“Going into the lab for a year or two…”

by Raja Mohan, MD

At the end of my second year of residency, I was on call for the downtown plastic surgery service at Johns Hopkins Hospital, and I knew after sign-out, I’d be in the lab for a year. Usually the only thought on my mind post-call is taking a nap, but this time around, there were a flood of thoughts in my stream of consciousness. After squeezing in a short nap, I have to get a new ID and fill out some obligatory paperwork; then I need to meet with the PI and the current researchers; I have to formulate a list of tasks for my ongoing projects; after the day ends, I promised a friend we would meet for happy hour. I liked the fact that my responsibilities had nothing to do with rounding or updating lists. Then I began to think about making time for the other aspects of the lab year, traveling, attending conferences, taking courses, and improving my golf handicap. My work was cut out for me in that year because my goal was to do as much as I could while not having the full responsibilities of being a clinical resident. To say the least, it was an exciting and busy time.

In my program, spending one year performing clinical or basic science research is required for graduation. In many integrated plastic surgery programs, this time off is optional. Many independent plastic surgery residents I know took time off during their general surgery residency to help garner a plastic surgery position. Whether it is mandatory or optional, in my opinion, one should take time off to pursue research or other interests if he/she is passionate about such endeavors.

If you have found an aspect of plastic surgery you ultimately want to be an expert in, this year is a great opportunity to build your CV and begin your academic career. Of course, it is also a year in which one can become a more mature surgeon scientist. It affords time to improve surgical skills, increase knowledge of plastic surgery, and critically understand evidence-based medicine. I spoke to many of my senior residents about their experiences and have also kept track of junior residents so with my approximate n of 20, there are numerous possibilities for this year, and my goal is to summarize them.

For residents who are interested in taking a year or two off from residency to pursue research interests, the groundwork begins well before the first day of the lab time. Many of my colleagues had identified their field of research and PIs approximately 6-12 months in advance. Some were ambitious enough to apply for grants to fund their research and were successful in obtaining those grants. For plastic surgery residents, here are links to some funding sources and prestigious research fellowship programs: (I suggest looking into these early so no deadlines or requirements are missed)

Plastic Surgery Foundation:
http://www.thepsf.org/research/psf-grant-funding.html

American Association of Hand Surgery:
http://handsurgery.org/grants/

American College of Surgeons:
https://www.facs.org/quality%20programs/about/cqi/internetresources/grants

American Foundations for Surgery of the Hand:
https://www.assh.org/afsh/Programs

American Society of Maxillofacial Surgeons:
http://maxface.org/awards/

Cleft Palate Foundation:
http://www.cleftline.org/healthcare-professionals/research/cpf-grants/

Department of Defense:
http://www.grants.gov/web/grants/search-grants.html

March of Dimes:
http://www.marchofdimes.org/research-grants.aspx

National Institute of Health
http://grants.nih.gov/grants/oer.htm

Susan G. Komen Foundation:
http://ww5.komen.org/ResearchGrants/FundingOpportunities.html

These different organizations and sites detail the requirements and guidelines for these grants or scholarships for residents interested in research. Sometimes, it can take many months to complete one grant proposal. Luckily in my program, there is funding provided by the department but this may not always be the case so it is best to inquire in advance.  Many residents have supplemented their income by moonlighting or taking call for their department. If one is considering moonlighting, it is difficult to generalize the process of obtaining the proper licenses and authorization to moonlight since each state and hospital has varying requirements. The best thing to do is start the process early and speak to others who have done moonlighting in the past. Another advantage of obtaining funding is it already helps you formulate research questions and write basic proposals.

The next step is to meet with your PI and his/her research group to determine a plan on how to carry out your proposal. One will need to determine well in advance if the supplies and resources are available to actually complete the project. Invariably every lab or research opportunity seems to have numerous projects one can contribute towards but the goal is to identify interesting projects that have clearly defined goals and can be completed in one to two years.  The ultimate goal is to publish or present one’s research, so one would ideally want to complete a project and use the end of the year or the following clinical year to submit abstracts to major surgical conferences as well as submit manuscripts to peer-reviewed journals. Here is a listing of national plastic surgery organizations that hold conferences for residents and fellows to submit and presents abstracts as well as potentially win awards:

ASPS (American Society of Plastic Surgery)

AAPS (American Association of Plastic Surgery)

ASAPS/ASERF (American Society for Aesthetic Plastic Surgery)

Rhinoplasty Society

ASRM (American Society of Reconstructive Microsurgery)

PSRC (Plastic Surgery Research Council)

EURAPS (European Association of Plastic Surgeons)

AAHS (American Association of Hand Surgery)

ASPN (American Society for Periphernal Nerve)

ASSH (American Society for Surgery of the Hand)

ACPA (American Cleft Lip and Palate Association)

ASMS (American Society of Maxillofacial Surgeons)

ISAPS. (International Society for Aesthetic Plastic Surgery)

It is recommended that you look on each laorganization’s website for details on abstract submission and deadlines for each one’s meetings.

Most of this knowledge is rather straightforward, but it’s helpful to distill the overall goals of the entire process.  By building one’s CV during that year off, it will help in the future during one’s job search or when applying for funding to do further research. In my program, most residents stay within our institution, but there are many reputable labs and research opportunities throughout the country, and you can find a brief listing specific to plastic surgery residents at http://ps-rc.org/lab/directory/.

There are a few residents I know who did not use this time for clinical or basic science research but pursued some other interesting opportunities.  For physicians and surgeons, there are many one year opportunities related to public policy, public health, business, and innovation. Some colleagues of mine have pursued master’s degrees in public health, business, or engineering.

Without the worry of clinical responsibilities, this year is a great opportunity to attend educational conferences and courses. Many of them have complimentary registration for residents and fellows and some even offer scholarships for residents and fellows to help defray the cost of travel and housing.

As I alluded to in my introductory paragraph, do not forget to take time during your research year to enrich your personal life. My wife and I spent time together taking cooking and wine tasting classes, and we went on some memorable trips. The slower pace and abundance of free time relative to the clinical years of residency offer an opportunity to find new interests and experiences. If one decides to take time off to pursue research or other interests, it is definitely a period that can be meaningful and productive, and as my mentor Dr. Rohrich states, “Enjoy the journey.”

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