To the Editor:
I believe the excellent article by Roberts et al1 requires that at least one more perspective be considered—the admission process and the criteria for selecting prospective medical students. It should be obvious that the characteristics we emphasize in choosing medical students will have a significant influence on their future directions in medicine. We are surely caught on the horns of a dilemma: On the one hand, most educators agree that increasing the number of clinician–scientists is an important goal, especially for future translational research, but on the other hand, we want our medical students to mature into sensitive caregivers who understand their patients’ anxieties, fears, and needs—both physical and psychological—and are prepared to best serve their patients and our society. With respect to the latter, a new MCAT is slated for 2015 that will also test for “basic behavioral and social science knowledge.”2
It’s not that we can’t have it both ways, but it is very hard, and as experience tells us, only a few can successfully navigate this path. Roberts et al1 discuss the “barriers to pursuing a career as a clinician–scientist” as well as programs to increase their numbers. What else can we do? Create more Medical Scientist Training Program positions and more formal research pathways? Dedicate whole medical schools for research training? The choices range from the sublime to the ridiculous, but only point out again that the problem is hard and without easy answers. We want our medical school graduates to be superb physicians responsive to the needs of their patients and families. At the same time, we want more of our medical school graduates to be in the vanguard of new medical advances. In order to accomplish these dual goals, and others as well, I believe we must look hard at ourselves and society to try and parse out how we choose who will have the privilege of being students in our schools of medicine and whether we should change our priorities.
Herbert T. Abelson, MD
George M. Eisenberg Professor Emeritus, University of Chicago Pritzker School of Medicine, Chicago, Illinois, and president, Abelson Medical Career Advising, Inc., Granby, Massachusetts; email@example.com.
1. Roberts SF, Fischhoff MA, Sakowski SA, Feldman EL. Perspective: Transforming science into medicine: How clinician–scientists can build bridges across research’s “valley of death.” Acad Med. 2012;87:266–270
2. Kaplan RM, Satterfield JM, Kington RS. Building a better physician—The case for the new MCAT. N Engl J Med. 2012;366:1265–1268