🔬 Quality Improvement Activity · Bradford VTS
Doing a Research Study
Because "I read a paper once" doesn't quite count as academic credibility — but knowing how to actually conduct a study? Now that's a genuine superpower.
For Trainees, Trainers & TPDs
Knowledge not found elsewhere
High-yield tips for GP training
Research in general practice is more accessible than most trainees think — and more valuable than any single QIA tick-box. Whether you are just exploring, designing a small study, or considering an academic career, this page gives you the foundations, the frameworks, and the insider wisdom to get it right.
Last updated: April 2026
📥 Downloads
Handouts, sample studies, marking grids and teaching extras — ready when you are.
path: DOING RESEARCH
🔗 Web Resources
A hand-picked mix of official guidance and real-world GP training resources. Because sometimes the best pearls are not hiding in the official documents.
📌 Core Official Guidance
RCGP
RCGP Research Hub
Research engagement pages, grants, fellowships, and the PACT network for GP trainees.
RCGP
RCGP QIA Guidance
Official guidance on Quality Improvement Activities — including research as a QIA type.
HRA
HRA: Research vs Audit vs Service Evaluation
The definitive HRA table that defines what counts as research. Essential first read before you plan anything.
HRA
Do I Need NHS REC Approval?
HRA's decision tool and guidance on when NHS Research Ethics Committee review is required.
NIHR
NIHR Good Clinical Practice (GCP)
GCP training is mandatory before most NHS research involving patients. Start here.
HRA
UK Policy Framework for Research
The core governance framework for all health and social care research in the UK.
🎓 GP Training & Academic Career Resources
RCGP
RCGP Research Engagement Hub
Career stories, funding routes, and how to get involved in primary care research as a trainee.
PACT
Primary Academic Collaborative (PACT)
GP trainee-led research network. Anyone can join. Great for getting a first study off the ground with peer support.
NIHR
NIHR In-Practice Fellowships
Funded academic time for GPs and GP trainees to carry out research. Competitive but very rewarding.
BJGP Open
BJGP Open Journal
Open-access RCGP journal — a realistic publication target for early-career GP researchers.
💡 Research Methods, Statistics & Writing Up
NHS England
NHS Research Toolkit (HEE)
Step-by-step guide to designing, governing, and publishing NHS research. Clear and practical.
BMJ
Statistics at Square One (BMJ)
The classic free statistics textbook for medical researchers. Gentle, readable, and comprehensive.
CASP UK
CASP Critical Appraisal Tools
Free checklists for critically appraising RCTs, cohorts, qualitative studies and more.
EQUATOR
EQUATOR Reporting Guidelines
CONSORT, STROBE, COREQ, PRISMA — the reporting standards journals require when you write up.
Bradford VTS
BVTS Evidence-Based Medicine & Statistics
Bradford VTS's comprehensive EBM and statistics pages — directly relevant to GP research literacy.
⚡ Quick Summary — If You Only Read One Thing
The essentials for understanding and doing a research study in GP training.
What it is
A research study systematically investigates a question using structured methodology to generate new knowledge — going beyond what an audit or case study can answer.
RCGP position
Research counts as a QIA (Quality Improvement Activity). You need at least 1 QIP + 2 QIAs in training. A well-executed research study satisfies QIA requirements beautifully.
Start here
Begin with a focused question. Use the PICO framework. A narrow question done well beats a broad question done poorly — every single time.
Ethics first
Before collecting any data, check if you need NHS REC approval using the HRA decision tool. Many small GP studies don't need full REC review.
Study types
Qualitative (why/how — interviews, focus groups) and quantitative (what/how many — surveys, case series). Mixed methods uses both.
The secret weapon
The best trainee research is small and focused. A properly designed 10-patient qualitative study impresses far more than an abandoned multi-site trial.
🏆 Top 10 Things to Remember
- Research = generating new knowledge. Audit = measuring against a standard. Know the difference before you start planning.
- A research study counts as a QIA — and a very impressive one when done well and reflected upon properly.
- Small, focused, and completed beats large, ambitious, and abandoned every single time.
- Use the HRA decision tool before you recruit a single participant or access any patient data.
- Good Clinical Practice (GCP) training is mandatory before most NHS research involving patients — book it early.
- PICO framework: define your Population, Intervention/Interest, Comparison, and Outcome before anything else.
- Choose qualitative for "why/how" questions; quantitative for "what/how many" questions. Don't mix them accidentally.
- Consent and confidentiality are non-negotiable — not optional extras. Document everything.
- Methodology must be described in enough detail that someone else could replicate the study.
- The reflection and learning matter as much as the results for your portfolio evidence.
💡 Why Research Matters in GP Training
Not just another hoop to jump through — this one actually shapes the future of the specialty.
General practice is the most research-rich specialty in medicine that most trainees never think to enter. One in three GP consultations involves uncertainty where no strong guideline exists. Who produces that evidence? GPs. Who benefits when GPs become research-literate? Every patient, in every future consultation.
Engagement with research builds critical appraisal skills, sharpens clinical reasoning, and makes you a more discerning consumer of the evidence base. Trainees who understand research methodology are harder to mislead by poor-quality data — and more likely to notice when a guideline rests on shaky foundations.
