All too often, issues encountered in today’s scientific publication process can profoundly shape research integrity. Reproducibility—the ability to replicate experimental findings—is essential to scientific methodology. Yet an alarming proportion of biomedical research papers struggle with independent verification.

In Unreliable: Bias, Fraud, and the Reproducibility Crisis in Biomedical Research, Csaba Szabo explains how these challenges stem from systemic issues within academic research: flawed incentive structures, hypercompetitive funding environments, and institutional biases that prioritize novel, positive results over methodological rigor. Research misconduct ranges from unintentional errors to deliberate data manipulation, facilitated by problematic academic cultures that tacitly encourage such behaviors, and a publication system rewards sensationalism over accuracy. Szabo not only diagnoses these systemic failures but also proposes comprehensive reforms. By introducing readers to “science sleuths” who tirelessly uncover misconduct, he offers a nuanced, ironic exploration of how real-world science operates—and how it can be improved. Szabo, a highly cited biomedical scientist, opens up about this consequential, complex problem in this conversation with senior publicist Robyn Massey.

Robyn Massey: What inspired you to write this book, and why now?

Csaba Szabo: This book came out of the kind of conversations scientists have behind closed doors. Why is so much research not reproducible? Is the entire scientific ecosystem fundamentally broken? Why are even “successful” scientists burning out, getting disillusioned, or outright leaving the field? And, most importantly, what can actually be done to fix this mess? These are urgent questions, and I felt it was time to bring them to the forefront—no sugarcoating, no polite evasions.

Massey: Did you ever get stuck while writing this book? If so, what helped you recover from this?

Szabo: Honestly, not really. I had collected a mountain of material over the years, and most of what I wanted to say had been stewing in my mind for ages. It just needed to be typed out. When I did feel drained, I turned to satire and dark humor—things that can cut through the nonsense and get to the heart of the issue. I sifted through countless cartoons, looking for ones that could visually hammer home my arguments. What made it into the book is just the tip of the iceberg. Absurdity helped me survive the process, and I’ve always been inspired by writers like Dürrenmatt, Mrozek, and Kafka. Not that I’m claiming to be in their league, but I definitely leaned on absurdism to get my points across.

Massey: At a time when major health organizations are being criticized and divested from, do you worry that your book will add further fuel to the fire in creating reasons to disengage from health-related research and investment? 

Szabo: Are you referring to the recent news about the NIH (U.S. National Institutes of Health) freeze and reorganization? Let’s be clear: none of this is happening because of concerns about reproducibility or scientific integrity. Whether the new leadership will take these issues seriously is anyone’s guess. We have to see.

As for adding fuel to the fire? Good. The establishment has been too quiet about these problems for far too long. If this book stirs up debate about how much money is wasted on irreproducible or outright fraudulent research, then it is doing its job. The truth is uncomfortable, but ignoring the truth has brought us to this point. Silence isn’t an option anymore.

Massey: If you could wave a magic wand, what would be the three things you hope to accomplish with your book?

Szabo:

1. 1. 1. Start a loud, relentless public debate about the reproducibility crisis.
      2. Force the establishment—like the NIH—to create a high-level task force that actually tackles the root causes of the problem, not just pays lip service to it.
      3. Overhaul the entire system: the way we train scientists, fund research, conduct replication studies, and publish results. In Unreliable, I’ve laid out some ideas for reform. Are they perfect? No. But they’re a starting point. And if someone has better solutions, great! I’d be thrilled. But the current system is unsustainable.

Massey: For a pre-college biology major interested in attaining their MD or? PhD, what are the top three tips you would give them?

Szabo:

1. 1. 1. Be strategic when choosing your field of research. It will define your entire career trajectory.
      2. Vet potential labs like your life depends on it because it often does. Check their publication record, PubPeer discussions, retraction history, and reputation. Don’t just pick the first shiny offer.
      3. Brace yourself. This path isn’t just challenging; it’s brutal. You’ll face failure, rejection, disillusionment with people and institutions, and a workload that will push you to your limits. Only pursue this if you are absolutely certain that the thrill of real scientific discovery is worth all the crap you’ll endure. If you see this as just a “job,” do yourself a favor and don’t even start.

Massey: Any final things you’d like to add? 

Szabo: I am not anti-science. Just the opposite, really. Scientific discovery is one of humanity’s most extraordinary achievements. But that’s exactly why it’s so infuriating to see it being reduced to an unreliable, unreproducible mess. That’s why I wrote this book, because this degradation needs to stop. Science deserves better, and so does everybody involved: the funders, the honest scientists, and of course the tax-paying public who ultimately holds the bill.