Adult Gastroenterology Training Program

Research Training

OVERVIEW

Gastrointestinal research at McMaster University has enjoyed considerable success for over 25 years due to the close collaboration between clinicians and basic scientists. Indeed, McMaster has often ranked within the top 5 institutions in the world in the number of abstracts submitted to international meetings such as Digestive Diseases Week. Many of our successful papers have been authored by Gastroenterology trainees. Many of the Faculty of the GI division are internationally renowned researchers and have published groundbreaking research in wide range of subjects. GI faculty have published approximately 400 peer reviewed papers and obtained over $78 million in funding from industry and grant agencies in the last 5 years. Research published by GI faculty has received over 24,000 citations with 47 papers each receiving over 100 citations.

The GI Training Program is particularly strong in its ability to offer training in research. Three blocks in the first year (and up to 3 more blocks in the second year) are designated to research activities. It is intended that the resident work on a viable project with an experienced supervisor, optimizing the chance that an abstract and paper will result. Residents are encouraged to submit their work to national (e.g. Canadian Digestive Diseases Week), international (e.g. American Gastroenterological Association) or local (e.g. McMaster Resident Research Day, Farncombe Family Digestive Health Research Institute Research Day) meetings.

The Training Program believes that exposure to research is an integral and important part of clinical training. Faculty members perform research in a wide variety of basic and clinical areas, and both clinical and basic research projects are feasible. Basic research is performed within the Farncombe Family Digestive Health Research Institute, and several members of the GI Division are Full Members of the Farncombe Institute. Clinical research may include retrospective clinical studies, case reviews, prospective clinical studies or even intervention trials. Furthermore, the Upper Gastrointestinal and Pancreatic Diseases Cochrane Review Group is based at McMaster University under the leadership of Dr. Paul Moayyedi and Dr. Grigorios Leontiadis. Residents are encouraged to take advantage of the expertise in systematic reviews and meta-analyses of the Cochrane Collaboration in conducting their research projects.

Research Curriculum

The research curriculum comprises three aspects:

  1. Research methodology workshops which consist of a series of academic half-day lectures focused on 1) introduction to research, trial design & biostatistics (Dr. P. Moayyedi); 2) introduction to meta-analysis (Dr. G. Leontiadis); 3) presentation skills (speakers training program); and 4) how to get your manuscript published (Dr. S. Collins).
  2. Protected research blocks allowing trainees to initiate and complete a research project during the 2 years of training. Three blocks in the first year (and up to 3 more blocks in the second year) are designated to research activities. It is intended that the resident work on a viable project with an experienced supervisor, optimizing the chance that an abstract and paper will result.

    Residents entering the GI Training Program are required to identify a Research Mentor and a research project within the first few months of training. A list of basic science and clinical research projects prepared by our faculty are available to trainees in the beginning of the academic year. Research projects and mentors are reviewed and approved by the Research Coordinator (Dr. Premysl Bercik). Residents are then asked to present their research question and/or research protocol at Farncombe Noon Rounds early in the academic year. The research proposal will state the question, hypothesis, objectives, design and proposed outcome measures of the study. The nature and scope of the project should allow the resident to generate an abstract for national or international meetings. Throughout their training, residents are also encouraged to identify unique and rare clinical cases that can yield case reports and/or literature reviews for publication. Residents are encouraged to submit their work to national (e.g. Canadian Digestive Diseases Week), international (e.g. American Gastroenterological Association) or local (e.g. McMaster Resident Research Day, IDRP Research Day) meetings.

  3. Evaluation of research training performance (See Evaluation of the Resident)

Responsibilities of the Resident

The overall goals of the Research Rotation are:

  1. To identify an area of research interest and a mentor
  2. To review the relevant literature and to distill from it a scientific question that can be answered using facilities available in an appropriate time period
  3. To organize and conduct a series of experiments to answer the research question
  4. To analyze and interpret data
  5. To present the data in oral and written format to a group of peers. This requires both submission of an abstract to a national, international or local meeting and preparation of a manuscript suitable for journal submission.

