Equitable distribution of research opportunities to medical students

Dear Dr Dermatoethicist: I receive multiple requests each year from interested medical students hoping to find faculty research mentors. Often, there is more student interest than available faculty research projects. How should I ethically distribute opportunities?—Concerned Academic Faculty Dear Dr Dermatoethicist: I receive multiple requests each year from interested medical students hoping to find faculty research mentors. Often, there is more student interest than available faculty research projects. How should I ethically distribute opportunities? —Concerned Academic Faculty Dear Concerned Academic Faculty: With emphasis on a holistic review of residency applications and United States Medical Licensing Examination Step 1 being pass/fail, medical students interested in dermatology residency turn to research output as an objective way to create a strong application. There has been a proliferation in the number of published manuscripts among medical students applying to the dermatology residency match.1Gandelman J. Mathes E.F. Butler D.C. Research fever in dermatology-a symptom of a larger problem.JAMA Dermatol. 2023; 159: 805-806https://doi.org/10.1001/jamadermatol.2023.1690Crossref PubMed Scopus (0) Google Scholar Between 2007 and 2018, the mean number of research items per matched dermatology applicant increased from 6 to 15.2Narang J. Eversman A. Kalra M. et al.Trends of research output of allopathic medical students matching into dermatology, 2007-2018.JAMA Dermatol. 2021; 157: 1-5https://doi.org/10.1001/jamadermatol.2021.2000Crossref PubMed Scopus (13) Google Scholar Research opportunities and faculty availability to appropriately mentor students in these research endeavors are both limited, particularly given the small size of many academic dermatology departments. How do we distribute limited research opportunities ethically and how do we emphasize quality over quantity of publications? A student’s access to research can seem arbitrary. Many factors are at play, including timing of their dermatology interest, access to a home dermatology program, prior research experiences, and other factors such as socioeconomic status, race, and gender. Recent studies suggest the value of race-concordant mentoring relationships for underrepresented minorities in achieving meaningful research experiences.3Winfrey S.R. Parameswaran P. Gerull K.M. LaPorte D. Cipriano C.A. Effective mentorship of women and underrepresented minorities in orthopaedic surgery: a mixed-methods investigation.JB JS Open Access. 2022; 7e22.00053https://doi.org/10.2106/JBJS.OA.22.00053Crossref PubMed Scopus (6) Google Scholar Underrepresented students may find it challenging to connect with mentorship and research. As an initial step to addressing justice and equity, we suggest academic departments to formally track student interest and available faculty projects, including which students are working on what project and which students are inquiring about opportunities. Individual institutions can use this information to organize a research allocation process, but guiding principles should be considered regionally or nationally by an organization like the Association of Professors of Dermatology. A new effort to distribute research projects centered on fairness would allow more students to gain benefits. However, other students who previously had more research projects may feel constricted in their ability to identify opportunities and subsequently feel negatively impacted. Nonetheless, beneficence, or doing good, should take precedence. Beneficience for students should include creating a culture emphasizing quality over quantity of publications. This shift will require buy-in from all involved, whether residency programs or medical students. Students should be encouraged to pursue projects that they find meaningful and put forth high quality work. Faculty should set the example of being fully invested in projects from start to finish to show what authorship encompasses.4Barbieri J.S. Grant-Kels J.M. Authorship contributions.J Am Acad Dermatol. 2023; 88: 1221-1222https://doi.org/10.1016/j.jaad.2022.04.004Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar Faculty should also provide guidance on which research questions add value to the dermatology literature. Reviewers of residency applications should take note of substantial student effort, even if unpublished. Such a culture shift could ease the research inquiry burden and have a greater impact on students’ personal development. Dermatology faculty who are in a position to help coordinate student research opportunities face many demands on their time. Implementing an ideal ethical solution may be difficult and in some cases, impractical. We propose that academic dermatology departments should thoughtfully consider what type of research distribution process is most equitable for their medical students and encourage a culture shift around quality over quantity as important steps in moving the needle on this difficult task. —Dr Dermatoethicist None disclosed.