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March 20, 2013

Overcoming Obstacles to Research in Residency

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliation: Stroger Hospital of Cook County, Chicago, Illinois (pclarke@rsh.net).

JAMA. 2013;309(11):1109-1110. doi:10.1001/jama.2013.1334

To the Editor: Dr Rothberg cited involvement in research as a prestigious and valuable asset for resident physicians, noting that “evidence of research activity is usually a prerequisite for competitive fellowships.” He suggested devoting more resident time, faculty focus, and funding to fostering research in residency.1

I disagree with this suggestion. Trainees are preparing to practice clinical medicine in an increasingly complex care environment. Time and resources are limited for their apprenticeship in an era in which the public funding that supports their training is closely scrutinized. This is especially true if time spent on research is subsumed, as it should be, within the strict duty hours restrictions to which programs must now adhere. The Accreditation Council for Graduate Medical Education has designated “scholarly activity” as one of the essential aspects of training and this seems sensible. However, more attention should be paid to what scholarly activity may be valuable for the future clinician. Excellent research is a demanding and impressive scholarly activity, but one that few practicing clinicians will require. Residents have demanding expectations for developing clinical competence during their training. Diverting their focus toward research may imperil their achieving this competence, not to mention the welfare of their future patients.