Saturday, 3 August 2013

An open letter to the Head of the Departments of all Surgery and Surgical Speciality Units......................


An open letter to the Head of the Departments of all Surgery and Surgical Speciality Units recognized for M.S, M.Ch and DNB training in India

My most respected seniors and colleagues,

It is because of your persistent and untiring efforts and the foresight of your predecessors that Surgical training in India has blossomed to its fullest potential. The course is getting structured and the examinations are getting streamlined because of your efforts and your students are crossing newer frontiers and flying your victory flag in all 5 continents. But amidst all this gala and celebrations, perhaps because of your pitiable doctor – patient ratio, the brilliant work that is being done in your Units is not being published in National and International Surgery journals. Time has come when we need to answer this issue as we can only brush it under the carpet at our own peril.
Sir / Madam, every candidate who chooses to be trained in Surgery or any super-speciality is actually offering to go for a doctoral or post – doctoral degree. He/she has not only to learn the speciality but also to contribute towards its progress. That was the idea of our fore-fathers when they thought of introducing a 'thesis' for these candidates. It was expected that the candidates besides their academic and clinical work will do some research, analyze the results and write a dissertation or a thesis from which research papers will be made so that the candidate can pay back his/her dues to the speciality. Now let us be truthful to ourselves and ask – has this preamble to acquiring the highest degree in the speciality been fulfilled? While each and every candidate under your care and guidance is writing a thesis, what is happening to all this colossal amount of data? If they are not being converted into research papers, peer reviewed and published are they worth the paper on which they are printed?

Sir / Madam, if the thesis which is being conducted under your guidance is not being transformed into at least one research paper worth publishing then there can be only 3 reasons:

  1. You are not convinced that they are of the quality that can stand up against peer review. If that is so, if they do not meet your standards then why are you accepting sub-standard work? Why are you not asking the PGs to go back to the drawing board and try all over again? Why are you closing your eyes to mediocrity and abetting it?
  2. Your candidate has a perfectly good thesis but has never published a paper, and doesn't know how to go about it. That is where you as a Guru come into the picture. I am a product of pre-computer era, and I was made to hand write my 90 page thesis 19 times before I could finally get it signed. I did not like it then, it was slavery. But before I appeared for my exams I had 3 indexed publications from my thesis. So I can only plead with you that please do not try to become a popular teacher, be a true teacher.
  3. The thesis is being written because the MCI asks for one and neither the candidate nor the teacher cares much about it. This is the most dangerous scenario. This only means that neither the teacher not the taught has fully understood the significance of scientific research. The fact that research streamlines the thought process, makes the mind judiciously analytical and teaches the brain to question beliefs and dogmas has totally escaped their attention.

Sir / Madam, training in Surgery involves 3 overlapping spheres – clinical, academic and research, and if any one is weak, the products of that training Unit cannot be strong. I would urge every one of you to put research and publication as a priority. Please put some fire under the seats of those who are just marking time in your Departments and give them time-bound tasks of writing research papers. Please do not sign the thesis until it has been converted into at least one research paper and submitted for publication in IJS. Let it be their Gurudakshina!

There are some Surgery Units in the Hindi heartland of our country, where English is not either their first language or the language of communication. This is a very trivial issue and it should not deter your candidates from expressing their scientific observations to the best of their ability. Once the paper is submitted to IJS, if the science in it is good, the language will not be a problem as there will be grammar editors to metamorphose it.

I also trust that you Unit Chiefs, when you don the role of examiners will give due credit to publications. I suggest you keep 20 viva marks solely for publications and ask every candidate what they have published in the last 3 years they were undergoing training in Surgery or any surgical super-speciality. Your this double prong approach both as a Head of the Department in your own Unit and as an Examiner in other units will go a long way to improving the scenario of publications in our country. Let us make it a point that no one is allowed to get an M.S, M.Ch or DNB degree if he/she has not published his/her work or at least submitted his paper for publication.

Our publications are our calling card to the world. We are identified by them. That is the reason why in all the 5 continents I have worked/observed Plastic surgery, the most popular Indian Plastic Surgeon is not someone who is seen in all the Conferences, or has ever held a very high office in our Association, but a certain gentleman who is known to the world as Thatte. R. They may not know his first name, they may not know how he looks like, but they all know his venous flaps, his random pattern de-epithelialized turnover flaps, tongue flaps, and his delayed closure of cleft palates. That is the power of publication. If a roadside singer in Europe identifies you as an Indian, he starts humming Aawara hoon, if a Plastic Surgeon recognizes you as an Indian, he asks you about Prof. Ravin Thatte! That is the power of publications. How can you deprive your students this colossal power?

Sir / Madam, research – both clinical and basic, is progressing at a fast pace. We cannot remain silent bystanders in this race, we have to run, and we have to win! Your cooperation in this run towards victory is of paramount importance. No Unit, anywhere in the world, is considered complete or even serious if it does not subject its work for peer review and publication. The fact that IJS stands to gain substantially from your strict vigil and insistence on publication goes without saying.

Optimistically yours'

Surajit Bhattacharya
Editor, Indian Journal of Plastic Surgery
Phone: 91 9415081668, 91 522 2328770

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