The correlates of research success

Are Medical Students Interested in Conducting Research? A Case Study on the Recruitment Outcome of an Elective Research Summer Opportunity

A pilot summer elective research opportunity was made available to medical students at the University of Malta. A call was sent out in June 2021. Interested students sent a short "intention to participate" email to the coordinator which was analysed. One in every twelve enrolled medical students applied. The commonest reason for participation was to gain research experience and knowledge, with a majority expressing no prior experience. Lack of research opportunities may be one of the barriers faced by students, resulting in the poor inclination to conduct research as undergraduates. Identifying specific barriers is recommended in order to provide a tangible research future.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01645-3.

Understanding the funding characteristics of research impact: A proof-of-concept study linking REF 2014 impact case studies with Researchfish grant agreements

BACKGROUND

All parts of the research community have an interest in understanding research impact whether that is around the pathways to impact, processes around impact, methods for measurement, describing impact and so on. This proof of concept study explored the relationship between research funding and research impact using the case studies submitted to the UK Research Excellence Framework (REF) exercise in 2014 as a proxy for impact.

METHODS

The paper describes an approach to link the REF impact case studies with the underpinning research grants present in the Researchfish dataset, primarily using the publications captured in both datasets. Where possible the methodology utilised unique identifiers such as Digital Object Identifiers and PubMed ID's, and where this was not possible the funding information within each publication was used.

RESULTS

Through this automated approach 21% of the non-redacted case studies could be linked to a specific research grant. Additional qualitative analysis was then done for unlinked REF impact case studies, which involved reading the document to identify additional information to make the linkage. This approach was taken on 100 REF impact case studies selected at random and resulted in only seven having no identifiable research grants funding associated. The linked research grants were analysed to identify characteristics that are more frequently associated with these grants, than non-linked ones.

CONCLUSIONS

This analysis did point to some interesting observations such as the grant funding linked to REF impact case studies are more likely to be longer, higher financial value, have more publications and be more collaborative (amongst other characteristics). These findings should be used with caution at present and not be over interpreted, this is due to the sample size for this proof of concept study and some potential limitations on the data which were not addressed at this stage.

Publication in the Australian medical student journal is associated with future academic success: a matched-cohort study

BACKGROUND

Medical student journals (MSJs) help to introduce the fundamentals of academic research and publication to future doctors. It has recently been shown that MSJs can influence doctors' future academic and professional success, however these findings have not been replicated in an Australian cohort. The aim of this study was to examine the association between publication in the Australian Medical Student Journal (AMSJ) and markers of a student's future academic trajectory, including future publication, attainment of higher academic degree or entry into specialist training.

METHODS

Articles authored by medical students in the AMSJ from 2010 to 2015 were retrospectively identified. A list of these student authors was made, with university- and year- matched control students randomly selected from university graduation databases. For all students, data related to academic success were obtained from multiple sources including PubMed®, Google, university databases and author affiliation information from publications. A multivariable conditional logistic regression model was used to assess correlation between variables. The primary outcome measure was the number of postgraduate PubMed®-indexed publications. Secondary outcome measures included attainment of higher degree or faculty position. Clinical speciality was also recorded.

RESULTS

Fifty-five AMSJ authors (14 case reports, 17 original research, 21 review articles) from 14 Australian universities were included. Publication in the AMSJ was associated with future PubMed® indexed publications (OR 3.43, 95% CI 1.74-6.77, P < 0.001) and higher degree attainment (OR 4.05, 95% CI 1.99-8.22, P = 0.0001). AMSJ authors were also significantly more likely to enter into surgical training (OR 2.53, 95% CI 1.10-5.84, P = 0.029). A multivariable conditional logistic regression model demonstrated that publication in the AMSJ was predictive of future PubMed indexed publication, independent of higher degree or faculty position attainment (OR 2.56, CI 1.22-5.39, P = 0.01).

CONCLUSION

We have shown that publication in a MSJ is associated with markers of academic success in an Australian cohort. PubMed®-indexed publications, attainment of a Masters degree, and entry in to surgical training were all significantly correlated to AMSJ publication. A conditional logistic regression model demonstrated that medical student publication in the AMSJ influences the number of future PubMed®-indexed publications, independent of major academic confounding variables.

