Research

There are many reasons why doctors want to undertake research and these include a desire to understand in more detail a particular problem they have encountered in their practice, a need to demonstrate commitment to their speciality, career advancement and of course a desire to contribute new knowledge.

Forensic and legal medicine is a fertile area for research and in common with other branches of medicine has a myriad of unanswered questions that can provide the “raw material” for research projects of varying complexity. It is important to ensure that projects are evidence-based.

In order to gain the most from a research project it is vital to plan and prepare carefully before commencing work.

Guidelines for Research

Selecting a Project

This is obviously crucial and it is important to choose a topic that is realistic. Many an enthusiastic neophyte who wants to “find the cure for cancer” has approached a supervisor! It is thus sensible to have a well-circumscribed project that is practicable and not necessarily open-ended. You should have a clearly defined question to answer and develop methodology to address it.

At this stage, you should search the literature as this will enable you to determine not only whether your project has already been carried out but assuming it has not, you will be able to establish the current state of the art, and gather contemporaneous references from peer reviewed literature. This is vital, as it will subsequently enable you to discuss your research in the context of relevant previous work.

It is essential you develop an ability to evaluate the quality of research papers and be able to discriminate between good studies and poorly constructed ones. A useful paper to read is “A simple method for evaluating the clinical literature” by Robert Flaherty.

It is a good idea to run your proposal past your colleagues who may be able to support your idea or more importantly see pitfalls that you did not appreciate!

The next step is to approach an established researcher or research group with your project and discuss the viability and practicalities of carrying it out.

It may be that the project fits in with that department’s existing research but if not you could be put in touch with a group with similar interests. Alternatively, most established research groups will have a number of potential projects that they wish to pursue and it may be that you could become involved.

One of the most important considerations is that the project you choose or that is offered to you is one that will not only interest you but will continue to interest you. Research as they say is 1% inspiration and 99% perspiration!

Other Considerations

There are many practicalities and considerations that require careful thought before embarking on a research project and these will be briefly outlined.

  • Ethics
  • Statistics
  • Animal work
  • Funding
  • Writing a grant application

Ethics

If your research is going to involve patients, their tissues or genetic material you must obtain ethical approval for the project. This is mandatory. Guidance can be obtained from the Health Research Authority who operate a helpful website.

Statistics

This is a complex area and if your project for example is comparing one treatment against another you need to establish the number of subjects that need to be recruited in order to demonstrate a statistical difference. It is advisable to seek the help of a medical statistician at an early stage, as the subject numbers will obviously have implications for funding and the duration of the project. A good starting point is to contact the Department of Medical Statistics or the Clinical Trials Co-ordinator at your local medical school.

Animal Work

This is a complex and controversial area but in general three fundamental principles apply. These are:

  1. No alternative exists to animal experimentation.
  2. The expected benefits outweigh any possible adverse effects.
  3. The number of animals employed and their suffering should be kept to a minimum.

Animal research is governed by the Animal (Scientific Procedures) Act 1986 and three tiers of licence are required which are, a personal licence, a project licence and a certificate of designation.

The Home Office grants licences and regulates and inspects animal experimental work. Further details can be obtained from: www.homeoffice.gov.uk/science-research/animal-research.

Funding

Although many creditable research projects have been funded on “a shoestring”, you will need to give serious thought on how to fund the project. It may be that your hospital or practice has some “soft money” for which you can apply but for more complex projects particularly if you intend to take time out, you will require funding from various national bodies such as the MRC, NIHR, Wellcome Trust or Health Foundation. Alternatively, various charities relevant to the research you intend to carry out could be contacted for example, the British Heart Foundation or Cancer Research UK.

Writing a grant application

There is a definite art to this. Your supervisor should be able to give you some advice about it and show you a previously successful application which could act as a template for you application. Do remember that it is your application and you should have a go at completing it and then show it to your mentor.

Costs and the impact on other related departments will need to be submitted and this requires careful consideration.

A series of tips and other advice on making a grant application can be found at NINDS website.

If you have not been put off by all these considerations and want to carry out some research sketch out your project and study the information given on the links. Then approach a suitable supervisor for advice.

Professor Paul Marks, BA, LLM, MD, FRCS, MFFLM

January 2011