We agree with you that correlation does not imply causation. Although we do believe an association between publications related to required research during medical school and subsequent publications is plausible, causality cannot be established using our study design.
We did not claim causation in our presentation of Results or in the Discussion. Rather, we discuss our findings using tentative terms such as “might stimulate pursuit of further research” or “association,” speculate about potential meanings of our findings, and offer alternative explanation for findings. We maintain that our results do suggest that “[r]equired medical school research experiences . . . may promote subsequent research productivity.” Inasmuch as a controlled trial has not been published, we believe this information is useful to medical school leaders, although conclusions drawn will need to consider other viable explanations.
Liselotte N. Dyrbye, MD
Assistant professor of medicine, Mayo Clinic College of Medicine, 200 Second Street SW, Rochester, MN 55905; ([email protected]).
David A. Cook, MD, MHPE
Director, office of education research, and associate professor of medicine, Mayo Clinic College of Medicine, Rochester, MN.