|Dr. Haider A. Naqvi||MBBS, FCPS, D.Epi. Assistant Professor, Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan.|
|Prof. Dr. Sohail A. Qureshi||Professor, Department of Biological and Biomedical Sciences, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, 74800, Pakistan.|
|“If I have seen a little further, it is by standing on the shoulder of giants.”|
During recent times, divide between clinicians and researchers has become more pronounced. Though there are professional development tracks for both, a genuine research question generally emanates from clinical coal mines. The case can be sighted of John Snow, Anesthetist by practice who carried out “shoe leather epidemiology’, going from house to house and reporting surveillance data on Cholera related deaths. Snow’s conclusion that contaminated water was associated with cholera related deaths is a prime example of observational data. Another example is association of lung cancer with cigarette smoking1. We see many other examples if we examine the chronicles of research-history.
Training in research methods does confer the advantage of assessing the outcome with accurate test statistics. To be able to think divergently on issues and measure outcome-variables accurately is an art as well as a science. One can learn the science through courses but the mastery of Art requires patience, discipline and mentorship. Research generally is a team game; team which relies on the strengths of its members is expected to win the prized trophy of scientific breakthrough – recognition, publication and research grants may very well be the milestones in this journey. At times, team work is the actual accomplishment. In handling the complex dynamics of human interaction there is an actual character development of an apprentice. Good mentors watch out for such subtle, supplemental learning.
Similar dichotomy exists between basic science and applied research. Basic scientists feel – rightly or wrongly – that clinicians don’t want to share their patients when it comes to clinical trials. Clinicians pretend to be the gate keepers, though they only provide service in lieu of a fee. Basic science research is long and precarious, taking years in order to have conclusive evidence as opposed to some areas in applied research where people just tinker with numbers2. Researchers in later area may churn out papers but it is at the cost of dogged bench research, which lays down the conceptual-foundation.
Collaboration is of paramount importance when it comes to a research inquiry. Often, while searching for an answer we find ourselves venturing in to an unknown territory. It is through collaboration that we are able to solve the scientific puzzle. The illnesses, so far have not started distinguishing themselves in sections and departments. The sooner we are able to recognize this the better it is; there are research issues at the interface of disciplines, which can never be solved unless one takes a multidisciplinary approach. Science has no boundaries, no drawing room clichés. It is ruthlessly honest, demanding integrity, collaboration and teamwork. Though it may not be focused on proving the truth, it does focus on falsifying the falseness of evidence or a hypothesis3.
The dichotomy of a clinician and researcher, or Basic science and Applied research is just a difference in Medical world view. Both, have a common goal i.e. patients well being. Their approach might be different. One is focused on the whole while the other might be looking at the obvious piece. It is just like lateralization; the left brain and right brain might have different specializations though one may not be superior to the other. These might be complementary, a whole brain which can reason logically, communicate coherently and be able to appreciate the abstractness of varied situations.
In the end, for believing researchers, we cite a prayer on Collaboration:
‘God give me serenity to accept my limitations, courage to collaborate where I can, and wisdom to put forth my own question!’
References and Further Reading:
 Gordis L. The Epidemiological approach to disease and prevention, in Epidemiology. Elsevier Saunders 2004, Philadelphia, Pennsylvania.
 Sackett DL, Hayes RB, Tugwell P: Clinical Epidemiology: A basic science to clinical medicine. Boston, Little, brown, 1985.
 Feinstein AR. Clinical biostatistics. Clin Pahrmacol Ther 1979; 25:108-16.
 Standing on the Shoulder of Giants. Available: http://en.wikipedia.org/wiki/Standing_on_the_shoulders_of_giants