The One Thing You Must Learn Before Going To Medical School

As a medical student in today’s world of 2015, being competent in academic success is not sufficient. Sure, it is definitely a big part of it, but certainly not the only part. Applicants entering medical school today contribute a host of different experiences, whether it is through involvement in student organizations, community service endeavors, or leadership opportunities.

However, the one avenue that is becoming increasingly prominent and will likely become indispensable as we move forward is research.

Looking across the major universities around the world, undergraduate students are taking an interest in doing some form of lab-based research during the course of obtaining their bachelor’s degree. By exposing themselves to hands-on work in a lab or clinical setting, students push themselves to learn the ins and outs of medical research. However, before one delves into this elite process of scientific investigation, it is crucial to have a fundamental and accurate understanding of what exactly research is. More precisely, how do we conduct research?

Given their relatively lower level of expertise and experience in this arena, undergraduate students often become involved in only a small segment of a project, depriving themselves of the chance to recognize and learn from the whole study, how everything started, and the way in which everything came together in the end.

This is where medical statistics comes in. Now let me start by clarifying a major misconception. When I say these two words – medical statistics – people have a tendency to directly jump to the assumption that I am talking about samples, normal distributions, p values, and t tests. And I am talking about this. However, before we can fully understand what these terms mean and how they can be applied to research, we first need to understand how research is conducted. What is the study design? Is it a valid one? Can realistic conclusions be drawn from it? How can it be improved? This is the essence of medical statistics – understanding how a study is designed and whether the results are applicable.

For someone who is just starting their journey in the field of medical research, it is important to begin with the right tools. While you may be years away from designing your own study, these concepts of study design help you with evaluating projects conducted by others. Considering the wealth of information published in peer-reviewed journals everyday, a systematic approach is warranted.

Some questions to ponder:

What do you want to study? Is it clinically relevant or just interesting?

First off, you need to determine what topic you want to study. This can be determined based on a topic of interest (or a PI’s topic of interest). Additionally, is it a question that can address a clinical problem in a realistic manner? A topic can be interesting, but if it does not relate to a significant issue, the scientific community will likely receive it poorly. For instance, studying the effect of grapes on Alzheimer’s disease may sound interesting, but not particularly relevant. However, trying to explore the physiological basis behind certain minerals on improving the prognosis of Alzheimer’s disease is both interesting and, more importantly, relevant.

What kind of work has been done in the field?

This relates across various different areas. You can look at how long this topic has been discussed in the medical community, how often articles on it have been cited in peer-reviewed journals, and the current hot questions surrounding the topic. Essentially, you don’t want to conduct a study on a question that has already been sufficiently answered.

What will the study design be?

This is the most crucial component that consists of several different components. A study design can be approached with tools such as sample size, population size, generalizability, and validity.

As it is physically and financially unfeasible to include the whole population as your group of subjects, you need to pick a randomized, representative sample that is large enough for you to be able to generalize your findings to the whole population. Furthermore, for prospective randomized studies, the methods have to be structured in order to ensure that the central question is being addressed in the most unbiased and systematic manner possible. One develops a sense for judging this over time and experience.

Additionally, you want to project potential sources of error and account for those to the best possible degree. This can be due to confounding variables that may be influencing your results or just random occurrences beyond your control.

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Setting up the right study design from the start ensures that the results can be trusted. Rather than aiming for a significant p value (as believed by a majority of students), think about the value itself in the context of the study. All the components work together to produce results, each contributing its part in order to make the whole.

As you move forward into medical school and beyond, try to stick by these fundamental concepts as you ingrain more information in the form of evidence-based medicine into your clinical practice. Research is the core of medical growth and it is not going away anytime soon. So we might as well roll up our sleeves and get to work, whether it is at our lab benches or at the patient’s bedside.

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