🌱 For the Trainee
- Develops critical appraisal skills that improve every clinical decision
- Provides strong evidence for QIA requirements
- Opens doors to NIHR fellowships, academic posts, teaching roles
- Builds a CV that genuinely stands out
- Satisfies the curiosity that makes better doctors
🏥 For Primary Care
- GP trainees bring fresh perspectives to existing clinical problems
- Training practices with active research culture show higher patient satisfaction
- Fills evidence gaps that specialist medicine never addresses
- Contributes to the NHS evidence base at low cost
- Builds the pipeline of academic GPs the UK urgently needs
💡
Insider Tip — From Trainee Experience
Trainees who present their research findings — even preliminary ones — at a practice meeting, VTS half-day, or local conference consistently describe it as one of the defining moments of their training. It builds confidence, demonstrates leadership, and creates a memorable portfolio entry. Even a small, well-presented study leaves a lasting impression.
📖 What Counts as Research? — Getting the Definitions Right
The most important table you'll read before you start. Get this wrong and your ethics application will be rejected before you've begun.
The HRA (Health Research Authority) defines research, audit, and service evaluation very specifically. The classification determines whether you need NHS REC ethics approval, R&D governance, or neither. Many trainees waste weeks applying for ethics approval they don't need — or worse, start collecting data without the approval they actually do need.
| Type | Purpose | Methodology | NHS Ethics Needed? |
|---|---|---|---|
| Research | Generates new knowledge — creates generalisable findings not currently known | Designed to test a hypothesis or answer a defined research question; findings intended to be transferable | Usually yes Use HRA tool to confirm |
| Clinical Audit | Measures current practice against an agreed standard; aims to improve local care | No new knowledge; compares to known benchmarks; results not intended for generalisation beyond the setting | Usually no But local R&D registration may be needed |
| Service Evaluation | Evaluates a specific service to define or judge current provision | Looks at what's happening now; no control group; findings specific to the service evaluated | Usually no But always check locally |
⚠️
Common Trainee Mistake
Labelling a project "audit" to avoid ethics approval when the methodology is actually research. This is a serious governance error. If you intend to generalise findings beyond your practice, test a hypothesis, or answer a question that isn't "are we meeting a standard?" — use the HRA decision tool. Don't guess.
🎯
The Practical Test
Ask yourself: "Am I measuring against an existing standard or guideline?" If yes → probably audit. "Am I trying to find out something that isn't already known?" If yes → probably research. When in doubt, use the HRA's online decision tool at hra-decisiontools.org.uk. It takes five minutes and its output can be printed as evidence.
🔬 Types of Research Study
Choose the right design for your question — not the design you've heard of most recently.
The research question determines the study design. Choosing the wrong design is the single most common methodological error in trainee research. Use this table as your starting point — and get input from a supervisor before you commit.
| Study Type | Best Used For | Example in GP | Key Limitation |
|---|---|---|---|
| Qualitative — Interviews | Exploring experiences, perceptions, attitudes, or processes | "Why do patients delay seeking help for chest pain?" | Results not generalisable to all; smaller sample |
| Qualitative — Focus Groups | Exploring group attitudes; understanding shared perspectives | "How do staff perceive the new telephone triage system?" | Group dynamics can suppress minority views |
| Cross-Sectional Survey | Measuring prevalence of an attitude, condition, or behaviour at one time | "What proportion of patients with hypertension are taking their medication as prescribed?" | Cannot establish causality; snapshot only |
| Case Series / Notes Review | Describing patterns in a clinical population within your practice | "Describe the outcomes of the first 20 patients referred to the PCN social prescriber" | No comparison group; potential selection bias |
| Literature Review | Synthesising existing evidence; identifying research gaps | "What interventions improve asthma inhaler technique in primary care?" | Quality depends on literature available; risk of bias in selection |
| Mixed Methods | Combining depth of qualitative with breadth of quantitative | "Survey: how many patients missed follow-up? Interviews: why?" | More complex; requires two methodological skill sets |
✅ Best Bets for GP Trainees
- Semi-structured qualitative interviews (5–15 participants)
- A simple cross-sectional survey of staff or patients
- Notes review / case series with your practice data
- A focused literature review on a primary care topic
- Mixed methods combining a short survey + 3–5 interviews
❌ Avoid in GP Training
- RCTs (too complex; require substantial infrastructure)
- Multi-site studies (too time-consuming in training)
- Studies requiring large sample sizes for statistical power
- Laboratory or experimental studies (wrong context)
- Any study without a clear, answerable question
🔍 Visual Guide: Choosing Your Study Type
Not sure which research method fits your question? This visual shows you how to choose — fast.
🗺️ Research Design Decision Map
📋 Step-by-Step: How to Do a Research Study
From vague idea to polished portfolio entry — the full pathway, with no steps skipped.
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1Identify your research questionWhat genuinely puzzles you in your clinical practice? What have you seen that made you think "I wonder why that happens"? Good research questions come from real GP encounters, not from textbooks. Use the PICO framework to make the question specific and answerable. A fuzzy question produces a fuzzy study.
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2Do a quick literature searchBefore you design a study, check whether your question has already been answered — or partially answered. Search PubMed, BJGP, and Google Scholar. You don't need to be exhaustive at this stage. You need to know: has this been studied? Is there a gap? Can I add something new, even locally?
