This study provided important clues on how to enable highly motivated students to improve their scientific competencies and gain research experiences in countries where there is no national policy encouraging medical undergraduates to do research. The RTP experience in EUFM revealed the challenges encountered in research training in medical schools with very high number of students and daily routine heavy workload of faculty members and indicated strategies to be followed for an effective process.
Studies conducted in different countries have demonstrated that students want to receive research training so as to acquire research skills, learn to think critically, make scientific publications, shape their career plans and establish interaction with faculty members [3, 6-8, 37-38]. Similar motivational reasons were reported both in the present study and in another study conducted four years ago which evaluated the RTP , but career planning remained behind the other reasons. This was expected since making research applications prior to graduation in Turkey does not provide a direct benefit. The coherence between the rationale behind the establishment of the RTP and the students’ motivational reasons has revealed the necessity of research programs that contain higher objectives than the curriculum. Study results have indicated that medical students vary with respect to their interests in research and a considerable portion of the students prefer special programs for the ones who are strongly interested in research in addition to scientific core curriculum. Thus, these results support the volunteer-based program approach [10, 26]. Moreover, difficulties related to mentoring and funding revealed by this study also reflects that only voluntary approaches are applicable for similar faculties. However, it should be emphasized that the existence of a program specific to a single group cannot be an alternative to a medical curriculum based on basic principles of scientific research as well as evidence.
Murdoch-Eaton et al.  suggested that scientific competencies of students should be developed in the early stages of their medical education. Similarly, in EUFM, all students get acquainted with science-related topics in the first year and the RTP starts at the beginning of the second year. The results of the research [3, 40] indicating that the duration of the programs that last several months, such as summer schools, is not sufficient for the completion of projects; that programs expanding over years yield more research show that it is logical to spread the RTP over five years. On the other hand, our findings have reflected that continuity is critical during these five years. The course in the first two years furnishes the students with basic competencies in research; however, students cannot integrate with this application because they have not built up conceptual knowledge and have not started research projects yet. The statements of the participants reflect that a more spiral curriculum can enable some learning objectives to be transferred to other years, thereby minimizing the disconnection to be experienced after the introduction course. However, time-protected activities should be allocated to the RTP in the last three years. In this manner, the problem of not having sufficient time for research especially during the later years of education, as both reported by RTP students and frequently encountered in the literature [9, 11, 19, 37,41-42].
The statements of all participants show that students required intensive support from RTP counsellors during the process of finding a project topic and a mentor. Students whose interests were determined by their counsellors and aided to meet with key people and visit related clinics and laboratories were able to progress further. For this reason, their counsellors should be in close contact with students even if they do not actively demand counselling themselves. The newly initiated regular meeting system has greatly reduced the dependence of counsellor-student relationships on personal traits. It is stated that not only the counsellors but also the RTP Commission itself can play a significant role in determining project topics and prepare a list of suitable topics for the students who need help. Another suggestion which consisted of listing the names of volunteer project advisors with research proposals was successfully executed at the University of Texas . Our findings indicated that mentors in such programs should be informed by the coordinators about students’ qualifications, points of support, feasible research topics, and the boundary between mentoring and making decisions on behalf of the student.
The fact that students found formulating a research question and hypothesis as well as preparing ethics committee and project application files more difficult than they had expected could be a natural consequence of the learning process. The same difficulties were reported in other studies and some students described such difficulties as a valuable learning experience [5, 42]. In any case, this learning process can only be successfully completed with the support of the mentors [43-44]. The mentor should direct the student to a project topic that may be attractive and feasible, discuss the literature together, structure the project proposal preparation processes, and supervise time management. Moreover, the key qualities of a good mentor in this study emerged as being easily accessible, answering questions in a short time, engaging in the learning process with the student and acting in a motivational manner. As stated in the literature, in order that students could play an active role rather than just ‘‘passive’’ mechanical assistantship or ‘‘passive’’ pure data collection, the mentor should make sure that the student understands all stages of the research and masters the essence of the research, which calls for experienced faculty members who can strike a balance between their roles as researchers and educators and do not consider the time spent on students as wasted [5, 19, 45]. Nevertheless, not getting efficient mentoring was among the problems most frequently reported by the students [3, 5, 19, 23, 40]. The fact that most the students participated in our study were able to find a mentor and had a positive communication may have led to a more positive picture than the existing one. Acknowledgements of the participating students concerning the problems encountered by their friends, rather than themselves, also support the possibility mentioned above.
It is a common problem for many medical faculties, especially those in developing countries, to provide students with opportunities for research experience during pre-graduate medical education and to convince faculty members to become mentors [6, 9, 11, 19, 40, 42, 46-48]. Our findings have revealed that the novel idea of performing research with students coupled with the intensity of daily routine workload limits the number of volunteers. Participants believe that the RTP should be embraced by the whole faculty to increase the number of mentors. Universities where faculty members are encouraged to support student research in line with institutional policies are good examples in this context . Recommendations put forward in this study in order to increase the number of mentors included explaining the advantages of working with students to the faculty members; introducing factors that encourage mentoring such as academic promotion criteria; and assigning non-medical faculty members as advisors. In consequence, as suggested by Tamariza et al. , universities wishing to support student research need to create a pool of mentors.
