60% Of Institutes Don’t Have A Single Publication In 10 Years, Only 4.3% Produced Over 100 A Year
Study reveals poor state of medical research in India. A handful of institutes, a majority of them publicly-funded, account for the bulk of research output from medical institutions in India. At the other extreme, nearly 60% of institutes did not have a single publication over a decade. Moreover, states that have the largest number of private medical colleges produce very little of research publication.
This was revealed in a study on the research output of all institutions in India during 2005-14 using Scopus, the largest database of peer-reviewed literature. The evaluation done by Dr Samiran Nundy, gastrointestinal surgeon and dean of Ganga Ram Institute of Postgraduate Medical Education and Research, along with two colleagues, looked at 579 institutes recognised by the Medical Council of India (MCI) and the National Board of Examinations (NBE), which conducts the largest portfolio of examinations in medicine in India.
According to the study published in ‘Current Medicine Research and Practice’, only 25 (4.3%) of the institutions produced more than 100 papers a year and these accounted for 40.3% of the country’s total research output. Over 57% or 332 of the medical colleges did not have a single publication during this period while over 90% of NBE-affiliated colleges in Karnataka and Kerala had none.
The annual research output of the Massachusetts General Hospital and Mayo Clinic in the US was over 4,600 and 3,700 respectively. Even the most prolific research institution in India, AIIMS, published less than a third of these numbers.
The top 10 medical institutes under MCI were AIIMS, Postgraduate Institute of Medical Education and Research in Chandigarh, Christian Medical College in Vellore, Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, King George Medical College in Lucknow, Kasturba Medical College in Manipal, Tata Memorial Centre in Mumbai, National Institute of Mental Health and Neurosciences in Bangalore, Institute of Medical Sciences of Banaras Hindu University, and Maulana Azad Medical College in New Delhi. These accounted for 40.8% of the research output from the 579 medical institutions. The top 25 institutes under NBE, all private, contributed just 5.6% .
Overwhelming clinical burden leaving little time for academic activities is often cited as the reason for this state of affairs. “This is belied by the fact that the most prolific Indian publications come from institutions that also deal with the largest numbers of patients. This is also true of many of the world’s great hospitals, which along with providing a high standard of patient care are also leaders in publication,” observed the study.
It said lack of guidance and absence of role models among seniors, who themselves have published little, were major factors as was inadequate institutional support in the form of funds and infrastructure. However, the lack of incentives to do research and publish could be an even more important factor, since most faculty promotions in India are usually time-bound, based on seniority and influenced by political and bureaucratic ‘contacts’, rather than on researching and publishing, the study noted.
The policy of increasing the number of doctors by liberally allowing the creation of new medical institutions, mainly through private funding and enhancing seats has not been an unqualified success with what is generally perceived as a fall in standards of medical education, “which has now become a business venture for many politicians and is accompanied by widespread corruption both in its entry and exit processes”, the study said, while calling for an overhaul of the medical education system.