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3Choose your study designLet your question guide your design — not the other way around. "Why do patients...?" → qualitative. "How many patients...?" → quantitative. "Is X associated with Y?" → cross-sectional or retrospective cohort. Discuss your design with your supervisor before committing.
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4Use the HRA decision tool — classify your projectVisit hra-decisiontools.org.uk. Work through the online tool. Print the output. This determines whether you need: NHS REC ethics approval, HRA approval, local R&D approval, or none of the above. Do not skip this step.
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5Seek ethics approval (if required)If ethics approval is needed, apply via IRAS (Integrated Research Application System). Allow 8–12 weeks for NHS REC review. For GP practice-based studies involving only staff views on their professional role, or using fully anonymised data, you may not need full REC review — but always confirm this in writing. Many small primary care studies only require local R&D registration, not full ethics review.
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6Complete GCP training (if involving patients)Good Clinical Practice training is mandatory before any research that involves NHS patients or their identifiable data. It is available free online via the NIHR. It takes approximately half a day. Get the certificate — you will need it for IRAS and for your supervisor's reassurance.
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7Write your research protocolA protocol is a detailed plan of your study. It should include: background, research question, methodology, sampling strategy, data collection approach, analysis plan, ethical considerations, and timeline. Writing it forces you to think through every decision in advance — and prevents expensive mistakes once you start.
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8Recruit, collect, and analyseFollow your protocol. Obtain informed consent before recruiting any participant. Collect data systematically. For qualitative studies: audio-record interviews with consent and transcribe them. For quantitative studies: use a piloted data collection tool and pre-specified analysis plan. Keep a reflexivity diary if doing qualitative work.
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9Analyse, interpret, and reflectQualitative: use thematic analysis or framework analysis. Quantitative: use descriptive statistics for small studies; inferential statistics if sample size allows. What did you find? What does it mean for GP practice? What surprised you? What would you do differently? The reflection section is where the portfolio evidence is generated.
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10Disseminate your findingsAt minimum: present to your practice team. Better: present at a VTS half-day or regional event. Best: write it up and submit to BJGP Open, Education for Primary Care, or a regional poster competition. Dissemination is an ethical obligation if you've involved participants — and it builds your CV considerably.
🎯 The PICO Framework — Building Your Research Question
P
Population — Who are you studying? Be specific: "Adults with type 2 diabetes over 60 registered at a single UK GP practice" not just "diabetic patients".
I
Intervention or Interest — What are you studying? An intervention (e.g. a new service), an exposure (e.g. delayed diagnosis), or a phenomenon (e.g. patient experience of telephone triage).
C
Comparison — Is there a control or comparison group? Not all research has one — qualitative studies often don't. But being explicit about this shapes your design.
O
Outcome — What are you measuring or exploring? Be as precise as possible. "Patient satisfaction" is vague. "Patient-reported experience of telephone triage, using a validated satisfaction scale" is specific.
📅 A Realistic Timeline for Trainee Research
How to fit a properly conducted research study into a busy training year — with ethics, collection, analysis, and write-up all included.
Week 1–2 — Define your question
Choose your topic from something that genuinely puzzled you in clinic. Apply PICO to sharpen it. Do a quick literature search — 30 minutes on PubMed is enough. Confirm with your supervisor that the question is feasible.
Week 2–3 — Classify and check governance
Use the HRA decision tool. Is this research, audit, or service evaluation? What approvals are needed? Start GCP training online (free, half a day). Register with local R&D if required. Do not skip this step.
Week 3–6 — Ethics application (if needed)
If NHS REC approval is required, apply via IRAS. Allow 6–8 weeks for review and decision. Use this time to write your protocol and design your data collection tools. Do NOT start collecting data before approval arrives.
Week 4–6 — Write your protocol & pilot
Write a one-to-two page protocol covering: background, question, design, sample, data collection, analysis, ethics, timeline. Pilot your interview guide or survey with one colleague. Adjust based on feedback.
Week 6–12 — Data collection
Recruit participants. Collect data systematically. Audio-record and transcribe interviews as you go — do not let them pile up. For notes reviews: extract data into a simple spreadsheet immediately. Keep reflexivity notes throughout.
Week 12–16 — Analysis
Qualitative: thematic analysis or framework analysis. Read transcripts several times. Code, then identify themes. Quantitative: descriptive statistics. For a small study, Excel is fine. You do not need SPSS for a 20-patient notes review.
Week 16–18 — Write up & disseminate
Use the standard write-up sections: background, question, methodology, results, discussion, limitations, reflection. Present at a practice meeting or VTS half-day. Upload to your FourteenFish portfolio as a QIA learning log entry.
⚡ Fast-track version: For a simple notes review or survey using existing practice data that doesn't need REC approval, the entire timeline from question to write-up can be compressed to 4–6 weeks. This is one of the most time-efficient QIA options available to GP trainees.
⚖️ Ethics & Governance — The Non-Negotiables
This is the part trainees most often underestimate. It's also the part that, if done wrong, can halt your entire study.
📋 Do I Need NHS REC Approval?
The Health Research Authority (HRA) decision tool gives you a definitive answer in about 5 minutes at hra-decisiontools.org.uk. As a general rule:
- Full NHS REC review needed: any study recruiting NHS patients as participants; accessing identifiable patient data without consent; involving people who may lack capacity.
