There are a number of options about timing research in surgical training and equally there are a number of different possible models for research/clinical training. At one end of the spectrum is the MB PhD model which involves PhD training seamlessly from medical studies. The model was developed to foster academic leadership and has a number of proponents. One of the criticisms of this model is that a PhD is usually undertaken at a point where clinical differentiation has not occurred. What this means is that the PhD may end up not only in a different subspecialty area but in a whole different branch of medicine from what the individual chooses to be their final career choice. This may not be an issue for some but it is for others. To my knowledge there have been relatively few academic surgeons who have pursued this path to date.
Generally speaking the later in your career that you undertake a period of dedicated research the more likely it is that it is going to be an area that genuinely matches your future clinical practice. However, for many people research unlocks doors in the career pathway and there are good reasons for doing research at a relatively early stage.
In the UK it has been quite common for individuals to undertake research either between core and specialty training or once a specialty training number has been obtained. The benefit of doing research before specialty training is that it makes an individual highly competitive for a training number by virtue of having research experience, publications, registration or the award of a thesis etc. The detriment is the risk imposed by having to compete for a training number and potentially have to move to a different deanery or region of the country. Others choose to wait until they have a training number to avoid this potential problem and also to be more certain of undertaking research in the area that they favour as a subspecialty.
Some schemes such as the devolved Wellcome Trust Edinburgh Clinical Academic Track schemes require individuals to have a National Training Number as an eligibility criterion prior to applying others like the Dundee Clinical Academic Track do not.
The issue of what kind of degree and how long to spend in research will be the subject of another blog. What most surgeons worry about is how long they will be out of clinical practice and specifically out of the operating theatre. I have supervised many surgeons in research and have yet to meet one who has developed disuse atrophy of their hands. Many centres will offer surgery trainees a phased return to clinical work so that they can re-discover their surgical skills but this is rarely a problem and should not be considered as a barrier to undertaking research. I always liked this quote from the famous American Neurosurgeon Harvey Cushing “I would like to see the day when somebody would be appointed surgeon somewhere who had no hands, for the operative part is the least part of the work.”
At the end of the day there is no right or wrong answer about the timing of research other than making sure it works for you and fits in with your postgraduate clinical training. In the same way it is not the end of the World if your doctoral research and clinical career do not match. If you wish to pursue an academic career then many of the skills learnt during doctoral research (in whatever subject) will prepare you well for later research practice in a different field. The most important piece of advice is probably to speak to people who know. By this I mean those who have undertaken research in your specialty, or the postgraduate dean or to academics in your area. You can also ask careers advice relating to research training from the major funding councils.