There has been concern in the recent years about a decline in the number of new researchers worldwide. Many factors, such as increasing cost of education, higher financial returns from clinical careers and reduction of research budgets with increased competition for research funding, may have contributed to this decline¹.

Advances in biomedical research during the last decade have highlighted the necessity of attracting greater numbers of physicians to careers that include a research component. Physician participation in research is essential to increase the number of clinical and research studies performed². Poor training in research skills in the medical curriculum is thought to be responsible for this³.

Medical students seem to be a logical and ideal participant pool for medical education research studies as they are directly affected by the quality of medical instruction, which presumably would make them willing and reliable participants. In many instances, medical students are readily accessible, thus making administration of educational research projects straightforward. Published opinions agree that medical students are able to comprehend study procedures, evaluate protocol risks and understand the importance of research. These attributes suggest that medical students are able to give informed consent to participate in the research⁴.

The review of the literature suggests that, in India, there is paucity of information examining the awareness, perceptions and practices of medical students towards research⁵.

Apart from knowing the perceptions and practices, it is also important to find out the factors that determine the medical student's choice of research as a career. Hence, this study was undertaken with the objectives to understand: (a) the awareness, skills, perceptions and practices among the undergraduate (UG) medical students and interns towards research; (b) the factors responsible for willingness to take up research as a career among the UGs; (c) whether medical students perceive medical education research as important to their medical training; and (d) the attitude of medical students towards participation as subjects in the ongoing research at the college.

The study was conducted at the PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India. There are four batches with 150 students each, making a total of 600 in the college. A total of 447 students were included in the study, excluding the odd batch students because of the small number in each batch. It was a questionnaire-based cross-sectional study and conducted from 1 to 15 November 2011.

The study participants were 5^th, 7^th and 9^th semester students and interns. These particular semesters were included because they were exposed to research activities at the college, hospital and for their academics and interns were included because, for the completion of their internship in community medicine, they are supposed to submit a research project.

A questionnaire was devised to collect the following three components of information from the students:

1. Information to know their awareness and perceptions about the importance of research in medical field.

2. Questions to assess their practices, i.e. attempts to write, conduct projects and publish in journals.

3. Opinion regarding choosing research as their career.

The pre-tested questionnaire had a mix of open-ended, closed-ended single and multiple response questions. Institutional Ethical Committee clearance was obtained for the study. Consent was obtained for student participation and it was voluntary and confidential.

A total of 447 students were included in the study, of which 349 responded, giving a response rate of 78%. Of the 349 students, 68 were interns, 95 from 9^th, 110 from 7^th and 76 from 5^th semesters. The proportion of male and female was nearly equal (48.4 and 51.6%, respectively). Majority (73%) of the study subjects were between 19 and 22 years of age and the remaining were aged between 23 and 26 years. The mean age of the study population was 21.5 years.

Table 1 depicts the perceptions and practices of the students regarding research in the medical field. Majority of the students said they were taught about research methodology during their medical course, except interns (19.1%). Interns and 9^th term students (54.4 and 50.5%, respectively) thought that research for medical students was important, while 7^th and 5^th term students (67.3 and 56.6%, respectively) opined that it was very important.

Majority (72.5%) of the respondents in all the groups never tried to be a part of the medical research study. Among those who tried, the major source of information regarding research was internet (49/96, 42.9%). Majority of the students, especially interns and 7^th term students (69.1 and 76.4%, respectively), believed that participation in research lead to better grades and recommendations. Nearly half of the participants found time for research and did not believe that research had an adverse impact on the regular course work, except 9^th term students.

Regarding their attitude towards participation as subjects, majority of students (205/349, 58.7%) in all the groups have not vested interest in participating as a subject. A total of 75.6% students (264) do not feel forced to participate as a subject because of a faculty member's position of authority. Nearly 73% (253) are concerned with confidentiality for participating in research and believe that they need special protection when asked to serve in medical education research studies (265, 75.9%).

Regarding practice of research, only 27.5% (96/349) tried to be a part of medical research study, 24.9% (87) tried to search medical literature and only 10.9% (38) were familiar with the writing protocol. The problems faced by medical students for undertaking research are lack of guidance, financial support and time (134/250, 53.6%), difficulty in selecting a topic and lack of interest in departments (57/250, 22.8%).

Figure 1 shows the factors responsible for students to choose a research career in future. Academic benefits and scholarships are the ones that attract students the most (30%) to take up research.

The overall response rate was higher in our study (78%) compared with similar studies conducted elsewhere^6,7. Similar to a study by Harsh Kumar and Jayaram⁶, the response rate was lower among the final year (9^th term) students because of lack of time. There was a significant gender difference (P=0.043) in preferences for a research career, with male preponderance similar to a cohort study done to ascertain the gender differences by tracking the careers of the doctors by Guelich et al.⁸. However, no gender preponderance was seen in coastal south India⁶. Only 45.8% students find time for research during their academic session in our study, whereas it is 70.9% in a study conducted by Goyal et al.⁵

It was interesting to note that, in our study, 92.5% disagreed that research should be done only by intelligent students compared with another study disagreement percentage of 62.8%⁵. In our study, 61.8–83.3% of the students do not feel forced to participate as a subject because of a faculty member's position or authority, which is comparable with a study by Joseph⁴ (91%).

Similar to a study by Akbar⁹ (80%), participants believe that they need special protection when asked to serve in medical education research studies in our study (75.4%). Research career for a doctor was thought to be a good option by majority of the students (58.7%) in our study; on the contrary, most of the students did not know about research (49.2%) and those who knew felt such career had no status/respect (17%) in another study⁶. This probably resulted in the interest to take up research career in future, as observed in the present study (64.9%) and in a study in coastal south India (6.7%)⁶.

Though 87.4–92.1% medical students agreed that medical education research should be conducted, only 41.3% indicated a vested interest in participating. The possible reason is that medical students believe they lacked sufficient time to participate because of final year exams and/or they may not have thoroughly understood the expectations of participating in medical education research. The results were similar to Joseph's study⁴.

Only 27.5% tried to be a part of a research study in our study, while 43% participated in research during medical study according to a study by Siemens¹⁰. The better awareness and perceptions of research may be because of better training in research methodology within the curriculum, but the practice of research is poor. A good training is known to improve the awareness and skill of medical students and help them develop a positive attitude towards research¹¹. An intensive training or exposure of the UG medical students to research will increase their chances of pursuing a research career¹². The medical faculty and institutions have to take up the challenge of showcasing their research, discuss possibility, benefits and support systems like Indian Council of Medical Research (ICMR) -Short Term Studentship (STS) projects for research with medical students, and take them as apprentices.

Majority of the students have orientation towards research activities, but they are hesitant to practice because of several reasons. There is a scope for learning and improving medical training so as to create interest among the medical students, and the medical college is the right place and the right time to teach about research to produce future researchers.

Note: Numbers in parenthesis indicate percentages, *Significance by Chi-square test.

References