Publishing Medical Research in Pakistan; Challenges and the Way Forward

Research in Pakistan has gradually progressed over the years. The recently published “Pakistan research and innovation landscape report” is all praises for research in Pakistan. They cited that in the past decade, Pakistan has produced 300% more publications indexed in the Web of Science Core Collection, 66% of its scientific papers are published in Journals with Impact Factor (JIF) and the Category Normalized Citation Impact of its publications has risen from 0.67 to 1.03. In this duration, the highest number of publications from our country was in Clinical Medicine compared to other disciplines and Normalized Impact in Clinical Medicine from the country exceeds the World average.1This achievement in health research should be attributed to the efforts and policies of the Pakistan Medical & Dental Council (PM&DC) and Higher Education Commission (HEC). The PM&DC had incrementally increased the requirement of research publications for the promotion of professors thus promoting research output by the Faculty. The HEC had also facilitated and funded medical institutes to start medical journals to cater to this research output. Due to awareness in the faculty and need for future promotions, in most Medical Colleges and Universities, the undergraduate curriculum had also been modified to provide emphasis on research though mostly limited to the domains of community medicine and public health. Rawalpindi Medical University in 2017 under the visionary leadership of the Vice-Chancellor Prof M Umar started the initiative of starting a separate publication titled Student Journal of Rawalpindi Medical College (SJRMC) which is published biannually and now some other Medical Institutes have also followed suit.However, what is sorely missing is the domain of medical research is quality and impact. HEC has mandated all Medical Universities to develop Offices of Research Innovation & Commercialization (ORIC) but in most Medical Universities including Rawalpindi Medical University, they are at a nascent stage. Capacity building and supporting the offices of ORIC and research at Medical Institutes will surely go a long way in achieving this goal.Last year was extremely turbulent for medical research and publications. Due to uncertainty in the working of medical regulating body PMDC or Pakistan Medical Council (PMC)2, the promotional structure and criteria have been unclear. Furthermore, the status of Medical Journals that were recognized by PMDC for promotions is also not available. As a result, the Faculty and Institutes look towards HEC for regulatory criteria for Medical Journals.In mid of 2019, HEC published a new criterion for recognition that all Journals need to fulfill by July 2020.3 Due to the harsh conditions, even some of the top Medical Journals were downgraded in rank.4 The previous Z category which was meant to support and facilitate weaker or nascent publications was abolished. Newer and stricter benchmarks for the remaining Y, X, and W categories. Some of these benchmarks are extremely difficult to meet for most Journals. The criteria states that for Y category, self-institutional authorship should not exceed 1/5th of the total articles and for the X category there should be no institutional publications. Then the question arises why would a medical institute encourage or facilitate a Medical Journal if it is not facilitating local research? Also, Y category requires an academic editorial board with Ph.D. members, however, in the medical profession, very few disciplines have PhDs and the highest qualifications are mostly Fellowships. The benchmarks also include that journals should use an online management system and should be abstracted internationally. This we believe is a very good step, but this requires regular training of Medical Editorial Teams and funding from HEC and Medical Institutions.Recently two important meetings were held to discuss and deliberate solutions to these problems. On February 21st 2020, a meeting was held at RIPHAH University in which a “Health Sciences Journals’ Editors Group” was created. Some of the key issues that this group is working on includes; 1) fostering collaboration, cooperation & communication among the editors of local medical journals of the twin cities of Rawalpindi and Islamabad, 2) improving visibility, citation, indexation, recognition and overall standard of their periodical; regulation, management, ethical issues, and 3) to meet the criteria of Regulating Bodies. On March 13th 2020, a Local Editors Meeting5 was organized by Punjab Health Care Commission (PHEC) in ARFA Tech Park Lahore. Some of the problems faced by the Editors that were discussed included the HEC’s criteria which is uniform for all disciplines however, each discipline should have their unique criteria; modifications according to HEC criteria requires expertise, financial support and at least 2 years which is very difficult for most Journals to achieve by June 2020. HEC criteria is tough especially for new journals; de-recognition will be highly demotivating as most Journals will not survive; editors have no financial or promotional recognition nether from neither their Institutes nor the Regulatory Bodies. It was decided that a Council of Editors should be formed which should recommend standards of publication in each discipline. HEC planned a workshop of Editors in March 2020, on World of Science and Scopus which was a very welcome step that could not materialize due to the recent Coronavirus pandemic.We at the editorial office of the Journal of Rawalpindi Medical College (JRMC) have strived very hard to achieve these criteria in the shortest possible time. To achieve these challenges, a group of dedicated section editors from all medical disciplines was created to discuss and deliberate fortnightly. Minutes of these meetings were approved by the Dean's Committee and sent to Academic Advisory Boards for comments and suggestions. The Editorial Team was trained in the use of Turnitin and the Open Journal System (OJS). A verified reviewer panel was formed and training material was sent to reviewers for improving the quality of the peer-review process. Institutional email addresses of the editorial and reviewer panel were used to ensure transparency of communication. Funds provided by HEC were used to acquire Crossref membership to issue Digital Object identifier (DOI) numbers to articles to increase the discoverability of our published research. We feel that though these recent steps by HEC have generated awareness among Medical Periodicals to improve publishing standards, however harsh actions such as de-recognition without proper training and financial support will be highly discouraging for the local searchers and publishers.