Comments: Response to Defining Scholarly Activity.

Abstract

We read with great interest the recent editorial by Simpson et al.1 Merriam-Webster defines scholarly as “of, characteristic of, or suitable to learned persons.”2 Because this is certainly a trait that we would expect for all physicians, it is imperative that residency programs teach their trainees to become scholarly. As such, our answer to the first question posed, “Are we seeking to ensure that ALL of our graduates are ‘scholarly physicians’?” is clearly a resounding “Yes.” The importance of developing scholarly residents is explicitly stated in the Accreditation Council for Graduate Medical Education program requirements, which call for program directors and faculty to participate in—and to support residents' participation in—scholarly activities.3 More precisely, the requirements require that “some members of the faculty should also demonstrate scholarship.” Although the requirements (and the editorial) are rather specific regarding qualitative definitions of scholarship, the quantitative expectations remain undefined. Scholarship by faculty that does not involve residents adds little to the scholarly development of trainees. We would answer the second question, therefore, that yes, ALL of our graduates should participate in the production of scholarship that adds to the body of knowledge in a field of inquiry. That having been said, not all programs are equally equipped to ensure the production of scholarly output. In surgery, many large and resource-rich institutions have required research years that allow their residents to meet this goal. For many smaller programs, without additional years of training, the expectation to have residents and their faculty mentors maintain scholarly activity while also mandating minimum scholarly activities for trainees may be problematic. The current health care climate necessarily prioritizes clinical productivity over academic pursuits. Furthermore, limits on resident duty hours have significantly restricted the amount of time trainees are involved in clinical care—while simultaneously demanding a given number of cases and increased documentation of procedural experience. We would like to propose increased use of regional consortia as a means to assist smaller and resource-limited institutions to meet the requirements for scholarly activity and scholarship. For example, collaborative research across institutions can capitalize on sharing expenses and pooling resources, including the workforce, to achieve substantial academic goals.