Medical students and research: Is there a current discrepancy between education and demands?

Abstract

This article refers to a correspondence letter recently published in The Lancet, describing successful student-led research initiatives in Latin America, which were introduced because of low support from universities and governments. As a final-year medical student with keen interest in science, the topic of student engagement in research activities caught my interest. Literature shows that while junior doctors are required to perform research on their own and face intense pressure to publish, formal training in principles of research and scientific writing is often neglected by medical schools. This contrast is worrying, as the progression of the medical profession and the quality of patient care depend on high-quality research and on future generations of physician-scientists being both enthusiastic and competent. Hence, this article summarizes suggestions to increase both students' research proficiency and participation in scientific activities, and offers a critical view on this important topic, as medical schools without curricular research education and without active student integration should urgently consider revising their policies.

Commentary

The progression of the medical profession indisputably depends on rigorous, unprejudiced, and ethically justifiable research. This requires researchers being both enthusiastic and competent.

As a medical student embarking on a scientific career, I read a recent article in The Lancet, describing research initiatives by undergraduate students in Latin America, with great interest [1]. According to the authors, student societies have played a key role in organizing and conducting scientific congresses over the past ten years. In addition, student-led publications have been developed in order to “familiarise students with scientific publishing and train future editors of biomedical journals” [1]. As much as I was impressed by these examples of academic student engagement, I was left with one question: As medical schools are in charge of developing not only doctors, but moreover academic professionals, is there a current lack of formal research education and support on behalf of academic institutions?

It is well documented that research by medical students has lastingly impacted medicine. The discovery of heparin by Jay McLean, Thomas Fogarty’s invention of the balloon embolectomy catheter, the first description of the pancreatic islets by Paul Langerhans, and the discovery of the sinoatrial node and its function by Martin Flack are just some examples “of what can be achieved by gifted and determined medical students undertaking a period of basic scientific or clinical research” [2]. However, a study among British students showed that only 14% had submitted an article for publication, while 22% felt they had been taught how to write scientific manuscripts [3]. Lack of opportunities was named by 55% of students as the primary reason why they had not participated in research activities [3]. Accordingly, it has been reported that opportunities to acquire basic research skills during undergraduate medical study in Germany are scarce [4]. Despite these worrying findings, numbers of performed research projects and publication quantity are important determinants of postgraduate career success, and junior doctors face intense pressure to publish, which has been termed “SCI article burden” [5].

A recent review article summarized suggestions aiming at fostering medical students’ participation in research [6]. Among the key points are

1. emphasizing research as the foundation of evidence-based medicine,

2. provision of opportunities for undergraduate students to participate in scientific activities, and

3. incorporation of research methodology education into curricula [6].

Student engagement in practice related research tasks may constitute a win-win situation, as students acquire scientific skills and healthcare institutions receive study data with little effort [4]. A study among Croatian medical students showed that participation in a course on research principles was associated with a significantly more positive attitude towards science, indicating the potential impact of such programs [7]. Analysis of student research programs at Duke University and Stanford University Schools of Medicine revealed increased interest in an academic career among participating students and high rates of published scientific manuscripts [8]. Furthermore, Kuhnigk et al. [9] showed that completing a dissertation project leads to improved ability to critically appraise studies and fosters students’ competence to independently perform research.

In times of evidence-based medicine, critical thinking and the ability to study and evaluate scientific literature are important traits for every healthcare professional. It is, therefore, not surprising that the majority of medical students would appreciate training in scientific writing and opportunities to take part in research projects in order to gain research skills [3]. Literature contains several examples of successful curricular integration of basic science and research education [4], [7], [8], [10], [11]. Medical schools without such educational programs would be well advised to take advantage of students’ distinct interest. Formal education in research principles, provision of mentorship, and active student engagement in research activities would not only foster scientific outcome in the short-term, but also have the potential to improve healthcare in the long-term by ensuring motivation and competence among tomorrow’s physician-scientists.

Competing interests

The author declares that he has no competing interests.