The impact of gender on early scientific publication and long-term career advancement in Israeli medical school graduates

BACKGROUND

Many medical schools and residency programs incorporate research projects into their curriculum, however most remain unpublished. Little is known on the long-term effect of early-career publication, especially in female graduates.

METHODS

We collected data on physicians 15-20 years after graduation (representing a mid-career point), and analysed data on early publication, publication volume and impact according to graduates' gender and professional characteristics. Physicians were divided into those who never published, early-publishers (EP) who published within 2 years of graduation and late-publishers (LP). We analysed and compared the demographics, publication volume, publication quality as well as current mid-career position.

RESULTS

Of 532 physicians, 185 were EP (34.8%), 220 were LP (41.3%), 127 (23.9%) never published, 491 (92.2%) became specialists and 122 (22.3%) achieved managerial position. Of the 405 who published, the average number of publications was 20.3 ± 33.0, and median (IQR) 9(19). H-index was significantly higher in EP, males, surgical specialists, and those holding a managerial position. Male gender was associated with higher publication rate (OR = 1.742; 95% CI 1.193-2.544; P = 0.004). Using quantile regression, female gender was negatively associated with the number of publications in Q50-Q95. Surgical specialty and managerial position were positively associated with publications in Q25 to Q75 and early publication in Q25 and Q75.

CONCLUSIONS

We found a strong association between EP and the number, impact, and quality of publications throughout their academic career. This study illuminates the need for further investigations into the causes of gender discrepancies. We should invest in support programs encouraging early high quality research projects for young physicians and female graduates.

Students' Perceived Benefits of Integrating a BSc in Health Sciences within a Medical Degree at Sultan Qaboos University

Objectives

After completing the pre-clinical phase of a Doctor of Medicine (MD) curriculum, undergraduate medical students may choose to add a Bachelor of Science (BSc) degree in health sciences to their MD degree. Limited data exists on the motives behind students' decisions to undertake such intercalated degrees. Hence, this study aimed to identify the factors that influence students in making this choice.

Methods

Undergraduate students who chose the research-based academic track of the intercalated phase of the BSc programme at the College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman, between 2014-2018 were enrolled. A standardised and validated self-explanatory questionnaire examining motivations to join the intercalated phase was administered to all students in the first week of enrolment.

Results

Over a five-year period, out of 557 eligible students, 18 (3%) were enrolled in the intercalated phase and all completed the questionnaire. The mean age was 22 ± 1.5 years and the majority (83%) were female. Out of the 18 students, 10 (55%) had taken the university's foundation programme. A total of 45% of students chose to intercalate out of their own interest, regardless of career ambitions. The main reasons to intercalate were an opportunity to enhance research experience, alignment with long-term career goals and a chance to publish in indexed journals.

Conclusion

Despite the benefits of obtaining an additional degree, a relatively small proportion of MD students were attracted to the intercalated phase. A better presentation of the BSc degree is needed to help students make a more informed decision.

Publication in a medical student journal predicts short- and long-term academic success: a matched-cohort study

BACKGROUND

Medical student journals play a critical role in promoting academic research and publishing amongst medical students, but their impact on students' future academic achievements has not been examined. We aimed to evaluate the short- and long-term effects of publication in the New Zealand Medical Student Journal (NZMSJ) through examining rates of post-graduation publication, completion of higher academic degrees, and pursuing an academic career.

METHODS

Student-authored original research publications in the NZMSJ during the period 2004-2011 were retrospectively identified. Gender-, university- and graduation year-matched controls were identified from publicly available databases in a 2:1 ratio (two controls for each student authors). Date of graduation, current clinical scope of practice, completion of higher academic degrees, and attainment of an academic position for both groups were obtained from Google searches, New Zealand graduate databases, online lists of registered doctors in New Zealand and Australia, and author affiliation information from published articles. Pre- and post-graduation PubMed®-indexed publications were identified using standardised search criteria.

RESULTS

Fifty publications authored by 49 unique students were identified. The median follow-up period after graduation was 7.0 years (range 2-12 years). Compared with controls, student-authors were significantly more likely to publish in PubMed®-indexed journals (OR 3.09, p = 0.001), obtain a PhD (OR 9.21, p = 0.004) or any higher degree (OR 2.63, p = 0.007), and attain academic positions (OR 2.90, p = 0.047) following graduation.

