Poor Relations

To the Editor: I read with interest the article by Dr. Azer1 identifying the top-cited articles in medical education. Many of the articles cited as most influential are, as noted in Dr. Sklar’s AM Rounds blog post2 on Dr. Azer’s article, summaries of social science research, though very few are original research articles. My concern is that while social science research results may be gaining deserved recognition, social scientists are not. Primary social science research and the researchers upon whom these valuable insights for education and clinical work depend are still undervalued, underfunded, and often invisible in medical schools. A body of work by Albert and colleagues shows there is still a distinctly negative attitude toward social science research, and that the experiences of social scientists in medical schools is less than reassuring. One recent article notes that, for social scientists, “moving into medicine has been a challenging experience, as their research practices and views of academic excellence collided with those of medicine” and many had to prove their worth through alternative means such as teaching and service, or, at the time of the interview, feared failing to meet their promotion criteria…. [Some] withdrew from the academic game or distanced themselves from their colleagues to work in isolation. These participants were disheartened by their milieu and the course taken by their career.3 I am a cognitive psychologist who has worked in a number of the areas and with several of the researchers whose work is summarized in the top articles. My experiences since moving into medical education strongly resonate with those who were interviewed by Albert and colleagues, and I am well aware that the same is true for many of my colleagues. We find that often we are seen, at best, as “trainers” to help clinicians with a particular piece of research rather than as valued colleagues in a sustained relationship. There is a continuing lack of respect for our skills and a resulting tangible lack of career progression which has led many, including recently myself, to leave medical education entirely. I hope that attitudes toward these vital disciplines continue to improve, not only by valuing the outputs of social science, but by properly recognizing and rewarding those who are developing the foundational theory and research on which these results are built. Jean McKendree, PhD Former senior lecturer in medical education, Hull York Medical School, York, United Kingdom; [email protected]