The speciality of medical education and medical education research has its roots in the seminal work carried out by George Miller at the State University of New York at Buffalo (USA) in the 1950s. Miller argued that the decisions that teachers should make while performing their teaching duties have to be based on scientific evidence; that medical education ought to be regarded as a field of knowledge like any other, with its own body of doctrine; and that research was needed in order to generate expert knowledge that could be applied to improve educational practice [¹].

Over the last few decades, medical education research has advanced significantly, especially in countries such as the United States, Canada, the United Kingdom, the Netherlands, and the Nordic European and South-east Asian countries. There are currently a significant number of quality international journals on medical education with relevant impact factors, such as Academic Medicine (6.8), Medical Education (6.2), Advances in Health Sciences Education (3.89) and Medical Teacher (3.6), to name but the best known. Another sign of the growth of medical education at the international level is the number of important medical education meetings that are held, such as the annual conferences of the Association for Medical Education in Europe, with more than 3,000 participants, or the biennial Ottawa Conference, with nearly 2,000 attendees. Yet, in our country, where there has been an undeniable exponential growth of research in the biomedical field, research in the area of medical education has not been developed, or at least not to a significant extent.

Reasons for this deficit include, on the one hand, those linked to the characteristics of this type of research and, on the other, those attributable to our sociocultural environment.

With regard to the former, we must consider the differences between biomedical research and medical education research. In biomedical research, controlled experimentation is a hallmark of good quality. Medical education research, however, is a complex field in which it is difficult, and sometimes impossible, to control the circumstances and where several variables interact with each other, such as the student, the teacher, the learning materials, evaluation, etc. Moreover, both quantitative and qualitative educational research often lead to contradictory conclusions, and research outcomes are sometimes very context-specific and can therefore be difficult to apply to medical education programmes. In addition, educational research is seen to be too theory-oriented with results that are not easily applicable in everyday educational practice. In some settings in which priority is given to biomedical research, educational research has even come to be seen as an exercise for the idle elites. All this makes it clear that conducting medical education research is not easy.

All of these considerations can be refuted in a reasoned manner. Processes such as problem-based learning, student-centred learning, teamwork, new commonly used assessment tools (objective structured clinical examination, Mini-Cex, etc.), workplace assessment and many other educational developments are used in the different stages of health professionals’ training. But if we reflect on all these developments, it becomes apparent that they do not appear spontaneously, but are the result of educational research. That is, they are used because their validity and reliability have been proved through research. Just as a clinician does not use a particular treatment on a patient without adequate clinical evidence, we should not use a particular educational methodology without evidence showing that it is useful and that it works properly. And evidence is only obtained through medical education research.

It is true that medical education research is difficult because of its idiosyncrasies, but there are also conditioning factors in our own setting that make it even more challenging. Some examples include the little recognition given to teaching tasks in general and to medical education as a scientific field in its own right, the lack of interest in this type of research on the part of professionals, as they do not appreciate the need to make evidence-based decisions in the field of teaching, the lack of specific training in medical education research and, last but by no means least, the lack of competitive grants to finance research projects in medical education.

Despite all these difficulties, in recent years we have witnessed some progress in the discipline of medical education and in the research conducted in this field. Nevertheless, we must acknowledge that our scientific output remains low, as evidenced by the scant number of research papers published in quality international journals and communications at prestigious international events. Thus, for example, in the conferences of the Association for Medical Education in Europe, Spanish participation is rather testimonial, as shown by the fact that, in the period 2000-2019, the total number of communications written by Spanish authors was 204 (an average of 7.4 per edition), a much lower figure than those of countries such as Portugal (300) and Latin American countries [²], where there is a greater interest in educational research.

As extenuating circumstances, it should be noted that the studies carried out in our context are of either a descriptive or a justificatory nature, which simply describe a particular curricular reform or an educational experience in a specific subject and in a very specific geographical context, in the first case, and compare whether a particular intervention really is better, in the second. Such studies are not easily accepted by the main international journals as being too local or of little interest to their readership, despite being well designed and conducted. These journals prefer studies that are clarifying and universally applicable, which are undoubtedly of greater complexity.

Let's accept that conducting quality medical education research is difficult and still has a long way to go, but we must be able to take steps in that direction. One such step would be to recognise medical education as a relevant scientific field in its own right, as postulated by Miller, to develop training programmes in medical education research and to establish calls for applications for grants for research projects in medical education, as occurs in other fields.

We must be clear about the fact that research in medical education is a tool for furthering the educational and professional development of health sciences teachers. It is useful both for those interested in medical education research and for all professionals involved in teaching activities, as they should base their teaching on the scientific evidence provided by medical education research.

Adequate competitive funding, on the one hand, and structures of medical education units (in medical schools, health centres, etc.), on the other, are two priorities that allow medical education research to develop.

Internationally, medical education is a developing scientific field that is being updated exponentially as in other scientific fields. Today's socioeconomic changes present major challenges for the future. Addressing these challenges goes hand in hand with carrying out quality medical education research in our setting. If all of those involved – teachers, university management, clinical management, politicians, etc. – are aware of the problem, we must introduce measures into our sphere of influence to promote medical education research.