Yes, argues Roosy Aulakh, an associate professor in the Department of Pediatrics in the Government Medical College and Hospital in Chandigarh, India. In last week’s BMJ, she argues that recent measures to force researchers in India to produce a minimum number of publications to obtain promotions could set the stage for many problems, including fraud.
Retraction Watch: You cite a recent paper that showed more than 50% of Indian medical institutions and hospitals didn’t publish a single paper between 2005 and 2014. Did that finding surprise you?
Roosy Aulakh: Well definitely yes! With over 400 medical colleges in India producing more than 50,000 doctors an year, such poor research output surely came as a surprise.
RW: In response, the Medical Council of India (MCI) is now requiring researchers to publish at least four articles to become an associate professor, and eight to become a professor. Does that concern you?
RA: It concerns the entire medical community at large. In the present era of evidence-based medicine, all treatment decisions and further research planning is based on the global medical research database created through decades of hard work by research-inclined individuals. Research is basically an art which every medical professional can’t be expected to possess. Research needs to be voluntary and measures should be taken to provide proper infrastructure and incentives to medical professionals keen in conducting research.
RW: You raise concerns about recent reports of widespread cheating in situations where scientists are under pressure to succeed, such as during medical and dental exams — including a criminal network that sent answers to students via WhatsApp during the exam (relying on tiny Bluetooth devices, vests with embedded SIM cars, and watches with cameras. Is there anything comparable that could occur in academic research, where researchers have the pressure to publish a fixed amount of papers?
RA: Mandatory research as a pre-requisite to promotions in medical colleges could prove counter-productive. It could create a ground for scientific fraud whereby professionals are forced to indulge in unscrupulous practices including plagiarism, fabrication of data, enrolling patients in trials without proper informed consent, and so on.
RW: In other countries, researchers are expected to have multiple publications in order to get promotions, even if they aren’t strict “quotas.” Are these systems equally vulnerable to fraud, in your opinion? Why or why not?
RA: Surely yes! Medical research is not limited to any country and so shall be the anticipated problems with forced research. Any such system in any country is equally vulnerable to incite scientific fraud. Any advancement in scientific knowledge gained via research in any country has a global impact. It not only guides medical professionals across the globe in their day to day decisions in clinical practice, but also incites a series of research activities globally. Hence, in order to avoid contamination of the medical database by fraudulent research findings, urgent steps need to be taken globally to refrain from forcing research output from medical professionals by setting mandatory research as a criteria for promotions.
RW: Clearly, India wants to boost its publication record. What do you suggest, if not the quotas proposed by the MCI?
RA: No doubt, research is the backbone of medical science. And ongoing research is the only way to update the medical database. However, measures/guidelines should be taken/framed to incentivize quality research. A few suggestions in this regard would be:
- Research methodology and medical ethics (in clinical practice & research both) need to be a part of undergraduate medical curriculum. This would motivate young medical professionals and also provide them necessary skills to carry out quality research.
- Separate posts for research doctors in every medical specialty in medical colleges could be created. Medical professionals having aptitude and interest in carrying out research should be selected for such posts.
- Medical professionals working in Indian medical colleges are mostly multi-tasking. Their work profile includes not only clinical work (outpatient and inpatient care along with running specialty clinics) but also teaching (clinical/ theory) of undergraduates and postgraduates, guiding and supervising postgraduates in carrying out their thesis, organizing scientific Continuing Medical Education/conferences, editing or reviewing college magazine/journals and organizing college fests/cultural bonanzas, as well as being members of various college committees. Hence, carrying out research activities needs genuine interest and utmost motivation, and cannot be expected from each and every medical professional. If such a requirement is made mandatory, then separate time needs to be provided to medical professionals when they are relieved of all other activities and encouraged to conduct quality research.
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