"Tell me about your research" Example 2 of 2 - research survey

In the last post, I shared with you the interview exchange between an applicant and the interviewer about her public health research project. In this post, let us look at another applicant [AK] who very enthusiastically shares with me [Dr Ed], in an online practice interview, his research survey that he completed before applying for residency.

Pay careful attention to how he describes the research methods, findings and how he did not settle for just data collection, but moved the project forward to the point of abstract submission in an attempt to present at the largest diabetes conference. Also, have a look at the time-frame when he was able to accomplish all this as it gives you valuable practical information.  Let us start... (Note: Personal information has been withheld to protect the identity of the applicant).

***

Dr. Ed: You indicated in your research experience that you were at __ University doing research in diabetes. Can you describe the research study to me?

AK: Certainly. When I was in (city) staying with my family preparing for Step 2 CS and Step 3, I worked as a research assistant in the Endocrinology division at __ University. The diabetes clinic was situated in downtown __.  I started the research work in May of this year. Dr.__, with whom I worked the most, had created a survey on patient knowledge of diabetes. My role was to survey the patients in the waiting area of the diabetes clinic.

It was a busy place and I was able to survey 106 patients for the study. The questions focused on patient's understanding of what a hemoglobin A1c is, what is the target A1c and what was their recent A1c as far as the patient could tell. After I completed the data collection by the end of August, Dr.__ showed me how to do a basic SPSS analysis. We found that half of the diabetic patients had no clue to what an A1c was, a quarter of the patients heard of the A1c but did not know the target A1c and another quarter knew what an A1c was and their A1c target. We took this one step further, pulled every patient's A1c from the medical records and worked with the biostatistician to look for a relation between knowledge of the target A1c and their actual A1c value. The most interesting finding was a statistically significant trend between a greater knowledge of A1c and a lower patient A1c, that is, a higher patient awareness of the target A1c was associated with better glycemic control in diabetes. I wrote the abstract for this study as the first author and we plan to submit the abstract for oral presentation at the American Diabetes Association conference.[AK then shows me a printout of these findings with a pie chart and bar graph]

Dr. Ed: Very interesting. How do you explain that better awareness of the target A1c led to improved diabetes control?

AK: Our study was not really designed to answer that question and so we could only report the association.

Dr. Ed: Right, right. You used the word 'associated' and not 'caused'.

AK: Yes, we discussed a few possible explanations. Patient knowledge of target A1c, to me, could mean that the person is educated and motivated to take better care of himself or herself and thus may make healthy lifestyle changes such as healthy food choices, close monitoring of the blood sugars, following up with the physicians or working with the diabetes educator.  These are some of the possible reasons for our findings.

Dr. Ed: Right, that's possible. What was the demographics of the patients you surveyed?

AK: The average age was 64 years. Most of the patients were of African - American ethnicity with low socioeconomic status and low educational status.

Dr. Ed: What do you plan to do next with this data?

AK: I wrote the abstract as the first author and I am waiting to hear back from the co-authors. Dr.__ encouraged me to submit it to ADA for oral presentation and I will be very curious to see the response. If it does get accepted at ADA, I will then work on the powerpoint slides or poster. I am interested to learn how to write the manuscript and do realize that its a steep learning curve. With the help and support of the research team, I believe I will be able to complete a first draft by the time I start residency.

Dr. Ed: Did you also look at blood pressure in this study? That is, if knowledge of their blood pressure target led to improved blood pressure control?

AK: In our study, we did not find that knowledge of blood pressure target was associated with better blood pressure control. Dr.__ was very keen on studying this. I saw patients with her in the diabetes clinic as part of my observership and she would ask the patients about their goal blood pressure. It was fascinating to watch some patients who knew their blood pressure target were not happy if their blood pressure was 150/90. She has written about 'physician inertia' and that if patients know enough about their medical condition, they may question the doctor on how they could do better and thus overcome the 'physician inertia'.

Dr. Ed: This certainly sounds like a very talented team of researchers.