CONCLUSION

Publication in a medical student journal is associated with future academic achievement and contributes to develop a clinical academic workforce. Future work should aim to explore motivators and barriers associated with these findings.

An Analysis of Medical Students' Attitude and Motivation in Pursuing an Intercalated MSc in Clinical Anatomy

OBJECTIVES

This study aimed to explore what factors influence and motivate medical students to undergo an intercalated degree and why they prefer to choose an intercalated MSc in Clinical Anatomy.

METHODS

The study consisted of 54 medical students enrolled in Queen's University Belfast which offers a range of intercalated degrees, including an iBSc in Medical Science and an iMSc in Clinical Anatomy. Five-point Likert scale survey was used to collect data, designed to discover what the influencing factors were in deciding to take an intercalating degree and if they have a desire to gain research experience. It measured the motivational features of their chosen courses.

RESULTS

In recent years, more students (68.5%, n = 54) opted for the iMSc rather than the iBSc. This difference in number of students was statistically significant (chi-square = 33.4, P < 0.0001). It was theorized that this was due to an interest in future surgical specialization; however, this study has shown that the prime reason 72.2% of students opt to take a year out of their medical degree to carry out an intercalated degree is simply to gain an extra qualification whilst 61.1% thought it would enhance their competitiveness in the job market. Ninety-four percent of the iMSc students recommended the intercalated degree to junior students in comparison to only 34.8% of the iBSc students. This difference in percentage was statistically significant (t = 2.78, P = 0.009).

CONCLUSION

The study shows no significant link to a desire to gain research experience in determining which intercalated programme to undertake. Students favoured iMSc more because they believed it will enhance their employability.

Inclination towards research and the pursuit of a research career among medical students: an international cohort study

BACKGROUND

Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians' inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school.

METHODS

Students from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed.

RESULTS

Of the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%-26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%-45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career.

CONCLUSION

Most medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.

Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis

Importance

Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research.

Objective

To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue.

Evidence Review

We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed.

Findings and Conclusions

Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD) before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may help in standardizing research education during medical school.

Impact of an intercalated BSc on medical student performance and careers: a BEME systematic review: BEME Guide No. 28

INTRODUCTION

Intercalated BScs (iBScs) are an optional part of undergraduate (UG) medicine courses in UK, Eire, Australia, New Zealand, the West Indies, Hong Kong, South Africa and Canada, consisting of advanced study into a particular field of medicine, often combined with research. They potentially improve students' skills and allow exploration of specific areas of interest. They are, however, expensive for institutions and students and delay workforce entry. There is conflicting evidence about their impact.

METHODS

A mixed-method systematic review (meta-analysis and critical interpretive synthesis) of the biomedical and educational literature, focusing on the impact of iBScs on UG performance, skills, and career choice, and to explore students' and other stakeholders' opinions about iBScs.

RESULTS

In the meta-analytic part of this review, we identified five studies which met our predetermined quality criteria. For UG performance, two studies using different methodologies report an improvement in UG performance; one study reported an Odds Ratio [OR] of 3.58 [95% CI 1.47-8.83] and the second reported a significant improvement in finals scores (1.27 points advantage 95% CI 0.52-2.02). One study reported a mixed result, while two studies showed no improvement. Regarding skills and attitudes, one paper suggested iBScs lead to the development of deeper learning styles. With regard to subsequent careers, two studies suggested that for those students undertaking an iBSc there is an increased chance following an academic career [ORs of 3.6 (2.3-5.8) to 5.94 (3.6-11.5)]. Seven of eight studies (with broader selection criteria) reported that iBSc students were less likely to pursue GP careers (ORs no effect to 0.17 [0.07-0.36]). Meta-analysis of the data was not possible. In the critical interpretative synthesis analysis, we identified 46 articles, from which three themes emerged; firstly, the decision to undertake an iBSc, with students receiving conflicting advice; secondly, the educational experience, with intellectual growth balanced against financial costs; finally, the ramifications of the iBSc, including some suggestion of improved employment prospects and the potential to nurture qualities that make "better" doctors.

CONCLUSION

Intercalated BScs may improve UG performance and increase the likelihood of pursuing academic careers, and are associated with a reduced likelihood of following a GP career. They help students to develop reflexivity and key skills, such as a better understanding of critical appraisal and research. The decision to undertake an iBSc is contentious; students feel ill-informed about the benefits. These findings could have implications for a variety of international enrichment programmes.

