8/12/2019 Why Med Students Are Crucial in investigation

1/2

PLoS Medicine | www.plosmedicine.org 1110

Health research is essential toimproving health care [1].Unfortunately, health research

has a low priority in the developingworld. In all disciplines of scienceand technology, India and Pakistancombined have 208 researchers permillion citizens [2,3], as comparedto 4,526 researchers per millioncitizens in the United States [4]. Thepublished research output from South

Asia is smallSouth Asian healthresearchers accounted for only 1.2%of all papers within the Institute forScientific Information database from19922001 [5]. Developing countriesmust therefore enhance their researchcapacity to efficiently address thegrowing burden of both communicableand non-communicable diseases [6].

Engaging Medical Students

in Health Research

One long-term strategy for promotinghealth research is to target medicalstudents early in their careers.Most of the research to date on the

effectiveness of such a strategy has beendone in Western settings. This researchhas shown that research experience asa medical student is strongly associated

with postgraduate research involvement[7,8].

Student research can also contributeto the published output of aninstitution. In Germany, for example,medical students authored 28% ofthe publications of one institution,including first authorship in 7.8%of papers [9]. Nothing can be more

motivating for a student than to getpublished.Even if the experience of doing

research as a student does not lead toa later career in academic medicine,research experience can help improvestudents skills in searching andcritically appraising the medical

literature, independentlearning, and writingresearch papers [10,11].Such exposure toresearch as a studentcan also help to identifyfuture careers, establishimportant contacts, andsecure better residencypositions. Given themany benefits of doinga research project as astudent, not surprisingly,97% of studentsconsidered research asa useful alternative toelectives [11].

Student research isnot without its problems.Good mentorship,for example, is a vital componentof effective student research, andinadequate mentoring can lead todiscontentment with research. Otherproblems include lack of time, neglectof routine studies and deteriorationof clinical skills due to more time

being spent on research activities, andinadequate project management [12].The perceived competitiveness andgreater demands of a career in academicmedicine and lower salary comparedto private practice may deter studentsfrom research. Another concern is thatstudents may work simply as juniorlaborers with no role in designing theresearch or in critical thinking duringthe research process. For example, theymay be told to review, say, 200 charts,and hand over the data to the principalinvestigator. Those who criticize medicalstudent research would also argue thatstudent papers are rarely cited, and thusare of limited utility.

Student Research in South Asia

Student research is dependent onnational research activity. Sincethere is still only a limited researchinfrastructure in many developingcountries, this means that opportunitiesfor medical student research arelimited. Research is not considered a

part of the medical curriculum in manyof these countries.

In one Indian study, for example,91% of interns reported no researchexperience in medical school [13].Thus, students in India rarely getexposed to research at this crucial stage

in their academic development whensuch exposure could encourage furtherresearch after qualification. Facultyacross South Asia themselves seldom

Student Forum

Open access, freely available online

November 2005 | Volume 2 | Issue 11 | e322

The Student Forum is for medical students

to give their perspective on any topic related

to health or medicine

Why Medical Students Are Crucial

to the Future of Research in South AsiaFawad Aslam*, Murtaza Shakir, Muhammad Ahad Qayyum

Citation:Aslam F, Shakir M, Qayyum MA (2005) Whymedical students are crucial to the future of researchin South Asia. PLoS Med 2(11): e322.

Copyright: 2005 Aslam et al. This is an open-accessarticle distributed under the terms of the CreativeCommons Attribution License, which permitsunrestricted use, distribution, and reproduction inany medium, provided the original author and sourceare credited.

Fawad Aslam and Murtaza Shakir are final-yearmedical students at the Aga Khan University inKarachi, Pakistan. Fawad Aslam is also the vicepresident of Aga Khan Universitys Student ResearchForum. Muhammad Ahad Qayyum is a final-yearmedical student at the Punjab Medical College inFaisalabad, Pakistan.

Competing Interests:FA is the vice president of theStudent Research Forum at Aga Khan University. MSand MAQ have declared that they have no competinginterests.

*To whom correspondence should be addressed.E-mail: fawadaslam2@hotmail.com

DOI: 10.1371/journal.pmed.0020322

DOI: 10.1371/journal.pmed.0020322.g001

Figure 1. Factors That Can Help Encourage South AsianMedical Students to Choose a Career in Academic Medicine

8/12/2019 Why Med Students Are Crucial in investigation

2/2

PLoS Medicine | www.plosmedicine.org 1111

engage in research owing to inadequatetraining in research, lack of incentives,

work overload, poor pay, and minimalresearch demand in clinical practicefrom patients, fellow physicians, andpolicymakers. Consequently, studentsare deprived of mentors and rolemodels. Medical training in generalin South Asia does not emphasize the

importance of research to medicalpractice. More than two-thirds of thepostgraduate trainees at one Pakistaniinstitution, for example, reportedreading scientific journals only once insix months or more [14].

Taking Action

What can be done to increase medicalstudents involvement in researchin South Asia (Figure 1)? First andforemost, the research infrastructureneeds extensive improvement, and

the meager funding for research mustbe boosted, so that there will be ahealthier research culture in whichstudents can participate. There alsoneed to be effective internationalagreements to halt the brain drain ofacademic clinicians from low-income tohigh-income countries [15], since thismigration robs medical students of rolemodels.

