Hanover — A prominent Dartmouth health policy researcher who the college found had plagiarized the work of a colleague has resigned in protest.
Dr. H. Gilbert Welch, who first came to what then was Dartmouth Medical School as an assistant professor in 1990 and is known for his research on medical screenings and over-diagnoses, announced his resignation from his post as a professor at The Dartmouth Institute for Health Policy and Clinical Practice in a letter to colleagues on Thursday.
“I feel that I can no longer participate in the research misconduct process against me — as I fear my participation only serves to validate it,” he wrote in the letter, which he also shared with the Valley News.
Dartmouth’s Provost Office in June found Welch, a 63-year-old Thetford resident, engaged in professional misconduct by failing to credit a colleague’s work in a paper titled “Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness.” Welch and three co-authors published the paper in the New England Journal of Medicine in October 2016. The article, which built upon Welch’s previous research, found that mammograms can result in the treatment of breast tumors that do not present a mortal risk.
Dartmouth’s finding came following an investigation into a report by Samir Soneji, a demographer at the Dartmouth Institute, who alleged that Welch, without credit, incorporated research and methodologies Soneji developed with Hiram Beltran-Sanchez, a researcher at UCLA, into the 2016 journal article.
Welch told his colleagues in Thursday’s letter that Geisel School of Medicine Dean Duane Compton wanted him to contact the NEJM and request that Soneji be named as first author of the paper.
“I cannot in good conscience accept the demand that I make the complainant an author — much less the demand that I make him the first author,” Welch wrote. “Doing so requires that I falsely attest that he meets the requirements of authorship: namely, that he materially participated in the work and is able to defend it. Much as I have enjoyed working at Dartmouth, I am not willing to falsely attest to anything simply to stay here.”
In addition, he said, Compton proposed that Welch could continue to be employed by Dartmouth but would be barred from teaching.
“The demand that I no longer teach subverts the very reason I came to work at Dartmouth,” Welch wrote.
Soneji told the Valley News in August that he filed a complaint with Dartmouth’s Office of the Provost that launched a 21-month investigation organized by the provost’s office.
The investigation found that Welch “engaged in research misconduct, namely, plagiarism, by knowingly, intentionally, or recklessly appropriating the ideas, processes, results or words of complainants without giving them appropriate credit, and that these actions represented a significant departure from accepted practices of the relevant research community,” according to a June letter signed by Interim Provost David Kotz.
As a result of this finding, and in accordance with the college’s research misconduct policy and procedures, the college pursued disciplinary action against Welch, Dartmouth spokeswoman Diana Lawrence said in an email on Thursday.
In addition, Lawrence said the college is “actively pursuing an investigation into allegations of retaliation in this matter.”
“Dartmouth remains committed to the highest standards of research integrity and academic scholarship, and maintains processes in connection with these matters which are designed to be both rigorous and fair to all parties involved,” she said.
Soneji, via email on Thursday, declined to comment on Welch’s resignation.
He had first revealed his and Beltran-Sanchez’s research, which involved data and methodologies relating to “quantifying the contribution of breast cancer screening,” during a May 2015 workshop at Dartmouth that was attended by Welch. Soneji previously has said Welch followed up with him after the workshop in person and via email seeking additional information, including a specific slide from the presentation.
Soneji said he provided the slide, noting in his email to Welch that “if this result/figure ultimately becomes part of a paper, I’d like the opportunity to be coauthor.”
He said that the paper Welch co-authored contained a specific graph illustrating “Breast-Cancer Tumor Size Distribution and Size-Specific Incidence among Women 40 Years of Age or Older in the United States, 1975-2012” which was based on Soneji’s “research ideas and research results” that he had shared with Welch. Soneji was not credited in Welch’s paper.
Welch, in his letter, disputed the college’s finding of misconduct and said that the finding does not affect the work’s validity.
“The Dartmouth finding was that the paper represents ‘idea plagiarism,’ ” wrote Welch, who holds a bachelor’s degree from Harvard, a medical degree from the University of Cincinnati and a master’s of public health from the University of Washington. “This finding is at variance with both the United States Office of Research Integrity (whose definitions of research misconduct are identical to Dartmouth’s) and the NEJM, both of whom deemed this an authorship/credit dispute — not research misconduct or plagiarism.”
Editors of the New England Journal of Medicine, in an August letter to those involved, which Soneji shared with the Valley News, said that they determined the matter to be an “authorship dispute” and did not find cause to retract the article.
“We are happy to work with you and the article authors to reach a solution whereby sufficient acknowledgment is given so that the contribution of the complainant is adequately recognized,” the journal’s editors wrote.
In a summary document attached to his letter of resignation, Welch said it remains unclear to him what idea he is accused of plagiarizing and whether that idea originated with Soneji.
“For the past 20 years, I have investigated the effects of efforts to detect cancer early and this paper was a natural progression of my work,” Welch wrote in the attachment.
Welch’s previous work includes the books, Should I Be Tested for Cancer? Maybe Not and Here’s Why, Overdiagnosed: Making People Sick in the Pursuit of Health and Less Medicine More Health: 7 Assumptions that Drive Too Much Medical Care, as well as numerous op-eds, essays and scientific papers.
In an email on Thursday, he said he has loved working at Dartmouth.
“There are a lot of great people here,” he wrote.
For example, he credited a D-H radiologist named Bill Black with introducing him, early on, to the “ambiguities of diagnosis: that patients don’t simply either ‘have’ or ‘not have’ a diagnosis, instead there is a large grey area in-between,” and launching him into “a research career examining the unexpected side-effect of cancer screening: overdiagnosis — the detection of small cancers not destined to ever bother the patient.”
Though he said he’s proud of his research accomplishments, it’s really his teaching work that has taken him to many departments across the college, including at Geisel, TDI, Thayer School of Engineering and Tuck School of Business, and that has been most meaningful, he wrote.
“The 30 plus sessions I had last spring with 50 Dartmouth undergrads was particularly rewarding,” he wrote.
Never before has he been the subject of a plagiarism investigation, he wrote.
“Without a doubt it has been the most painful episode of my career,” he wrote.
Lawrence, via email on Thursday, declined to comment on Welch’s resignation because it is a “personnel matter.”
Welch’s departure comes at a time when TDI is experiencing a void in leadership. Elliott Fisher, director of TDI, and Adam Keller, the institute’s chief of strategy and operations, have been on administrative leave since late July, while an investigation into a workplace misconduct complaint proceeds.
No interim director for the institute has been appointed yet, Lawrence said in an email. The investigation is ongoing.
Lawrence previously told the Valley News that the Fisher and Keller investigation is unrelated to the Welch matter.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com and 603-727-3213. Business writer John Lippman contributed to this report.