Residents should not be mandated to do research

Because residency already has enough mandatory thingslike learning to eat lunch in under four minutes without getting ketchup on your white coat.

Every few years, the same argument flares up in graduate medical education: Should residents be required to do research? Some leaders see a research mandate as a badge of “academic rigor.” Some residents see it as a late-night paperwork scavenger hunt stapled onto an already full-time job. And most programs live in the messy middletrying to honor accreditation expectations for scholarship while keeping patient care, education, and resident well-being from getting crushed under a pile of “just one more requirement.”

This article makes a clear case: Residents should not be mandated to do research. Not because research is unimportant, but because mandating research for everyone is often the least effective, least equitable way to build the skills residency is actually meant to produce: strong clinicians who practice evidence-based care, improve systems, and keep learning long after graduation.

Research vs. scholarship: the crucial distinction programs often blur

Let’s start with a truth that can save everyone a lot of frustration: research is only one slice of the “scholarship” pie.

In U.S. residency accreditation, programs are expected to support scholarly activity and an environment of inquiry. But that doesn’t mean every resident must run a traditional research project with an IRB, a dataset, and a last-minute abstract submission the night before the deadline.

In fact, the modern view of scholarship includes multiple pathways that still build academic muscle:

• Quality improvement (QI) and patient safety projects that measurably improve care
• Systematic reviews, evidence summaries, or clinical guidelines work
• Case reports when they genuinely add clinical insight
• Medical education scholarship such as building curricula or teaching tools that can be peer-reviewed
• Professional presentations and dissemination that spreads learning beyond one team

When programs mandate “research,” they often accidentally mandate the narrowest, most resource-intensive form of scholarshipand then wonder why outcomes look like rushed posters, underpowered studies, and residents quietly questioning their life choices.

What the rules actually require (and what they don’t)

The accreditation landscape matters here, because many research mandates are justified with a vague wave toward “requirements.” But the details tell a more nuanced story.

ACGME’s Common Program Requirements emphasize that programs should allocate resources for scholarly activity and advance residents’ practice of the scholarly approach to evidence-based care. They also state that residents must participate in scholarshipwhile allowing Review Committees and specialty requirements to define details more specifically.

Importantly, the same framework recognizes broad domains of scholarly activity (for faculty) that include not only research, but QI/patient safety initiatives, systematic reviews, case reports, educational materials, and innovations in education. That broader menu is a hintbordering on a billboardthat scholarship does not have to equal “traditional research for everyone.”

Meanwhile, organized medicine has also argued that accreditation requirements should connect to the purpose of training and the competencies residents must achieve, without compromising patient care. That principle is a direct challenge to “research for research’s sake” mandates.

Why mandatory resident research often backfires

1) Time poverty is real, and “add research” doesn’t magically add hours

Residency is built around service and learning in the clinical environment. Even with duty-hour limits and scheduling reforms, residents still face long shifts, overnight call, and cognitive load that doesn’t end when the pager stops. Add administrative workdocumentation, inbox tasks, EHR clicksand you get a classic recipe for “Sure, I’ll do research… sometime between 2:00 and 2:07 a.m.”

When research is mandated without protected time, residents end up doing scholarship in the margins of exhaustion. That’s not professional development; it’s academic sleep deprivation with a bibliography.

2) Mandates incentivize low-quality output, not meaningful learning

If a program requires “a poster” or “a publication,” residents quickly learn the hidden curriculum: the goal is to produce something that counts, not to ask a question that matters.

This creates predictable problems:

• Topic selection by convenience (whatever dataset is easiest to access) rather than clinical relevance
• Minimal mentorship because faculty are busy and the project was never truly “owned” by anyone
• Rushed methodology and superficial analysis because the timeline is dictated by graduation, not rigor
• Poster inflation where “scholarship” becomes a checkbox instead of a skill set

Ironically, mandatory research can erode respect for research. Residents don’t come out thinking, “Science is awesome.” They come out thinking, “Science is a form with six signatures and a spreadsheet that hates me.”

3) It’s inequitable across programsand within programs

Not every residency has the same infrastructure. Academic medical centers may offer statisticians, research coordinators, funded investigators, and established datasets. Community programs may have excellent clinical training but fewer research resources. A blanket research mandate punishes residents based on geography and institutional budget rather than effort or talent.

Even within the same program, mentorship access can be unequal. Residents who already know how academia works (often from earlier exposure) find mentors faster, choose “publishable” topics, and get invited onto projects. Othersparticularly first-generation physicians or residents new to academic culturecan get left behind, even if they’re equally capable.

4) It can compete with patient care and core clinical education

Residency’s primary mission is producing competent, safe, independent physicians. Anything that threatens that mission should be questioned, not romanticized.

