Research project

Today was a bad day.

I should explain that while we are on elective, the university requires us to do a short project - most people do a reflective essay on their experiences, some do case studies, but I chose to do a research project. I read a paper several months ago about some research in Nottingham looking at parental involvement and satisfaction in decision making processes regarding oncology, and thought it would be interesting to see how both parental involvement (or teenager's involvement for older children) and satisfaction varied between the UK and a developing country such as Nepal (thinking that in Nepal parents would be less involved in decisions, but have higher satisfaction - ie not want to be as involved). At the time I was fortunate enough to be working with a consultant in paediatric and adolescent oncology, Dr Stoneham, who helped me through the process and offered to assist me in finding patients in UCH to compare to those in Nepal. I went in on a couple of days over the summer holiday to ask some teenage patients to fill out the short questionnaire, and had also prepared a questionnaire for Nepali patients (or their parents given the younger ages).

I applied to various funds for grants towards my elective, and back in April I emailed my supervisor in Nepal, Dr Kailash, who said "your proposal will be review by board [for ethics approval], then only it will be O.K . I will try my best for your propsal to  pass from our board of scientific commette". Despite asking for confirmation, the replies were a little hit and miss, but I didn't think there would be any reason why I would not get ethics approval (and, by the way, I didn't even need this for London!)


A few days before I left, I found I had been successful in two UCL grants for my elective, and a couple of days ago I found out that I had also been awarded the Wellcome Trust elective award - something I was quite pleased about and also totally a quite considerable sum of money which would have been very useful given the amount I have spent! So anyway, everything seemed great. But it wasn't.


In my second week I was speaking to Dr Kailash and he said that he had not got sought permission from the board, and I would not get it if the results looked bad on KCH (this sort of bias resembles 'publication bias' - where the published research is overly optimistic as only 'good' results get published. I would also have thought it was quite unethical in itself. Nevertheless, he referred me to the research secretary, Dr Agit, and said that we should be able to work something out. I have been looking for Dr Agit daily, but he has been away, and yesterday I went about 2pm but he had already gone. 


Determined to get this sorted once and for all, I skipped surgical outpatients today and went to find him. After following his ward round, we sat down and discussed my research. However, I was told that all research of any kind needs to go through the committee, and the next meeting was in a couple of weeks. I hadn't lost hope yet, as that would still leave me a few days to do my research - possible if I pulled out all the stops!  So I needed to write a proposal to submit to the board. However, he then kindly informed me that approval would take 2-3 months for approval, so obviously that would have been pointless.


To be fair, it was not Dr Agit's fault - if the approval has been sought back in April that would have left me plenty of time, but I didn't know my proposal had never been submitted. Now Dr Kailash in away for a week, so it will be a while before I find out either. However, I have been left with the unfortunate conclusion that I have been told what I wanted to hear so that I would come to KCH and pay my fees to the oncology fund. Don't get me wrong, I don't begrudge those poor children the money for medication at all, but I am upset and angry about the situation at present.


Would I recommend Nepal to others?
For a holiday, yes, there are plenty of sights to see, activities to do, the people are on the whole very friendly and welcoming, and I am now really looking forward to Everest Base Camp trek.
However, I think as for hospitals, I would recommend applying to others apart from Kanti - such as the Teaching Hospital over the road, or the (in)famous Bir Hospital, especially if you have to do a project there. It's not just the problems I have had with this project, but generally there has not been a great deal to do here in the hospital. A combination of everything seeming to finish at lunchtime and generally being so many junior doctors means that I fear other students may be disappointed. (one Dutch medic went away to India for a bit because he was so frustrated about his research being denied).

Still, as it looks like I will be doing a reflective piece now, at least I will have lots to reflect on.