World Cancer Research Day: How to Get Involved in Research With Waqas Haque, MD, MPH

Oncology Data Advisor: Would you like to tell us about yourself and your career in research?

Waqas Haque, MD: Hey everybody, I'm Waqas. I'm a third-year Internal Medicine Resident at NYU in the Clinical Investigator Track. For medical school, I went to the University of Texas (UT) Southwestern in Dallas, Texas, which is where I grew up. There, I was involved in a project for my dissertation on the financial and clinical utility of Foundation Medicine testing at our institution's cancer center.

In this video and podcast today, I'll be talking a little bit about how I got involved in research, some tips and tricks I would give to a younger version of myself trying to navigate a career in medicine and research. Also, some general advice I would give for Internal Medicine Residents trying to forge a path towards being an oncologist and trying to figure out how to balance research with all the clinical duties and responsibilities that you have.

Most of my research in the past throughout the years has been involved in the melanoma space at NYU, and I've also published a lot on health price transparency, given my public health and economics background. One of my key publications was a research letter in JAMA looking at compliance of hospitals with different price transparency laws that are now required to be followed. Most of my future research that I hope to be involved in as an aspiring oncologist is trying to figure out ways to bring new therapies to patients. I'm trying to focus more on learning about innovative clinical trial designs and learning about how early-phase clinical development works.

Oncology Data Advisor: How can someone get started in research?

Dr. Haque: A really common question that I get is how to actually get started in research, especially if you didn't have much of a background in it as an undergraduate student or if you did any kind of graduate work before medical school. One thing I say is that your research productivity and your success in research, especially early on, is self-paced but also driven by your choice of mentorship.

One thing that I recommend you do, if you haven't already found a research mentor, is to look at the PubMed profiles and the recent publications of the principal investigator (PI) you're interested in working with. If this is someone who is publishing 10, 20, 30, or even more times a year in leading journals in your field, then that's probably someone who's going to be a good mentor for you because they're really productive. It's obviously not a guarantee because you don't know how much support they're going to be giving you, but at the same time, the fact that they have a positive track record shows that if you have a goal of trying to publish something and have a tangible output, whether it's a publication or some type of presentation or abstract at a national conference, that's probably going to be a pretty good fit for you.

But if this is someone who maybe doesn't publish that often, if their last publication was a few years ago, or if there are multiple years between their publications, then that might not be someone who's going to be able to publish with you in the next few years. It's obviously not an exact formula, but that's a general thing that I try to recommend to people when they're looking at mentors. Also try to find someone who has a similar area of interest as you. Once again, if you go on the faculty profiles and read a little bit about people's publications, what they're interested in, and what motivated them to get involved in their area of research, then that might be a great way for you to get started as well.

If you're having difficulty finding someone at your institution, there are ways to get involved with research at a national level. There's obviously the opportunity to go to a conference and network with people and find opportunities there. There are some more nationwide groups like Machine Learning for MDs or MDPlus where you can get connected and plugged in with other early-stage trainees, med students, and residents to possibly find a project. There are also different opportunities like the Caris Precision Oncology Alliance where there have regularly recurring meetings where people share some of the latest publications they're working on. That can be another area where you can maybe tag onto a project.

But really, the easiest way is to find someone at your institution. You're already plugged in, you will be seeing that person in the hospital or the wards, and it's usually easy to get things like institutional review board (IRB) set up as you're trying to get involved in research. If you're interested in a certain topic but don't really know where to start, doing literature review might be a good way for you to get started in research, because you can work with your librarian to figure out the search terms that you need to initially approach the research topic you're interested in or the area you want to review. Once you've made some progress, you can probably find a mentor in a similar area of interest who is willing to mentor you or at least supervise you as you go through the lit review. That's always another area where you can find a way to get started if you haven't already with research.

Oncology Data Advisor: After you find a topic you're interested in, how do you learn more about it?

Dr. Haque: So, you've found a potential mentor, and you've found a potential area of research that you're interested in. What's the next step? How do you actually explore a topic substantially and in a way that you'll be able to work towards an eventual publication?

I can explain this by giving a personal example. I've recently become interested in early cancer detection and the role of liquid biopsies for multicancer early detection. This is the idea that through doing a blood test or by sampling fluid in a more minimally invasive way, you can actually test for a variety of different cancers with different kinds of technologies and get a better sense of a patient's prognosis or risk for cancer in the near or long term. There's obviously a lot of debate about the utility of this compared to a single cancer screening that we have, as recommended by the United States Preventive Services Task Force (USPSTF), but that's obviously beyond the scope of our discussion today.

To learn more about this topic, I looked at some of the key reviews and big journals, finding the different perspectives on multicancer early detection—who are the proponents of it, who are the opponents of it, what's the discussion that you're seeing in some of the leading reviews and leading systematic reviews and perspective pieces in big journals. Also, I know that this might be a little bit tedious, but It's always good to figure out the affiliation of the authors and the place where the article is being published. What you'll notice is that in any really niche field of research, it's always a small world. You might be reading a paper, then you see someone from your institution who's on a paper, or you might recognize one of your PIs or one of your collaborators who's on that same piece. That might be a good way to get an introduction or to learn more about that specific piece of research.

