July 2011 Newsletter Research During Residency Being a pediatrician in the twenty-first century requires that one sort out physical, psychosocial, and economic forces playing upon the health of patients, families, and communities, and that one separate wheat from chaff in the barrage of scientific and medical information that confronts us all. Developing analytical skills must be a component of what one accomplishes during residency. This URMC Pediatrics Research Newsletter gives a glimpse of the collaborative, collegial research and mentoring environment that helps us help our residents develop their interests and aptitudes in this mission-critical area. Research for the Research-inclined The University of Rochester Medical Center (URMC) houses a rich research environment that has a long history of going from bedside to bench and from bench to bedside. The H. influenzae B vaccine, the implementation of surfactant treatment of premature babies, the modification of oxygen therapy of preemies to minimize the incidence and severity of retinopathy of prematurity, the HSV vaccine, and our understanding of the nutritional needs of adolescents during pregnancy all had their origins in our labs and conference rooms and clinics and hallways. Even the original layout of the faculty offices has clinical department offices in a hallway off of which come perpendicular halls lined with basic science department laboratories and offices. For those who come to URMC knowing they want to make research a part of their careers and for those who fall in love with research while they are here, our Resident Research Track offers an opportunity to mix mentored research with clinical rotations and get a head start on fellowship and career research. Residents enter the Research Track at the start of their second year. To date, 14 residents have joined and 13 have completed their residencies. Projects pursued by these residents have included exploration of radiation effects on megakaryopoiesis, pulmonary toxicity of novel synthetic surfactants in a preclinical model, systemic and localized inflammatory markers in second-hand smoke exposure, access to care among young adults with asthma after “aging out” of Medicaid, and differential gene expression in leukemia cells following allogeneic bone marrow transplant. Six peer-reviewed papers and 3 manuscripts in preparation have resulted so far. Two graduates pursued research fellowships, one under the auspices of the Robert Wood Johnson Foundation. Others pursued fellowships in General Pediatrics, Neonatology, Critical Care Medicine, Nephrology, Cardiology, Hematology-Oncology, Allergy-Immunology, and Child Neurology. Hypothesis-driven Research = Evidence-based Medicine Many of our residents are headed for careers in child and community advocacy. Indeed, for decades, this has been a product of the Rochester biopsychosocial model of medicine and healthcare. Our Pediatric Links with the Community (PLC)/CARE track puts residents in community-based implementation pilot projects aimed at providing the evidence base for interventions that make a difference. This systematic, analytic approach to community efforts to keep children and families healthy is research in its most practical iteration. Projects pursued by PLC/CARE track residents include combining education and fitness in collaboration with the Boys and Girls Clubs in the Rochester Cyclopedia Program, improving childhood literacy in collaboration with the Rochester City School District using music education, and curbing school violence and bullying in collaboration with the Rochester City School District using the Coping Power afterschool program. Graduates of the PLC/CARE track have won awards from the AAP and the AAMC. Many have gone on to become the lifeblood of the Rochester Pediatric Research in the Office Setting network while others have pursued subspecialty training in Adolescent Medicine, General Pediatrics, Hospitalist Medicine, and Nephrology, Neonatology, Endocrinology , Cardiology, Development and Behavior, Tropical Medicine, and Palliative Care; here in Rochester as well as at institutions like Harvard and Johns Hopkins. Research: It’s for Everyone! All of our residents participate in our monthly Journal Club. Whether a resident in our program does research or not, he or she will learn from first-hand experience to evaluate data, study design, and conclusions in light of a central question and hypothesis. We feel this is critically important for everyone, especially because every patient’s history should enable the physician to form a hypothesis, the testing of which drives the additional historical inquiries and physical examination.