Schools of medicine are institutions where education is revered. Growth also entails learning. Most of the time, when we talk about professional growth, we typically envision attending conferences and workshops, pursuing fellowships and certificate courses, attending professional training, reading self-help books, journals, and other similar activities. But research is essential for advancement in any subject. Faculties with several years of real-world experience and keen students who wish to learn everything are the best candidates for research and training. This combination enables medical institutions to stay on the cutting edge of medical breakthroughs while contributing to these advancements by conducting unique research. In medical institutions, professors are responsible for various duties, including teaching, assessment, research, patient care, and administration. Research and publication have become integral to academic growth, besides delivering subject knowledge to medical students. These responsibilities are the avenues through which faculties in medical education offer professional service to society.[1 , 2 , 3 , 4
Since its inception, teaching and research have been two fundamental facets of medical education. Medical students or budding doctors are profoundly influenced by their teachers. From corpse dissection to acquired surgical skills, the faculty's knowledge and ability to instruct students impact young minds. Research has disclosed that teaching must be prioritized more than academic research.[5 , 6 7
It has been seen over time that academic research is valued and is given precedence over teaching. In the current context of “publish or perish,” medical institute research has taken precedence over teaching. We need to know why and how this change happened.
An Indian institution with a significant impact on science and education and a pivotal role in developing highly skilled personnel may receive the Institute of National Importance (INI) status. The act of the Parliament of India defines INIs. Medical institutions like All India Institute of Medical Sciences (AIIMS), Post Graduate Institute of Medical Education and Research Chandigarh, Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry, National Institute of Mental Health and Neurosciences Bangalore, etc., are autonomous institutions established by the Act of Parliament.[8 Figure 1 ].
Figure 1: Three pillars of Institutions of National Importance
Dr. Sneh Bhargava's Committee recommendations for Assessment Promotion Scheme (APS), applicable in the institutions of national importance as per order no. V-16020/57/2008-ME-I (Pt) Government of India, Ministry of Health and Family Welfare emphasizes equal significance to teaching, research, and patient care as per the responsibilities of basic science, para-clinical, and clinical departments. However, it has been observed that during assessment as per APS, research and publications are given more weightage rather than teaching or patient care. For promotion, the committee mandates a minimum of three publications for the assistant professor, three to five publications for the associate professor, five to seven publications for the additional professor, and five to ten publications for the professor in PubMed-indexed journals during the assessment period. The evaluation criteria for such research publications are national/international journals, the total citation index, the average impact factor of journals, and the quality of the publication. Ph.D. scholars guided, patents, and elected membership/fellowship of medical and science academies are other areas given credit.[9
In supersession of the Medical Council of India, the Board of Governors amended the guidelines to make an introductory course in medical education technology and basic research in biomedical research courses mandatory for promotion. However, it also requires a minimum of three publications and one publication for promotion from Associate to Professor and Assistant to Associate Professor, respectively.[10
The NIRF ranking prioritizes research and patents over teaching.[11 Figure 2 ]. Because of this deviation, teachers have been forced to live in the shadow of researcher.[12 13
Figure 2: Professional assessment criteria: Present scenario
Analysts, such as Ronald Barnett, who believe that teaching and research are unrelated and antagonistic, contend that faculty members' self-absorption with research publications hinders education or that long teaching hours consume precious research time.[14
There is an alternative perspective to this debate. Analysts who recognize the value of teaching and research argue that active researchers are more informed and engaging teachers and that teaching fosters faculty creativity and enthusiasm for research. Teaching and research are mutually beneficial because they share resources, facilities, and personnel. Therefore, combining research and education is more productive than doing each separately. As a result, faculty ought to engage in activities that enable them to effectively and efficiently accomplish their teaching and research goals.[15
Arguments for integrating teaching and research are consistent with the belief that medical institutions and health universities should respond to rising healthcare costs by viewing faculty as professionals–highly qualified, flexible, and complex workers who can connect related tasks in novel ways and handle unforeseen issues independently. We recently experienced a deadly pandemic, necessitating that all medical professionals share their virus knowledge. Most faculty, regardless of specialty, have contributed to the study of the said lethal virus.[16
Faculty are imparting education and training to students along with patient care. At the same time, knowledge and experience gained in these technically advanced and high-valued institutes must be shared to medical fraternity for advancement in medical education and patient care. Therefore, research and publication methods also become an integral part of education for students. Hence, research is always considered the third pillar of medical education. Nevertheless, making it high volume compulsorily for promotional avenues has brought it down to necessary evil and reflecting poorly upon quality, creativity, and morality. Excessive importance placed on research or the requirement of it for promotion can lead to scientific misconduct. No wonder it can compel the faculty for the fabrication and falsification of data, unethical co-authorship and other mal practices related to publication. On the other hand, this has resulted in money-making predatory journals to flourish. Clinicians may invest their valuable time in research work compromising patient care. So, we propose that research, teaching and patient care should be equally weighed in evaluating professional advancement. Faculty should have ample opportunities to hone their teaching skills through various faculty development programs and other training and academic activities apart from research and publications.
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