Is it intelligent to intercalate? A two centre cross-sectional study exploring the value of intercalated degrees, and the possible effects of the recent tuition fee rise in England

AIMS AND OBJECTIVES

To explore the value of intercalated degrees, including student perceptions and academic sequelae. To gauge the likely effect of the recent tuition fee rise and to identify any differences in intercalated degrees between Bristol and Sheffield universities.

DESIGN

Cross-sectional study using questionnaires.

SETTING

Bristol and Sheffield Medical Schools, UK.

PARTICIPANTS

1484 medical students in their clinical years were e-mailed the questionnaire. 578 students responded: 291 from Bristol and 287 from Sheffield (n=578; mean age=22.41; SD 1.944; 38.9% male; 61.1% female). The response rate from previous intercalators was 52.5% from Bristol and 58.7% from Sheffield, while for non-intercalators it was 27.7% and 34.6%, respectively.

MAIN OUTCOME MEASURES

(1) Student preconceptions, opinions, results and academic sequelae from intercalated degrees at both centres. (2) Students' attitudes concerning the effect of the increase in tuition fees.

RESULTS

Those with clinical academic supervisors gained significantly more posters (p=0.0002) and publications (p<0.0001), and also showed a trend to gain more first class honours (p=0.055). Students at Sheffield had a significantly greater proportion of clinical academic supervisors than students at Bristol (p<0.0001). 89.2% said that an intercalated degree was the right decision for them; however, only 27.4% stated they would have intercalated if fees had been £9000 per annum.

CONCLUSIONS

Students clearly value intercalated degrees, feel they gained a substantial advantage over their peers as well as skills helpful for their future careers. The rise in tuition fees is likely to reduce the number of medical students opting to undertake an intercalated degree, and could result in a further reduction in numbers following an academic path. Sheffield University have more intercalating students supervised by clinical academics. Clinical academics appear more effective as supervisors for medical students undertaking an intercalated degree in terms of results and additional academic sequelae.

The effect of an intercalated BSc on subsequent academic performance

BACKGROUND

The choice of whether to undertake an intercalated Bachelor of Science (BSc) degree is one of the most important decisions that students must make during their time at medical school. An effect on exam performance would improve a student's academic ranking, giving them a competitive edge when applying for foundation posts.

METHODS

Retrospective data analysis of anonymised student records. The effects of intercalating on final year exam results, Foundation Programme score, application form score (from white-space questions), quartile rank score, and success with securing Foundation School of choice were assessed using linear and ordered logistic regression models, adjusted for course type, year of graduation, graduate status and baseline (Year 1) performance.

RESULTS

The study included 1158 students, with 54% choosing to do an intercalated BSc, and 9.8% opting to do so at an external institution. Doing an intercalated BSc was significantly associated with improved outcome in Year 5 exams (P = 0.004). This was irrespective of the year students chose to intercalate, with no significant difference between those that intercalated after years 2, 3 and 4 (p = 0.3096). There were also higher foundation application scores (P < 0.0001), academic quartile scores (P = 0.0003) and resultant overall foundation scores (P < 0.0001) in intercalated students. These students also had improved success with securing their first choice Foundation School (p = 0.0220). Participants who remained at the institution to intercalate in general performed better than those that opted to intercalate elsewhere.

CONCLUSIONS

Doing an intercalated BSc leads to an improvement in subsequent exam results and develops the skills necessary to produce a strong foundation programme application. It also leads to greater success with securing preferred Foundation School posts in students. Differences between internally- and externally-intercalating students may be due to varying course structures or greater challenge in adjusting to a new study environment.

Does undertaking an intercalated BSc influence first clinical year exam results at a London medical school?

BACKGROUND

Intercalated BScs (iBScs) are an optional part of the medical school curriculum in many Universities. Does undertaking an iBSc influence subsequent student performance? Previous studies addressing this question have been flawed by iBSc students being highly selected. This study looks at data from medical students where there is a compulsory iBSc for non-graduates. Our aim was to see whether there was any difference in performance between students who took an iBSc before or after their third year (first clinical year) exams.

METHODS

A multivariable analysis was performed to compare the third year results of students at one London medical school who had or had not completed their iBSc by the start of this year (n = 276). A general linear model was applied to adjust for differences between the two groups in terms of potential confounders (age, sex, nationality and baseline performance).

