Yet for people on the spectrum of training to become a physician, the value of participating in research in terms of the potential benefit to their careers is real and, at times, troubling issue.
Medicine is undeniably linked with research. It is a rapidly evolving discipline, which draws on knowledge from virtually every field of research to develop, design, discover, and test new, presumably better ways of keeping people healthy. Understanding research is essential to the good practice of medicine and medicine doesn't improve without good-quality research. Physicians in particular have a large role in this - physicians often conduct their own research or enable research activities as part of a larger group. They can also stifle research performed by others. In clinical research, the most valuable resource is access to patients and their medical information. Obtaining access to these patients often goes through physicians, or at least involves their consent and cooperation. Without an interest in or support of research, physicians can deny or significantly hamper clinical research initiatives.
As a result, research is often considered valuable in terms of improving a person's CV at virtually every stage of training. Research helps undergrads become medical students (though not at all schools and probably not as much as some pre-meds think). Research helps medical students obtain their desired residency positions. Research helps residents get their desired fellowships and/or their desired employment. Even after employment, research productivity can enhance their career prospects.
Yet being a good physician doesn't necessarily require being a good researcher, or even a mediocre one. It is entirely possible to be able to understand emerging research without producing your own. Furthermore, while physicians resistant to research can hamper its progress, physicians do not need to lead or even be active participants in the research process to be supportive of research involving the patients they see.
And to be clear, some physicians and physicians-to-be hate conducting research. However, because it is so highly valued at each stage in the process of becoming a physician, including working in medicine, many people feel compelled to engage in the research process even if they would generally prefer not to. It's a hoop they have to jump through, nothing more.
So, should physician careers hinge as much as they do on research output? Should research output matter at all? Are we creating a perverse incentive scheme by placing a value on research throughout the career checkpoints of medicine?
There are certainly people at all stages of training and practice who would argue we shouldn't put any emphasis on research productivity in medicine, or at least clearly separate research achievements from progress in clinical ability. There are others who argue that physician disinterest or inability in a research sense is holding back the progress of medicine, to the detriment of the patients these physicians treat.
For my part, I engage in quite a bit of research and will likely continue to do so for most of my career. But I do this because I enjoy participating in research! I learn a lot from my time doing research and I'm willing to go to some extremes to be a more active researcher. I had my last set of pre-clerkship exams a few months ago, with four exams in five days - Monday, Tuesday, Thursday, and Friday. On the Wednesday of that week I presented some of my research at an international conference. Spent hundreds of dollars in conference fees (it was a week-long conference), 8 hours in a car, and lost the one day I had to relax/study during my exam week for 15 stress-inducing minutes on a stage in front of people much smarter than I am. Totally worth it. It'll look good on my CV, don't get me wrong (competition for an oral presentation is fairly high at this conference, I'm told), but I could have had a colleague do the presentation and it still would have looked good on my CV. I just really enjoyed the experience, even though it was not my first (nor, I hope my last) time presenting my research in such a manner.
So I'm torn on this issue. I've seen first hand the value of research, both to society at large and to the competencies of individual physicians-to-be. I've also seen how hard it can be for intelligent, interested, and even experienced researchers to be productive in their field without physician support. However, I've also seen first hand how the insistence on research can frustrate and depress physicians or physicians-in-training who would rather focus on doing the best they can for the patients in front of them, which is, ultimately, their primary duty. I don't have a good answer of how to reconcile these observations.
Any thoughts from the audience?
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