- Usually not required: studies involving NHS staff recruited only by virtue of their professional role (e.g. a questionnaire sent to GPs about their prescribing attitudes); studies using fully anonymised data from local records.
- Local R&D registration: even if full REC review is not needed, research in NHS settings usually requires registration with the local R&D office.
Always print and retain the output of the HRA decision tool as evidence that you assessed this properly.
✅ Informed Consent — What Does "Informed" Actually Mean?
Informed consent is not a signature. It is a process. Participants must:
- Receive a written participant information sheet (PIS) — minimum 24–48 hours before consent is sought, in plain language (readability score ~60+)
- Have the opportunity to ask questions
- Understand they can withdraw at any time without consequences
- Sign a consent form — or in some anonymous surveys, completion of the survey implies consent (but this must be clearly stated)
Your PIS should explain: what the study involves, what will happen to the data, how confidentiality is maintained, and your contact details. The HEE Research Toolkit has a free template.
🔒 Confidentiality & Data Protection
Research data must comply with UK GDPR and the Data Protection Act 2018.
- Anonymise data as early as possible in the analysis phase
- Store identifiable data on NHS or university-approved encrypted systems only — not personal laptops or non-NHS cloud storage
- Destroy identifiable data after the agreed retention period (often 5–10 years for NHS research)
- Audio recordings: transcribe and then delete the recordings once transcription is verified
- Never name individual participants in a write-up — use participant numbers or pseudonyms
📜 Good Clinical Practice (GCP) Training
GCP training is mandatory before any research involving NHS patients or their data. It takes approximately 3–4 hours and is freely available online via the NIHR Learn website at nihr.ac.uk. The certificate is valid for 2–3 years. You will need it for your IRAS application.
Even if your study doesn't strictly require GCP, completing the training demonstrates research governance awareness — which is itself good evidence for your portfolio.
🚨
Critical Warning — Do Not Skip This
Do not collect a single piece of data — not a survey response, not an interview transcript, not a patient record — before your ethics and governance approvals are in place (or you have written evidence from the HRA tool that no approval is needed). Starting data collection before approval is a serious research governance violation with real professional consequences.
⚖️ Visual Guide: Do I Need Ethics Approval?
The single most-asked question by new trainee researchers. Answer it in under two minutes with this flowchart. (Always confirm with the official HRA decision tool.)
🔒 Ethics Approval Decision Flowchart — for GP Trainees
🔗 The HRA Decision Tool — use it at hra-decisiontools.org.uk/research. It takes five minutes, it's free, and you can print the output as formal evidence that you assessed your governance correctly. Many trainees spend weeks worrying about this. Five minutes on the tool ends the worry.
🔎 Sample Sizes — Busting the Biggest Myth
The most misunderstood concept in trainee research. Almost every new researcher overestimates how many participants they need.
📐 Typical Sample Sizes by Study Type in Primary Care Training
Key point: For qualitative research, the goal is data saturation — the point where new interviews stop producing new themes. Most focused primary care qualitative studies reach saturation at 8–12 participants. You are not trying to be statistically representative. You are trying to understand lived experience in depth.
✍️ Writing Up — Making Your Study Count
The write-up is where the educational value is generated. A study without a good write-up is like a consultation without notes.
For QIA purposes, your write-up needs to demonstrate engagement, reflection, and learning — not just a list of what you did. The RCGP wants to see evidence that the research process taught you something applicable to your future practice as a GP.
| Section | What to Include | Common Mistakes |
|---|---|---|
| Background & Rationale | Why is this question important? What gap does it fill? Brief literature summary. | Making this too long; not linking it to GP practice specifically |
| Research Question | One clear, specific, answerable question — ideally in PICO format | Vague question that can't be answered; multiple questions merged into one |
| Methodology | Study design, sampling strategy, data collection tools, ethical approvals, analysis approach | Insufficient detail; no mention of ethics; inconsistent method and analysis |
| Results / Findings | What did you actually find? Present data clearly. Use quotes for qualitative; numbers for quantitative. | Presenting interpretation as results; cherry-picking favourable findings |
| Discussion | What do the findings mean? How do they compare to existing literature? Limitations? | Ignoring limitations; over-claiming generalisability of small studies |
| Conclusion & Reflection | What did you learn? What has changed in your practice? What would you do differently? | Thin reflection; no personal learning; no mention of impact on practice |
🔥
What Gets You Good Marks — Trainee-Tested Insight
Supervisors and ARCP panels consistently rate research write-ups highly when the reflection section is genuinely personal and specific. "This made me think differently about how I approach..." is far more impressive than "This study confirmed existing evidence." Show intellectual engagement, not just methodological competence.
📝
Reporting Guidelines — Use Them
If you intend to publish, use the correct reporting guideline for your study type. CONSORT for RCTs; STROBE for observational studies; COREQ for qualitative interviews and focus groups; PRISMA for systematic reviews. All checklists are freely available at equator-network.org. Using them also makes the write-up considerably easier — they tell you exactly what to include.
🔥 What Actually Gets You Good Marks
Based on patterns from ARCP feedback, deanery guidance, and trainee peer accounts — here is what distinguishes a well-received research QIA from an average one.