AK: Yes, I feel very fortunate to be a research assistant in this endocrinology division. I gained very valuable first hand experience in survey design, conducting the patient interviews, learning analysis on SPSS and presenting the data to the division.

Dr. Ed: Great! Let's move on and see if you have any questions for me?

***

Again, you will see that the applicant did an excellent job describing his research study concisely, had a deliverable (printout of the important data with pie chart and bar graph), and fielded followup questions thus demonstrating his ability to critically think and know the ins and outs of his project.

Preparing yourself for the interview by a careful reflection of your learning experiences, as in this interview exchange, can certainly improve your performance on the interview day and increase your chances of being ranked high by the residency program.

Check out ed4medus.com and learn how personalized services such as online practice interviews can help you in your goal to a US residency program. 

Before you go: Here's your golden opportunity to have your voice heard! I am working on some of the questions that you asked (including this topic). But I need more questions!

Write down your ONE question regarding your US residency program application, personal statement, interviews or anything that has been bothering you and keeping you up at night. You can reply at the end of this post or message at my Facebook page or email me at varun@ed4medus.com

The top 10 popular questions will be featured on my next blog posts at https://ed4medllc.blogspot.com/ and the winners will receive a coupon each for a FREE practice interview at Ed4medus.com ! Put those thinking caps on and hurry up!

Photo credit for images in blog post: https://weillcornell.org/sites/default/files/clinical_service_images/c_endocrinology_and_diabetes.jpg
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"Tell me about your research" Example 1 of 2 - a public health project

Here are excerpts from an online interview that I recently conducted at Ed4MedUS.com. The applicant is an IMG from India [SS], where she talks about her research project during medical school.  Look carefully at how she describes her study, the choice of words by the applicant and follow-up questions by me [Dr Ed, the interviewer].

To me, this is an exemplary way of presenting your research study, even if you feel that 'your project is not great'. This post is the first in the series of 2 posts. In the 2nd post, I will describe the conversation about another research project that was completed prior to the applicant’s residency application.

Dr. Ed: I see on your application that you have done some research in med school. Can you describe your research experience?

SS: Yes, I would be glad to. In my third year of medical school, I performed a research survey with the guidance of my professor of community medicine. This was a cross-sectional study, where we wanted to explore the knowledge and practices of waste management in a rural area in Kerala, India.  You may have heard of Kerala in India being 'God's own country' but there are many villages in this state. I and four medical students formed a team and we created a survey. We approached 450 households over one and half years where he went to each house in our assigned area of survey and asked the head of the household about demographics, socioeconomic status and education. We then asked a list of questions about waste management that is how were the families handling biodegradable wastes, plastic, electronic and glass materials. We had some very interesting findings and some findings that were concerning.

Dr Ed: Go on. {Following image comes to mind}

SS: Almost all the houses that we surveyed in the village were finished houses and had a toilet. We found that about two-thirds of the households did not practice safe handling of biodegradable wastes and half of the homes did not handle plastic wastes appropriately. Interestingly, three-fourths of the homes handled electronic wastes well by discarding batteries, toys and devices through a collection service.  I worked with my colleagues entering the data into an excel file and then we took the help of our professor in doing an SPSS analysis. What was interesting and concerning at the same time is that the waste management practices did not appear different based on educational or socioeconomic status, that is, it did not matter whether the head of the household was educated up to 10th standard or had higher education and whether they were above or below the poverty line.

This study really made me realize that we need to do a better job educating the public on waste management. Incentives for use of technology such as a bio-gas plant or a compost pit located far from a water source may improve waste management practices and reduce pollution. The study helped me learn the importance of careful data collection, timely recording in an excel, SPSS analysis, presenting the data and writing the report.

Dr Ed: Very nice. Is there any similar data available?

SS: I did a literature search and there is very limited data from India. In fact, one study found even worse, that is 90% of households disposing solid wastes inappropriately.

Dr Ed: What should be done next?