Evaluation of the Resident

At the end of the first year, each resident must review his/her project with the Research Coordinator. Residents who demonstrate sufficient interest and productivity will be offered up to three blocks of research time in their second year to continue their work and/or begin new projects. Successful completion of the research training component requires each of the following:

  1. Attendance at the research methodology workshops
  2. Presentation of proposal, interim and/or completed research data at the Farncombe Noon Rounds
  3. Successful evaluation of each research block is undertaken by the Research Mentor and the Research Coordinator. Input is sought from other members of the research team who have worked with the resident. Based on all feedback received, at the end of the rotation, a formal web-based CanMEDS compliant ITER is compiled by the Research Mentor. Final evaluations are discussed with the resident. Successful evaluation is defined as a grade of “Meets Expectations” or higher in each evaluated category. Each 4-week research block is evaluated in a similar fashion to clinical rotations using the Research Block Evaluation Form by the Research Mentor. If the trainee receives a grade of less than “Meet Expectations”, he or she is encouraged to meet with the Research Mentor and the Research Coordinator to discuss a course of action to improve future performance. As long as improvement in performance is documented at the end of the project, a passing grade will be given.
  4. Attendance at 1 outpatient endoscopy list and 1 outpatient clinic list per week.

Completion of each of these requirements will result in a “PASS” of the Research Component of the Final in-Training Evaluation Report (FITER).

Evaluation of the Rotation

Residents are encouraged to provide feedback on how the rotation and teaching are structured. If issues arise during the rotation, the resident is encouraged to bring these to the attention of the Research Coordinator. A mechanism for dealing with any shortcomings will then be discussed with the resident and the Research Mentor, and subsequently at the Residency Program Committee meeting. As with all rotations, an anonymous rotation evaluation is handled by the One 45 WebEval System. Each teaching faculty is evaluated separately in a similar manner. The Residency Program Committee meets semi-annually to compile a collective rotation and faculty evaluation, respecting anonymity. This has been important to maintaining feedback.

GOALS AND OBJECTIVES

The Adult GI Training Program at McMaster University incorporates research training as part of the requirement of the Royal College of Physician and Surgeons of Canada. Specific goals and objectives of the research rotation in CanMEDS format are as follows:

Medical Expert

Specific Requirements: Gastroenterology residents are able to

  1. Critically appraise the background literature of the research project
  2. Demonstrate an understanding of the basic principles of research design, methodology, biostatistics, and clinical epidemiology
  3. Demonstrate in-depth knowledge of the research topic of interest

Communicator

Specific Requirements: Gastroenterology residents are able to

  1. Demonstrate skills in conveying and discussing scientific research on gastrointestinal diseases to scientific communities through posters, abstracts, teaching slides manuscripts, grant applications, or other scientific communications
  2. Communicate and collaborate effectively with research team members to conduct the research

Collaborator

Specific Requirements: Gastroenterology residents are able to

  1. Identify, consult and collaborate with appropriate experts to conduct the research

Manager

Specific Requirements: Gastroenterology residents are able to

  1. independently identify an area of research interest and a research mentor in order to engage in the scholarship of scientific inquiry and dissemination
  2. Independently utilize available resources and regularly meet with an identified research mentor
  3. Demonstrate effective time management in research setting
  4. Demonstrate leadership and administrative abilities, where appropriate, in leading a research team

Health Advocate

Specific Requirements: Gastroenterology residents are able to

  1. Recognize the contributions of scientific research in improving the health of patients and communities

Scholar

Specific Requirements: Gastroenterology residents are able to

  1. Pose a research question (clinical, basic or population health)
  2. Develop a proposal to solve the research question:
    • conduct an appropriate literature search based on the question
    • propose a methodological approach to solve the question
  3. Carry out the research outlined in the proposal
  4. Critically analyze and disseminate the results of the research
  5. Identify areas for further research

Professional

Specific Requirements: Gastroenterology residents are able to

  1. Uphold ethical and professional expectations of research consistent with institutional review board guidelines, including maintenance of meticulous data and conduct of ethically sound human or animal subjects research
  2. Demonstrate personal responsibility for setting research goals and working with mentors to set and achieve research timeline objectives
  3. Participate as possible in specialty organizations that promote scholarly activity and continuous professional development
  4. Publish accurate and reliable research results, with attention to appropriate authorship attribution criteria
  5. Disclose potential financial conflicts of interest (including speaker fees, consultative relationships, investments, etc.) as appropriate when engaging in and disseminating research results