Medical Students' Perceptions of Clinical and Research Training: An International Needs Assessment of 26 Countries

Objective

Despite calls to incorporate research training into medical school curriculum, minimal research has been conducted to elucidate trends in research knowledge, opportunities, and involvement globally. This study aims to: (1) assess medical students' perceptions of the level of training they received on research based on their medical school training, and (2) evaluate the obstacles related to conducting research as part of medical students' training.

Methods

A 94-question, bilingual survey designed by a small focus group of individuals from medical schools across the globe and administered to medical students from different parts of the world, distributed via social media networks (Twitter, Now X, Facebook) and email distributions via international partnerships from November 1 to December 31, 2020. The survey collected demographic information including age, gender, medical institution and country, degree, year in training, clinical rotations completed, plans for specialization, and additional graduate degrees completed. Statistical analysis included a summary of survey participant characteristics, and a comparison between regions, with a variety of comparison and logistic regression models used.

Results

A total of 318 medical students from 26 countries successfully completed the survey. Respondents were majority female (60.1%), from Latin America (LA) (53.1%), North America (NA) (28.6%), and Other world regions (Other) (18.2%). Students felt research was an important component of medical training (87.7%), although many reported lacking research support from their institution (47.5%). There were several reported barriers to research, including lack of research opportunities (69.4%), lack of mentors (56.6%), lack of formal training (54.6%), and barriers due to the coronavirus disease 2019 (COVID-19) pandemic (49.3%). Less frequent were barriers related to financial resources (41.6%), physical resources (computer or internet access) (18%), and English language ability (6.9%). Students from Latin America and Other were more likely to report a desire to pursue research later in their medical careers compared with students from North America.

Conclusions and Implications for Translation

Despite significant interest in research, medical students globally report a lack of formal research training, opportunities, and several barriers to conducting research, including the COVID-19 pandemic. The study highlights the need for student research training internationally and the role of further regional-specific and institutional-specific evaluation of research training needs.

Effect of stretch on growth and collagen synthesis in cultured rat and lamb pulmonary arterial smooth muscle cells

There are no studies of the effect of stretch in cultured pulmonary vascular smooth muscle, and some data suggest that a stretch-mediated increase in connective tissue synthesis in pulmonary arteries is mediated by the endothelium. To investigate whether stretch can serve as a growth stimulus in this smooth muscle, we studied two types of cultured pulmonary arterial smooth muscle cells (a multiply passaged clonal line of rat cells [PAC1], and early passage lamb cells [EPTC]). Cells were grown on a collagen-coated silicone surface and subjected to repetitive stretch (0.33-0.5 Hz; 10-20% strain). The relative rates of total RNA, DNA, protein, and soluble collagen synthesis were determined using 3H precursors, and c-fos and collagen mRNAs by Northern blot analysis. Stretch caused no significant change in the rate of RNA synthesis in either PAC1 cells (+9%) or EPTC (-3%). The relative rate of total protein synthesis was decreased by stretch (6% in PAC1 cells and 36% in EPTC [both NS]) as was the rate of collagen synthesis (-24% in EPTC [NS]). In EPTC, the percentage of 3H-thymidine labeled cells was modestly increased with 24 h stretch (17 +/- 5.7%; P < .001), but trichloroacetic acid (TCA) precipitated 3H-thymidine was unaltered by stretch, and the number of cells not significantly changed with stretch. c-fos mRNA expression was only inconsistently induced by stretch x 30 min in EPTC, and not at all in PAC1 cells. Expression of mRNA for alpha 1 (I) and alpha 1 (III) collagen was not changed significantly by 24 h or 48 h of stretch. We conclude that stretch does not serve as a significant growth stimulus in cultured pulmonary vascular smooth muscle cells in this system. These findings do not rule out the possibility that stretch is a growth stimulus for these cells under different conditions, but do suggest that other models will be needed to determine if and how mechanical stimuli affect growth of pulmonary vascular smooth muscle.