Barriers to Medical Research

Despite the fact that research plays an important factor in shaping evidence based medicine and helps US residency application, inequality in access to medical research exists around the world. It is important to understand those systemic barriers which contribute to inequality in developing research capacity and probably marginalizes disadvantaged residency applicants. The first step to overcome barriers is to contemplate the barriers. This article highlights a few important barriers. If you think that it is very difficult to overcome these barriers, there are many other ways to make your CV stand out from the crowd.

High Demanding Medical School Curriculum: Medical students undergo extensive training which demands long hours of work. It may include clinics, weekends and night shifts. It is intellectually draining. There is little time to work on research or develop research skills. It takes extra steps to motivate yourself to research. Moreover, medical school is geared towards preparing you to treat patients and not shape you to be an excellent researcher.

Lack of Research Capacity, and Culture There are medical schools or universities around the globe where there is negligible research capacity which includes the infrastructure and human resource. Medical students in such universities do not get the opportunity to be in the “research culture” environment and research experience. This prevents medical students/graduates in such universities from being familiar with research methodology or journal publications.

Lack of Training: Physicians from other countries if they are not trained they do not have the research skill that is needed for a specific research program. When you come to the United States, established researchers have to train you to do research and it takes time to train to a level where you can work independently in the research program. Since training takes time, researchers look for long term commitment and continuity which may not work for a young physician looking for residency training as an end goal.

Lack of Funding: Governments of many developing countries and underdeveloped countries provide very little financial support for academic research. This lack of support not only affects bold science but also trickles down on medical students by preventing them from being academicians in future. They often find it challenging to develop high quality research which can be published in high impact journals (which is important for US residency application). Researchers greatly depend on funding and grants to do their work and they earn very little. Without big grants (from the NIH for example), you can’t really do much.

USMLE Preparation Is Time Consuming: Particularly, for international medical graduates who are not trained in the US medical system, USMLE preparation takes a lot of time and commitment. During the preparation, prioritizing time is very important as it is difficult to get residency interviews when you are an old graduate. Even if you are studying for USMLE in the US and want to research when you study, researchers/physicians may not take you seriously as it takes time to train a researcher and by the time you are trained, you are likely to QUIT for USMLE, observations or interviews! Or maybe, are matched into a residency program!

Language as a Barriers: Native English speakers think in English. When medical graduates who are trained/think in different languages around the world, comprehending in English enough to effectively communicate in terms of dissemination of complete and correct knowledge becomes a challenge. High impact journals require high quality English and the language can be a great obstacle.

Visa Issues: Majority of IMGs need a visa to come to the United States. While it is extremely hard to get a working visa for research, you usually come with B1/B2 which allows you to stay in the US for 6 months at a time. Also, when you come with B1/B2, you are required to NOT work for funded research projects or monetarily benefit the University by volunteering. Hence, it is practically difficult to come to the United States, find a good research mentor and complete the research with publications within 6 months. In addition, academic hospitals have medical students and residents who are there for long term and do not need a visa for research.

Connections: For a medical scientist to select a research volunteer, prior knowledge of the candidate plays a vital role. International medical graduates often do not know anyone who can be a potential research mentor because of a lack of network/connections. This is the same problem the medical schools in the United States face when they try to set up global health rotations in different continents.

Expensive Living: When IMGs come to the United States, the cost of living (compared to the home country) is very high. As research efforts take time and IMGs will have to spend 1000s of dollars. This includes accommodation, food, travel, visa, insurance etc especially when you are not earning money. Additionally, attending a conference will cost high and often IMGs cannot afford to spend so much money with no additional support.

High Competition: All the above mentioned barriers have created enormous competition. For every research-related volunteer position or salaried job that is posted, there are hundreds of applicants. So, people who are familiar with research and regulatory processes will take the upper hand and the disadvantaged candidates are left behind which increases the disparity.

In spite of these barriers, there are several ways to get research experience. Take a look!