Being Successful with Family Medicine Residency Research: Lessons Learned from Others

The American Academy of Family Physicians and the Program Requirements for Residency Education in Family Practice acknowledge the importance of research during residency training.¹ The Accreditation Council for Graduate Medical Education requires formal scholarly activity to occur in residency programs through their core competencies of medical knowledge, practice-based learning and improvement, and systems-based practice. Finally, Stange et al² recommend that the generation of relevant knowledge should be supported through incorporating the pursuit of new knowledge as a central feature of training programs and policy.

Despite these recommendations, Mainous and colleagues³ found that research appears to have a minor role in academic family medicine. Of a potential rating of 5, research was ranked fourth in a survey of chairs of institutional members of the Association of Departments of Family Medicine. Approximately 10 peer-reviewed articles per year were published per department. Departments in less intense institutions published a median of 0.7 articles, whereas those in research-intense institutions published 0.5 (P = .30).

Although research is often included in the residency curriculum, it is not always a required component. In a survey of family practice residency program directors, Neale⁴ found that 48.6% of respondents reported requiring a resident research project, but only one fourth linked annual resident promotion to progress on the project. The top 2 reasons for requiring resident research were to develop critical thinking and patient care skills and to understand the medical literature. The top 2 reasons for not requiring resident research were the attitude that research isn’t necessary and lack of faculty or time.

Residency programs can further integrate research into their curriculum and make scholarly activity a priority. Residency directors model research behavior and should look to successful researchers as they develop their curriculum. Gonzales et al⁵ noted several key elements of a successful research program for medical students. A development program (eg, the Family Medicine Scholars Program), financial support for student research, a core of faculty mentors, a strong coordinating effort by the predoctoral office, and research agendas geared to student schedules increased the number of students involved in primary care research, presentations, and publication.

In a survey of community residency faculty and nonfaculty family physicians who published at least 1 article during a 2-year period, Hueston and Mainous⁶ found that 60% of community faculty and nonfaculty family physicians reported previous research experience in the undergraduate, medical school, or residency level. The respondents noted several keys to their success: a mentor, a supportive infrastructure, and an inherent enjoyment of research. Interestingly, research training received during residency was evaluated as poor.

In a follow-up interview, Dr. Hueston said curiosity is a key element in being a successful researcher. “While some people are just born curious, I think we can train our learners to be curious through modeling traits, such as the reliance on evidence-based information and challenging expert opinions, that should be part of the approach of any successful teacher.”

On a cautionary note, Dr. Hueston notes that “the mistake that most people make in choosing a research topic is biting off more than they can swallow. Usually, residents have to hone down their initial idea into smaller component projects that are essential to finding out the answer and, more importantly, are feasible.”

Family medicine programs should be able to learn from lessons of successful researchers as they further implement research into the curriculum. To be successful, the programs need to have research as a priority. As noted by Stange et al, “we cannot let the competing demands and threats of the current environment dissuade us; they make the need and opportunity even stronger.”

Peter J. Carek, MD, MS

Member, Board of Directors, AFPRD

AFPRD Representative, Research Subcommittee

Academic Family Medicine Organizations (AFMO)

• © 2003 Annals of Family Medicine, Inc.