RESULTS

The results of third year summative exams for 276 students were analysed (184 students with an iBSc and 92 without). Unadjusted analysis showed students who took an iBSc before their third year achieved significantly higher end of year marks than those who did not with a mean score difference of 4.4 (0.9 to 7.9 95% CI, p = 0.01). (overall mean score 238.4 "completed iBSc" students versus 234.0 "not completed", range 145.2 - 272.3 out of 300). There was however a significant difference between the two groups in their prior second year exam marks with those choosing to intercalate before their third year having higher marks. Adjusting for this, the difference in overall exam scores was no longer significant with a mean score difference of 1.4 (-4.9 to +7.7 95% CI, p = 0.66). (overall mean score 238.0 " completed iBSc" students versus 236.5 "not completed").

CONCLUSIONS

Once possible confounders are controlled for (age, sex, previous academic performance) undertaking an iBSc does not influence third year exam results. One explanation for this confounding in unadjusted results is that students who do better in their second year exams are more likely to take an iBSc before their third year.

The Emphasis Program: a scholarly concentrations program at Vanderbilt University School of Medicine

In 1999, a faculty committee at Vanderbilt University School of Medicine reviewed the mission and goals of the school and determined that graduates should receive initial preparation to develop scholarly careers in medicine. The authors describe the design of a scholarly projects course, the Emphasis Program, which is required of all students in the first two years of medical school. Each student undertakes a mentored project in one of nine areas of scholarship related to medicine. Curricular time is devoted to the program during the first two academic years, and students also spend eight weeks working on their projects in the intervening summer. The program includes a core didactic curriculum on topics common to all areas of scholarly work, such as biostatistics and study design. Implemented with the entering class of 2004, 467 students had completed the program as of May 2010, and only two students have been unable to complete projects in the allotted time. The majority of graduating seniors reported that they felt this was a valuable aspect of their medical education. Whereas the program offers a broad spectrum of scholarship opportunities, most students have selected projects in more traditional areas, such as laboratory-based research and patient-oriented research. The authors describe early successes in meeting program goals as well as some of the ongoing challenges of administering a required but individualized program of this nature.

A mandatory intercalated degree programme: revitalising and enhancing academic and evidence-based medicine

BACKGROUND

Recruitment of medical graduates to research careers is declining. Expansion of medical knowledge necessitates all graduates be equipped to critically evaluate new information. To address these challenges, a mandatory intercalated degree programme was introduced as part of curriculum reform.

AIMS

To review the place on intercalated degrees, the methods available for learning about research and to analyse experience with a new university programme focusing on research.

METHODS

A literature review followed by the analysis of experience with eight cohorts of students who had completed the new programme.

RESULTS

A total of 1599 students completed the programme. Laboratory-based research was the most common choice followed by clinical research, population health, epidemiology, medical humanities and mental health. Also, 93% of students spent over 75% of their time undertaking research. Sixty-three students published their research, half as first authors. Students and coordinators support the programme. Learning about research during the postgraduate phase is variable and frequently left to individual choice.

CONCLUSION

Intercalating an additional degree focusing on research can achieve a number of learning objectives but demands a level of maturity, autonomy and preparedness, not uniformly present in students undertaking a mandatory intercalated programme. A more realistic goal is the development of 'research-mindedness' amongst all students.

An intercalated BSc degree is associated with higher marks in subsequent medical school examinations

BACKGROUND

To compare medical students on a modern MBChB programme who did an optional intercalated degree with their peers who did not intercalate; in particular, to monitor performance in subsequent undergraduate degree exams.

METHODS

This was a retrospective, observational study of anonymised databases of medical student assessment outcomes. Data were accessed for graduates, University of Aberdeen Medical School, Scotland, UK, from the years 2003 to 2007 (n = 861). The main outcome measure was marks for summative degree assessments taken after intercalating.

RESULTS

Of 861 medical students, 154 (17.9%) students did an intercalated degree. After adjustment for cohort, maturity, gender and baseline (3rd year) performance in matching exam type, having done an IC degree was significantly associated with attaining high (18-20) common assessment scale (CAS) marks in three of the six degree assessments occurring after the IC students rejoined the course: the 4th year written exam (p < 0.001), 4th year OSCE (p = 0.001) and the 5th year Elective project (p = 0.010).

