Lack of research training in med schools could imperil patients, say Temple and Penn profs

A surge in the number of new medical schools across the country has some physicians worried about the quality of education. Facing reduced budgets — and a rising need for primary care providers — medical schools have been backing away from research. Some say that’s at the peril of patient care.

The emphasis away from rigorous scientific training and toward clinical experience, especially at newer medical schools, troubles Temple University School of Medicine Dean Arthur Feldman.

“That bodes poorly for the future of medicine because there’ll be a number of physicians that don’t have any exposure to research,” he said. “It will be harder for them to interpret new findings, and it will be more difficult for them to participate in research themselves.”

The issue prompted Feldman and University of Pennsylvania professor of medicine Arthur Rubenstein to pen a policy paper published in the journal Science Translational Medicine. They analyzed National Institutes of Health funding data and found that over the past decade, grants have fallen most precipitously to schools already receiving the least amount of money, in part because 19 schools opened without research programs.

“We are particularly concerned about this because medical practice these days needs to be cognizant of tremendous advances in research and science, such as new genetics, immunology, public health epidemiology, and so on,” said Rubenstein.

Paul Katz, dean of Cooper Medical School at Rowan University in Camden, disputes the notion that good training requires doing research the traditional way.

“Not all of that has to occur in a wet lab, not all of it has to occur with research that’s funded by the NIH,” he said. “There’s an awful lot of scholarship and investigation and creation of knowledge that occurs at all of the new schools.”

Cooper, so new it has yet to graduate its first class, bills itself as a “mission-driven medical school that focuses on community service, early clinical exposure, and an innovative curriculum.” The school has received NIH funds, and students have opportunities for summer research. All trainees take a four-year course called “scholar’s workshop” that includes a capstone project around a research question.

But Katz acknowledged that the school’s primary focus in its first years is getting established.

“The most important thing right out of the chute is getting accredited, providing a top quality education for students, and having them graduate to meet the health care needs of our communities,” he said.

Falling support from the federal government isn’t helping.

“Generally, for every dollar in a research grant, there’s at least another 25 to 30 cents that has to be spent by the institution,” said Katz. For fledgling schools without significant endowments, that can be a challenge.

Rubenstein and Feldman, agreeing the drop in federal dollars is a problem, call on the government to devote more funds. Without more equitable access, they fear the evolution of a two-tiered medical educational system in which only some students get the research experience they believe is so critical.

“This concept that we can take people who want to be primary care physicians and train them without any exposure to research,” said Feldman, “I think that shortchanges both the physicians but also their patients.”