There are over 50,000 indexed journals on PubMed alone, with several journals for each medical specialty, subspecialty, and niche topic in existence. And that does not include nonindexed journals and the litany of “pop-up” journals that have probably requested you to submit your “eminent work” at least a few times already. Medical literature tends to get hyperspecialized at the publication stage, unless you make a habit of reading general medical journals. That is understandable, of course, as we all desperately try to keep a grip on a small corner within our specialty.
If I, an anesthesiologist, collaborated with an orthopaedic surgeon on a great trial and wanted to publish our results, should I pick an anesthesiology journal or an orthopaedic surgery journal? Knowing full well that we would be losing almost half our initial audience either way, this is not a trivial decision. On the other hand, if one journal publishes our topic, it would be difficult to discern whether the other journal is already considering a similar manuscript due to the topic overlap.
This theme recurs in local, national, and international collaborations and affects research teams and medical publications. International co-authorships seem to be prevalent in more basic fields and more isolated research groups. There is a silver lining, however. According to published work, collaboration in research is generally increasing and has a positive effect on productivity. This may be due, in part, to the massive shift to virtual meetings over the past few years and the increasing access to and familiarity with online tools.
So how can we improve?
First, it is important to recognize the limitations we currently face starting from our training years: Preoccupation with “core” clinical training, reduced working hours (which has its benefits on other fronts), insufficient widespread formal research education, lack of interest, paucity of exposure, and limited funding are some factors that come to mind. Despite most residency programs requiring trainees to be involved in research, the topic is often regarded as a “side quest” or a lower tier project that does not deserve as much attention as clinical knowledge to pass an exam (or several).
Second, we must recognize that excellent researchers are hard at work everywhere and every day, producing elaborate protocols and practice-changing results. The disconnect occurs in transferring the zeal of those researchers into the young minds of trainees and early career clinicians. This is where educators and incorporation of research training come into play. If nothing else, this would enhance everyone’s ability to critically read manuscripts and adjust clinical practice appropriately.
Third, it behooves us to promote a culture of inclusivity and collaboration as early on as possible. Our residencies, medical schools, high schools, and even elementary schools are prime soil to plant seeds of appreciating each other’s strengths and working together toward a common goal.
Fourth, it is imperative to realize that good researchers are not created “at some point in the future.” Skills are honed over years to decades before high-quality work can be expected. A trainee cannot be expected to “figure out” the benefits of research or to fully commit to it without appropriate exposure and training. And the well-trained will go on to become key leaders in future research and, hopefully, key educators of the generations to come.
Patient safety research affects all medical specialties, yet patient safety projects seem to follow the silos of specialized publications and we end up seeing much of the same processes happening independently and yielding rather similar results. This is not to say that appropriate efforts are lacking. Multiple medical centers have centralized multidisciplinary patient safety committees that meet routinely and occasionally engage in academic pursuits. This is to say, however, that these collaborative efforts need to be optimized, supported, expanded, and generalized to as many centers as possible in order to benefit our patients the most.
What do you think can be done to improve collaboration in medical research? Share in the comments.
Dr. Saasouh completed an anesthesiology residency at the American University of Beirut (Lebanon), a research fellowship at the Cleveland Clinic Department of Outcomes Research (Ohio), where he was chief research fellow, received training in neuroanesthesiology at the Cleveland Clinic (Ohio), and completed an anesthesiology residency at the Detroit Medical Center (DMC - Michigan). He is currently a Board-certified Anesthesiologist and a Director of Research. Dr. Saasouh was a 2019–2020 Doximity Conference Fellow and is a 2022–2023 Doximity Op-Med Fellow and a 2023 Doximity Digital Health Fellow.
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