Scientific publications: Much ado about nothing?

“Lord, we know what we are, but know not what we may be.” Hamlet

They say surgeons have gifted hands. The slender fingers are carved to flourish a scalpel with ease, and the agile wrist is crafted to swing the suture needle with grace. Why then do we deprive them of their surgical skills and employ them on the measly task of pressing keyboards or writing illegible scripts on a notebook? Why are publications so important, we are different from the PhD doctors?

“Ignorance is the curse of God; knowledge is the wing wherewith we fly to heaven.” Henry VI

Let us look at it from the point of view of a new ophthalmology resident. One of the first tasks assigned to him is the thesis that he must complete during his residency. He is taught statistics, ethics of clinical trials, and given deadlines and data. A good guide will assess the progress from time to time; a not so good guide may not bother the student at all till the final presentation. For all practical purposes, thesis gets done. But so what? What happens to the months of late nights, patient evaluation, excel sheets? It is of no consequence unless it is read by others which would only happen if one publishes. Ideally, this should be done within a few months of completion of the thesis, otherwise it tends to gather dust and loses significance.

For a resident, nearly 50% and for a fellow, almost 80-85% of the studies are based on published literature. What others have published allow us to learn and apply. That is the fundamental basis for evidence-based medicine, a written proof with clinical validation. It also makes one more observant and mindful of the clinical findings, uniqueness of a case, similarity between cases and existing lacunae in available information.

“How well he’s read, to reason against reading!” Love’s Labor’s Lost

For ophthalmologists already in practice, medical literature is the only source of continued knowledge with updates. It also adds to the resume while applying to hospitals, especially institutions where the number of peer reviewed publications matter. It also brings fame and scholarly grants to the Institutes.^[1] With literature being freely available to all, it is a reliable source of networking, spreading the word about one’s field of interest and acumen. The importance and appreciation of scientific publications are greater abroad. Active and productive participation in academic conferences demands a research inclination. Many international conferences award travel grants particularly if one has robust publications. Research work greatly helps in collaborating with like-minded national and international peers.

“To thine own self be true, and it must follow, as the night the day, thou canst not then be false to any man.” Hamlet

The collateral to the importance of scientific publication is the inherent desire for the same. Unless one finds joy in research, it is a drab, dry, and dreadful activity. Publishing articles will neither bring you financial gains nor additional time. It is definitely not necessary and therefore, should not be forced upon anyone. It is an informed choice that one must voluntarily make because to fully imbibe the joy of seeing one’s published work is to be honest to that project. A forcibly, half-heartedly done project done for the sake of completion will always remain as a reminder of a painful experience much like an unhappy patient returning repeatedly with fresh complaints and no visible solution. It is not a rat race as it is often made out to be and in no way judges the clinical potential of a doctor. Compulsion would add to the stress of increasing numbers and indices, plagiarism, salami-slicing of large data, duplicate publishing in different journals, conflict of interest and lower the quality of the research and publications.^[1,2] It will also stimulate predatory journals to entice the vulnerable section of young ophthalmologists.^[1,3] Another practice that is often hushed up is authorship based on seniority. This will certainly add to one’s number of publications and possibly citations but it is unethical and blatant abuse of power. Credit should be given as well as demanded only for actual and significant contribution.^[1]

“Love all, trust a few, do wrong to none.”All’s Well That Ends Well

Scientific publications are meant to add to the public pool of knowledge, fuel evolution and lead to improvement in the practice of medicine and initiate further research. At an individual level, one should prioritize quality over quantity of publications. Instead of handing an oar to the students and pushing them into the sea, they should be taught the steps and methods of research, encouraged to find a topic of interest for their thesis, gather the materials and build their boat before they sail into the vast ocean. It is important for mentors, guides, and teachers to understand that publication is not everyone’s cup of tea and must distribute and allocate time and resources accordingly. Institutions should identify faculty and fellows with aptitude and potential and make the environment conducive for their research work such that they do not have to take their work home.

“Cowards die many times before their deaths; the valiant never taste of death but once.” Julius Caesar

A publication should excite the author, interest the readers, respect the past, update the present and question the future. Writing an article is not only ambitious but also courageous. Rejection is part of the learning process. Good journals always give suggestions even if they reject an article. It is important to include those suggestions and make appropriate changes and submit to another journal. With practice, the success rate most certainly improves. Take heart, pick up the pen, and make a beginning.

“How far that little candle throws his beams! So shines a good deed in a weary world.” The Merchant of Venice