📊 What ARCP panels and supervisors value most
★ ratings indicate relative emphasis seen in ARCP feedback and supervisor guidance. Bottom two items are not expected for portfolio QIA — they are bonuses, not requirements.
Write your reflection last — but think about it first. Start a notes document the day you begin your study. Jot down what surprises you, what changes your thinking, what you'd do differently. Reflection written from live notes is always richer than reflection reconstructed months later.
Name the limitation — then explain why you did it anyway. Saying "this was a small study in one practice, which limits generalisability — but it still has value because..." shows analytical maturity. Supervisors actively look for this kind of honest reasoning.
Connect findings back to your clinical practice. The best QIA write-ups include a paragraph like: "As a result of this study, I now approach [X] differently because..." That sentence alone can lift an average write-up to an impressive one.
Tell someone your findings — even informally. A five-minute summary at a practice meeting counts as dissemination. Mention it in your write-up. It shows the research had real-world impact. Plus, your colleagues will actually find it interesting.
🗣️ What Trainees Say — Community Voices & Real Experiences
Patterns of insight drawn from UK GP trainee forums, blogs, and peer networks. Translated into professional teaching points and checked against RCGP guidance.
💡 Common Realisation
I spent three weeks worrying whether I needed full ethics approval before I even started. If I had just used the HRA decision tool on day one, I would have found out in five minutes that I didn't — and could have started collecting data immediately.
— Recurring theme in UK GP trainee peer networks
⚠️ Common Mistake
I planned to interview 30 patients. I managed 6. By that point I had enough data to write a solid qualitative study. The pressure to have a big sample size for a qualitative project is completely misguided — but nobody told me that at the start.
— GP trainee experience, UK deanery forum
🔥 What Works
The best thing I did was use my own practice's data from EMIS. No patients to recruit. No ethics hurdles. The practice manager ran the search in 20 minutes. I had a dataset the same day and wrote it up in a week.
— UK GP trainee, shared on training scheme peer forum
💬 What Impresses Trainers
My supervisor said the thing that impressed her most wasn't the results — it was that I'd clearly thought about limitations honestly in my write-up. She'd seen lots of studies that pretended to have no weaknesses. Mine didn't, and that's what made it credible.
— GP trainee, UK training network discussion
🎯 Insider Insight
PACT is genuinely brilliant. I joined, contributed data to one study, and ended up as a named author on a paper published in BMJ Open Quality. I was an ST2 with no research background whatsoever. You really don't need to be an academic to be involved in real research.
— PACT member, GP trainee (West Midlands, shared publicly)
⚡ Time-Saver
GCP training sounds daunting but it honestly only took me an afternoon. The NIHR e-learning is free, self-paced, and the certificate downloads instantly. I wish I'd done it at the start of ST2 instead of scrambling for it when I actually needed it.
— GP registrar, UK deanery trainee community
💎 Insider Pearls — Real-World Wisdom
What experienced trainees and academics wish they'd known at the start.
💡
Insider Tip — Start Tiny, Finish Completely
The single most consistent piece of wisdom from GP trainees who have completed research studies is this: start smaller than you think you need to. A focused study of 8–10 interviews, fully transcribed and analysed with proper thematic analysis, generates richer and more credible findings than a poorly designed 100-patient survey. Supervisors and ARCP panels are not impressed by sample size. They are impressed by methodological rigour and genuine learning.
🔥
Quick Win — Use Your Practice Data
Some of the most impressive trainee research in primary care has involved existing practice data — a notes review, a prescribing analysis, or a case series. This approach often doesn't require NHS REC ethics approval (check with HRA tool), can be completed within a training rotation, and produces highly relevant findings for the practice team. Your practice manager or data manager can often run a EMIS or SystmOne search for you in minutes.
🤝
Insider Tip — Join PACT Before You Start
The Primary Academic Collaborative (PACT) is a free, trainee-led GP research network that supports anyone — from those who have never done research to those designing their first formal study. Members get access to peer support, collaborative project opportunities, and senior academic advice. If you're starting out, this community is invaluable. Many trainees have produced their first publication through PACT collaborations.
🎓
Insider Tip — Research as a Portfolio Differentiator
At ARCP panels, a well-presented research QIA stands out far above the minimum. Not because it is required to be large or published — but because it demonstrates intellectual curiosity, methodological awareness, and the kind of self-directed learning that future employers look for. Trainees who present their findings at any public forum (VTS half-day, practice meeting, local conference) consistently receive positive ARCP feedback on their QIA evidence.
🩺
Primary Care Research Shortcut — The 3-Question Study
For time-pressed trainees, a highly practical approach: pick one specific thing you observed in practice that surprised you. Ask: (1) Have others observed this? — brief literature search. (2) Why does it happen? — 5–8 qualitative interviews. (3) What can we do about it? — reflective analysis with practice team. This three-question structure produces a coherent, mini-study that maps perfectly to background / methodology / discussion / recommendations. Done in 6–8 weeks for a motivated trainee.
💎 What Nobody Tells You at the Start
These are the things that experienced trainee researchers consistently wish they had known earlier. None of them are in the official guidance.
1
The hardest part is not the research — it's getting started. Every trainee researcher describes the same experience: a period of paralysis at the beginning while they try to make everything perfect before beginning. The solution is to start messy. Write a rough question. Use the HRA tool. The shape of the study becomes clearer once you begin, not before.
