused on acknowledging all aspects of their work and led to the conclusion that traditional quantitative academic reward metrics do not fully align with their translational goals.

Analysing the Impact of an Elective Research Experience on Medical Students' Research Perceptions

INTRODUCTION

Physicians are at the centre of bench-to-bedside research, yet the number of physicians engaging in research is declining. One solution to overcome this alarming trend is exposing medical students to research. This study aims to assess the impact of engaging medical students in research, and the feasibility of conducting research solely using online communication.

METHODS

A pilot elective research opportunity was offered to medical students enrolled to the University of Malta Doctor of Medicine and Surgery course by a resident academic (summer 2021) of the same institute to assess the epidemiology of COVID-19 in Europe. An anonymous survey was distributed to seventy medical students recruited to participate in this elective research project. The data collected was analysed and interpreted.

RESULTS

A response rate of 88.73% was achieved. "Career progression" and "lack of time" were the most reported motivating and hindering factors towards conducting research, respectively, before engaging in a research experience. Research experience helped overcome reported barriers (p < 0.01), while also challenging students' perceptions towards research. An increase in positive perceptions towards research was observed after conducting research. An overwhelming majority (90.47%) of participants reported that mentorship played an influential role in their overall experience, and 95.24% commented that they would like research opportunities to be made available by their faculty.

DISCUSSION AND CONCLUSION

Giving students the opportunity to conduct research demonstrated how research experience improves students' soft skills and the understanding of research. This study also portrayed how remote research opportunities are effective in engaging students and increased the number of students who would consider a career in research.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-023-01727-w.

Are We Scared of Clinical Trials if Not Sufficiently Informed and Educated?

PURPOSE

Educational interventions have already been shown to positively affect awareness of clinical trials (CTs) among medical students. We aimed to explore basic knowledge and attitudes about CTs among medical students in terms of educational interventions that should be reflected in their further involvement in performing CTs and their role in raising awareness about CTs.

METHODS

This cross-sectional, self-report anonymous online survey involved undergraduate medical students of the Medical Faculty University of Sarajevo enrolled in classes held within the Department of Pharmacology and Toxicology in the academic year 2015-2016. To include all accessible subjects for better representation of the whole population, consecutive sampling was applied.

RESULTS

Among 142 students who completed questionnaire, 50% of them expressed partial or full agreement with the questionnaire statement that they were satisfied with the available information on CTs. Only 38% said they would participate in a CT, 21% would not, while 41% were not sure. Positive correlations were detected for composite subscale scores of agreement with questionnaire statements conveying the student's knowledge about ethical and legal aspects of CTs and their perception about reliability/integrity and impact of CTs on medical practice.

CONCLUSION

Students have knowledge of the basic design and ethical aspects of CTs. Positive attitudes toward the impact of CTs on medical practice were shown in students of higher years of study, where educational intervention of additional knowledge of CTs was inserted and those students expressed better knowledge of CTs. However, no significant impact was detected between knowledge and willingness to participate in CTs, irrespective of years of study, reflecting the third of students that would participate in CTs. Changes in medical curricula led to the change in students' knowledge and attitudes regarding CTs as well as their involvement in CTs.

A global view of the aspiring physician-scientist

Physician-scientists have epitomized the blending of deep, rigorous impactful curiosity with broad attention to human health for centuries. While we aspire to prepare all physicians with an appreciation for these skills, those who apply them to push the understanding of the boundaries of human physiology and disease, to advance treatments, and to increase our knowledge base in the arena of human health can fulfill an essential space for our society, economies, and overall well-being. Working arm in arm with basic and translational scientists as well as expert clinicians, as peers in both groups, this career additionally serves as a bridge to facilitate the pace and direction of research that ultimately impacts health. Globally, there are remarkable similarities in challenges in this career path, and in the approaches employed to overcome them. Herein, we review how different countries train physician-scientists and suggest strategies to further bolster this career path.

Establishing CREATE: lessons learned in setting up a training environment for early-career researchers in respiratory medicine

BACKGROUND

The purpose of the National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis (CRE-PF) is to improve and extend the lives of patients living with pulmonary fibrosis through the development of a comprehensive and integrated program of basic and clinical research and education across Australia. A key objective of the CRE-PF was establishment of a unique national training scheme, CREATE, for early-career researchers (ECRs) in respiratory research. CREATE ECRs are broadly drawn from two main fields of researchers: clinicians and scientists, where clinicians tend to be involved in part-time translational research and scientists are involved in broad scientific research including laboratory or genetic research, health economics or population research.

