Should we ban pre-med and medical student research?

The sentiment is spot on, even if the solution is impractical.

I chuckled when I heard a recent proposal arguing that not only should we ban pre-med and medical student research, but the penalty should be jail time.

I share the sentiment, and have been making a similar argument for 10+ years. One of my early papers showed that medical school and early residency publications have no predictive value over who will have a research career (i.e. continue publishing in fellowship). Since then, others have confirmed and extended this finding.

Of course, you can’t criminalize research, but the feeling is right. The bulk of this research is slop. It has no scientific value. It is not the best use of a student’s time. It is all part of the modern “arms race” to pick students— but it is unclear these capricious metrics means we get better candidates.

The reason students jump through the ‘useless research’ hoop is because the people on the committees that select them value the commodity. That’s the real failure— the leadership of admissions committees for medical school and residency programs.

Our paper from a decade ago showed that doing research in the past was not able to predict future research— meaning it was all for show and didn’t tell you who the budding scientists were. I assumed (naively) that it would lead programs to stop valuing these projects. I didn’t count on the fact that program leadership is numerically illiterate.

I joke— but it is also not a joke— it is amazing how little medical school and residency admissions folks know about the science of prediction. In fact, the Venn diagram of people interested in medical education and people who understand medical research has slim overlap— which is why medical admission decisions often appear closer to pseudoscience or the selection criteria for the Cambridge sociology department.

Some argue that doing bad research is the best way to understand how to read and critically appraise bad research. Nothing can be further from the truth. Cooking poorly does not help you become a restaurant reviewer. Killing houseplants does not teach you how to manage a farm. Watching a video lecture series on critical appraisal is a much better way to train students to understand and dissect research. If only we had one for free…. oh you are in luck.

How Not To Get Fooled by the Medical Literature

Forgotten in all this debate is one unspoken assumption: the goal of medical school is to train doctors to take care of patients. If that remains the core goal— and I still think it is (for the time-being)— we have to prioritize that.

Of course, folks running labs will be disappointed to have fewer hands to help. Don’t worry about that— with the next batch of cuts to science funding, you won’t have reagents for the students to work with anyway.

Folks running retrospective chart review will be disappointed to have to pay for Claude subscription.

Folks doing qualitative research will have to fall back to just making things up.

(Ok, these are jokes, don’t @ me)

Jokes aside, I have been lucky to have worked with amazing pre-med and med students. Because my research has been challenging of conventional, entrenched interests, I have almost always gotten students and residents who had read and processed a lot and wanted to do the work for the sake of the work.

One student—Ben Knudsen—comes to mind. He, like me, was frustrated by COVID-19 policy that was deranged, illogical, and unscientific. He read voraciously and found me. Together we published research that challenged the CDC and “the science” himself— Dr Fauci. Ben was (and is) brilliant, and he did this work not to check a box, and probably at great career risk— because it was the right thing to do and he believed in it. In many ways, he inspired me to be braver and more outspoken— because he had much more to lose than I did, and yet he felt compelled to do the right thing.

I know it is possible for students to do work that actually matters, and for the right reasons. I just think the majority of medical student research is not this. If we deprioritized it in admissions— I am not worried about folks like Ben— They would still do it— because they were never checking a box.

The same is true for all types of research. There are some people who work in lab who actually want to do that. There are some people who actually do good chart review work. By removing the incentive, you will retain the folks who do it because they aren’t do it for points.

For these reasons, I am supportive of the fact that we should not value these metrics early in one’s career. For Cambridge professors of sociology— however— I do think research matters.

PS: I picked Ben, but this applies to probably all of the people who are my co-authors— you know who you are— I am fully aware that given the nature of the topics we discussed and papers we wrote, you weren’t checking boxes.