It is important to realize that participating on an IRB is generally a demanding and time-consuming task that people undertake on a voluntary basis. Thus, getting the participation of public members is not easy. Second, once appointed, these individuals often do not become significant contributors to IRB deliberations until they have served for a long enough period of time to develop a relevant ethical and scientific knowledge base. At that point, they generally bring the same concerns and perspectives to the table as their other colleagues on the board. In the end, what benefits the IRB process and patients the most is the quality of outside members and the contributions they make, not simply the number of them on the committee.
Medical students can be extremely effective members of IRBs.
Because they understand the language and the risks, there is little that escapes their attention. The challenge of getting people to serve on IRBs also is quite germane to faculty. But now it is not. There are several factors that undermine faculty motivation and a sense of satisfaction for serving on an IRB, ranging from the increased workload and the amount of time and energy that must be expended to address and document in detail even relatively minor issues to the negative publicity surrounding IRBs. It must be re-emphasized that this is a voluntary system.