In addition, students need to besensitized to researchthat is,they should be made aware of whyresearch is so crucial to health care.

The medical curriculum must begin toincorporate and emphasize evidence-based medicine. To stimulate studentsinterest in research, we believe thatthey should undertake a mandatorycourse on research skills, along with acompulsory community project. Suchprojects undertaken in the primary-caresetting will allow students to executeall the steps of a research project, fromconception to final report writing,thereby narrowing the gap betweentheory and practice. Elective slots

should be available to those students

who are interested in pursuing furtherresearch. Young researchers need tobe encouraged, for example, by beingawarded scholarships. Prior researchexperience should be seen as valuable

when recruiting postgraduate trainees.Only when students are sensitizedin this wayand provided that theyalso have sufficient flexibility and

security to pursue a career in academicmedicinewill they choose careerpaths involving research.

Conclusion

At our own medical schools, we believethat medical students are becoming

more enthusiastic about getting involvedin research, which is encouraging. Some

efforts to promote student researchare already underway in South Asia.

For example, student conferences andresearch workshops are being held

in major cities of Pakistan, and somemedical journals, including theJournal

of Postgraduate Medicine(India) and the

Journal of the College of Physicians and

Surgeons of Pakistan, have introduced

student sections. The students at AgaKhan University in Pakistan, which has a

well-established research infrastructure,have won awards for their projects

at international student conferences

and have published widely in indexedjournals. Given the right amount of

support, medical students interest in

research can be successfully nurtured.

Acknowledgments

We are grateful to Fahim Jafary for criticallyreviewing the manuscript and being a

worthy mentor. We are also thankful to ourcolleagues Abdul Waheed and Abdul MoizKhan for providing valuable input.

References

1. Global Forum for Health Research (2004)10/90 report on health research 20032004.Geneva: Global Forum for Health Research.

Available: http:www.globalforumhealth.org/site/002__What%20we%20do/005__Publications/001__10%2090%20reports.

php. Accessed 26 September 2005.

2. United Nations Educational, Scientific andCultural Organization Institute for Statistics(2005) Country profile: India. Quebec: UnitedNations Educational, Scientific and CulturalOrganization Institute for Statistics. Available:http:www.uis.unesco.org/countryprofiles/html/EN/countryProfile_en.aspx?code=3560.htm. Accessed 26 September 2005.

3. United Nations Educational, Scientific andCultural Organization Institute for Statistics(2005) Country profile: Pakistan. Quebec:United Nations Educational, Scientific andCultural Organization Institute for Statistics.

Available: http:www.uis.unesco.org/countryprofiles/html/EN/countryProfile_en.aspx?code=5860.htm.

Accessed 26 September 2005.4. United Nations Educational, Scientific and

Cultural Organization Institute for Statistics(2005) Country profile: United States. Quebec:United Nations Educational, Scientific andCultural Organization Institute for Statistics.

Available: http:www.uis.unesco.org/countryprofiles/html/EN/countryProfile_en.aspx?code=8400.htm.

Accessed 26 September 2005.5. Sadana R, DSouza C, Hyder AA, Chowdhury

AM (2004) Importance of health research inSouth Asia. BMJ 328: 826830.

6. Buddha Basnyat, Rajapaksa LC (2004)Cardiovascular and infectious diseases in South

Asia: The double whammy. BMJ 328: 781.7. Segal S, Lloyd T, Houts PS, Stillman PL,

Jungas RL, et al. (1990) The associationbetween students research involvement inmedical school and their postgraduate medicalactivities. Acad Med 65: 530533.

8. Reinders JJ, Kropmans TJ, Cohen-SchotanusJ (2005) Extracurricular research experienceof medical students and their scientific outputafter graduation. Med Educ 39: 237.

9. Cursiefen C, Altunbas A (1998) Contributionof medical student research to the Medline-indexed publications of a German medicalfaculty. Med Educ 32: 439440.

10. Houlden RL, Raja JB, Collier CP, ClarkAF, Waugh JM (2004) Medical studentsperceptions of an undergraduate researchelective. Med Teach 26: 659661.

11. Frishman WH (2001) Student research projectsand theses: Should they be a requirementfor medical school graduation? Heart Dis 3:140144.

12. Diez C, Arkenau C, Meyer-Wentrup F (2000)The German medical dissertationTime tochange? Acad Med 75: 861863.

13. Chaturvedi S, Aggarwal OP (2001) Traininginterns in population-based research: Learnersfeedback from 13 consecutive batches from amedical school in India. Med Educ 35: 585589.

14. Aslam F, Qayyum MA, Mahmud H, QasimR, Haque IU (2004) Attitudes and practicesof postgraduate medical trainees towardsresearchA snapshot from Faisalabad. J PakMed Assoc 54: 534536.

15. Dovlo D (2005) Taking more than a fair share?The migration of health professionals frompoor to rich countries. PLoS Med 2: e109. DOI:

10.1371/journal.pmed.0020109

November 2005 | Volume 2 | Issue 11 | e322