You do not need to create a PubMed account to utilize it for research. However, there are some benefits to creating a PubMed account:
Highlight your search terms in your result list
Create collections and save articles for the future
Access your recent search history
Create saved search alerts that will be sent to your email
You can use your RFUMS Google account to sign up for a PubMed account. Due to the DUO authentication process, if you have issues creating an account try clearing your cache or setting up the account in a different browser you don't normally use.