Pasteur's Quadrant: preparing training programs for "use-inspired" surgical research

Ensuring that scientific research is an integral element of surgical residency training is critical to the future viability of the field. The ability to nurture surgeon-scientists, invoke them to ask pertinent questions, design experiments, and translate these findings into clinical applications will set this specialty apart from competing fields. Involving residents and younger faculty in this process of translational research is crucial to develop academic leaders and improve patient care. It is as critical as it is complex. Here, we propose that this objective can be attained only if academic departments of surgery recognize its value, create a solid framework of support, encourage partnerships, and above all provide the patient and essential mentorship that residents and young faculty need to pursue meaningful surgical research. To provide usable frameworks, a unique 2-dimensional quadrant termed "Pasteur's Quadrant" is generated based on the original work of Stokes. Briefly, it creates 4 quadrants that separate pure basic science or discovery (X-axis) from applied research or innovation (Y-axis). In doing so, it also defines a median-research that satisfies both goals: scientific advancement AND clinical improvement. This novel use-inspired method of categorizing research provides guidelines to select research programs prudently. Using the Pasteur's Quadrant approach to the conduct of resident-performed surgical research offers several advantages: It is clinically applicable; it advances goals of fundamental scientific research; it is provocative, productive, and retains high visibility; and it makes it attractive to funding agencies and industry alike. Lastly, it charts a vibrant course for their main beneficiaries, residents and academic surgical programs.