Does research make sense any more? The dire need for new ways to measure success

This article was exclusively written for the Sting by Ms.  Stijntje Dijk , a medical student at the Erasmus Medical Center in Rotterdam. She is also affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

 The question “Medical Research Worldwide – Who is leading and who is lagging behind” – requires us to first identify what it means to be successful. It’s not uncommon to judge individuals based on their numbers of publications, the prestige of journals they published in, their chances of receiving grants. That is after all what we hear we will be judged on in our careers.

What if, instead of chasing prestige, we were judged by the degree to which our research positively impacts our communities? And what if we knew for certain that this was really what our schools cared about when they assessed us? Would our priorities shift?

 A socially accountable medical school takes action through its education, research and service activities to meet the priority health needs of society. It works with governments, health service organizations, and public to positively impact people’s health and demonstrates this through relevance, quality, equitabiliy, cost-effectiveness. [1]  Its aim is to deliver graduates who are change agents with capacity to work on health determinants and contribute to adapting the health system.[2] This was a conclusion also reached by the Global Consensus on Social Accountability for Medical Schools, created in 2010.

Although these principles do look good on paper, they are often poorly reflected in practice, and decisions remain to be taken on external factors such as personal interest. Rudolf Virchow once accurately wrote: “Medical Education does not exist to provide students with a way of making a living, but to ensure the health of the community.”

This april 2017, the World Summit of Social Accountability will reflect on how we can drive the recommendations of the Global Consensus document.

Of course not all science directly shows the value it will have to our societies eventually, and not all other issues should be disregarded. However, we should remain mindful that health professionals have a priviliged position to start with: We had the opportunity to study medicine, whereas many others did not. (In the majority of cases) Our communities have invested in us to receive this education. They often invest in the time we spend on doing our research for our work. Finally, it’s them who often indirectly pay the fees to read the results of that work through journal paywalls.

Several guidelines exist in medical research, however most focus on research involving people, in order to protect them under ethical guidelines. But if even research done without direct population involvement still ultimately effects them, shouldn’t ethical guidelines be then always applied?

Then what is socially accountable research, and how do we assess it? There’s no straightforward answer. I would propose however, the following questions to ask ourselves, when setting our priorities:

• Would anything change in the world based on the research I’m doing – is it translatable to policy or practice?
• Am I doing this research because there is a need in the world/in my community, or just because I need to get enough publications on my name to earn a title?
• Is there an opportunity for participatory action research? Can I collaborate with those affected by the issue studied, and create shared ownership over the research project?
• Can I effectively argue that this research should be a priority over other potential research areas, considering that time and monetary investments are scarce?
• Is there any way I can prevent the public from paying double/triple for this research? Can I find any open access opportunities that allow me to still reach my intended audience?

Only then can we live up to our social mandate, and truly lead medical research and education worldwide.

References

[1] Boelen C, Heck J. Defining and Measuring the Social Accountability of Medical Schools. Geneva: World Health Organization; 1995. Available from: http://www.moph.go.th/ops/hrdj/Hrdj_no1/charles.html.

[2] Boelen C, Dharamsi S, Gibbs T. The Social Accountability of Medical Schools and its Indicators. Educ Health [serial online] 2012 [cited 2017 Mar 25];25:180-94. Available from: http://www.educationforhealth.net/text.asp?2012/25/3/180/109785

About the author
Stijntje Dijk is a medical student at the Erasmus Medical Center in Rotterdam. She previously served as the former Liaison Officer for Medical Education issues and Medical Education Director for the International Federation of Medical Students’ Associations.