Once again, for me, I looked at the different review articles. I looked at the economics of multicancer detection. I looked at some articles that review the science behind it, the different kinds of methods—whether they be methylation, looking at microRNAs, looking at extracellular vesicles, or looking at proteomics—different kinds of approaches that are being done to capture liquid biopsies for cancer detection. The second thing I would say, beyond just reading on your own, is to go to your mentor. This is where mentorship is really important. Ask them questions and ask them how the topic that you're looking at, or the approach you're taking, is a little bit new or different from what's being done conventionally. This will give you a really good sense of how you can target literature research. Bring a clipboard, take notes, and once you have a really good sense of at least the basics of the area you're looking at, you'll probably be in a good space to continue your research project.

Oncology Data Advisor: How do you keep up research during residency?

Dr. Haque: One of the most challenging aspects of residency is that you're trying to take care of patients and trying to do the best job you can, but then you have a really short timeline to get involved in research. Your intern year is really busy, you have a lot of inpatient blocks, and you obviously don't have that many weekends off. During second year, you're working and getting more involved with oncology or a fellowship that you're interested in. And then boom, the end of second year hits you, and you have to start looking into the Electronic Residency Application Service^® (ERAS^®), getting recommendation letters, and writing a personal statement. If you haven't done that much research, it can all be overwhelming, and it can come up on you pretty quickly. Obviously, patient care comes first as a resident, but with that being said, there are a lot of ways to maximize your research productivity and make sure that you're on a steady platform during your training.

The first thing is you really have to know your schedule. There are a lot of residency programs, including my own, that follow the X + Y schedule where you have a number of inpatient weeks followed by a number of outpatient weeks. This is great, because as you all are probably aware, during your inpatient time, you don't have many weekends off, you're working late, and you're really trying to focus on taking the best care you can of sick patients. You may not have the mental bandwidth at the time to intensively focus on one part of your project for multiple hours, maybe on your off day if you have time. But during outpatient blocks, you're working 9:00 AM to 5:00 PM, you have weekends off, and you're in a more relaxed and predictable setting. You know you're going to go home at a certain time. This is a time where you're really able to make progress on your projects.

Now, one pitfall that you're going to run into if you're only working on a single project is that you're doing all this great work, but then when it comes time for your outpatient block, there's some kind of roadblock. You need access to a dataset, your PIs need a little bit of extra time to get back to you because they're on vacation or they're at a conference or traveling, or there's some kind of roadblock that's preventing you from taking the next step. By the time that roadblock is solved, you're back on your inpatient block, back to being really busy, and you end up losing a couple months of making progress on your research. What you need to do, if possible, is to be involved in multiple projects. Of course, they should be of reasonable time commitments that'll work with you, but the good thing is about being involved in multiple projects is when one thing becomes a little bit calmer, less busy, you're able to turn towards the other project and make some more progress on that one.

Second thing I'll say is that you really need to be prepared and know your timeline. If you want to apply for the American Society of Clinical Oncology (ASCO), know the deadlines for the ASCO conference or for the trainee aspect of the conference where you can present. Know the deadlines so that you have at least somewhat of a finished product or something that you could present to make your research have some kind of tangible output. Next thing I'll say is take ownership of your project. Instead of being involved in a lot of projects where you're the third or fourth author or have a more peripheral role—where you don't really know what's going on with the actual paper itself and aren't fully responsible for all aspects of the paper—be the first author. When it comes to talking about your research, you want to be able to show that you took a project from conception all the way to doing the manuscript preparation and submission.

It often becomes a very meaningful experience. You'll be able to learn about all aspects of the research process, and you're able to describe it more articulately as well. Another piece of advice that one of my mentors gave me is that if you write a sentence a day, no matter what, you'll find that you can speed up your research quite a bit. I know that it's really hard, as I said, to do research during your inpatient blocks. But even if you can find a really small task for your project—whether it's literally writing a sentence, or not even doing the data analysis but just planning what kinds of tables or figures you want or knowing where to find the data, or sending an email to one of your collaborators or someone who's collecting data with you—if you just do a mini task during your inpatient blocks or really busy days, those things will eventually add up. It'll make your time easier once you have a little bit more flexibility to work on the next steps of your project.

So, while it is difficult to be productive during your residency and you're obviously focused on being as good of a clinician as you can, there are ways to mold yourself towards that next step of fellowship where you can specialize yourself in a certain therapeutic area, a certain modality, or a certain aspect of cancer care.

About Dr. Haque

Waqas Haque, MD, MPH, is a third-year Internal Medicine Resident at NYU in a Clinical Investigator Track. As a Clinical Investigator Track Resident, Dr. Haque has balanced his patient care work with a variety of research projects. He hopes to begin fellowship training next year in Medical Hematology/Oncology at an academic program with opportunities to further his work in innovative clinical trial design, value-based care delivery to cancer patients, and becoming an early-stage clinical investigator.

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Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.