When interviewing for medical school, many of us were asked to specify what kind of research we were interested in: basic, translational and clinical research. Under the descriptions of each category were topics that fit into each, and under basic research, it listed “immunology.” When one of our tutors went through this process, within a few minutes, he heard someone respond that they were offended that their immunology research was considered “basic...”.
It became abundantly clear at this point that people in and outside of medicine are still confused about these terminologies, which are fundamental to understanding the research world. More importantly, an understanding of the differences between basic, translational and clinical research is almost imperative to helping you decide on a future lab!
Basic Research or “How does this work?”
Basic research is sometimes referred to as “basic science” or “fundamental research.” Basic research attempts to provide answers to the mysteries of modern medicine, with the goal of a better understanding of a particular concept, as niche as it may be. Basic science experiments might study how cancer cells replicate on a molecular level, or how an abnormal protein folds to cause some congenital disease. Even more “basic” experiments might explore how atom-atom interactions affect the ability for blood to coagulate, or even the electron-electron distance of an atom!
Most physicians are not doing basic research, and sometimes the demands of increased biophysical and molecular expertise to answer these questions necessitate advanced degrees, such as a Master’s or Ph.D. Basic science is a field for naturally curious individuals with a propensity for designing experiments. Basic science is the most time-consuming of the types of research, as elucidating a mechanism for some medical mystery can take years, if not decades or more. It is not for the faint of heart, as these projects fail and fail fast. However, with the right mindset, dedication and project, basic science can be extremely rewarding and can lead to fundamental discoveries (like when Watson and Crick found out DNA was double stranded) that changed the way biology and medicine is thought about.
Translational Research, or “Let’s turn this into something useful!”
Nowadays translational research is a hot topic and it seems everyone is doing a little bit of it. The goal of translational research is to take some knowledge of a particular biological phenomenon (that the basic scientists discovered) and translate it into something that might eventually be used in a clinical setting. Some examples of this are taking the knowledge of an enzyme’s structure that a basic scientist discovered and synthesizing a drug that will bind to that enzyme and block its activity. Another might be trying to find a better way to deliver chemotherapy to cancer cells without exposing it to the rest of the body. A lot of translational research will take place in animal models and can range in everything from mice to horses, which can provide a valuable tool for testing different therapies before moving into humans.
Many physicians are doing translational research! Translational research is for curious individuals who are equally eager to apply knowledge in the design of a new therapy. These individuals often are pragmatic, less concerned with theory and more with result. Oftentimes, translational research will overlap with fields of engineering and pharmacology. Doing translational research can provide promise of something that can potentially be game-changing in medicine and is highly appealing for that reason. Many people also are enticed by going through the extensive process that requires screening, validation and ultimate application of therapies to humans. In many ways, translational research is all about this process. However, be warned: very, very few therapies actually make it to humans!
Clinical Research or “Is this actually useful?
Clinical research is the last step, and everyone has heard of this one. Usually clinical research is answering some question about human populations—and the key word here is human. In the context of basic to translational to clinical, clinical research is the last step in which you validate a new drug or therapy in real patients, looking at efficacy and safety, often compared to other gold-standards for treatment. With the right experimental design, sometimes these are called “clinical trials.” Clinical research in this regard is for the most practical, pragmatic individuals who are results focused. Clinical research can also include efforts at improving outpatient waiting times, decreasing emergency room waiting times, or decreasing patient hospital readmissions. These may not be “drugs” or “therapies” in traditional senses, but are interventions nonetheless. Clinical research is rewarding because it is most directly related to the lives and health of human beings, and among the types of research it is the most seemingly relevant.
Almost all physicians have done clinical research at some point in their lives, and most physicians at academic centers are doing clinical research. If taking care of patients is your calling, your pride and joy, then clinical research will only make that endeavor more fruitful. Clinical research usually involves patient interactions, lots of paperwork, and heavy doses of statistics and epidemiology. At the same time, it provides the promise of legitimately changing countless lives in the short-term. There is less emphasis on experimental design and curiosity, and sometimes clinical research will be described as dull or mundane. Clinical research is also often times considered “low-hanging fruit” in academia, as answers can be found relatively quickly. For this reason, clinical research is probably the most abundant in opportunities wherever you are, so this may be a good place for most people to get started.
If after reading all of this you’re still confused, we don’t blame you! A lot of research actually falls into more than one of these categories, and some people can even use these terms interchangeably (especially basic and translational). Lots of physicians also have basic, translational and clinical projects to make it even more confusing. Hopefully from this you can get a better sense of what you like and what might entice you the most. However, while these generalizations can help you get a picture of where to start and where to look, nothing can replace the actual experience of taking on a research project. For tips on that, check out Research in Medicine: How To Pick the Perfect Project.