Some of the participants recommended that students gain experience by joining another project team before starting their own work. However, except for a few successful examples in the scope of which this proposal was made, there were instances where students were only used as a labour force without having a chance to develop their own research skills. Therefore, this recommendation should be implemented only after the student’s tasks are clearly defined and the RTP counsellor is properly informed. The members of the RTP Commission expressed that the suggestion that the students join an existing research team instead of conducting a project under their sole responsibility could lead to a similar result. The study conducted by Murdoch-Eaton et al. also supported this caution. When 475 projects that students engaged in were evaluated in terms of skill acquisition, the research methods remained at the 31 percent level and it was found that students were assigned tasks such as finding patients and entering data .
The motivation of the students decreases dramatically during the project stage, and hence some of them quit the program because of some difficulties they encounter. The decrease in the dropout rate observed in recent years was explained with the better structured process and with the inclusion of academic achievement as a selection criterion. The study conducted by Salgueira et al.  has also demonstrated that academic achievement is related to student engagement in scientific activities. On the other hand, as declared by participants, it would be unrealistic for all students to complete such programs. Problems encountered by RTP students such as not being able to devote time to research alongside their education and changing their priorities have been reported in other programs as well [9, 11, 19, 23, 37, 41-42, 48-49]. Moreover, unlike many countries [3, 5-6, 17], completing the RTP does not give an advantage in competition for the specialty education or even creates a disadvantage in terms of time spent for exam preparation. Lack of institutional incentives such as obtaining a valid certificate or a title upon completion discourages also the students from conducting research [11, 50]. What should be done here is to support students who come to the point of quitting RTP not because of lack of external motivation but because they do not receive enough mentoring or financial support.
It has been reported that conducting a research enables medical students to understand research methods and furnishes them with skills such as generating research questions, planning and executing research, analysing data, authoring articles, making scientific presentation [3, 5-6, 10, 23, 47, 49]. Students who successfully completed the RTP also learned their research process through experience. However, as is the case with RTP, the learning outcomes of courses in research are not limited to the realization of a project. Research is a learning process and its outcomes are not just output-oriented [43-44]. Consequently, even those who could not complete their project have undoubtedly gained considerable benefits from this process. Research programs such as RTP offer students the opportunity to be in an environment where interrogative thinking is the core value. Furthermore, the RTP has also influenced career preferences of the students. Publications stating that research experience acquired as student results in a research-oriented career choice in the future, and that research and lifelong learning become a behavioural pattern for the individual also supports this potential impact of the RTP (6, 49). In addition to all these, the RTP has also improved students’ communication and time management skills as other research programs [3, 5, 10]. On the other hand, the statements of the participants revealed that more emphasis should be placed on time management skills, and mastering teamwork skills, which is reported as another outcome of research training [10, 23].
Program coordinators assume a critical role in maintaining continuity of research programs, sustaining a supervisory relationship between the students and the faculty, and creating a positive pedagogical atmosphere [3, 42]. Our findings demonstrate the importance of forming an RTP Commission from stable members who are competent in research training, have communication and empathy skills, act as role models for students, and are determined to devote time to the program. The fact that members represent different disciplines paves the way for a broader perspective. Students suggested that the frequency of scientific and social meetings be increased to strengthen the positive atmosphere. On the other hand, the support of the university administrations is imperative for executors of the research programs . Suggestions made at this point included ensuring that RTP becomes more special and popular, promoting project mentoring, finding resources for the projects, and encouraging the students to participate in scientific congresses.
The students interviewed in this research feel privileged due to the scientific environments they can be a part of. However, these positive emotions belong to students who have been able to progress in their projects. Chang  also reported that students who successfully completed their research had positive perceptions regarding the process. Lagging in the project stage weakens students’ emotions and sense of belonging towards the program. Reluctance of the students, who have not completed their projects, to attend the meetings may be stemming from their negative feelings towards the program. In addition to this source of participation bias, another limitation of the study is that students possibly refrain from expressing their negative emotions. Moreover, as Chang  stated, the outcomes reported by the students rely on their self-assessments. Such outcomes need to be evaluated basing on objective criteria. The fact that the study is based on the experience in a single faculty is the limitation of the generalizability of our results.
This research showed that it was realistic to implement research programs designed for highly motivated and talented students as well as educational activities that provide basic scientific skills to all students in medical schools with conditions like those in EUFM. Our results also pointed to the need to plan these programs over years in a spiral manner by preserving their integrity. Students need the intensive and structured support of program executives and mentors. Listing the names of volunteer mentors together with prospective research suggestions can facilitate the process of finding mentors and research topics for students. The starting point for the solution to the mentor shortage is the adoption of student research as a policy at a national and university level. Besides, medical schools can develop specific strategies in accordance with their conditions. Program coordinators should guide the mentors throughout the whole process; closely monitor all student processes; and provide timely support to students experiencing problems. On the other hand, coordinators need to be supported by university administrations in order to perform these functions. The outcomes of research programs like the RTP should not be evaluated only as output-oriented processes aimed at carrying out and publishing a project. Instead, getting acquainted with the interrogative and systematic thinking style, conducting research, and making lifelong learning a core value should be considered as the most important program outcomes.