The Essential Guide to Research for DO Graduates in General Surgery Residency

Why Research During Residency Matters for DO Graduates in General Surgery

For a DO graduate entering general surgery, research during residency is no longer a “nice to have”—it is a powerful lever for career development, subspecialty fellowship placement, and credibility in an increasingly academic surgical world.

Even if you don’t envision yourself in a lab or running clinical trials, understanding how to ask questions, analyze data, and interpret the literature directly improves your operative decision-making and patient care. For DO graduates, research participation can also help counter lingering bias from some allopathic programs by demonstrably showcasing academic rigor and scholarly productivity.

In the context of the osteopathic residency match and now a unified ACGME system, many DO graduates feel pressure to “catch up” academically. The good news: general surgery residency is one of the best times to build a research portfolio that can open doors to competitive fellowships, academic careers, and leadership roles.

This article will walk you through:

• How research fits into general surgery training
• Unique considerations for DO graduates
• How to get started and stay productive
• Types of resident research projects that are feasible amid a busy surgical schedule
• How to align your work with an academic residency track or future fellowship

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Understanding the Role of Research in General Surgery Residency

Why Programs Care About Resident Research

General surgery is increasingly evidence-based. Programs expect residents to:

• Interpret literature to guide perioperative management
• Evaluate new techniques or technologies critically
• Contribute to quality improvement (QI) and patient safety

From the program’s perspective, resident research matters because it:

• Increases the department’s academic output
• Strengthens the institution’s reputation and rankings
• Helps fulfill ACGME requirements for scholarly activity
• Attracts higher-caliber applicants and faculty

For residents, research during residency offers:

• Stronger fellowship applications (e.g., surgical oncology, MIS, vascular, trauma/critical care, colorectal)
• Enhanced CV for academic job searches
• Professional networking with faculty at other institutions
• Deeper understanding of surgical literature and methodology

For DO graduates in particular, a solid research portfolio demonstrates:

• Ability to compete academically with MD peers
• Comfort with critical appraisal and evidence-based practice
• Commitment to academic general surgery or subspecialty training

ACGME Expectations and the “Academic Mindset”

ACGME-accredited general surgery programs must show that:

• Residents participate in scholarly activities
• Faculty mentor and support resident projects
• There are structured opportunities (journal clubs, research conferences)

Even if your program is more “community-based” than academic, you will almost certainly have:

• A research director or faculty research champion
• Institutional Review Board (IRB) access
• Opportunities for case reports, QI projects, or retrospective reviews

The mindset that program leadership wants to see is:

• Curiosity: noticing patterns or clinical problems that don’t have clear answers
• Initiative: being willing to own a project and move it forward
• Follow-through: not abandoning work once the initial excitement fades

For DO graduates navigating the surgery residency match and beyond, displaying these traits combats stereotypes that osteopathic trainees are “less academic” or “more community-oriented only.” Your work can prove otherwise.

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Unique Considerations for DO Graduates in General Surgery

Navigating the Osteopathic Background in a Unified Match Era

The transition to a single ACGME accreditation system has changed the landscape for the osteopathic residency match. Many formerly osteopathic general surgery programs have transitioned to ACGME accreditation, and more DO graduates now enter historically allopathic surgery programs.

What does this mean for you as a DO graduate?

• You are being compared directly with MD graduates within the same program
• Research involvement is a visible, objective way to showcase parity or superiority
• Publications and presentations can offset any program director concern about your prior institutional resources or research exposure in medical school

If you came from a DO school with limited research infrastructure, your residency years may be your first realistic chance to build a meaningful academic portfolio. That’s okay. Programs don’t expect you to start residency with dozens of publications. What they do expect is:

• Growth over time
• Increasing levels of responsibility on projects
• Evidence you can take an idea from inception to publication

Overcoming Imposter Syndrome and Perceived Gaps

Many DO residents quietly worry:

• “My MD co-residents had research years; I’m starting from zero.”
• “I’ve never used REDCap, written IRB protocols, or run stats.”
• “Will I be judged for asking ‘basic’ questions?”