CONCLUSION

Intercalating was associated with improved performance in Years 4 and 5 of the MBChB. This improved performance will further contribute to higher academic ranking for Foundation Year posts. Long-term follow-up is required to identify if doing an optional intercalated degree as part of a modern medical degree is associated with following a career in academic medicine.

Should all medical students be graduates first? NO

Most people enter medical college straight from school. Ed Peile argues that changing to a single system of graduate entry medical schools would provide the diverse multiskilled workforce needed for the future, but Charles George thinks that there is insufficient evidence to make this a criterion of entry

Scientific production of research fellows at the Zagreb University School of Medicine, Croatia

AIM

To evaluate scientific production among research fellows employed at the Zagreb University School of Medicine and identify factors associated with their scientific output.

METHOD

We conducted a survey among research fellows and their mentors during June 2005. The main outcome measure was publication success, defined for each fellow as publishing at least 0.5 articles per employment year in journals indexed in the Current Contents bibliographic database. Bivariate methods and binary logistic regression were used in data analysis.

RESULTS

A total of 117 fellows (response rate 95%) and 83 mentors (100%) were surveyed. The highest scientific production was recorded among research fellows employed in public health departments (median 3.0 articles, interquartile range 4.0), compared with those from pre-clinical (median 0.0, interquartile range 2.0) and clinical departments (median 1.0, interquartile range 2.0) (Kruskal-Wallis, P =0.003). A total of 36 (29%) research fellows published at least 0.5 articles per employment year and were considered successful. Three variables were associated with fellows' publication success: mentor's scientific production (odds ratio [OR], 3.14; 95% confidence interval [CI], 1.31-7.53), positive mentor's assessment (OR, 3.15; 95% CI, 1.10-9.05), and fellows' undergraduate publication in journals indexed in the Current Contents bibliographic database (OR, 4.05; 95% CI, 1.07-15.34).

CONCLUSION

Undergraduate publication could be used as one of the main criteria in selecting research fellows. One of the crucial factors in a fellow's scientific production and career advancement is mentor's input, which is why research fellows would benefit most from working with scientifically productive mentors.

Outcomes of cytopathology studies presented at national pathology meetings

The purpose of this study was to determine what factors influence the final publication status of cytopathology studies presented at national meetings. Abstracts involving cytopathology material were obtained from the following journals: Modern Pathology (volume 11, 1998), Acta Cytologica (volume 42, 1998), and the American Journal of Clinical Pathology (volumes 109 and 110, 1998). Using the National Library of Medicine Website, each abstract was searched by author and topic to determine if the study was published as a peer-reviewed article. The following parameters were evaluated: meeting where the abstract was presented, type of institution where the research was based, type of material used in the study, and application of ancillary techniques used in the study. The subsequent published articles were evaluated for journal and time to publication. Out of 257 studies presented in 1998, 85 (33%) were published in peer-reviewed journals by May 2000. The majority of papers were published in Diagnostic Cytopathology (n = 21), Acta Cytologica (n = 15), and Cancer (n = 18). The mean time for publication was 12.8 mo. The highest percentage of published studies was presented at the United States and Canadian Academy of Pathology (USCAP) meeting (50% of presented abstracts), followed by American Society of Cytopathology (ASC) (28%) and American Society of Clinical Pathologists (ASCP) (17%) meetings. Ancillary techniques were applied in 40 of 85 (47%) published studies, 27 of 85 (32%) articles focused on morphology, and 18 of 85 (21%) papers covered other topics (e.g., quality assurance (QA), cost, and role of cytology). In nonpublished studies (n = 172), special techniques were the main focus in 40%, morphology in 25%, and other topics in 35% of abstracts. The great majority (97%) of published studies were from academic institutions. Gynecological and nongynecological material were roughly equally covered in published and nonpublished studies. Only a relatively small percentage of presented studies was finalized in the form of peer-reviewed articles. Type of material and application of ancillary techniques do not significantly influence the outcome.

Intercalated degrees, learning styles, and career preferences: prospective longitudinal study of UK medical students

OBJECTIVES

To assess the effects of taking an intercalated degree (BSc) on the study habits and learning styles of medical students and on their interest in a career in medical research.

