Click here to read an original op-ed from the TED speaker who inspired this post and watch the TEDTalk below.
When The Huffington Post invited me to put in my two cents regarding Ben Goldacre's thought-provoking talk
on publication bias in the medical field (see it here), I at first thought, "what would a resident in medical training have to say about this?"
I don't claim familiarity in editing or peer-reviewing medical research, and besides a few upcoming editorials and case studies my experience as a published author in peer-reviewed medical journals is minimal at best.
My thoughts then turned to the ambitious and well-deserved career aspirations of my fellow colleagues training in medical residency programs across the nation. All of us have jumped through a series of hoops
to get where we are today and many of us anticipate more hoops to come.
One of these check boxes that almost goes without saying is spending time conducting some sort of academic research during medical training.
While largely unspoken, the culture behind pursuing medical research as a resident, especially for those planning on attaining positions in specialty fellowships or academic medicine, is highly geared toward the outcome of research (i.e., publication) rather than the process or content. So much so, that it is not uncommon for those in medical training to forgo pursuing personal academic interests only to join other research teams that are known for getting their work published in high-impact medical journals.
After all, a curriculum vitae looks much better when fleshed out with a publication or two.
So who's to blame?
Certainly this push to publish research in medical training cannot be attributed to a single source. To be fair, I know that my own residency program, like many others across the nation, focuses most of its resources and efforts on ensuring and encouraging solid clinical training while offering research time for those residents who seek it.
While physicians in search of fellowship positions and careers in academic medicine are encouraged to publish medical research, I am well aware of colleagues who have obtained these revered spots with little more than a presentation or case report under their belts.
I believe that a large component of this frantic endeavor to get published in medical journals is part and parcel to the culture of medical training itself; the same one that takes a cohort of driven, (sub)consciously competitive, type-A individuals like myself through repeated trials of career dedication and professional self-worth. -- Brian Secemsky, M.D.
All in all, I believe that this drive to get published in medical journals is the same drive that may keep a resident in the hospital beyond duty hours or a medical student in the library overnight. I believe that a large component of this frantic endeavor to get published in medical journals is part and parcel to the culture of medical training itself; the same one that takes a cohort of driven, (sub)consciously competitive, type-A individuals like myself through repeated trials of career dedication and professional self-worth.
While I am the first to admit to having pursued past research in this mindset (perhaps too publicly), I know that I am not the last -- so much so that many readers within my field won't bat an eye when agreeing to have done this at some point in their medical careers.
So how does this not-so-subliminal push for publication as a physician in medical training relate to the bigger issue of publication bias?
As any psychology major can attest to, behavior is more efficiently modified earlier in one's experience than years later when customs and constructs become fully developed. In this same vein, we need to start changing the culture surrounding research in medical training before we can make better headway in avoiding the very real issues of publication bias in academic medicine that Ben Goldacre so eloquently discusses in his TEDTalk lecture.
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