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Medical students are using popular research tool to pump out misleading studies

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Re: Medical students are using popular research tool to pump out misleading studies

#61

Post by currymj »

residencies have decided to outsource part of their hiring decisions to journal peer-review processes. so now for some submissions, editors and reviewers are not actually doing scientific peer review, but rather screening job candidates for hospitals.

peer review is built to assume good faith work by people who are all part of a community of scholarship, it can partially hold up to people within the community gaming metrics. if people are just going to appear, game the system to publish some papers, and then disappear into their real careers, there's no hope of this working.

i don't understand why residencies want med students to publish papers anyway. it's very difficult to do good scientific research, it requires training, time, and almost always apprenticeship. none of this is part of the medical school curriculum, which is why we need special MD-PhD programs for people who want to do both. nobody expects that doing a PhD in biology or epidemiology would give you any clinical know-how, why is it reasonable to expect the reverse?

Re: Medical students are using popular research tool to pump out misleading studies

#62

Post by abeppu »

There is something a bit ironic that the evidence to refute the "more research is better" position is selecting (cherry-picking?) a particularly bad study. Are there better ways to measure whether the population of studies using these databases has declined as a whole, rather than just saying there are more of them and at least some are pretty bad?

Re: Medical students are using popular research tool to pump out misleading studies

#63

Post by currymj »

internet_user wrote: post #24

admissions and residency matching give a lot of weight to "research output", aka publications. For residency, the two most important things are: 1) board scores. 2) research output. It's not uncommon to see 40-50 publications for competitive residencies. incentives, incentives, incentives.

[dead]

Re: Medical students are using popular research tool to pump out misleading studies

#64

Post by GerryAdamsSF »

eunos wrote: post #50

That aside I am a bit perplexed that almost absolute insistence of medical students to become researchers as well, it seems just become a pure practitioner is not a feasible option. To make it worse it looks more acceptable that a doctor really provide bad service or lacking communication and empathy to patients than not being a researcher.

Most doctors drop the research once they get a residency spot. It's just the selection mechanism for residency.

Re: Medical students are using popular research tool to pump out misleading studies

#65

Post by GerryAdamsSF »

spchampion2 wrote: post #55

My potentially unpopular opinion: Congress should ban residency programs from using Medicare training dollars to pay for research. They should do this with the goal of speeding up the training pipeline for actual practitioners, many of whom are now required to spend a year of their residency doing research of some kind. If medical residents, or teaching hospitals, want people to do research, they should go get fundin…

This is wrong.

It's medical students, not residents, who take research years, and that's only for extremely competitive specialties.

The lack of doctors, as it has always been, is because of the shortage of residency spots.

That cannot be addressed without Congress reversing 50+ years of neoliberalism trends and political failure and refusal to invest in public services and/or a communist revolution. Good luck fixing that.

Re: Medical students are using popular research tool to pump out misleading studies

#66

Post by gowld »

currymj wrote: post #61

residencies have decided to outsource part of their hiring decisions to journal peer-review processes. so now for some submissions, editors and reviewers are not actually doing scientific peer review, but rather screening job candidates for hospitals. peer review is built to assume good faith work by people who are all part of a community of scholarship, it can partially hold up to people within the community gaming…

Residency is a guild (aka, anticompetitive trust) designed to limit the medical workforce and drive up doctor salaries. It needs artificial metrics to ratonalize the increasing salaries as being for "increasing talent".

Re: Medical students are using popular research tool to pump out misleading studies

#68

Post by gowld »

nickgros wrote: post #60
eunos wrote: post #50

That aside I am a bit perplexed that almost absolute insistence of medical students to become researchers as well, it seems just become a pure practitioner is not a feasible option. To make it worse it looks more acceptable that a doctor really provide bad service or lacking communication and empathy to patients than not being a researcher.

Guidelines and standards can change quickly. It's important for clinicians to have a foundational understanding of statistical methods and to be able to critique studies. For certain specialties, the number of residency positions is so limited that medical students have to publish research to be competitive, even if they have no interest in doing so later in their career. But altogether I sort of agree, the incentive…

Publishing a study does not show "a foundational understanding of statistical methods and to be able to critique studies." It's literally the opposite!

Re: Medical students are using popular research tool to pump out misleading studies

#69

Post by jmyeet »

jansport123 wrote: post #56
jmyeet wrote: post #43

I can explain what's going on here. For context, you need to know how somebody becomes a doctor in the US. 1. You get a 4 year degree in college. You hopefully get a very good GPA. You need to do so-called pre-med classes that really don't have much to do with medical education but are known as "weed out" classes, particularly Organic Chemistry. If you don't do these in your 4 year degree, you can do a program afterw…

don't existing doctors aim to keep supply short? Seems like it's like the homeowner problem (existing homeowners always want their house prices to go up)

It's complicated. The AMA seeks to restrict supply. The number of medical schools has been cut dramatically from historic highs. The AMA relented in WW2 because of the need for combat physicians but then went right back to their old ways after WW2 ended. Doctors don't necessarily share that view.

But there are multiple issues that contribute to shortages. Just like with homes (as you brought up), there can be homes where nobody wants to live. Likewise, some specialties never fill all their places. So earning potential is a factor. Not wanting to live rural is often also a factor, despite efforts to attract people to both using things like PSLF. PSLF itself is on shaky ground under this administration and you will see physicians unwilling to sacrifice career potential for a program that won't trust will be there to forgive their debt.

And then there's burn out. Many doctors leave the profession in their 40s and 50s. And if you didn't really become a doctor until your 30s, that's a relatively short professional life. But why do they burn out? Insane hours, administration, insurance, work-life balance are all up there.

Re: Medical students are using popular research tool to pump out misleading studies

#70

Post by gowld »

thomasfedb wrote: post #10
fn-mote wrote: post #3

My assumption is the credibility of a non-PhD-holding medical student’s research is 0, just like (almost) any other inexperienced researcher.

As a clinician-academic who published in The Lancet during medical school, I think this goes a bit far. Unfortunately student doctors are encouraged to publish whether or not they actually have an interest in research… but that shouldn’t discount the work of those who are genuinely engaged. But certainly we should always approach the literature critically, including the author list, journal of publication and its pee…

Were you first-author on an unsupervised project and paper, or did someone stake their reputation on your work?
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