DESIGN

Longitudinal questionnaire study of medical students at application to medical school and in their final year.

SETTING

All UK medical schools.

PARTICIPANTS

6901 medical school applicants for admission in 1991 were studied in the autumn of 1990. 3333 entered medical school in 1991 or 1992, and 2695 who were due to qualify in 1996 or 1997 were studied 3 months before the end of their clinical course. Response rates were 92% for applicants and 56% for final year students.

MAIN OUTCOME MEASURES

Study habits (surface, deep, and strategic learning style) and interest in different medical careers, including medical research. Identical questions were used at time of application and in final year.

RESULTS

Students who had taken an intercalated degree had higher deep and strategic learning scores than at application to medical school. Those with highest degree classes had higher strategic and deep learning scores and lower surface learning scores. Students taking intercalated degrees showed greater interest in careers in medical research and laboratory medicine and less interest in general practice than their peers. The effects of the course on interest in medical research and learning styles were independent. The effect of the intercalated degree was greatest in schools where relatively few students took intercalated degrees.

CONCLUSIONS

Intercalated degrees result in a greater interest in research careers and higher deep and strategic learning scores. However, the effects are much reduced in schools where most students intercalate a degree. Introduction of intercalated degrees for all medical students without sufficient resources may not therefore achieve its expected effects.

The MB PhD programme. Training to be a clinician-scientist in the UK

Rapid changes in the universities and in the organisation of the National Health Service are altering the perception of opportunity for clinical scientists in training. Cambridge University has established an integrated programme that combines training in scientific research and clinical medicine leading to the MB, BChir, and PhD degrees. The need for this and other options in the development of careers for aspiring medical researchers is reviewed here.

Why do medical school applicants apply to particular schools?

5427 applicants to British medical schools indicated the importance of each of 22 specific reasons for applying to the five choices they had put on their medical school application. The 24852 applications were aggregated by medical school, and the profile of reasons analysed for each school. Factor analysis showed four clear dimensions, labelled as 'Reputation', 'Personal contact', 'Location' and 'Prospectus'; scores and rank order for each school on each factor are reported. Scrutiny of the pattern of ratings of individual schools suggested that although many of the applicants' perceptions were probably valid, there were some perceptions which appeared inconsistent with other evidence. Cluster analysis showed that in general the London schools clustered together as did the provincial schools of England and Wales, and the Scottish schools; Oxbridge and Belfast were perceived as very separate from the other schools.

Mature-age entrants to medical school: a controlled study of sociodemographic characteristics, career choice and job satisfaction

A comparison of 121 mature-age and 270 normal-age entrants who graduated from the University of Queensland Medical School between 1972 and 1987 shows that mature-age entrants are some 7 years older, are more likely to come from public (state) schools and less likely to have parents in professional/technical occupations. Otherwise, the two groups were similar in terms of gender, marital status, number of children, ethnic background and current practice location. The educational background of mature-age entrants prior to admission includes 44.6% with degrees in health-science areas and 31.4% with degrees in non-health areas. Reasons for delayed entry of mature-age entrants include late consideration of medicine as a career (34.7%), financial problems (31.4%), dissatisfaction with previous career (30.6%), poor academic results (19.8%), or a combination of the above factors. Motivations to study medicine include family influences (more so in normal-age entrants), altruistic reasons (more so in mature-age entrants) and a variety of personal/social factors such as intellectual satisfaction, prestige and financial security (similar for both groups) and parental expectations (more so in normal-age entrants). Mature-age entrants experienced greater stress throughout the medical course, especially with regard to financial difficulties, loneliness/isolation from the students and family problems (a greater proportion were married with children). While whole-course grades were similar in both groups, normal-age entrants tended to win more undergraduate honours/prizes and postgraduate diplomas/degrees, including specialist qualifications. Practice settings were similar in terms of group private practice, hospital/clinic practice or medical administration, but there was a greater proportion of mature-age entrants in solo private practice, and a smaller proportion in teaching/research. If given the time over, some two-thirds of both groups would choose medicine as a career. Reasons for job satisfaction include helping patients, intellectual stimulation and financial rewards. Reasons for dissatisfaction include pressure of work, red-tape/paperwork, 'doctor-bashing', long working hours, emotional strain, financial pressure, unfulfilled career expectations and irritation with trivial medical complaints.

Medical researchers: training and straining

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