Institutions of complementary and integrative health (CIH) face many challenges in fostering robust research. This is largely due to 1) clinical education being the primary focus of the institutions; and 2) development of a research enterprise requiring a significant investment of time and resources with delayed returns.3,6
At large universities, other professions can pursue dual degree programs that train them for robust research (e.g., MD/PhD, DPT/PhD, etc.); or if a dual degree is not desired, students can take a year off clinical training to engage in research at an institution, and develop research skills and publish scientific manuscripts.
Establishment of graduate research programs at CIH institutions (especially PhD) also would require significant investment of time, resources, administration, and established research faculty.
A Compelling Need
With the CIH clinician's specialized training and unique approach to health care, there is a compelling need to support the research trajectory and development of CIH clinician-scientists.1,4-5 This research development is vital to establishing sustainable, long-term, competitive, and rigorous scientific investigation on the usefulness and safety of CIH interventions (especially chiropractic) and their roles in improving health and health care.
However, as a profession, if we fail to invest in those individuals who are interested in either fully or partially devoting their time to research, we will continue to lack the ability to develop our profession with evidence-based CIH approaches.
A Common Challenge
I cherish my chiropractic education! It is a large portion of my identity and philosophy toward health and health care. Even though I may not practice full-time as many of my colleagues do, I still take pride in chiropractic and work every day toward its advance.
When I was drawn to research and faced with the complicated choice of leaving my private practice in Colorado, I had difficulty with application to faculty positions or graduate research programs within larger academic institutions. Even with many years of college-level teaching experience, the institutions were looking for qualified research experience in my repertoire.
I lacked knowledge and experience about study design, research methodologies, data post-processing, statistical analysis, data interpretation, and scientific writing. Many of my chiropractic colleagues have faced similar issues and this problem could continue without intervention.
A Tremendous Opportunity
With recent networking of the entire Division of Chiropractic within the Department of Neurosurgery & Brain Repair at the University of South Florida (USF), we are honored to announce that the associate dean of the Morsani College of Medicine (MCOM) and director of the PhD Program in Medical Sciences has provided us with a letter of support that states DC students or existing clinicians who participate in a research preceptorship at USF for at least 4-6 months will be offered a guaranteed interview for potential acceptance into the Medical Sciences PhD program when they apply! This is huge, especially as we have many champions supporting chiropractic at USF.
Research preceptorships will provide DC students or existing clinicians the ability to acquire knowledge and skills in research, potentially warrant authorship in scientific publications, and provide competitiveness in applications to research in academia (not just at USF). Further, a research preceptorship will provide adequate time to develop relationships with diverse faculty and allow networking/collaboration within and beyond USF.
The Medical Sciences PhD program offered through MCOM at USF is unique in that it is an umbrella program, offering concentrations in 1) allergy, immunology, and infectious disease, 2) molecular medicine, 3) cardiovascular biology, 4) molecular pharmacology & physiology, 5) neuroscience, and 6) pathology & cell biology. Some students also work at Moffitt Cancer Center and with the Department of Medical Engineering. Thus, the opportunities here at USF present great potential.
Supporting the DC-PhD Pathway
Research is not for everyone, but those pursuing their clinical education who have interest in research should be provided with opportunities to grow the DC-PhD pathway. This is just the beginning – as this DC-PhD research enterprise flourishes, so will other opportunities on other campuses across the globe.
I am hopeful that a pipeline of highly qualified chiropractic clinician scientists will be instrumental in continuing to establish our wide academic presence and interdisciplinary collaboration. Further, it will establish the designation of "DC" as a more widely recognized degree in academia and potentially decrease the bias that my colleagues and I have faced as we seek academic promotion or recognition.
I strongly encourage all chiropractic colleges and chiropractic-associated businesses to consider how they could contribute financially and/or administratively to help our profession grow into this DC-PhD opportunity; for example, by ensuring that research preceptorships qualify for DC graduation requirements or establishing competitive scholarships to support a research preceptor.
References
- de Almeida Andrade F, Schlechta Portella CF. Research methods in complementary and alternative medicine: an integrative review. J Integr Med, 2018;16(1):6-13.
- Bredan A. Conducting publishable research under conditions of severely limited resources. Libyan J Med, 2020;15(1).
- Medina NG, Báez LS, Méndez LB. Collaborative transdisciplinary research in a small institution: challenges and opportunities. Inf Sci, 2018;21:235-253.
- Nahin RL, Straus SE. Research into complementary and alternative medicine: problems and potential. BMJ, 2001 Jan 20; 322(7279):161-164.
- Sugito R, Son D. Obstacles to the use of complementary and alternative medicine by primary care physicians: preliminary study. Traditional & Kampo Med, 2019;6(3):173-177.
- Veziari Y, Kumar S, Leach M. Addressing barriers to the conduct and application of research in complementary and alternative medicine: a scoping review. BMC Complement Med Ther, 2021;21(1).
Dr. Nathan Schilaty is the Lincoln Endowed Chair of Chiropractic & Biomechanics Research, director of the Center for Neuromusculoskeletal Research, and assistant professor of neurosurgery & medical engineering, Department of Neurosurgery and Brain Repair, at the University of South Florida (USF).