METHODS

We describe the CREATE Program which, with limited budget and the assistance of key organisations, has provided funding opportunities (scholarships, fellowships, prizes, travel and collaboration grants), professional development (mentoring program, symposia, presentation opportunities and on-line training) and fostered a connected, supportive research community for respiratory ECRs.

RESULTS

The CREATE program has successfully fostered the development of the supported researchers, contributing substantially to the future of pulmonary fibrosis research in Australia. During the life of the program the CRE-PF has offered 10 PhD scholarships and five postdoctoral fellowships, awarded 13 travel grants and three grants to promote collaboration between ECRs from different institutes. A mentoring program has been established and CREATE Symposia have been held in association with key meetings. During COVID-19 restrictions, a series of virtual research meetings has offered 12 CREATE ECRs from seven universities the opportunity to present their research to a national audience. CREATE research-related achievements are impressive, including over 80 first-author publications by ECRs, and many conference presentations. Contributions to the research community, measured by committee membership, is also strong.

CONCLUSIONS

In spite of a very limited budget, wide geographic distribution of participants and the multi-disciplinary nature of the cohort, we have succeeded in providing a unique, supportive academic development environment for CREATE ECRs. Lessons learned in the process of developing this program include the importance of leveraging funding, being flexible, building networks and seeking and responding to ECR input.

The experiences, attitudes and understanding of research amongst medical students at an Australian medical school

BACKGROUND

Research engagement plays an integral role in developing clinicians that practice effective, evidence-based medicine. Research participation by clinicians, however, is declining. Given the link between research during medical school and future research output, promotion of medical student research is one avenue by which this shortage can be addressed. Student research attitudes and participation in Australia are not well-documented in the literature. This study therefore aims to investigate research practices, motivators, and barriers amongst Australian medical students in order to determine whether there is a need for further integration of research within Australian medical school curriculums.

METHODS

A cross-sectional study design was used to explore research experience and attitudes, as well as the enablers and barriers to research amongst students enrolled in all years of the five-year medical course at Monash University. A questionnaire was created by combining questions from several surveys on medical student research and comprised Likert scales, multiple choice options and free-text responses assessing research experience, attitudes, motivators, and barriers.

RESULTS

Seven hundred and four respondents (69.4% female; survey response rate 36.7%) reported variable research experience and interest. Less than half of the cohort (n = 296; 44.9%) had contributed to a research project. Increasing employability for specialty training programs was the primary motivating factor (n = 345; 51.9%) for pursuing research, with only 20.5% (n = 136) citing an interest in academia as a motivator. Time constraints (n = 460; 65.3%) and uncertainty surrounding how to find research opportunities (n = 449; 63.8%) were the most common barriers to research.

CONCLUSIONS

Medical students at Monash University are interested in but have limited experience with research. Students are, however, primarily motivated by the prospect of increasing employability for specialist training; medical schools should therefore focus on encouraging intrinsic motivation for pursuing research. Greater integration of research education and opportunities within medical school curricula may also be required to provide students with the skills necessary to both pursue research and practice evidence-based medicine.

Factors Predictive of Medical Student Involvement in Research: Results from a New Zealand Institution

BACKGROUND

Previous studies have elucidated several benefits of engagement in research by medical students. The aim of the current study was to assess if any factors influenced the student's actual involvement (not mere interest) in scholarly activities during medical school.

METHODS

All medical students at the University of Otago were invited via e-mail to complete an online questionnaire. The outcome was a substantial contribution to a research project. The predictors were prior research experience, student's entry route, and planned career type. Multiple regression analysis was undertaken to control for any confounding factors influencing medical students' involvement in research.

RESULTS

Valid responses were gathered from 669 students (yielding a response rate of 44.8%). Of those, 254 students (38.3%) had engaged in one or more research activities. Students who engaged in research activities indicated a higher likelihood of future involvement in research but expressed less interest in internal medicine sub-specialties as potential future careers.

CONCLUSION

A sizeable proportion of our samples has been involved in the research. Targeting medical students not yet involved in research may necessitate additional curricular and faculty support in order to stimulate their research curiosity.

Factors impacting on retention, success and equitable participation in clinical academic careers: a scoping review and meta-thematic synthesis

OBJECTIVES

To examine and synthesise current evidence on the factors that affect recruitment, retention, participation and progression within the clinical academic pathway, focusing on equitable participation across protected characteristics including gender, ethnicity and sexual orientation.

