> no reason they can’t publish valuable work with the right collaborators

Despite h-index claiming to balance quantity and quality, it obviously incentives quantity over quality (no single publication can increment h-index as much as churning out a few worthless publications that cite each other); med students overwhelmingly follow those incentives trying to secure better residencies

in that case, it's a question of proportion. we cannot automatically conclude that a (supposed) "good handful" doing good research makes up for "most students" doing bad research.