2
Your practice manager is a research asset you may not be using. Practice managers can often run data searches from EMIS or SystmOne in minutes — searches that would take a trainee hours of manual record review. If you ask them nicely (and explain why), they can hand you a ready-made dataset for a notes review or prescribing analysis faster than you'd believe possible.
3
Qualitative research is not "easy research." Many trainees choose qualitative methods because they think it avoids the statistics problem. In reality, rigorous qualitative analysis (proper thematic analysis, reflexivity, audit trail) is intellectually demanding in its own right. The advantage is that it is achievable in training without a power calculation — not that it is simple.
4
You can present before the study is finished. Presenting preliminary findings at a VTS half-day or practice meeting — even partway through your data collection — counts as dissemination and generates genuinely useful feedback. You don't have to wait for the final write-up. Sharing work in progress is a perfectly legitimate and valued academic practice.
5
Academic GPs are not a different species — they're just clinicians who stayed curious. The BJGP paper "Ten things I wish I had known about academic primary care" (2023) notes a persistent myth of tension between "real doctors" and "real academics." In reality, academic GPs in the UK are practising clinicians who also do research. If you like asking questions about how things work, you may be more suited to it than you think.
6
The reflection is not a summary of what you found — it's a record of how you changed. The most consistently cited reason for QIA write-ups being considered strong at ARCP is a reflection section that describes genuine personal development. Saying "this confirmed the existing literature" is not reflection. Saying "this changed how I think about X and I now do Y differently" is.
7
IRAS is not as intimidating as it looks — but it does take longer than you expect. The IRAS form for a straightforward low-risk study is long, but most fields are standard. Doing the free IRAS e-learning module first (available via the HRA website) makes the form much less daunting. Allow two to three weeks to prepare your application — not two days.
⚠️ Common Pitfalls & Trainee Traps
Every trainee researcher makes at least some of these. Read them now and save yourself considerable pain later.
⚠️
Common Trainee Mistakes
- Overscoping the project. A well-designed study of 10 patients, completed and written up, is worth far more than an ambitious study of 500 patients that is never finished.
- Mislabelling an audit as research (or vice versa) and then getting the ethics pathway wrong. Always use the HRA decision tool first.
- Starting data collection before ethics approval. This can invalidate the entire study and has professional conduct implications.
- Not piloting data collection tools. A 5-minute pilot with a colleague reveals most design flaws before they ruin your data.
- Forgetting to document the methodology as you go. Trying to reconstruct methods retrospectively from memory produces an inaccurate write-up.
- Thin reflection. "I found X. This confirms Y" is not reflection. Reflection involves personal learning, changed practice, and honest engagement with limitations.
- Ignoring the limitations section. Every study has limitations. Acknowledging them honestly shows methodological maturity — hiding them shows the opposite.
- Failing to disseminate. If you involve participants, you have an ethical obligation to share what you found. Even a five-minute presentation at a practice meeting counts.
🎯
What Candidates Often Forget
- GCP training must be completed before data collection — not after
- Participant information sheets need to be written in plain language — not medical jargon
- Audio recordings are identifiable data — handle them exactly as you would a patient record
- Your supervisor needs to sign off your protocol before you start recruiting, not while you're already halfway through
- Recording findings in real time is far better than trying to remember them later
✅ Do This / ❌ Not That — At a Glance
The most common mistakes that trainees make — and the simple alternative. Each row is a real pattern seen in trainee research.
| ❌ What trainees often do | ✅ What you should do instead |
|---|---|
| Plan a study with 50+ participants because it sounds more impressive | Plan for 6–12 participants in a qualitative study. Aim for data saturation, not numbers |
| Start data collection and then wonder if ethics approval was needed | Use the HRA decision tool before you do anything. Print the output. Keep it safe |
| Write the reflection at the end, from memory, in one sitting | Keep a running notes document throughout the study. Reflection written live is far richer |
| Describe a project vaguely as "looking into patient experience" | Use PICO: define the population, the interest, the comparison (if any), and the outcome |
| Ignore the limitations section or mention only one trivial weakness | List real limitations honestly — small sample, single site, potential bias — and explain what they mean |
| Try to squeeze in NHS REC approval in the final few weeks of training | Plan for 10–12 weeks for REC approval. Use the IRAS e-learning early. Allow enough time |
| Do qualitative interviews but skip transcription — just use memory notes | Audio-record (with consent) and transcribe. Transcripts are your data — memory is not |
| Work in isolation and not share findings with anyone in the practice | Present at a practice meeting. Your colleagues may find the findings genuinely useful |
| Label every project "audit" to avoid ethics — even when it's really research | Use the correct HRA classification. Mislabelling has professional consequences |
🤝 PACT — Your Shortcut to Real Published Research
The Primary care Academic CollaboraTive — and why every GP trainee should know about it.
PACT is a free, UK-wide research network of over 1,000 primary care clinicians — including medical students, GP trainees, qualified GPs, nurses, pharmacists, and allied health professionals. It was founded in 2019 specifically to break down the barrier between front-line clinicians and academic research.
You do not need a formal academic post. You do not need a research supervisor. You do not need any previous research experience. You just need to be curious and willing to collect data for a project that someone else has designed and governed.
