Life as a Junior Doctor

As a medical graduate stepping into the medical work space I am no professional on this topic but I think it would be helpful for me to share my knowledge on research bias to spread the awareness and be a catalyst for deeper understanding of the topic to our fellow readers. Shout-out to @medlifecrisis on YouTube for inspiring this article.

What is bias?

Bias happens when a disproportionate weight is given to or against something or someone. It can happen by intention or be unintentional. Without proper knowledge and intervention to minimize biases, the results of a study might be flawed and inaccurate. Even so, we might not be able to truly avoid all the known biases depending on the type of study and the subjects involved.

Types of Bias

1.       Confirmation bias

Confirmation bias happens when an individual search for or favour information that supports their belief or hypothesis with disregard of contradictory evidence. This is not only prevalent in research but in our everyday lives as well. For example, I believe the cough I have been having recently that won’t go away is a sign of me getting lung cancer. Without knowing better I go online and search “does cough cause cancer”. Sure enough, I found out that cough can be a sign of cancer and I start to panic even though there are dozens of other reasons why a person coughs and cough was never a strong indication of cancer in the first place. While this is an oversimplified example of confirmation bias, it is not uncommon to see unethical use of confirmation bias to ignore the opposing facts and justify an intended outcome in research often for financial gain.

2.       Selection bias

Selection bias occurs when a sample population selected for a study is not truly random. An example would be a study looking at the number of smokers in Malaysia and the volunteers for the study recruited online. Despite having a large sample size, the result at the end does not reflect the whole Malaysian population because only people living near urban areas have access to the internet and participated. This leads to a study population that mostly stays in cities and cannot be generalized to the population of the whole of Malaysia.

3.       Confounding

Confounding occurs when other factors that are not part of the study affects the result. This can happen when potential affecting factors are not considered or properly eliminated when designing the study. It is most common in observational studies where the effects of a particular intervention are only observed. While it may seem as though the intervention is causing a change in the study population, the real cause might be other confounding factors not taken into consideration and is not actively controlled or eliminated. A good thing to remember is that correlation does not always imply causation.

4.       Recall bias

Recall bias is as what it says, a bias that arises when participants are asked to recall information from the past. It is often used in retrospective studies where a particular incident has already occurred and researchers are looking backwards to look for the source.  A good but cheeky example given by @medlifecrisis is that when we ourselves are not able to clearly remember our lunch from yesterday, how are we able to accurately recall information often months or years in the past for a study?

5.       Blind spot bias

Blind spot bias is a type of cognitive bias where a person recognises the impact of biases on other’s judgement but not own their own. Whether it’s because of increased self-esteem or a lack of introspection, we must remind ourselves that we are just as easy to fall into the trap of biases because bias often occurs without conscious intent. Only when we actively seek or avoid them do they become obvious.

6.       Publication bias

Publication bias work in a situation where studies with positive findings (ie the result supports the hypothesis) are more likely to be accepted, published or receive news coverage. This might lead researchers to either disregard their negative results or lose interest in the study as a whole because of the negative results. But, both positive and negative findings hold equal weight and are equally as important for the advancement of knowledge in all fields. New knowledge must be tested and old outdated incorrect information needs to be disproved to avoid misconceptions.

This is far from an exhaustive list of research bias but I hope this article might have sparked an interest in the topic for you.

It is a long long long wait between the end of medical school and the start of housemanship. Define long? 8 months till 1 year.

A lot of things can be done during that period. For myself, I spent a good amount of my holidays watching Netflix, sleeping, eating, lazing around, travelling around different countries and volunteering in part time work that is non-medical related. (I'll leave all the juicy bits in my future posts.) Time passes really quickly when you find something interesting to do, but after a while, life tends to get slightly mundane as you no longer have a goal to look forward to.

Source: ama

Somewhere around March this year, I stumbled upon an offer to work as a Research Assistant (RA) under the Clinical Research Centre. I knew that my time would be tied down but since I was not busy with anything else....I figured, WHY NOT? The pay is pretty decent anyway. Before accepting it, I went around asking about the job scope of a RA but my queries were never properly answered. Mind you, Google was not being very helpful too.

Now, after 3.5 months into my current job, I feel that I am in a better position to give an overview of what a RA really does on a daily basis. Depending on the research that you are involved in, the job lists and responsibilities vary.

Source: The Cartoonist Group

Contrary to popular belief, RAs do not coop up in the lab and run tests on lab rats or other tiny animals. The job scope is very diverse and you tend to be that 'odd job worker' that gets everything running smoothly when all others are unavailable. There are definitely times where you feel that you are running a one-man show; but there are times too where delegated jobs get done efficiently by the rest of the team, giving you plenty downtime to unwind. 

Do consider and give this a thought if you are someone who needs to keep yourself busy during the pre-housemanship period. You still get to be in a hospital setting and could use the opportunity to familiarize the local healthcare system and the hospital protocols. 

Hit me up if there are any questions! Cheers!