SS: The effect of an intervention on waste management practices, such as improving public awareness, should be studied. For example, there is a public health mission going on in India called 'Swachch Bharat' that aims to increasing people's awareness and motivating them to keep their environment clean.

Dr Ed: If you had to redesign the study and had all the resources in the world to do research, what would you do?

SS: [after thinking briefly] I would test the level of pollution in the air and water and study the effect of an educational intervention and an incentive program where each household is rewarded to turn in all the wastes appropriately. I would study the effect of this intervention by retesting the air and water and show a decreased level of pollution.

Dr Ed: Interesting. How will this research experience help you in the future?

SS: The study makes me more aware of how there could be a problem with management of biomedical wastes. For example, when I was observing in Oregon Health Science University, I was concerned about the medication changes and wondered if a patient had a 90-day supply of a medicine and the doctor then changed the medicine due to intolerance, then how would the patient dispose of those unused tablets. If they cannot return the medicines to the medical store, are they dumping it in the toilet? I was glad to see separate medication bins to dispose unused medicines. Also, I visited the local library when I went to visit my cousin and saw prepaid envelopes to mail unused medicines. I did some more reading and found that these medicines are then burned to reduce pollution and prevent damage to water life.

Dr Ed: Uh-huh...

SS: Also when I was rotating in nephrology in Oregon, the attending I rounded with had concerns about the amount of waste generated in dialysis such as water waste, plastic tubes, dialyzer waste, blood waste. We discussed papers where some nephrologists are trying to make dialysis less harmful to the environment. I feel this would be a great quality improvement project in the future.


Dr Ed: Are you going to do this improvement project in residency?

SS: I am not sure about a nephrology project, but in internal medicine residency, I would like to survey the patients and find out what they are doing with their bottles of medicines after the doctor asks them to stop the medicines.  For example, when I was rounding in nephrology, I saw that dialysis patients need to take a lot of phosphorus binders. If a dialysis patient is prescribed calcium carbonate 1 tablet 3 times a day with meals, then a 90-day supply means 270 tablets. What happens if after 2 weeks of taking the calcium, the patient has an intolerance to the binder? I would really find this topic to be very interesting and a quality improvement project that could be completed.

Dr Ed: What else did you learn from your research project?

SS: This research project taught me a lot about how important it is to carefully plan every step right from the survey questionnaire, the visits, data collection and storage in excel. My skills in working in a team of medical students, working to finish the assigned work and helping each other out allowed us to complete the study. The project also improved my skills of organizing and presenting data in a form that is easy to understand and with the help of tables and bar graphs. I also learned to collaborate with a biostatistician for the analysis and doing a literature search. As this was a teamwork, we all had different pieces of the report to write and thanks to our perseverance, I am glad that the report turned out very well.

Dr Ed: Did you get any award for this study?

SS: No, I did not. And I am fine with that as my goal was not really to compete with other teams, but to learn the research skills and do more research or quality improvement projects in the future.

Dr Ed: OK, let's move on to the clinical side of things.....

___

You will see that the applicant has done a marvelous job of describing her research project very concisely and demonstrated the ability to critically assess how this helped her be a better physician even if her future goals (or research efforts) are very different from her medical school project. She demonstrated presence of mind by very satisfactorily answering the questions that followed the results of her project.

Preparing yourself for the interview by a careful reflection of your experiences, as in this interview exchange, goes a long long way in improving your chances of being ranked high by the residency program.

Before you go: Here's your golden opportunity to have your voice heard! Write down your ONE question regarding your US residency program application, personal statement, interviews or anything that has been bothering you and keeping you up at night. You can reply at the end of this post or message at my Facebook page or email me at varun@ed4medus.com

The top 10 popular questions will be featured on my next blog posts at https://ed4medllc.blogspot.com/ and the winners will receive a coupon each for a FREE practice interview at Ed4medus.com ! Put those thinking caps on and hurry up!

Photo credit for image on top of post: https://elearningindustry.com/wp-content/uploads/2015/11/10-online-research-tools-every-online-learner-know.jpg
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