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The students revolutionising surgical research

Medical students interested in undertaking research and audit have limited options to contribute to high-quality, meaningful clinical research.

Looking back a year and a half ago, I remember receiving an email from a new medical student-led group called STARSurg asking for interested medical students and junior doctors to collaborate in a multicenter, prospective study in gastrointestinal surgery.

Having spent considerable time looking for such opportunities, I signed up and rallied friends whom I knew were interested in surgery and evidence based medicine. I was attracted to this ‘first of its kind’ project and had an inkling that this was going to transform how medical students could contribute to research. My hunch was right!

starsurg-logoIt is not an overstatement that the Student Audit and Research in Surgery (STARSurg) Collaborative has revolutionised how students can contribute meaningfully to high quality research and audit projects. In 2013, the collaborative, led by a group of pioneering medical students, undertook a multi-center prospective audit of the use of non-steroidal anti-inflammatory drugs (NSAIDs) in gastrointestinal surgery.

This study saw over 250 students participate from medical schools across the UK, with the results published in the British Journal of Surgery, Europe’s premier surgical journal. Our 2013 study produced interesting results on what still remains a contentious issue – it showed that there was an association between reduced rates of post-operative adverse event in patients undergoing gastrointestinal surgery and the use of NSAIDs.

The collaborative follows an established model pioneered by surgical trainee research collaboratives. Each participating hospital has a ‘mini-team’ of 3 collaborators, comprising of medical students and junior doctors, all supervised by a consultant surgeon. A key feature of the collaborative model is its authorship policy which recognizes all collaborators working within these mini-teams on the subsequent journal paper authorship.

This means that the work is published under the group name (‘STARSurg Collaborative’) and all contributors receive PubMed citable collaborative authorship for their hard work (as seen here). For large-scale multi-center projects with many contributors, this is a much fairer publishing model and undoubtedly one that will be adopted more widely in the years ahead.

There was no turning back after the success of the 2013 study. The STARSurg collaborative won a competitive INSPIRE special project grant from the Academy of Medical Sciences to further develop its aims and take these to the next level, training medical students in essential research and audit skills, and promoting a wider interest in academic endeavors.

Collaborators taking part in the 2014 study also put in a phenomenal effort, delivering a multicenter audit looking at obesity and post-operative outcomes in gastrointestinal surgery. Determining Surgical Complications in the OVERweight (DISCOVER) saw expansion to include medical students in the Republic of Ireland. The numbers say it all – the size of our group this year expanded more than four-fold, with 1200 medical students and junior doctors contributing data from over 140 hospitals.

On graduating, these research trained-and-ready students will feed in seamlessly into the postgraduate research collaboratives and beyond, developing research capacity nationally and easing the problem of dwindling academic clinicians in the NHS.

In the future, STARSurg aims to move forward from observational studies to interventional ones. In all, these are game-changing times for those in the early stages of medical training passionate about working together with their peers and in producing evidence which will inform the best care of patients in the future!

Visit our website to learn more about STARSurg and register, or email us at: [email protected].

This article was produced in collaboration with Ed Fitzgerald, general surgery registrar in London and a member of the collaborative’s Steering Committee. And, Chetan Khatri, who is a penultimate year medical student at Imperial College and a member of the collaborative’s Steering Committee.

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