My take on our resident’s orthopedic research outputs: They will hate me!!!

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It was with high hopes that I went all the way from my province and brave the rains to attend the research forum of our residents in the city. Complete with the formal attire I trooped to the posh location hoping I can learn something new in the field of orthopedics. With the current crop of research that was presented, I’d say we have a long way to go. Potentials were darn obvious, but the delivery was just way below their talents.

Not that I wasn’t appreciative of our resident’s efforts nor I was oblivious of the research committee’s remarkable feat of producing quality research papers from the department. In fact, I can honestly say we did improved the quality of research from previous outputs. I did emphasize the importance of evaluating the research from the perspective of the residents and the type of environment their in. Time and logistics are very common drawbacks to residency research as in any other research endeavor.

Such limitations however do not make up as a lousy excuse for a poorly executed research protocol. The internet alone (JBJS spend a whole column on evidence based orthopedics) produces thousands of “how to” in conducting a well designed and properly executed research. The consultant coauthor’s suggestions and corrections are likewise very important had residents asked their assistance prior to conduct of research. In the recent years, there was a deluge of knowledge in the standardization of research protocols, the conduct of research and ethical considerations. This will ensure the applicability and quality of research outputs that will come out of any scientific institution and be included in the pool of sound evidence for medical practice.

Thus, I am making some observations on the research presented by our residents and hopefully improve on them for the next year’s research output. This is in no way to degrade their research output nor to dampen their research enthusiasm. A wise orthopedic clinician and researcher knows that the only way to improve his skills is through constructive criticisms. I wasn’t able to get hold of the actual papers (and was not allowed to ask the presenters) since this was limited to the judges themselves and not to spectators like me.

  • None of the research presented were clinical studies involving patients. All of them where either in vivo or biomechanical studies. I must agree that such clinical studies is difficult in the field of orthopedics especially when it comes to getting patients and ethical considerations. But there are existing guidelines on these and they can certainly be overcome.
  • Most of the studies were experimental, a few were cohorts and a substandard randomization protocol and thus the level of evidence is weak.
  • Some researches did not perform a feasibility study and thus lost track of their research goals along the way.
  • Since most were experimental, such research can be done in a week’s time( if all their materials are present). Moreover, there were two residents per research (some three) and they were given a year to complete their study. How come they’ve got only one experimental research study?
  • Most of the studies were attempts at modifying an already standard method of treatment. This maybe viewed as an attempt to modify the procedure or technique to lessen cost and thus benefit more of the underprivileged. But some are merely repetitions of a standardized scheme and could have improved their results with a cost analysis study.
  • Statistics may not be at the heart of any orthopedic research but its importance can not be set aside. It can either make or break a research. Not one of the research expounded on how they arrived in their statistical designs and conclusion.
  • Lastly, the individual presentation was wanting. I’m not sure if the judges were just overly courteous and encouraging but I simply could not follow what the presenters are talking. If the audience cannot understand what the author is presenting, you might as well just hand them the paper for them to read in their leisure time!

In the end, orthopedic residency research is not just about finishing the requirements set forth by the institution and the board. It has something to do with contributing to the very field you choose to live in for the rest of your life. Nobody wants to waste time, effort and money on something not worth doing. A half baked research is quackery!

Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

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