💬 PACT Member, GP Trainee
I thought research was only for established academics and that I was too junior to be part of it. But all you need to start is curiosity. PACT is a great way to develop that curiosity and get involved with real research.
— Bilal Salman, GP Trainee, West Midlands (PACT member, shared publicly)
💬 PACT Member, GP Trainee
The PACT model feels relevant and accessible. It's about working with like-minded peers to pose and answer clinical questions that affect ourselves and our patients day to day. That's exactly what I wanted from research during training.
— Marcus Stevens, GP Trainee, Bath (PACT member, shared publicly)
🌍 For International Medical Graduates — What's Different in the UK
The UK research governance system has specific processes that may be very different from your home country. This section explains what you need to know.
🇬🇧 UK-Specific Research Concepts
- HRA (Health Research Authority) — the UK's central ethics and governance body for health research
- IRAS — the Integrated Research Application System, used to apply for ethics and governance approvals
- NHS REC — Research Ethics Committee; your application is reviewed by one of these committees
- R&D approval — additional governance step required at each NHS site involved in your research
- GCP — Good Clinical Practice training; mandatory before researching with NHS patients
- Caldicott Guardian — each GP practice has one; they protect patient data and must approve data access
- PACT — trainee-friendly national research network unique to UK primary care
- BJGP / BJGP Open — the main UK primary care journals; realistic targets for your first publication
💡 Common Points of Confusion for IMGs
- In many countries, ethics approval is simpler or less formalised. In the UK, it is structured and strictly required — do not assume your home-country norms apply
- The HRA decision tool is specific to UK law — use it even if you have ethics experience elsewhere
- The distinction between research, audit, and service evaluation is legally and professionally important in the UK. These are not just different words for the same thing
- NHS patient data is subject to strict UK GDPR rules — anonymisation must be thorough and early
- IRAS can feel very bureaucratic; this is normal. Plan extra time for the first application
- Your supervisor may be less familiar with research governance than you expect. Use the HRA and NHS England resources directly — they are designed for researchers at all levels
A note on language: All UK research ethics documentation (consent forms, participant information sheets) must be written in plain English that a person with a reading age of around 12 can understand. This is a requirement, not a suggestion. Simple sentences. No medical jargon. No abbreviations without explanation. This is good practice — and it's also the law under UK GDPR's principle of transparency.
🧠 Memory Aids & Cheat Sheets
The things that need to stick — made sticky.
🔤 DESIGN — Your Research Study Checklist
D
Define your question precisely — PICO it before anything else
E
Ethics — use the HRA decision tool; get approvals before touching data
S
Study design — qualitative, quantitative, or mixed? Let the question decide
I
Instruments — design, pilot, and finalise your data collection tools
G
Go — collect data systematically; document methodology as you go
N
aNalyse, write up, and disseminate — including honest reflection
📌 Quick-Reference: The Governance Flowchart
Before starting any study, work through these questions in order:
| Question | If Yes | If No |
|---|---|---|
| Is this research? (HRA decision tool) | Continue below ↓ | Likely audit/service eval — different pathway |
| Does it involve NHS patients or their data? | Likely need NHS REC ethics + R&D approval | May only need local R&D registration |
| Have I completed GCP training? | Ready to apply for approvals | Complete GCP training first — free online via NIHR |
| Do I have all written approvals? | Ready to recruit and collect data | Wait — do not start data collection without them |
| Have I written my protocol? | Proceed to data collection | Write the protocol first — it's your safety net |
📊 Qualitative vs Quantitative — At a Glance
| Qualitative | Quantitative | |
|---|---|---|
| Asks | Why? How? What does it mean? | What? How many? How often? |
| Data | Words, themes, experiences | Numbers, frequencies, statistics |
| Sample size | Small (5–20 typical) | Larger (depends on power calculation) |
| Analysis | Thematic, framework, grounded theory | Descriptive and/or inferential statistics |
| Strength | Depth, nuance, context | Breadth, generalisability, precision |
| Best for GP training | Exploring patient/staff experiences | Describing patterns in practice data |
📌 Research Study — Quick Reference Cheat Sheet
Everything you need on one screen. Save this. Screenshot it. Keep it.
6–12
participants for qualitative research
5 min
HRA decision tool takes
10–12 wk
for NHS REC approval
🎯 PICO — Your research question must answer all four
P — Population (who?)
I — Interest or Intervention (what?)
C — Comparison (vs what? or none?)
O — Outcome (measuring what?)
🔑 DESIGN mnemonic — 6-step research checklist
Define question (PICO)
Ethics — HRA tool first
Study design choice
Instruments — pilot them
Go — collect systematically
Nalyse, write, disseminate
⚡ Fast-track options — no REC approval likely needed
📊 Notes review (anonymised)
📋 Staff survey (professional role only)
📚 Literature review
🔍 Case series (anonymised)
🤝 Join a PACT project
⚠️ Always confirm with the HRA decision tool — don't assume. These are common patterns, not guarantees.
🎓 For Trainers & TPDs — Teaching Research Skills
Research supervision is a distinct teaching skill. These pearls will save you (and your trainee) considerable time.
🎓
Trainer Insight — Supervising Trainee Research
The most productive first tutorial on a research idea spends 80% of its time on the research question — not the methodology. Trainees arrive with methods in mind ("I want to do interviews") before they've clarified what they're actually trying to find out. Reverse this. Get the question sharp. The methodology then becomes almost obvious.
