We would like to thank the authors of “Publish or Perish: The Research Arms Race in Residency Selection”1  for their insight into the unsustainable pressure on medical students to produce research, often at the expense of scientific rigor and their interests outside of the hospital. As current medical students, we support the argument against the research “arms race” and would like to provide an alternative perspective.

Is the goal of medical student research to “develop critical thinking skills,” and appreciate “the challenges of producing high-quality research,” as proposed by Elliott and Carmody? The core competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME) emphasize residents’ ability to critically appraise and synthesize a body of research in the context of evidence-based patient care.2  Similarly, the Electronic Residency Application Service (ERAS) section for publications, posters, and oral presentations highlights the value of medical student research in the development of writing and presentation skills.3  While student publications may fulfill individual learning goals and showcase valuable skills, the growing number of reviews and case reports produced by medical students make, at best, minor contributions to the field. The time and effort put into them could be spent on other, more meaningful endeavors.

Elliott and Carmody argue that more often than not, students engage in research to check a box on their application. We urge medical schools and residency programs to look beyond the checkbox, to find other, creative means to fulfill these same goals and competencies in ways that align with students’ interests. Students who are passionate about immigrant health can demonstrate critical thinking skills by developing an educational curriculum on the topic. They can develop communication skills by delivering evidence-based legislative testimony on their experiences caring for immigrant populations and the value of caring for all members of their community. Those who are passionate about the medical humanities can hone these skills through personal narrative writing or oral storytelling. These activities, while not considered formal research on the ERAS application, provide humanitarian value and formative opportunities for students to develop their professional identities and contribute meaningfully to the field of medicine.

While the ERAS application already includes space for extracurricular activities, Elliott and Carmody point out that program directors value research above other components of the application. Further, they discuss how disproportionate access to research opportunities puts many students at a disadvantage. Broadening the definition of research to encompass any significant academic experience allows students to acquire valuable skills regardless of their institution’s funding prowess. As residency programs begin to move toward a more holistic approach, it is increasingly important for students to have diverse interests. If we broaden what “counts” as research—and weigh it just the same as papers and abstracts—students will follow their passions and evolve into well-rounded physicians.

Publish or perish: the research arms race in residency selection
J Grad Med Educ
Stanford Graduate Medical Education
ACGME Core Competencies
Association of American Medical Colleges
ERAS tools and worksheets for residency applicants