In practice, faculty care less about where you start and more about how fast you grow:

• You can learn research methods systematically during PGY1–PGY3
• You can focus on clinically relevant, feasible studies that don’t require a PhD
• You can leverage your osteopathic training by asking whole-patient, systems-level questions (e.g., pain control, functional outcomes, integration of OMT concepts into perioperative care where appropriate)

Osteopathic training often emphasizes holistic care and patient-centered outcomes, which aligns well with:

• Quality improvement
• Patient-reported outcomes research
• Health services and disparities research

These are high-impact areas in contemporary general surgery scholarship.

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Getting Started: Building a Research Plan in Residency

Step 1: Clarify Your Career Goals Early

Your research strategy should match your long-term career interests. Ask yourself:

• Do I see myself in academic surgery, private practice, or a hybrid role?
• Am I interested in a competitive fellowship (e.g., surgical oncology, pediatric surgery, vascular, MIS, trauma)?
• Do I enjoy clinical questions more than lab or basic science questions?

If you are aiming for:

• Highly competitive fellowships or an academic residency track:
  Aim for multiple projects with at least several first- or second-author publications and regional/national conference presentations.
• General community practice without fellowship:
  A smaller portfolio (e.g., some QI projects, a couple of case reports, and perhaps one retrospective study) is often sufficient but still valuable for professional growth.

Document these goals and review them with:

• Your program director
• A research mentor
• A recent graduate who took a path you’re considering

Step 2: Find the Right Research Mentor(s)

A good mentor is more important than a glamorous topic. Ideally, find:

• A surgeon with an established record of publications and presentations
• Someone who has a track record of getting residents published
• A person whose communication style meshes with yours

Red flags:

• Faculty with many “ideas” but few completed projects
• Someone chronically behind on manuscripts or IRB renewals
• No evidence of prior resident co-authors on their papers

For DO graduates, a mentor who:

• Understands your background and can advocate for you at conferences and fellowship interviews
• Is willing to explain concepts step-by-step (from IRB to submission)
  can be transformative.

You can also consider:

• A primary clinical mentor (e.g., a colorectal surgeon)
• A secondary methodologic mentor (e.g., a biostatistician or outcomes researcher)

Step 3: Start Small but Finish What You Start

In PGY1–PGY2, prioritize small, finishable projects:

• Case reports/series of unusual surgical presentations
• Chart reviews addressing practical clinical questions
• Simple QI projects (e.g., reducing SSI rates, optimizing ERAS compliance)

These provide:

• Low barrier to entry
• Fast(er) timelines to publication or presentation
• Early wins that build confidence and momentum

Example:

• You notice frequent delays in starting elective general surgery cases because of incomplete pre-op labs.
• You work with your attending and QI team to:
  • Gather baseline data on delays
  • Implement a standardized pre-op checklist
  • Re-measure delays at 6 months
  • Present findings at a hospital QI day and submit a brief report to a surgical journal

This is practical, impactful, and realistic alongside a busy operative schedule.

Step 4: Learn Basic Tools and Methods

Early in residency, invest time in:

• Learning to use reference managers (EndNote, Zotero, Mendeley)
• Understanding IRB basics (exempt vs expedited vs full review)
• Gaining comfort with:
  • REDCap or similar data capture tools
  • Basic statistics (p-values, confidence intervals, common tests)
• Improving your scientific writing skills

Many programs offer:

• Resident research bootcamps
• Protected didactics on statistics and study design
• Access to institutional biostatisticians

If your program does not, seek:

• Online courses (Coursera, edX, university-based modules)
• Specialty society resources (e.g., ACS, AAS, subspecialty societies)

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Types of Resident Research Projects That Work in General Surgery

1. Clinical Outcomes and Retrospective Chart Reviews

Most accessible and high-yield for busy residents:

• Use existing patient records
• Focus on specific conditions, procedures, or perioperative protocols

Examples:

• Outcomes of laparoscopic vs open hernia repair in obese patients
• Readmission predictors after emergency general surgery
• Impact of DO-led perioperative pain protocols on opioid use after cholecystectomy

Why this fits DO graduates:

• Often minimal funding required
• Can align with osteopathic emphasis on holistic outcomes (pain, function, quality of life)
• Flexible timeline

2. Prospective Cohort Studies or Registries

More complex but powerful:

• Collect data on patients going forward from a specific start date
• Often used for:
  • ERAS protocol adherence
  • New surgical techniques or perioperative pathways
  • Patient-reported outcomes (PROMs)

You may not have the bandwidth to design a large prospective trial during residency, but you can:

• Join an existing registry (e.g., NSQIP, specialty registries)
• Coordinate data collection and contribute to analyses and manuscripts
• Lead sub-studies focused on a specific question (e.g., effect of osteopathic manipulative treatment–informed positioning or pain strategies, where institutionally appropriate and supported)

3. Quality Improvement and Patient Safety Projects

These often satisfy both institutional QI requirements and scholarly output:

• Root cause analysis of postoperative complications
• Bundled interventions to reduce CLABSI, VTE, or SSIs
• Standardization of perioperative antibiotic use

A well-designed QI project can become:

• A podium presentation at a regional or national meeting
• A peer-reviewed publication in a surgery or QI-focused journal

This aligns tightly with:

• ACGME milestones
• The holistic patient-centered principles emphasized in DO training

4. Basic Science and Translational Research

More common in high-volume academic centers, this involves:

• Animal models
• Cell lines and molecular pathways
• Surgical device development

Considerations:

• Often requires a dedicated research year (or two)
• Most demanding in terms of time, techniques, and funding

If your long-term goal is a heavily academic career (e.g., in surgical oncology or transplant), this can be valuable. But:

• It is not mandatory for every DO graduate in general surgery
• Many successful academic surgeons focus on clinical outcomes and health services research instead

5. Education and Simulation Research

Surgical education is an expanding area of scholarship:

• Simulation-based training for laparoscopic skills
• Evaluations of new curricula for residents or medical students
• Studies on feedback, milestone assessment, or competency-based progression

Example:

• A DO resident designs and evaluates a skills curriculum for incoming interns focusing on core open and laparoscopic techniques, including objective skill metrics.

This can support an academic residency track focused on:

• Program leadership
• Clerkship or residency directorship
• Education committee involvement

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Balancing Operative Training, Call, and Research Productivity

Time Management Realities

General surgery residency is time-intensive:

• Long operative days
• In-house or home call
• Clinic, conferences, and studying for ABSITE

To succeed in resident research projects without burning out, you need realistic strategies:

1. Set protected research hours

   • Even 2–4 hours per week can be productive if used consistently
   • Try early morning work before rounds on non-call days or a fixed weekend slot

2. Chunk tasks
   Break projects into:

   • IRB submission
   • Data collection
   • Data cleaning and analysis
   • Drafting introduction and methods
   • Drafting results and discussion
   • Revisions and submission

3. Use “micro-moments”

   • Waiting for cases to start? Work on literature review or references
   • On a lighter rotation? Schedule meetings with mentors or statisticians

Choosing the Right Project Scope

A common mistake is agreeing to large, unfocused projects that drag on without results. For DO graduates aiming to build a portfolio efficiently:

• Prioritize 2–3 manageable projects where you can be first or second author over 8–10 marginal contributions with little ownership
• Ask up front:
  • “What is the realistic timeline for this project?”
  • “Who will be responsible for which parts?”
  • “Has IRB already been approved?”

Collaborating with Co-Residents and Students

Leverage the team:

• Partner with co-residents to:
  • Share data collection
  • Cross-edit manuscripts
  • Cover each other during tough clinical weeks
• Mentor medical students (including DO students) who can:
  • Help with chart abstraction
  • Build figures and tables
  • Work on literature reviews

This not only boosts productivity but also demonstrates leadership—valuable for program letters, fellowship applications, and future academic roles.