📚 Common Trainee Difficulties with Research — and How to Address Them
| Common Difficulty | How to Help |
|---|---|
| "I don't know what to study" | Ask: "What have you encountered in clinic in the last month that genuinely puzzled or surprised you?" Real questions come from real encounters, not textbooks. |
| "I don't have time to do proper research" | Help them scope down to something genuinely achievable in 6–8 weeks: a notes review, 5 interviews, or a focused literature search. Done is better than perfect. |
| Confusion about research vs audit | Work through the HRA decision tool together in a tutorial. It takes 5 minutes and produces clarity that no amount of explanation achieves. |
| "My ethics application was rejected" | Review the methodology — they may have described it as research when it was actually audit. Or they may need to redesign to avoid identifiable data. |
| Thin write-up / weak reflection | Use the questions: "What surprised you most? What has changed in how you think about this clinical area? What would you do differently next time?" |
💬 Tutorial Discussion Prompts
- "What question came up in clinic this week that no guideline could answer?"
- "If you could find out one thing about your patient population that would genuinely change how you practise — what would it be?"
- "Walk me through how you would classify your project using the HRA decision tool."
- "What would good look like for this study in six months? What would 'just good enough' look like?"
- "If you presented this at a VTS half-day, what would the one key take-home message be?"
- "What assumptions are you making that might not be true? How would you test them?"
🏆 What Excellent Trainee Research Looks Like
- A genuine, answerable question arising from real clinical practice
- Correct classification using HRA tool, with written evidence retained
- Appropriate and proportionate study design for the question
- All ethics and governance steps documented and completed before data collection
- Systematic data collection with clear methodology
- Honest discussion of limitations — not buried, not over-apologised for
- Deep, specific reflection that demonstrates changed practice or thinking
- Dissemination — even informally — to a clinical audience
🙋 FAQ — Quick Answers to Common Questions
Does my research study count towards QIA requirements?
Yes. A research study is explicitly listed by the RCGP as a type of Quality Improvement Activity. A well-documented, reflected-upon research study more than satisfies the QIA requirement for one training year.
Do I always need NHS ethics approval for a research study?
Not always. It depends on the study design, participants, and data used. Studies involving NHS staff only in their professional role, or using fully anonymised practice data, often don't require full NHS REC review. Always use the HRA decision tool to confirm — and document the outcome.
How long does NHS ethics approval take?
NHS RECs aim to give a decision within 60 calendar days. In practice, allow 10–12 weeks from submission to final approval, including the time to prepare your IRAS application and any amendments. This is a significant commitment — plan your training year around it.
Can I do a qualitative study without lots of participants?
Yes — and this is a common misconception. Qualitative research is not made more valid by larger sample sizes. The goal is data saturation (when no new themes are emerging). For a focused trainee study, 6–12 semi-structured interviews typically achieves saturation on most primary care topics.
What is the difference between a research study and a literature review?
A literature review synthesises existing evidence — it doesn't generate new primary data. A research study collects new data to answer a question. Both are valid QIA types. A literature review is generally quicker and avoids the ethics process but is seen as a lighter-weight activity by most ARCP panels.
What if I want to publish my study?
BJGP Open is the most accessible journal for GP trainee research. Education for Primary Care is another good option for educational research. Both have clear author guidelines and welcome early-career submissions. Use EQUATOR guidelines when writing up (COREQ for qualitative; STROBE for observational). Get a co-author with research experience if this is your first submission.
What do IMGs find most confusing about research in UK GP training?
The biggest adjustment for IMGs is the UK's research governance framework — specifically the HRA, IRAS, and NHS REC process. In many countries, ethical approval processes are either more straightforward or less formalised. The HRA's UK Policy Framework and IRAS system have specific processes that are worth reading about before starting. The Bradford VTS EBM pages and the HEE Research Toolkit are both written in accessible English and explain UK context well.
Can I do a collaborative research project with another trainee?
Yes — and this can be very effective for small studies. Collaborative projects must clearly document each person's contribution in the write-up. The RCGP expects evidence of personal involvement and personal reflection. Simply being a named co-investigator on someone else's study is not sufficient for QIA purposes on its own.
✅ Final Take-Home Points
- Research = generating new knowledge. Know the difference from audit and service evaluation — the HRA decision tool settles this definitively.
- A well-executed, small-scale research study is one of the most impressive QIA types you can demonstrate in GP training.
- Use the PICO framework to define your question before you decide on a methodology. Question first. Methods second. Always.
- Use the HRA decision tool before you do anything else. Print the output. Keep it safely. This protects you and your study.
- Ethics and GCP training are not bureaucratic irritants — they are the foundation of trustworthy research. Treat them as such.
- Qualitative research is not "less rigorous" than quantitative research. It answers different questions. Both are valid, both are challenging, both require methodological skill.
- Small, focused, and completed is always better than large, ambitious, and abandoned. Always.
- The reflection section is where your portfolio evidence lives. Make it specific, honest, and personal.
- Disseminate your findings — even informally. You have an ethical obligation to participants if you involved them, and a professional opportunity regardless.
- Consider joining PACT. You don't need to be an academic to do useful primary care research — you just need to be curious.