As residents, one of the most important things that we have to do is complete a dissertation, or thesis in course of our training. This is one of the credits we need to have obtained in order to be eligible to sit for the final MD exams. The basic aim of doing a thesis is introducing us to research and honing our observation, analytic and expression skills. Without going into too exhaustive details of the whys and the wherefores of doing this, I must say this seems to be a worthwhile endeavor to me, especially since most Indian medical students are barely exposed to research in their undergrad days. Although there was a period when a few experimental batches were taken who did not have to do their dissertations, but I think it was only in AIIMS and that too was scrapped soon.
In order to do the thesis, the first pitch of the idea before a group of experts is known as the Protocol Presentation, and at present, this is the ordeal we are going through. The tertiary teaching hospital where I am doing my residency, University College of Medical Sciences, or UCMS, has a very active Medical Education Unit, which has been organizing a thesis writing workshop at first, and now, a protocol writing workshop for the new residents. Needless to say, this makes our lives so much easier.
The session started yesterday with an intense session on hands-on PubMed searching skills. It was a very essential tutorial and was of prime importance for us since we used rather crude methods to search through the PubMed archives. This went down with a bang with most of us as we were broken up into groups of 3 who were given a single computer to do the hands on training with. However, unfortunately, the internet connection conked out at 1540 hours leaving my two compatriots bristling with rage because I had hogged the keyboard all the time!
Today the sessions were more numerous and more in line with the real business of protocol writing.
The day was packed and we took on several topics one by one. Starting with the business of framing a research question, to the the introduction of the PICO concept… for many of us this was an aspect of Medicine that our Amit Ashishes and Mudit Khannas had scantily prepared us for.
The best thing was that the the whole day was a two way traffic. I was worried that the sessions, essentially heavy topics, would turn out to be very cumbersome and torpor-inducing, but, thanks to the faculty members actively involving us in the discussions, it turned out to be quite a lot of fun. As usual, I was at the forefront making a fool of myself, but the empowering environment, where one would not be judged too harshly for making an apparently foolish observation was very liberating. The past year, most of us have been living under the heavy observation of critical eyes, as we stepped and stumbled our way through to PG. The removal of this Saruman’s Eye was almost a physically liberating exhilaration!
The dash of color and diversity added by the congregation of Residents from the various departments was also a wonderful experience. Although I have a horrid memory for names and faces and need multiple reminders before they stick to my mind, it was nice meeting a lot of my contemporaries. As residents, we remain so embroiled in our own lives and work (more so for us out-of-Delhi folks), that we lack a properly developed social life. One of the important side effects of the protocol writing workshop, therefore, was bringing together the residents from all the departments, who would have otherwise never have even crossed paths. A true social networking, if there ever was one!
Today also we were broken up into groups to do some sample exercises. I think they were the real “business ends of things”. In some cases, some didactic time could have been deducted to make way for more hands on work. Compared to the PubMed workshop, today’s workshop had much lesser opportunities for hands-on work though there were several sessions after or during which some problems were to be solved by us.
Some of the folks really got hyper about the whole business and readily lapsed into the sepulchral frame of mind that had helped them to jump over the hurdle of the PG entrance exams with élan. They were typically the ones from the Departments like Medicine, Orthopedics, Dermatology and Radiology – aka the Over-achievers.
However, our group, eventually ended up concentrating more on having fun than working maniacally:
One of the major reasons I did whatever little research work I did in the undergraduate days was that I had a lot of fun in the whole process. I did not find any reason to change courses today. So, instead of feverishly copying notes and trying to remember everything, I just concentrated on having fun. And all I can say now is… so far, so good!
After some of the group activities were over, we were supposed to present our work. The first session was to write aims and objectives of a research topic given to us. We presented the efficacy of conservative method versus operative methods in acute appendicitis and managed to come out with a decent presentation: credits to BMJ!
I must say the session where we were supposed to present our analysis of different aspects of a mock protocol (Azithro vs Cipro in treatment of cholera) was an awesome one. Gagan (Dermatology Resident and an “endemic” UCMS student) and his team were by far the best ones at this session and really broke down the whole issue into the good-bad-and-ugly. That was one lesson in proper critiquing of a paper.
We had loads of fun, and the sessions towards the end of the day were a little hurried but were truly awesome. There was a really short and sweet recap of the ethical issues of research and this being one of the topics that I can never hear more about, I was left a little wanting. Of course, it would be unreasonable to expect cramming everything into a 15 minute session, but I wait to listen to the stories of Auspitz, Nuremberg, Tuskegee and Guatemala in every ethics session! Aside from being hair raising issues ethically, they make for awesome stories!
One of the biggest misconceptions that I and a lot of other greenhorns had was that the enthusiasm for research or extra-curricular academic activities was a business for the people from the pre-and para-clinical disciplines, where the horrors of night duty, emergency days, admission and post-admission days were non-existing. However, seeing the heads of the Surgery and Medicine, and Profs from Pediatrics and Ophthalmology, (the so-called hardcore clinical disciplines) departments take center stage smashed these conceptions.
Biostats has always been a horror for all of us, and it was refreshing to see Dr. Amir’s rather irreverent, casual and yet, supremely effective presentation on the topic. The way he cut it out was bold and intriguing, especially since he made applause winning statements like we did not need to do anything more than devote only a paragraph (the very outline of which he also gave out for us) to the devil called biostats. He made number crunching sound quite an innocuous experience!
The best experience in public-speaking, however, was waiting for us at the end of the day, when Prof. Navjeevan Singh took the stage. He conjured a session on Title writing right out of the air. We had had to skip it by because of a shortage of time, but he ensured we did not miss it out entirely. He stood aside in that he went the old chalk-and-talk routine instead of motoring on through powerpoint slides. The exuberance, the confidence and the ability to hold the audience’s attention even after two days of continuous lecturing was a lesson to learn. That his sessions were brilliant and insightful (my epiphany: the ideal title is a myth – everyone has their own definition of one) were a given… and the openness with which he summoned feedback from us was also surprising. We’re not used to teachers asking us about how they ran stuff. It’s usually the other way around, and bitter!
I also realized that one of the faculty members, Dr. Upreet, also happened to have authored a chapter in the Chicken Soup for the Indian Doctors’ Soul! I mean if THAT is not cool, I don’t know what it!
I got my seat in UCMS in my first counseling, and as some of my seniors know, I did not even apply for the other rounds seriously. They, of course, trashed my reasons for not applying, but somehow, I have always felt vindicated by the decision, if not the reasons. And after this two-day extravaganza, I must say that I have absolutely no doubt that not only was this a great decision, but it probably was one that is going to lead me to a three-year-long (at least!) ride of fun and frolicking!
And the take home message for me from the whole experience?
Well, I look really bald from behind. I have gotta do something about it, and soon!