Types of Research

With the recent change of the COMLEX Level 1 and USMLE Step 1 exams to pass/fail, it has become increasingly important to distinguish yourself for residency applications. One such way to accomplish this can be through valuable research experiences while in medical school [1,2]. For many students, a medical school campus may offer various opportunities to participate in research. This could include connecting with faculty at your medical school, or physicians at  hospitals you may work with. Sometimes research opportunities may not be as available; however, research is still realizable, and obtaining research experiences can be valuable to a student for multiple reasons. This can include giving a competitive edge for a residency spot [2], discovering a passion for a specific field of medicine [3] or developing you into a better physician [2]. However, keep in mind that in your residency applications you are building a unique story for yourself. Find your passions and if you discover research is how you can build your story, then begin to utilize mentors, professors, and doctors to carry that out [3]. Research experiences may also be a significant talking point in residency interviews [3], so it is necessary to understand the different types of research you can take part in that can enrich your medical education.

5 Types of Research: There are 5 main types of research to get involved in: prospective clinical studies, retrospective clinical studies, bench or translational studies, case reports, and systematic reviews. There are many pros and cons to consider when deciding which type of research to get involved in. Depending on the type of research you want to do, a variety of methods can be used to carry out your project. Some types may require an IRB–forms needed to perform human research–and others might give you more or less freedom with how you want to design your project. So, let’s dive right in!

Some types of studies are defined by the timing of the research in relation to the outcome being examined. Two such studies are Prospective and Retrospective clinical studies. A Prospective clinical study is a classic study in which the outcome is unknown, and participants are followed while data is gathered [4]. An example of this would be to follow the effectiveness of a drug on a group of patients compared to a placebo. The best part of this type of study is that you can design it how you want, so there is more freedom to create this project. However, these projects generally require a research advisor or mentor for guidance, IRB applications, and may need a recruitment team for enlisting subjects to be in the study. Thus, this type of research can generally be more time-consuming because of IRB approval, or length of the project depending on the research topic. While results can be impactful, these can be more difficult projects to run as a student without research experience. So, this type of project might not be your go-to right off the bat, but is highly valued in the research world [5].

In contrast to Prospective clinical trials in which the outcome is unknown, Retrospective studies look at outcomes which have already occurred [4-6]. The investigator’s purpose in this study is to compare and contrast patient-centered, pre-recorded data to answer one or more research questions [6] An example of this is a case-control study in which cases with and without a condition of interest are identified, and the degree of exposure to a possible risk factor is then retrospectively compared between the two groups [5] Sometimes termed “chart reviews”[6], these are great projects to do as a student as they’re fairly simple and quick. The data is already available in hospital systems, and often an IRB is not needed, which can streamline the research process significantly. However, although the data is already available, it is necessary in this type of study to properly gain access to patient charts with permission from either an attending physician, hospital administrator or medical student coordinator, which could take time. Another downside to this type of study is limited variability in existing data, so it might be more difficult to end up with unique findings.

A bench or translational study is Basic Laboratory Science Research. This is another classic study that is often performed using human cells or mice to understand the function of many parts of the human body [7]. These types of projects may include working in a laboratory with cell cultures, animal studies, or physiological studies to better understand the interplay of human physiology [7,8]. These can be very meaningful projects, but can take a long time to finish as a medical student. These types of studies generally may require you to collaborate with on-campus Principal Investigators (PI’s), but are often available as summer research opportunities. These projects provide great hands-on experience, and you can end up making a significant contribution to the field. However, because hands-on experience is expected, getting trained in carrying out the project in the laboratory may take up quite a bit of time before you actually get to perform experiments. These projects may also require an application and interview process to join, which can take extra time away from the little time available as a student.

Case studies in medicine are used to generate an in-depth knowledge of a disease in its real-life context [9]. They can provide both practitioners and students alike opportunities for learning more about a certain disease, especially since the majority of clinical interactions occur in everyday patient visits [9,10]. These are great projects to do as a medical student, especially if you’re just beginning research, because they are easy to write with a very straightforward format. An IRB application is not needed in these studies, either. One downside is that they may not be weighted as heavily as other studies. It is also necessary to receive approval from your attending physician to access a patient’s chart, perform a background literature review on the disease being studied, and to recruit other co-authors, if needed. One thing to keep in mind as well is that the case should be considered an “interesting” or notably educational patient case [9]. So, while on rotations, look for unique cases that pique your interest and talk to your attending physician about writing up a case report.

A systematic review is a methodical summary of all the current literature that is available about a specific topic [11]. It is important that the methods you use are “systematic” and reproducible [11]. “Systematic” refers to a specific structured or organized method that is followed. By performing your search in a structured way, this should allow readers to be able to theoretically reproduce your results by following the steps you laid out in your paper [11]. One such method to perform this type of research is called “PRISMA”, or “Preferred Reporting Items for Systematic Reviews and Meta-analyses” [12,13]. It is essentially a checklist to be followed as you prepare your systematic review for publication. 

Systematic reviews are excellent projects to do as a medical student, and are looked at favorably for many reasons. You can learn a significant amount of information about a specific topic, and with the busy life of a medical student, it doesn’t take as much time as other projects that may require gathering data from patients or hospitals. However, without proper guidance in conducting this type of project, systematic reviews may be more time-consuming than necessary. So, it’s important to have a mentor with experience in writing reviews to guide you in the process.

Conclusion: Each of the 5 types of studies have unique differences between them. A Prospective study will examine an unknown outcome whereas a Retrospective study will draw conclusions from previous research. Bench or Translational Research will give you hands-on laboratory experience, whereas a case study will provide an in-depth look at a unique presentation of disease in a patient. Lastly, a systematic review will provide a methodical summary of the current literature on a specific topic. Every type of project is unique in its own way. It is important to keep in mind that research is completely optional, and as such, should be sought after if it is your passion [3]. Research shouldn’t just check a box off your residency preparedness list; rather, it should be used to find your own passions and to build your story as a future resident.

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