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Positioning Yourself for an Academic Residency Track or Fellowship

Building a Coherent Research Narrative

When you apply for fellowships or academic roles, selection committees look for:

• A coherent theme in your work (e.g., foregut surgery outcomes, trauma systems, health disparities, ERAS pathways)
• Demonstrated progression (from helping on projects to leading them)
• Measurable output (publications, abstracts, invited talks)

For a DO graduate in general surgery, a strong narrative might look like:

• PGY1–PGY2: Case reports and small retrospective or QI projects around one topic (e.g., acute care surgery, colorectal, hernia)
• PGY3–PGY4: Larger retrospective studies, multi-institutional collaborations, or prospective databases in that domain
• PGY4–PGY5: Lead or senior-author roles, national presentations, invited talks or workshops

Document everything:

• Maintain an updated CV with:
  • Published and in-press articles
  • Abstracts and posters
  • Oral presentations
  • Awards and distinctions
• Keep copies of acceptance letters and conference programs

Research During Residency vs. Dedicated Research Years

Not all residents will or should take a dedicated research year. Consider:

You might not need a research year if:

• You are aiming for less competitive fellowships or broad-based general surgery practice
• Your program allows consistent productivity during clinical years
• You already have a solid foundation from medical school or earlier projects

You might benefit from a research year if:

• You want a highly competitive academic fellowship (e.g., complex surgical oncology, pediatric surgery)
• Your goal is a heavily research-focused academic residency track or faculty career
• Your program has strong infrastructure for resident research (mentorship, funding, lab space)

For DO graduates, a successful research year:

• Can significantly elevate your profile to parity with MD applicants from research-heavy institutions
• Helps neutralize any perceived disadvantage from medical school resources

If you choose this path, ensure:

• Strong mentorship and a clear project plan before starting
• A realistic expectation of outputs (e.g., X manuscripts submitted, Y abstracts)
• That you stay clinically engaged (call coverage, assisting on cases) to avoid skills atrophy

Showcasing Research in Applications and Interviews

When you apply for fellowships or academic positions:

• Highlight 2–3 key projects in your personal statement
• Be prepared to discuss:
  • Your hypothesis
  • Methods and limitations
  • Practical clinical implications
• Emphasize how your osteopathic background informs your research lens (e.g., focus on functional outcomes, whole-patient care, and system-level questions)

In interviews, program directors may ask:

• “What was your most meaningful project and why?”
• “How did you handle obstacles in your research?”
• “How will you continue scholarly work as a fellow or faculty member?”

Your answers should show:

• Maturity in dealing with setbacks (IRB delays, rejected manuscripts)
• Persistence and adaptability
• A realistic, sustainable plan for future research

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FAQs: Research During Residency for DO Graduates in General Surgery

1. I’m a DO graduate with little research experience from medical school. Is it too late once I start residency?
No. Many residents, DO and MD, begin serious research only during residency. Start with small, achievable projects (case reports, retrospective reviews, QI studies), find a strong mentor, and aim for steady growth over your PGY years. It’s the trajectory and consistency that matter most, not how early you started.

2. How many publications do I “need” for a competitive general surgery fellowship?
There is no universal number, but for more competitive fellowships, many successful applicants have:

• Several peer-reviewed publications (often 3–8+)
• Multiple regional/national presentations
• At least a few first- or second-author works
  Quality, thematic coherence, and your role in the project are just as important as raw numbers, especially for DO graduates demonstrating academic capability.

3. Can I do meaningful research in a community-based general surgery program?
Yes. While you may have fewer basic science options, community programs often have excellent opportunities for:

• Clinical outcomes research
• Quality improvement and patient safety projects
• Health services research (e.g., access to care, referral patterns, disparities)
  If your institution partners with a university, you may also access additional statistical and methodological support.

4. How do I decide between pursuing an academic career versus community practice if I like research but also value work–life balance?
During residency:

• Explore both: participate in research while experiencing various practice models on rotations and electives
• Talk to faculty in academic and community roles about their day-to-day lives
• Note that many surgeons now have “hybrid” careers: community-based practice with ongoing research collaborations or part-time academic appointments
  You don’t have to decide immediately, but building a solid research foundation keeps both doors open for you as a DO graduate in general surgery.

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By approaching research during residency strategically—especially as a DO graduate in general surgery—you can not only strengthen your CV but also enhance your clinical judgment, expand your professional network, and keep pathways open to both academic and advanced clinical careers.