A Perspective On Empowering Clinical Research In India - Albina Arjuman Nair

Indian Biomedical Journals are currently undergoing a transformation with a felt need for increasing the global footprint and worldwide visibility. Given this, the longstanding Indian Biomedical Journals are caught up in a conceptual dilemma of publishing quality research on the one hand and strategizing to publish more citable research to increase their global visibility and impact on the other. While there are different schools of thought regarding the validity of adopting such metrics at all, the fact remains that on a global turf, Indian research will be received based on the actual impact and volume it generates, as we witnessed during the recent pandemic. So this is in a way a necessary evil of a concept for us to stomach as of today. Given this wild white rabbit chase, somewhere down the road, the possibility of accommodating substantial start-up research from undergraduates and postgraduates does inadvertently get side-tracked.

The National Medical Council (NMC) is strategically placed in the Indian academic scene in that it serves as a guiding beacon for the under/post-graduate talent in our country. However, the need of the hour is that more than focussing on promoting Indian Journals, NMC is best placed to help empower Indian research capability as a whole by identifying and honing the ‘research temperament’ in our country.

From my experience through capacity building exercises across the country, reading research published across India over the past decade and through discussion forums there is presently a lack of willingness or priority for undertaking research among the Clinician fraternity in our country. There could be various reasons for this including various challenges involved in clinical practice including a large patient load. However, I strongly feel that adequate training in research methodology, scientific publishing and domain specific mentoring is currently inadequate or even lacking at the undergraduate level. Furthermore, this is also the case with the overarching ’need for prioritising research’ where efforts are lacking at the under/postgraduate level. This is crucial since clinical research is unique in that it involves a clinician who is the key point-of-contact for healthcare access for the patient. A clinician would know best on a case-to- case basis regarding what needs of a patient need to be catered to, whether it is in fact clinical intervention or therapy or community engagement. Given this, a practicing clinician is in fact an empowered entity to identify relevant research questions which can provide translatable solutions towards achieving more sustainable patient outcomes and better population health as it would include the practice perspective of a clinician and the translational need as felt directly by the patient.

This may provide clarity on identifying the actual research need for funding agencies as well to invest in trials or technologies only where there is in fact an unmet need specific to our country rather than relying singularly on researcher guided global literature review on a given healthcare issue to identify research gaps and tailor the same in India specific contexts.

While not touching upon the opportunities for research in India, I remain focused only on the under/post-graduate medical researchers since this is still an untapped group of talent and a missed opportunity towards quantifiable Indian research outcome at present. Furthermore, if India needs to increase its research output and make a statement globally, then we certainly need as may hands as possible.

So, What do I feel needs to be done?

• In my opinion NMC needs to make all efforts towards identifying and honing research temperament among under/postgraduate medical students through intensive capacity building involving a core expert group, who will resonate with the ideologies of NMC focused on empowering research in the country. This core team should be a group of individuals non-native to the requisite medical college elected for such a training and should comprise of veteran researchers with an impressive publication track record (veteran researchers will be full of experience and vision and will be most focused on such an exercise), policy makers/regulatory authorities (who can guide young minds regarding the realities, challenges and opportunities in research) and Journal Editors (who can build expectation of outcome, research competitiveness and best practices to conduct & present research data). This will allow for a neutral and targeted training to inculcate research temperament.
• NMC should develop a new Journal, specific for under/postgraduate students which are free from conventional metric systems, etc. An in-house evaluation mechanism needs to be developed for assessing articles submitted to this Journal including criteria for peer-review, etc. Publication in this Journal should provide ‘publication credits’ to the respective student usable for postgraduate in-country entrance examinations.
• Short-term certificate programmes of 3-6 months on topics such as Research ethics/integrity, Basic statistics, Quality control, etc for MBBS students should be introduced. These certificate programmes should be tough to clear and have high credits upon success to make the programme attractive for the students and at the same time make it desirable for them to be able to clear it to achieve the needed credits for their post-graduate exams where these credits will add value.
• Opportunity for internship programmes in research institutions for individuals who clear at least 3 such certificate programmes mentioned above.

These I believe would be achievable mechanisms to firstly identify and hone clinical research talent in India. Eventually this can translate into measurably more scientific/research output from our country with the probability of more quality research outcomes towards increasing our global visibility and impact.

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.