Medical innovation depends on continuous investigation into how the body works, what causes disease and how to treat patients.
This search leads to an abundance of potentially useful medical research, experts say, but the challenge for medical students is to learn how to interpret the research and apply it when they treat patients.
Experts say prospective students should determine whether a medical school delivers rigorous training in “evidence-based medicine,” a research-based approach to discovering and evaluating treatment options.
A doctor who practices evidence-based medicine, experts say, is one who stays up to date on clinical research and critically analyzes that research , looking to reject unproven therapies and identify the most effective remedies.
Evidence-based medicine is rapidly becoming the standard way to care for patients, experts say, so it is key for medical students to learn.
“We have been moving towards using evidence-based guidelines because that tends to give patients the best care, and it’s more consistent between hospitals,” says Dr. Justin Sloane, a third-year resident physician at Abington–Jefferson Health in Pennsylvania and a 2014 graduate of the Pennsylvania State University College of Medicine.
However, although the idea that medicine ought to be evidence-based is popular, expert say, doctors often vehemently disagree about what fits under its umbrella .
[Consider these reasons to study evidence-based medicine.]
‘Evidence-Based Medicine’ Up for Debate
A controversy has emerged over whether alternative medicine, which includes techniques like acupuncture and meditiation, ought to be presented to medical students as viable treatments.
Critics of alternative medicine say it is not evidence-based and that it has no place in a medical school.
“One red flag to me is whether or not the school uncritically teaches unscientific treatment methods,” says Dr. Steven Novella, the editor of Science-Based Medicine and an assistant professor of neurology at the Yale School of Medicine. “There is a lot of infiltration of alternative medicine or complementary medicine or integrative medicine, or whatever you would like to call it.”
[Learn about how M.D.-Ph.D. programs balance research with the practice of medicine.]
However, others say that alternative therapies show significant promise for treating stress-related health ailments, and that there is solid research to back up its integration into the practice of traditional medicine.
Dr. Rusha Modi, a gastroenterologist and an assistant professor of clinical medicine at the University of Southern California’s Keck School of Medicine, says there is statistically significant evidence that alternative therapies help treat chronic digestive disorders of the sort that he specializes in treating like irritable bowel syndrome, and he advises prospective students to keep an open mind about the medical potential of these therapies.
“I think to a certain degree that is going to be a personal or values-based discussion in terms of what kind of medicine the student is looking to practice or what kind of patient population they look to interact with,” he says.
[See why some medical schools embrace alternative medicine.]
Assessing Evidence-Based Medicine Programs
Experts say most medical schools teach students about evidence-based medicine, but that some do a better job of showing students how to put the concept into practice.
Sloane says prospective students should look for schools with courses on how to read and analyze clinical literature and that these courses were a critical component of his medical school experience.
“As doctors, we’re lifelong learners,” he says. “It’s always our job to continue to read, and we need to have the tools to be able to read and analyze the articles we are reading and decide which ones are applicable and which ones aren’t well done.”
Another important factor, experts say, is whether the research being taught at a school is current. One way to judge is to ask current students whether they feel as though they are well-versed in recent medical research, says Dr. Cedric Rutland, an assistant clinical professor of internal medicine at the University of California–Riverside. A red flag is when professors rely on outdated research, he says.
Experts say applicants should look into whether a medical school teaches its students to rigidly interpret treatment guidelines from the American College of Physicians and other organizations that issue clinical recommendations to doctors, or to critically examine those guidelines to determine when to apply th ose rules .
The goal, experts say, should be to have sufficient training in statistics and data analysis to determine which guidelines are truly justified by evidence and which are based on flimsy research.
Dr. Akikur R. Mohammad, a psychiatrist who specializes in addiction medicine and an associate professor at the Keck School of Medicine, says medical students should be taught to evaluate whether guidelines are appropriate for specific patients, since there are exceptions to every rule.
Mohammad, the founder and medical director of an evidence-based addiction treatment center called Inspire Malibu, says prospective medical students should remember that the practice of medicine is an art which requires independent thinking.
Jonathan Fuller, a medical student at the University of Toronto who completed a Ph.D. in the philosophy of medicine, says there are certain challenges with evidence-based medicine that a medical school ought to confront.
“These challenges include fixing problems with the evidence for evidence-based medicine, which is tainted by industry bias, publication bias and a whole host of other issues,” Fuller said in an email. “They also include improving evidence-based medicine’s methods, particularly the way we use evidence in clinical reasoning.”
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Identify Strong Evidence-Based Medicine Programs originally appeared on usnews.com