DESIGN

Scoping review and meta-thematic synthesis.

DATA SOURCES

Web of Science, Google Scholar.

ARTICLE SELECTION

We conducted a scoping review of English language articles on factors affecting recruitment, retention, progression and equitable participation in clinical academic careers published in North America, Australasia and Western Europe between January 2005 and April 2019. The most recent and relevant 39 articles were selected for meta-thematic synthesis using detailed inclusion/exclusion criteria.

DATA EXTRACTION

The articles were purposively sampled to cover protected characteristics and career stages and coded for factors related to equitable participation. 17 articles were fully coded. No new themes arose after nine papers. Themes and higher level categories were derived through an iterative consensual process.

RESULTS

13 discrete themes of factors impacting on equitable participation were identified including societal attitudes and expectations; national and organisational policies, priorities and resourcing; academic and clinical workplace cultures; supportive, discriminatory and compensatory interpersonal behaviours and personal factors related to social capital, finances, competing priorities, confidence and ambition, and orientation to clinical, academic and leadership roles.

CONCLUSIONS

The broad and often interconnected nature of these factors suggests that interventions will need to address structural and cultural factors as well as individual needs. In addition to standard good practice on equality and diversity, we suggest that organisations provide equitable support towards early publication success and targeted mentoring; address financial and role insecurity; address the clinical workplace culture; mitigate clinical-academic-personal role conflicts and overload; ensure that promotional structures and processes encourage diverse applicants and promote family-friendly, coherent and transparent national career pathways.

Student Perceptions of M.D.-Ph.D. Programs: A Qualitative Identification of Barriers Facing Prospective M.D.-Ph.D. Applicants

Phenomenon: Despite a high degree of interest in research among matriculating M.D. students, very few apply to combined M.D.-Ph.D. training programs. Even fewer of those applicants are female, leading to a gender disparity among M.D.-Ph.D. trainees. We used a qualitative approach to understand why students choose not to apply or matriculate to M.D.-Ph.D. programs. Approach: We recruited recently matriculated medical students at a private research university with a self-reported interest in academic medicine and biomedical research to participate in focus groups, in which students discussed their career and life goals, general knowledge and sources of information for M.D.-Ph.D. programs, perceived benefits and downsides, and barriers to applying to such programs. Findings: Twenty-two students participated in focus groups. Participants desired careers combining clinical work, research, and teaching. Students had knowledge of the structure and goals of M.D.-Ph.D. training and received information about dual-degree programs from research mentors, the Internet, and peers. Tuition remission and increased grant access were cited as benefits of M.D.-Ph.D. programs, whereas duration, perceived excessive research training, and early commitment were downsides. Perceived competitiveness, misconceptions about training, a lack of M.D.-Ph.D. program-specific advising, discouragement from applying, and duration of training all served as barriers preventing students from pursuing dual-degree training. Insights: Through this qualitative study, we identified perceptions and misconceptions that recent medical school applicants have about M.D.-Ph.D. programs. These findings suggest targetable barriers to increase applications from interested students, such as improving awareness of programs, increased accessibility of advising and resources, and addressing concerns over training length, with the goal of improving training access for aspiring physician-scientists.

[Design and Evaluation of a Clinical Investigator Training for Student-lead Prospective Multicentre Clinical Trials: a CHIR-Net SIGMA Research-based Learning Project]

BACKGROUND

Scientific skills are not sufficiently taught during medical training, neither in medical school nor during postgraduate education. This results in a lack of clinician scientists. In order to counter this problem, the surgical study network (CHIR-Net) founded SIGMA (Student-initiated German Medical Audit). This paper describes the development, performance and evaluation of a Clinical Investigator Training (CIT) aiming to qualify students to autonomously conduct clinical trials.

MATERIAL AND METHODS

Based on the Kern cycle, a curriculum was developed, composed of three parts: online tutorials, a workshop and a follow-up period. The educational objectives were defined according to Bloom's taxonomy of knowledge. The learning objectives were based on the requirements of the "Network of Coordinating Centers for Clinical Trials" and the German Medical Association as well as content relevant to clinical studies. A wide range of educational instruments and assessments were used. By including all relevant professional groups involved in clinical trials, an interconnected working environment for students was generated. The increase in knowledge was assessed by a multiple-choice pre/post exam. The satisfaction of participants was analysed by a 5-point Likert scale, on which 5 indicated full approval.

