Aditya J Nanavati: Are Indian medical students pessimistic about participating in research?

Aditya J NanavatiI recently completed my residency in general surgery. Towards the end of my residency, I was introduced to the world of research and publishing. Far from knowing it all, the more I explore this world, the more I realize that I should have been introduced to it much earlier.

I believe I speak for the average medical student in India when I say that the world of research publishing is something that we are overawed by. It is assumed that only great physicians can participate in and publish their research. I can say with sufficient confidence that rarely will you meet medical students who imagine they can do the same someday. It is looked upon as an elite club where entry is extremely difficult, if not impossible. Why is this so?

The curriculum in Indian medical schools does introduce students to the concept of research—the problem being that the appeal is limited. It is largely assumed to be a “western” practice that cannot be easily replicated in India. Information on the topic is remembered to help pass exams and rapidly forgotten thereafter. It is only when the student goes on to pursue residency that the importance of research is realized. The exposure at this level is almost so sudden that it stuns the young resident.

The average medical student in India is used to reading textbooks that rarely present the subject with a research orientation. They steer away from controversy by presenting singular opinions. This is in contrast to research articles where, even if authors have one thought process, the counter opinion is presented for the reader’s consideration.

Even though these textbooks may be adequate for a medical student, the information presented is accepted as gospel truth. The student would be ill-advised to question the “facts.” Questioning in general is frowned upon within Indian medical schools, even by those in teaching positions—and students fear incurring their wrath. The student therefore learns to remain mute.

Apart from this lack of familiarity with research principles early on in their medical career, there are several reasons for the gaps in understanding of research in medical students in India. Inadequate fluency with the English language, a lack of funding, and a general lack of exposure to research in their area are only a few that come to my mind.

India has produced many great scientists and researchers in medicine. There is hardly any reason to be pessimistic. I believe that there is a need to raise the emphasis on teaching about research in medical schools.

Learning needs to include looking up databases in libraries and on the internet, advice on how to read an article, as well as how to analyze it. Students also need to be taught how to extract crucial information from a research article so that it may improve decision making in clinical scenarios. It is never too early to teach this and I believe starting early is better. Lastly, interactions with well published authors need to be arranged for and encouraged. These steps may dispel the pessimism around research in the Indian medical student’s mind.

Aditya J Nanavati is a general surgeon working in Mumbai, India.

Competing interests: None

  • Tommy

    I dont thing this is true . He speaks for the below average and “bookworm” kind of medical student. The ICMR run STS programme for MBBS medical students has been very successful and produced extremely good quality work published in leading medical journals. Saying this of course the syllabus needs to be improved and make it more research oriented but it is wrong to say that research is introduced at end of “residency”.

  • Vinay Jathen

    Having worked with you, I can vouch for what you say, Aditya!
    But, even those inclined towards publishing papers would have a hard time doing so, what with the work-load of residency and basically a lackadaisical approach of people around. And it is true that only after residency do you realize the need to publish the wonderful work that you have or had been doing….
    All in all, well written….looking forward to more such enlightening reviews from your side. Kudos!

  • Aditya J Nanavati

    I agree Vinay we are doing good work and must be proud. Also I agree that we should be publishing our work more often.

  • Aditya J Nanavati

    I agree that ICMR runs STS programs but they’re optional. Most students only do it without understanding the intricacies of research and sometimes only to reflect on their CVs. While I find your comment that below average and bookworm medical student comment bordering on offensive I couldn’t disagree more. I would love to see research institutionalized into each medical school’s program. In the mean time I would love to read your voluminous research and may be we could find out how many medical students have you published with or helped get published. If it’s high I would love to see your model replicated all over India. I just feel the “average” medical student has reservations about research. The bright ones may not. It may be safe to assume that you are one of the bright ones. I meant this for the lesser mortals. If medical education is standardized so that all categories of students can benefit we will be producing better doctors. Anyway thanks “Tommy” for your response to my blog.

  • Aditya J Nanavati

    Thanks Vinay, I agree we do good work and we should be better at publishing it. After I left Sion I realised what a treasure trove of material it had. Only if I had the time and more insight in research.

  • Vinay Jathen

    Apparently, “Tommy” has a thing for “thinging”….or was it thinking?….. am confused?!?

  • Great to read a plea for research training by a early-career surgeon. I am often struck by the lack of curiosity among young doctors and a singular focus on clinical skills development. This creates professionals who are unable to fully contribute to meeting needs of patients, hospitals, and the healthcare system. My curiosity is piqued not only by real-life situations but by reading articles that discuss situations pertinent to me.

    I wholly support the idea of introducing research in the curriculum – but not by overloading students. What will be taken out? Good research needs time for relaxed reflection – something that seems to be nearly eliminated during the training years.