When research becomes a graduation requirement, residents may face painful tradeoffs: study time vs. clinic preparation, QI participation vs. continuity care, rest vs. “just one more data pull.” Programs don’t intend to create these tradeoffs, but mandates often doespecially when productivity metrics or staffing shortages already squeeze the schedule.

5) It can worsen burnout risk when done without structural support

Resident burnout has been widely discussed in medical education literature for years, and it’s tied to workload, loss of autonomy, and competing demands. A research mandate can act like a force multiplier: another high-stakes obligation with ambiguous expectations and uncertain payoff.

On the flip side, there’s evidence that even small amounts of protected nonclinical time can support well-being and professional growth. The takeaway isn’t “never do scholarship.” It’s “don’t pretend scholarship is free.” If programs want meaningful scholarly activity, they need to invest in time, mentorship, and structurenot simply mandate a deliverable.

So what should residents be expected to learn?

Here’s the pro-scholarship, anti-mandate middle ground: residency should absolutely teach residents to think like scholarseven if they never run a traditional study.

That means residents should graduate able to:

• Practice evidence-based medicine: ask answerable questions, appraise evidence, apply it to patients
• Improve systems: identify care gaps, test changes, measure outcomes, sustain improvements
• Teach effectively: create learning objectives, give feedback, evaluate learners
• Disseminate learning: communicate insights through presentations, posters, publications, or durable educational products

Those skills align cleanly with the “scholarly approach” expected in modern training. And they do not require forcing every resident into the same research-shaped box.

A better model: “menu-based scholarship” instead of a research mandate

If you want residents to participate in scholarship, give them choices that match their career goals and your program’s resources. Think of it like ordering at a restaurantexcept the specials are “QI project” and “curriculum design,” and the dessert is “a good night’s sleep.”

Option A: Evidence-to-practice projects (EBM in real life)

Residents identify a clinical question from their own patients, perform a structured evidence search, and translate it into a practice tool: a clinical pathway, order set, patient handout, or a teaching session for the team. This builds scholarship muscle without pretending everyone needs to run a trial.

Option B: Quality improvement and patient safety scholarship

QI is often the most “resident-realistic” form of scholarship because it connects directly to daily work. Residents can improve discharge processes, reduce delays, increase vaccination rates, or strengthen handoffs. When projects include measurement and dissemination (presentation, write-up, or publication), they become true scholarly activitynot just “we talked about it in committee.”

Option C: Medical education scholarship

Residents teach constantly: interns teach students, seniors teach interns, everyone teaches patients. Programs can channel that work into scholarship by helping residents develop curricula, simulation cases, evaluation tools, or educational resources that meet peer-review standards. Platforms like medical education repositories demonstrate that educational products can be legitimate scholarship when built rigorously and shared widely.

Option D: Traditional research (for those who want itand will be supported)

Yestraditional research belongs in residency. But it works best when it is:

• Optional or track-based (resident chooses it, not the program forcing it)
• Mentored by faculty who have time and expertise
• Resourced with access to statistics, IRB navigation, and data support
• Protected with scheduled nonclinical time to do it ethically and well

This approach produces better studies, happier residents, and fewer “mystery posters” whose methods section reads like a cliffhanger: “Data were analyzed… somehow.”

What programs should do instead of mandating research

If your program’s goal is to create physicians who can evaluate evidence, improve care, and contribute to the profession, here are practical steps that beat a blanket mandate.

Create a structured scholarship pathway with flexible endpoints

Define “counts as scholarship” in a way that respects accreditation expectations and your local reality. Examples of acceptable endpoints:

• QI project with baseline and follow-up data + presentation
• Systematic review or evidence summary with faculty oversight
• Case report with literature synthesis + submission-ready manuscript
• Curriculum or teaching tool with evaluation data + peer review submission
• Research study for those on an academic research track

Build in protected time (even small amounts can matter)

Protected time doesn’t have to mean months off service. Some programs use a few hours weekly, scheduled blocks, or “4+1” style models that create predictable nonclinical space. The key is consistency: residents should be able to plan, meet mentors, and actually finish what they start.

Invest in mentorship infrastructure

Mandates fail when mentorship is optional. Programs can improve outcomes by:

• Creating a mentor directory (research, QI, med-ed, population health)
• Hosting quarterly project pitch sessions
• Providing a “project manager” coordinator for IRB/QI logistics
• Offering writing support (abstract clinic, manuscript workshop)

Measure what matters

Instead of counting posters like Pokémon cards, evaluate whether residents are learning transferable skills:

• Can they frame a clinical question clearly?
• Can they appraise evidence and explain it?
• Can they measure improvement and interpret outcomes?
• Can they communicate findings ethically and effectively?

If your graduates can do those things, you’ve achieved the real purpose of scholarshipregardless of whether every resident published a paper.

