Do all roads lead to ROME (Research Oriented Medical Education) in India?

Research is a massively neglected part of undergraduate medical training in India. Students join undergraduate medical courses straight after high school, but the emphasis on scientific inquiry in the secondary and higher secondary levels at school is restricted. This, together with a curriculum that does not encourage research during medical studies, goes a long way to ensuring that medical students have minimal exposure to research.

Classically, the developing world has applied the medical knowledge generated in the developed world to solve their needs. But as we progress into an era of evidence based medicine, the need for thinking global and acting local is getting more intense. We need Indian medical practitioners to generate research data specific to India. But with an undergraduate education system that barely touches on research, the average Indian Medical Graduate lacks  the tools s/he needs to provide the best service to society and to Medicine. If India is to become a major player in the medical/healthcare fields in the near future, then a medical education system which incorporates the best of both the clinical and research worlds needs to be devised and implemented at the earliest possible opportunity.

A survey by the Indian Council of Medical Research (ICMR) revealed that about 20% of medical colleges did not publish a single original research paper in the period between 1990 and 1994 . A recent survey by Elsevier based on bibliometric analyses revealed that while India is in the global top ten for research article output, ‘health sciences/medicine’ still featured in the ‘not so strong’ category. Although the nation produces more than 30,000 doctors annually, the research output is insignificant. However, this cannot be blamed on a lack of interest of medical students in research. The Summer Research Training Scholarship offered by the ICMR (ICMR-STS) has gained great popularity amongst the students, as seen by the rise in recipients from 496 in 2005 to 802 in 2011.

What can be done to promote a Research Oriented Medical Education in India?

1. Provide a formal introduction to research methods as part of the medical curriculum, including critical appraisal of evidence.
2. Establish an MBBS/PhD or MD/PhD Course. Initiating such a program would produce more physicians committed to research and produce role models that we, as medical students, could emulate.
3. Support INFORMER: the Forum for Medical Students’ Research, India (INFORMER) brings all students interested in medical research together. Its annual flagship conference, MEDICON, is organized by medical students for medical students. INFORMER needs institutional support, from the Medical Council of India and the State Medical Councils to extend its support to more medical students. In this regard, it is worthy to mention the efforts of the Moving Academy of Medicine and Biomedicine, which has started regional conferences for undergraduate medical students to present their research and attend research orientation workshops as well. (5)
4. Strengthen Infrastructure and Research in Medical Colleges:
Trained mentors, teachers, research infrastructure, adequate laboratory support are lacking in all but the best of institutions.
5. Student Publications:
There are few student journals in India. The launch of the Student IJMR is a laudable step forwards. Student-led efforts in editing and running journals focused towards students’ research need to be encouraged in medical schools.
6. Rewarding Research Involvement:
Until and unless medical research brings some benefits to the students, there is little chance that it shall be viewed as anything else but a distraction.

The revolution to involve more medical students in research so as to improve the quality and quantity of biomedical research in India has started. It now needs institutional support and impetus to go forward. And the first step in that direction is to expose medical students to research as early as possible. The Medical Council of India has advocated the introduction of electives in various topics including research methodology in its proposed Vision 2015. And though these reforms may take some time to be brought in, one has to remember that ROME was not built in a day.

Guest post by Pranab Chatterjee, MBBS, Medical College Kolkata, Kolkata, India & Tamoghna Biswas, 8th Semester(Final Year) MBBS, Medical College Kolkata, Kolkata, India (tamoghnab@gmail.com)

Competing interests: Pranab Chatterjee was associated with INFORMER. Both the authors(PC and TB) were reviewers at Student BMJ and the Lancet Student (not presently reviewing). Both PC and TB have been recipients of some/all of the research fellowships mentioned in the text. Both PC and TB are country representatives of HIFA 2015, and have been staunch supporters of the open-access movement. TB was selected a student ambassador of Elsevier India.