I embarked on research just after passing my MRCP in 1997, when I was doing locum posts before applying for a registrar rotation.

I saw an advertisement in the BMJ for a stroke research position at Bournemouth, leading to a Master of Philosophy (MPhil) degree from the University of Southampton. I fancied a challenge and applied for the job, although at that stage, I had no intention of going down an academic career path.

The research post originally came with a project proposal in place but this fell through, as a result of which meant I had to design and plan a research project from scratch, including performing literature searches and obtaining local ethics committee approval. I decided to perform a longitudinal study of the change in cerebral autoregulation in patients with acute ischaemic stroke. The process of designing and planning the project was novel and exciting – I particularly enjoyed dealing with the nitty-gritty elements of the protocol, organising the technology and equipment, and making use of the local expertise to improve the methodology of the study. Recruiting patients was sometimes slow and unpredictable; some weeks were very quiet and some were extremely busy with late nights and early starts. Funding came from ‘soft money’, paid out for patients recruited into clinical trials and sponsored by pharmaceutical companies.

The discipline of being your “own boss”
As a research fellow, I was essentially my ‘own boss’, with no fixed time to start or finish each day. This was great in many ways but I had to be much more organised and self-disciplined with my time management. It was easy to be organised in doing interesting activities such as screening for suitable participants for my study, but certain other tasks were less appealing, such as data management which included data collection, cleaning-up, backing-up, and analyses (and backing-up many more times!). Early consultation with a medical statistician probably saved me a great deal of time, effort, and unnecessary mistakes. One thing I learned was that one should start writing the thesis early in the project, and to write whenever there is any ‘spare’ time. Before one knows it, the research post comes to an end and one has to return to clinical work where there is little time for non-clinical activities. Luckily, I had good supervisors who ensured that I made steady progress, and I had three months of dedicated writing time to finish my MPhil thesis (I also got married and had a honeymoon in the middle of this!).

Bitten by the bug
Following the MPhil experience, I have caught the ‘academic bug’ and found myself doing another research fellowship, this time leading to a Doctor of Medicine (MD) degree in Edinburgh. I was fortunate enough to work in a very active academic unit with plenty of ongoing stroke-related research. However, I still had to design and plan my own research project, and because of the local developments at the time, I chose to study the effects of introducing a new integrated care pathway in an acute stroke unit, which turned out to be a very ‘hands-on’ and clinical project. I also gained experience in writing research grant applications and attending grant-specific interviews – this was a truly laborious task but an invaluable experience.

Free weekends to explore Scotland
Compared with the MPhil project, the MD project was more substantial, required a longer duration to complete, and generated much more data to analyse and report. A few months into the fellowship, I became a little better at multi-tasking (something which comes naturally to my wife!), including simultaneously performing a Cochrane review, planning and undertaking the research project, applying for grants, and recruiting patients into a number of clinical stroke trials and departmental research studies. I also found myself becoming involved in several ancillary projects such as a Health Technology Assessment project, entering acute patients into an ongoing stroke register, writing abstracts and articles, and tutoring final-year medical students. One saving grace was the sanity breaks in the form of free weekends throughout the two years, which were perfect for exploring Scotland!

I was really getting a taste of academic life, and I actually enjoyed it! I was glad I chose a project which involved regular contact with patients, which meant that I was able to maintain my clinical skills and communication with the other disciplines. It was also helpful to have other research fellows around so that I could have a whinge or bounce ideas off them whenever I wanted to.

Going on a medical statistics course was one of the best things I did at the beginning of the fellowship, because it helped me in the design of the project including how to handle the huge mass of data I was to gather. My two supervisors were strict, making sure that my appraisal occurred regularly, so I managed to stay on top of it all. Again, I began to write my MD thesis just after the first year of the fellowship, and I managed to finish the first draft by the time I left the post to start my registrar rotation. After this, with many late nights and a non-existent social life for a further five months, I finally completed the thesis.

For those interested in doing some research, I recommend that it is done during the registrar rotation. There are many reasons why people do research and there is no right or wrong reason. Some people want to add to the knowledge-base created by research; some want to improve their CV; and some simply want to publish. Many registrars are probably considering doing some research or just starting out, and those of us who have had some experience could help by supporting them (the BGS Research Forum is one vehicle for doing so). There are also many registrars who have no desire to do any research, but I believe there should at least be the opportunity for registrars to receive formal training in research methodology (as some deaneries provide). For those who wish to take research further (for example in the form of a postgraduate qualification), they should receive adequate support and guidance in making the right decisions and finding the appropriate research posts.

Misconceptions
There are many misconceptions about research. Some people think that it has to lead to a postgraduate degree lasting two or more years, or that it always involves little or no patient contact resulting in clinical de-skilling. I hope that the BGS Research Forum will go some way to demystify research and encourage those with an interest to take part.

Joseph Kwan
SpR in Geriatric Medicine (Wessex Deanery)