Domhnall MacAuley on Sailing to Byzantium

Domhnall MacauleyYeats’s poem (Sailing to Byzantium), written as he approached old age, looked to the wonders of Byzantium, and its immortal beauty.  I would never have dreamt, sitting in that classroom long ago, that I would one day visit its modern day incarnation as Istanbul.  (Even less that I would grow older too.)  Visiting Istanbul, for a BMJ training workshop, was a drama filled experience that would encourage anyone to contemplate mortality – and, that was just the taxi ride. 

Meeting the key players at the Istanbul Research and Teaching Hospital was enriching and exciting.  There was a major focus on education and the young doctors I met were keen to look at opportunities to widen their horizons, were very web savvy and had used electronic media both during their undergraduate careers and in preparing for postgraduate exams.  Research didn’t appear to have the same importance. Publishing is essential if one is to progress up the academic ladder but is not critical to ones later career.  This may explain why there are so many Turkish medical journals -about 50, one doctor told me- but fewer researchers later publish in the major peer reviewed journals.  Many of these research publications were never cited, described by one of my hosts as “empty papers.” Aspiring academics are now expected to publish in journals included in the Web of Science  and the impact of this research and subsequent citation is becoming increasingly important.  Academia brings few monetary rewards, however. Clinical practice is a priority.

Doctors have to choose between private or public practice and rewards in public practice are modest. Perhaps that might partly explain why the audience at our research seminar included, not just internal medicine specialists, but many surgeons and, unusually in my experience, orthopaedic surgeons (who were most enthusiastic).  In conversation afterwards, I was fascinated to learn that, while major research funding might be lacking, the government does reward research publication.  It provides  a modest sum based on the status of the journal. This is more a symbolic than significant monetary reward  and the purpose is to further national esteem through publication in the fields of Science, Technology, and Medicine.

As a afterthought….in my hotel room later I read of an Irish cultural figure who did make it to Byzantium/Istanbul eventually this September, when U2 had their first concert in the Olympic stadium. The Istanbul version of Time Out asked other artists for their views of Bono. One quotation caught my eye “…I didn’t want to go to a concert for some ******* to talk down to me that I should be thinking of some kid in Africa …”  Coming to this ancient city to talk about the secrets of publishing in peer reviewed journals, I hope I showed appreciation and understanding of the rich traditions of my medical colleagues.  After all, this city was the centre of Byzantine medicine long before the rest of the world knew anything about research and education.

Domhnall Macauley is primary care editor, BMJ