RESULTS

The first SIGMA CIT was realised in 2018; the workshop took place in Heidelberg in February. Thirty-two medical students from thirteen different centres participated. On average, 53.8 ± 8.3% of questions were answered correctly in the pre-test, compared with 71.2 ± 7.2% in the post-test (p < 0.0001). The maximal individual improvement was 30%; the lowest difference compared to the pre-test was 5%. Subjective evaluation results were positive with an average result of 4.63 ± 0.34 on a 5-point Likert scale.

CONCLUSION

It is feasible to teach medical students the fundamentals of clinical trials. A compact Clinical Investigator Training using modern principles of teaching is able to prepare students for an autonomous performance of clinical trials.

Publication in a medical student journal predicts short- and long-term academic success: a matched-cohort study

BACKGROUND

Medical student journals play a critical role in promoting academic research and publishing amongst medical students, but their impact on students' future academic achievements has not been examined. We aimed to evaluate the short- and long-term effects of publication in the New Zealand Medical Student Journal (NZMSJ) through examining rates of post-graduation publication, completion of higher academic degrees, and pursuing an academic career.

METHODS

Student-authored original research publications in the NZMSJ during the period 2004-2011 were retrospectively identified. Gender-, university- and graduation year-matched controls were identified from publicly available databases in a 2:1 ratio (two controls for each student authors). Date of graduation, current clinical scope of practice, completion of higher academic degrees, and attainment of an academic position for both groups were obtained from Google searches, New Zealand graduate databases, online lists of registered doctors in New Zealand and Australia, and author affiliation information from published articles. Pre- and post-graduation PubMed®-indexed publications were identified using standardised search criteria.

RESULTS

Fifty publications authored by 49 unique students were identified. The median follow-up period after graduation was 7.0 years (range 2-12 years). Compared with controls, student-authors were significantly more likely to publish in PubMed®-indexed journals (OR 3.09, p = 0.001), obtain a PhD (OR 9.21, p = 0.004) or any higher degree (OR 2.63, p = 0.007), and attain academic positions (OR 2.90, p = 0.047) following graduation.

CONCLUSION

Publication in a medical student journal is associated with future academic achievement and contributes to develop a clinical academic workforce. Future work should aim to explore motivators and barriers associated with these findings.

Factors Influencing Decisions to Become Involved in Research: a Study of Pre-clinical Medical Students from New Zealand

BACKGROUND

The rate of medical student participation in research remains relatively low despite the number of benefits it affords. The aim of the current study was to explore the factors influencing the decision to become involved in research as it pertains to pre-clinical medical students at our institution.

METHODS

An anonymous questionnaire was handed to second and third year (i.e. pre-clinical) medical students.

RESULTS

A total of 249 students returned the completed questionnaire (response rate of 42%). A sizeable proportion of the respondents (40.2%) indicated an interest in being involved in research (e.g. ethics application, data collection or reporting of results), as medical students. Neither age nor debt-burden seemed to influence the students' interest in research. Intrinsic interests in research and career progression were cited as the main motives for involvement in scholarly activities. On the other hand, the main barriers to research participation were time and financial costs.

CONCLUSIONS

Creative solutions specifically addressing the obstacles identified by medical students are needed in order to enhance their participation in research early in their careers. Given the limitations of this study, further research is required to corroborate our findings.

Academic medicine: the continuing challenges

BACKGROUND

Numbers of academic medicine trainees have been declining internationally. Many countries have taken differing approaches to improving recruitment, with some having established pathways. In the UK, the academic foundation programme (AFP) is one such pathway aimed towards those interested in an academic medical career. Variation exists amongst universities with respect to application and success rates. As a group of AFP doctors, we aimed to explore these issues. Numbers of academic medicine trainees have been declining internationally METHODS: We created and implemented a 1-day national course, comprising lectures and small group workshops, geared towards informing applicants about the AFP. It was evaluated via pre- and post-course questionnaires using a Likert scale, ranging from 1 to 5. We created and implemented a 1-day national course, comprising lectures and small group workshops, geared towards informing applicants about the AFP RESULTS: A total of 150 attendees were present from 16 different medical schools; 95% (143/150) of the attendees filled in both questionnaires. Attendees appeared unaware of the stages involved in the application process and felt underprepared. Following the course, learners reported median scores (with interquartile limits) that demonstrated increased overall knowledge, from 2 (1) to 4 (1) (p < 0.01), and increased preparedness, from 2 (1) to 3 (1) (p < 0.01).

