Medical Student Research

What we expect students to do to get into medical school -- and then match into a desirable residency -- is absurd. Why do we do this? Because we won’t admit that we can’t predict who will be a successful doctor. Because there are too many good applicants for the spots we have. Because we are too lazy, or cheap, to invest the time and energy to get to know our applicants. Our expectations are harmful. They rob college students of summers working in ice cream shops. They fill the medical literature with meaningless research. They favor students of means, those with connections, who can spend a gap year (one of my most hated terms) to buff their CVs.

When I received this essay from Jonathan Sutkowski, I had the feeling he might agree with me.

Adam Cifu

I was recently having lunch with a friend who is a first-year medical student, one year behind myself. He had been working with a few professors on clinical research projects and was hoping to first-author a project of his own soon.

“My research mentors all tend to give me a lot of room to take my own initiative for projects,” he was explaining.

“Does that mentorship style work for you?” I asked.

“No,” he smiled sheepishly and went on to talk about how it had been challenging adjusting to doing medical research. He often felt research meetings were rushed, leaving him with a few next steps and no clear idea why the question he was told to ask mattered in the grand scheme of things. What he did know, however, was that to be competitive for his desired specialty, he needed publications. So, while this arrangement wasn’t the ideal research relationship, it was a mutually beneficial one. The professor provided a question about which a paper could be published, and the medical student did the legwork.

“Publish or perish” refers to an academic’s need for output to continue in his or her career. This is a necessary, perhaps even useful incentive in academia. However, for students, I have to ask: Has this gone too far?

As students, we struggle to find time to meet research demands while mastering the curriculum. What’s more, the very research we do is often of little interest. It often takes the form of an analysis of some dataset in the hope of finding a publishable result.

Maybe I am too early in my career for this, but I ask myself, “is this the training path we want for the next generation of academic clinicians?” The answer may be yes—perhaps hours in the library trying to more deeply understand what is taught is no longer necessary. Perhaps medical student research is just supposed to get one’s “feet wet”, with the real hypothesis generation and question-asking beginning later in training.

In this article, I want to suggest that we need to clearly articulate fundamental questions for medical training: what does it take to be a good doctor? What does it mean to be a good academic doctor? For the medical student aspiring to these goals, where should his or her focus be during the preclinical and clinical years?

Students beginning medical school are talented, driven, and want to use their training to help people in a meaningful way. But they’re also looking for direction: practically, how can I make the most of my preclinical years? More fundamentally, what are the ideals of good medicine to strive for? This vision is typically presented to students by doctors who are striving for the same thing.

The modern medical student probably does need to spend time on research to succeed in an academic medical center. But understanding what the point of this early-stage research is — in the broader context of a training plan towards becoming an excellent, reliable doctor in a rapidly evolving medical landscape — would give students the opportunity to dive into these experiences with their whole heart.

Jonathan Sutkowski is a medical student at Northwestern University with an interest in internal medicine, particularly pulmonary and critical care medicine.

Photo Credit: Christin Hume