Conduct of research for establishing the beneficial effects of newer drugs, techniques, or perioperative care modalities is an essence in medical science. Simultaneously, its publication remains equally important to disseminate knowledge for global benefit. Although at times research outcomes would be of interest to a regional community, at large, it provides insights for the global community. Hence, publication in a journal that remains accessible to practicing physicians globally is paramount.
This issue publishes an interesting article by Kar et al. related to the publication performance of Indian authors in high-impact anesthesiology journals, namely Anaesthesiology, British Journal of Anaesthesia, Anaesthesia, Anaesthesia &Analgesia, European Journal of Anaesthesia, and Canadian Journal of Anaesthesia. We appreciate the authors for their thought-provoking perspective regarding the limited contribution of Indian authors in high-impact anesthesia journals globally. The authors pointed out various probable reasons for low contribution such as poor infrastructure, lack of resources/financial support, poor writing skills/language, and the requirement of publications for promotion and thus search for a faster alternative. We wish to add a few in-depth points about the possible reasons for lesser contribution and scope for the improvement. Although the contribution of Indian authors in high-impact anesthesia journals may be low, the citations of Indian authors’ publications in any other journals (Indian journals/subspecialty journals) cannot be ignored. With the findings of the currently published article, we can conclude the percentage of contribution in high-impact journals, but not the overall quality of publications from the Indian authors.
To enhance the quality and contribution of Indian researchers, the inclusion of research methodology training at the undergraduate level is an essential step. To encourage interest in medical research and familiarize research methodology among undergraduates (MBBS/BDS), the Indian Council of Medical Research (ICMR) is running Short Term Studentship (STS) Programme since 1979. As it is not made mandatory, the majority of undergraduates are unaware of the STS Programme and even medical faculty do not publicize the same. To inculcate research attitude, the National Medical Commission (NMC) added one research paper (to present and publish/sent for publication) during postgraduate training as one of the eligibility criteria for final examinations. Recently, the NMChas also made mandatory a “Basic course in biomedical research” (BCBR) for postgraduate medical students and faculty which is an online course offered by the ICMR-National Institute of Epidemiology. Besides this course, faculty and resident development programmes must be initiated and continued at the institutional level.Researchers should frequently attend (annually) manuscript writing and statistical analysis workshops at conferences or other academic programmes. Due to the lack of formal training in the art of manuscript writing, Indian researchers also lack the understanding of the importance of ethical issues such as fabrication, falsification, conflict of interest, plagiarism, Salami publications, predatory journals etc. It may perpetuate mistaken belief for ethical issues as acceptable conduct. The high-impact journals put Indian research work in a dubious category due to these ethical issues, leading to rejection from the editorial board without going for peer review even for good-quality research papers. Indian authors must understand these issues before submissions to match the high ethical standards of the high-impact journals. Many young medical researchers are also unaware of various funding agencies such as ICMR, Defence Research and Development Organisation (DRDO), University Grants Commission (UGC) etc., which can sponsor under extramural research schemes. These funding agencies also provide financial assistance for organizing workshops/seminars.
In India, as per gazette notification dated February 2020, teachers in medical institutions must have specific number/s of research publications for their promotion. Mostly, research publications for promotion/job become a compulsion and result in research misconduct. Though its utility has been debated, the impact of research work on better teaching quality and patient care cannot be denied. Implementation of formal training for faculty and provision of incentives in the form of awards/fellowships/remuneration etc. can improve publication quality. There are many universities and collegesthatoffer Doctor of Philosophy (PhD) courses in Anesthesiology. Still, we do not have a defined weight age for PhD degree during promotion and job.
In India, the prospective registration of clinical trials to “Clinical Trials Registry - India (CTRI)” was made mandatory on April 1,2018. But most of the high-impact journals have been accepting only prospectively registered clinical trials for many years. The “Anaesthesiology” journal is accepting only prospectively registered clinical trial since May 2013, while the British Journal of Anaesthesia is accepting it since January 2009. This could be one of the reasons for the lesser contributions to high-impact journals. There are many anesthesia journals (index/non-indexed) that are still accepting nonregistered clinical trials. This could have added reluctance for timely clinical trial registration among Indian medical researchers. As now registration has been made mandatory, we can expect more contribution to high-impact journals in the coming years.
We have our own Indian anesthesia journals (indexed/non-indexed) such as Indian Journal of Anaesthesia, Journal of Anaesthesiology and Clinical Pharmacology, Indian Journal of Critical Care Medicine, and many more which are maintaining the highest standards of publications. Many a time, the study findings from a Western population cannot be generalized to the Indian population due to the demographic, social, and geographical differences. These journals play a very important role as a bridging link to fill the knowledge gap in Western literature, leading to an opportunity for the global research community. The combined effort from the editors, editorial board, and reviewers is needed to promote these Indian journals to international platforms along with other high-impact journals.
The anaesthesiologists are not only involved with the perioperative care of patients but also with the intensive care, pain and palliative care, resuscitation, and administrative work. Budding researchers, especially junior faculty and junior and senior residents find more difficulties while balancing themselves with clinical and research work to build up their research credibility. The lack of dedicated time is considered as the biggest barrier, which could lead to a loss of interest in research work and publications. Efforts should be made to provide a conducive environment for research work such as dedicated time per week or month, availability of research support staff, conducting research day at the institute level etc.There is no dearth of clinical cases, but understanding of research, creation of data registries, and availability of research support staff shall lead to more good-quality publications from Indian authors.
To conclude, we need to promote and improve the quality of our research work. The formal training on research methodology for undergraduates, postgraduates, and faculty, provision of dedicated time and support staff for research work, awareness about various funding agencies, and promotion of Indian journals in the international forum will add quality research work from India in the future.
1. Kar P, Kar AK, Gopinath R Publication performance of Indian authors in high impact anesthesiology journals:Are we doing enough? J Anaesthesiol Clin Pharmacol 2021 505-8
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