82Copyright © 2006 by MJM
LETTER TO THE MJM
MJM 2006 9(2):82-83
STUDENT JOURNALS: FACILITATING
MEDICAL STUDENT RESEARCH AND
PHYSICIAN-SCIENTIST DEVELOPMENT
Dear MJM,
There is growing concern over the declining number
of physician-scientists over the last two decades.
Although James Wyngaarden, former National
Institutes of Health Director, called attention to this
issue more than 25 years ago (1), history tells his
concerns were mostly ignored. The number of
physician-scientists decreased by more than 6% from
15,377 in 1980 to 14,434 in 1997. In the same period,
there was almost a doubling of physicians reporting
patient care as their primary career from 376,512 to
620,472 (2), thus confirming a declining interest among
physicians to perform biomedical research as their
primary professional activity, which is the general
definition of physician-scientists. Physician-scientists
generally include those who conduct basic science,
disease-oriented, and/or patient-oriented research.
Does it really matter if physicians play a small role in
medical research? After all, there is a growing number
of competent Ph.D. scientists performing clinical
research (2). Dr. Leon E. Rosenberg offered a response,
"It may be true that a medical education does not
adequately prepare one to answer scientific questions,
but it is the ideal setting in which to ask them (3)."
Physicians ask questions that reflect their experiences
based on direct care of patients. They also act as the link
between bench and bedside. Physicians can
communicate their work with both scientists and other
health professionals more directly than any other group.
At the end of his article, Dr. Rosenberg proposed five
recommendations that addressed the declining number
of physician-scientists, one of which was establishing
and maintaining a supportive environment in medical
schools, which encourages and rewards students
committed to research (3).
Modern medical schools incorporate both scientific
method and critical appraisal into their traditional basic
science/clinical education. This is important to training
future physicians to practice evidence-based medicine
(EBM). The future of EBM does not rely solely on
learning methodology but includes the active
participation of physicians in research. Extracurricular
research has long been encouraged in medical schools
and is recognized as an important determinant in the
decision to continue postgraduate research (4,5).
Furthermore, high quality medical student research is
publishable in peer-reviewed journals and can
contribute considerably to the scholarship of a medical
faculty (6,7).
Since 1997, there has been a small but encouraging
increase in interest in research as part of their careers
among medical students (8). It is important to continue
the efforts made to maintain this trend and to support
medical students in their endeavours to become
physician-scientists. And this is where student journals
play a critical role.
Although student journals have long been recognized
to offer opportunities for students to express their ideas,
the impact of student journals to spark research interests
is often understated. Student journals have the unique
opportunity to engage students at a more personal and
understanding level. They recognize that for many
students publishing their first article is a daunting task.
Many students can spend numerous hours writing and
revising their submissions to leading journals only to
have their confidence crushed by a rejection letter. The
mandate of student journals is particularly sympathetic
to submissions from students who are embarking on
their research careers. Even if they have no scientific
data to submit an original article, students can make
contributions in other forms such as letters and
commentaries. Critical appraisal letters can often
demonstrate a student's competence in using the
scientific method and are likely to stimulate interest in
research and academic medicine (9). Many students
have published their first articles in student journals.
Indeed, student journals, including the McGill Journal
of Medicine, have often been the launching pad for
those aspiring to research careers.
Many student journals are advocates for high quality
medical and scientific research, and devote many of
their pages to scientific evidence in the form of original
research and review articles. However, it is equally
important to maintain a balance in medicine and
recognize that not all aspects of medicine lend
themselves to rigid study. The art of medicine still
involves an exchange of ideas and opinions.
Furthermore, many student journals provide eager
students the unique opportunity to be part of an editorial
board in which to learn and practice their critical
appraisal skills. A balanced approach to medical science
will enable student journals to encourage critical
thought, student research, and willingly, the
development of future physician-scientists.
Sincerely,
Steven Lin, BMSc
MD,CM 2007 Candidate
MJM Consultant

83 McGill Journal of Medicine
REFERENCES
1. Wyngaarden JB. The clinical investigator as an endangered
species. N Engl J Med 1979; 23:1254-9.
2. Zemlo TR, Garrison HH, Partridge NC, Ley TJ. The physician-
scientist: career issues and challenges at the year 2000. FASEB
J 2000; 14:221-30.
3. Rosenberg LE. Physician-Scientists-Endangered and Essential.
Science 1999; 283:331-2.
4 Segal S, Lloyd T, Houts PS, Stillman PL, Jungas RL, Greer RB.
The association between students' research involvement in
medical school and their postgraduate medical activities. Acad
Med 1990; 65(8):530-3.
5. Jacobs CD, Cross PC. The value of medical student research: the
experience at Stanford University School of Medicine. Med
Educ 1995; 29(5):342-6.
6. Wehrens XH, Leiner T. Publications from extracurricular
research. Lancet 2001; 358(9284):846.
7 Cursiefen C, Altunbas A. Contribution of medical student
research to the Medline-indexed publications of a German
medical faculty. Med Educ 1998; 32(4):439-40.
8. Ley TJ, Rosenberg LE. The physician-scientist career pipeline
in 2005: build it, and they will come. JAMA 2005;
294(11):1343-51.
9. Hanratty B, Lawlor D. Getting letters published in journals is
good aim for medical students. BMJ 1999; 319(7218):1198.
2006
Steven Lin is a MJM Consultant and previous Editor-in-chief. He received his B.M.Sc.(Hon.) in physiology from
the University of Western Ontario. His research in cardiovascular disease has earned him scholarships from the
Heart and Stroke Foundation and St. Michael's Hospital in Toronto, Canada.