DISCUSSION

Our findings indicate that recruitment remains challenging, even in countries with established pathways. In the UK, the awareness of these pathways appears to be poor and courses such as ours may remedy that. Further exploration into the most effective methods to increase recruitment is necessary. The effect of institutional disparities in research culture and impact on application success needs investigation. Perhaps medical schools should introduce students to the prospect of academic careers earlier in training. Globally, efforts still need to be concentrated largely towards establishing integrated pathways.

Medical student mentoring programs: current insights

Medical school mentoring programs incorporate a wide range of objectives. Clinical mentoring programs help to develop students' clinical skills and can increase interest in under-subscribed specialties. Those that focus on teaching professionalism are integrated into medical school curriculums in order to overcome the "hidden curriculum". Positive mentoring plays a part in reversing the decline of academic medicine, by sparking interest through early research experiences. It also has an important role in encouraging recruitment of under-represented minority groups into the medical profession through widening access programs. The aim of our review of the literature, is to analyze current trends in medical student mentoring programs, taking into account their objectives, execution, and evaluation. We outline the challenges encountered, potential benefits, and key future implications for mentees, mentors, and institutions.

The clinician-scientist track: an approach addressing Australia's need for a pathway to train its future clinical academic workforce

BACKGROUND

Clinician-scientist training represents the epitome of preparation for biomedical scientific discovery. The significance of, and need for, clinician-scientists is universally recognised as essential to progress medical research across what is regarded as the 'translational gap'. Despite a rich history of cutting-edge biomedical research, Australia has no infrastructure or career pathway for training clinician-scientists.

DISCUSSION

The Clinician-scientist Track (CST) was developed to address this concern at the University of Queensland. The CST concept began in 2010 with the Concurrent MD-Masters that allowed students to undertake a research Masters concurrently with their medical program. The rationale was to offer an attractive and realistic option to recruit our highest performing students into a research higher degree, with the underlying aim of encouraging those most capable, to transfer to the MD-PhD. The Concurrent MD-Masters was immediately popular and remains so. Over 8 years, enrolments rose seven-fold (60 MD-Masters, 36 MD-PhDs). The transfer rate from MD-Masters to MD-PhD is 28% supporting our original aim.

CONCLUSIONS

Many challenges remain for the future of the program. These challenges are underpinned by a culture that values clinician-scientists as crucial to ensuring that high quality health and medical research is undertaken and translated to patient care, but lags behind in establishing an infrastructure to develop and maintain a new generation of this vital workforce. A future challenge is to develop a coordinated approach to a supported Australian MD-PhD pathway for our most talented and committed students beginning in the undergraduate Bachelor's degree into the medical degree and throughout specialty training. Shared responsibility is necessary between institutions and stakeholders to support and nurture newly trained MD-PhDs into the post-graduate years. Flexibility across this medical training continuum that allows integration of both degrees will help ensure students make the most meaningful connections between the research and the medicine. What is paramount will be acknowledging the career expectations of an emerging cohort of medical students, in particular females, wishing to pursue research. Without these considerations we risk losing our next generation of potential clinician-scientists.

Attractions and barriers to Australian physician-researcher careers

BACKGROUND

There is a global concern that physician-researchers are 'a dying breed'. Recent studies of clinical career choices of Australian medical students and doctors have signalled the rising age of medical graduates, generational shifts in work-life attitudes and increased proportion of female graduates. There are scant data regarding Australian physician-researchers.

AIMS

To develop and utilise a questionnaire determining respondent characteristics and 'push' and 'pull' factors for medical graduates to incorporate research into their careers.

METHODS

We developed and administered an 88-item online survey, including quantitative and qualitative questions, to medical students, faculty and alumni of Sydney Medical School, The University of Sydney, asking about their medical career, research experience and interest and reasons for doing or not doing medical research. Responses to all 74 quantitative questions are reported here.

RESULTS

Data from 427 respondents (44% female; mean ± standard deviation age 38 ± 13 years; 56% completed or undertaking a PhD) were analysed. Attractions of research included a desire to improve human health, intellectual stimulation and career diversity. Barriers included low funding rates, job insecurity and low salaries. Although few were prepared to undertake or recommend full-time research, 71% would recommend part-time research. Respondents perceived a smaller-than-actual gap between clinical and research salaries, and if comparable (75-100% of a clinician's) salaries were available, 89% would like to spend 21-60% of their work time undertaking research.

CONCLUSION

Many Australian medical students and doctors are interested in research, especially part time. Perceived obstacles include job insecurity, low funding rates and salary. Respondents underestimated clinical and research salary differences.