What residents can do when research is “expected” anyway

Some residents are stuck in programs where research is still mandated. If that’s you, here are practical ways to protect your time and still get something meaningful out of it:

Pick a project that connects to your actual clinical life

QI and evidence-to-practice work often fit more naturally into workflow than traditional research. If your requirement is broad enough, aim for something that improves patient care and creates a scholarly deliverable.

Choose mentorship over topic “coolness”

A strong mentor can turn a modest question into a high-quality project. A flashy topic without mentorship often becomes a half-finished document named “final_FINAL_reallyfinal.docx.”

Clarify expectations early

Ask the program (in writing, politely): What counts? What are deadlines? What support exists? The earlier you reduce ambiguity, the less likely your project becomes a late-year scramble.

Don’t confuse “mandatory research” with “mandatory solo suffering”

Projects can be team-based. Collaboration can reduce workload and improve qualityespecially for QI initiatives and education scholarship.

Bottom line: mandate scholarly growth, not mandatory research

Residency should produce physicians who are curious, evidence-driven, and capable of improving care. That requires a scholarly mindset and real opportunities for scholarship.

But mandating research for all residents is usually the wrong tool for that goal. It often creates time pressure, inequity, low-quality output, and resentmentwithout reliably producing better clinicians or better science.

The smarter approach is clear and humane: offer multiple scholarship pathways, provide protected time and mentorship, and evaluate skill-buildingnot just deliverables. When residents can choose meaningful work aligned with their future careers, scholarship becomes what it was always supposed to be: a way to improve medicine, not a way to fill a checkbox.

Experiences from the trenches: what “mandatory research” feels like (and what works better)

Experience #1: The “Poster That Ate My Weekend”
A resident gets told, “You need a research project to graduate.” No one explains what counts, who can mentor, or how much time is protected (spoiler: none). The resident picks a chart review because it sounds doable. Weeks later, they’re chasing access approvals, learning that the dataset is incomplete, and discovering that the “simple analysis” needs a statistician who is booked until next season of life. The deadline doesn’t move, though. So the project gets compressed into late nights: cleaning a spreadsheet after call, rewriting an abstract between admissions, and building a poster at 1 a.m. while wondering why PowerPoint insists on moving every text box by exactly one millimeter. The poster gets presented. People nod politely. The resident feels… mostly tired. The learning is realmostly about time management and the emotional range of Excelbut it’s not the kind of scholarly growth anyone intended.

Experience #2: The hidden inequity problem
Two residents in two different programs both have a “research requirement.” One has a department with ongoing studies, a research coordinator, and a mentor who meets monthly. That resident joins a team project, learns how protocols work, contributes meaningfully, and co-authors a manuscript. The other resident trains at a smaller site with limited infrastructure. They’re clinically excellent, but there’s no clear research pathway, and mentorship is informal and inconsistent. They end up doing a small project largely alone. Both residents are smart and hardworkingyet their experience of “mandatory research” is completely different. That’s the equity issue in a nutshell: a mandate rewards resources as much as effort.

Experience #3: When scholarship is flexible, residents surprise you
In a program that shifted from “mandatory research” to “menu-based scholarship,” residents started picking projects that matched their interests. One resident who loved teaching built a short curriculum for interns on common consult questions, collected feedback, and refined it into a durable resource. Another noticed repeated delays in discharge medication reconciliation and led a QI project that reduced delays and improved patient satisfaction. A resident interested in academics chose traditional researchwith real protected time and a mentor who knew the field. The vibe changed. Residents weren’t doing scholarship because they were afraid of failing a requirement; they were doing it because it felt connected to patient care and professional identity.

Experience #4: Protected time changes the conversation
Even modest protected timelike a predictable weekly blockcan turn scholarship from chaos into craft. Residents can meet mentors during business hours (a radical concept), access resources, and make steady progress instead of sprinting at the end. Programs that schedule scholarship time also send a quiet but powerful message: “This matters, and we’re not asking you to do it by sacrificing sleep forever.” Residents still work hard, but the work feels feasible, ethical, and higher quality.

Experience #5: The best outcome isn’t a publicationit’s a habit
The most valuable “scholarship win” isn’t always a paper. It’s the resident who graduates with the habit of asking better questions: Why do we do this? What does the evidence say? How can we measure improvement? How do we teach this clearly? Those habits follow residents into practice, whether they work in an academic center, a community hospital, or a clinic that just wants fewer bottlenecks and better outcomes. Mandating research can accidentally teach residents to hate scholarship. A flexible, supported system can teach them to own it.

In other words: the goal isn’t to make every resident a researcher. The goal is to make every resident a better physicianone who can think critically, improve care, and keep learning. Research should be available, supported, and celebrated. It just shouldn’t be compulsory for everyone.