Open access, freely available online

Student Forum

Why Medical Students Are Crucial

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

H
ealth research is essential to literature, independent
improving health care [1]. learning, and writing
Unfortunately, health research research papers [10,11].
has a low priority in the developing Such exposure to
world. In all disciplines of science research as a student
and technology, India and Pakistan can also help to identify
combined have 208 researchers per future careers, establish
million citizens [2,3], as compared important contacts, and
to 4,526 researchers per million secure better residency
citizens in the United States [4]. The positions. Given the
published research output from South many benefits of doing
Asia is small—South Asian health a research project as a
researchers accounted for only 1.2% student, not surprisingly,
of all papers within the Institute for 97% of students
Scientific Information database from considered research as
1992–2001 [5]. Developing countries a useful alternative to DOI: 10.1371/[Link].0020322.g001
must therefore enhance their research electives [11].
Figure 1. Factors That Can Help Encourage South Asian
capacity to efficiently address the Student research is Medical Students to Choose a Career in Academic Medicine
growing burden of both communicable not without its problems.
and non-communicable diseases [6]. Good mentorship,
for example, is a vital component part of the medical curriculum in many
Engaging Medical Students of effective student research, and of these countries.
in Health Research inadequate mentoring can lead to In one Indian study, for example,
One long-term strategy for promoting discontentment with research. Other 91% of interns reported no research
health research is to target medical problems include lack of time, neglect experience in medical school [13].
students early in their careers. of routine studies and deterioration Thus, students in India rarely get
Most of the research to date on the of clinical skills due to more time exposed to research at this crucial stage
effectiveness of such a strategy has been being spent on research activities, and in their academic development when
done in Western settings. This research inadequate project management [12]. such exposure could encourage further
has shown that research experience as The perceived competitiveness and research after qualification. Faculty
a medical student is strongly associated greater demands of a career in academic across South Asia themselves seldom
with postgraduate research involvement medicine and lower salary compared
[7,8]. to private practice may deter students
Citation: Aslam F, Shakir M, Qayyum MA (2005) Why
Student research can also contribute from research. Another concern is that medical students are crucial to the future of research
to the published output of an students may work simply as junior in South Asia. PLoS Med 2(11): e322.
institution. In Germany, for example, laborers with no role in designing the Copyright: © 2005 Aslam et al. This is an open-access
medical students authored 28% of research or in critical thinking during article distributed under the terms of the Creative
the research process. For example, they Commons Attribution License, which permits
the publications of one institution, unrestricted use, distribution, and reproduction in
including first authorship in 7.8% may be told to review, say, 200 charts, any medium, provided the original author and source
of papers [9]. Nothing can be more and hand over the data to the principal are credited.
motivating for a student than to get investigator. Those who criticize medical Fawad Aslam and Murtaza Shakir are final-year
published. student research would also argue that medical students at the Aga Khan University in
Even if the experience of doing student papers are rarely cited, and thus Karachi, Pakistan. Fawad Aslam is also the vice
president of Aga Khan University’s Student Research
research as a student does not lead to are of limited utility. Forum. Muhammad Ahad Qayyum is a final-year
a later career in academic medicine, medical student at the Punjab Medical College in
research experience can help improve Student Research in South Asia Faisalabad, Pakistan.

students’ skills in searching and Student research is dependent on Competing Interests: FA is the vice president of the
critically appraising the medical national research activity. Since Student Research Forum at Aga Khan University. MS
and MAQ have declared that they have no competing
there is still only a limited research interests.
infrastructure in many developing
The Student Forum is for medical students countries, this means that opportunities *To whom correspondence should be addressed.
to give their perspective on any topic related E-mail: fawadaslam2@[Link]
for medical student research are
to health or medicine
limited. Research is not considered a DOI: 10.1371/[Link].0020322

PLoS Medicine | [Link] 1110 November 2005 | Volume 2 | Issue 11 | e322

engage in research owing to inadequate who are interested in pursuing further 2. United Nations Educational, Scientific and
Cultural Organization Institute for Statistics
training in research, lack of incentives, research. Young researchers need to (2005) Country profile: India. Quebec: United
work overload, poor pay, and minimal be encouraged, for example, by being Nations Educational, Scientific and Cultural
research demand in clinical practice awarded scholarships. Prior research Organization Institute for Statistics. Available:
http:⁄⁄[Link]/countryprofiles/
from patients, fellow physicians, and experience should be seen as valuable html/EN/countryProfile_en.aspx?code=3560.
policymakers. Consequently, students when recruiting postgraduate trainees. htm. Accessed 26 September 2005.
are deprived of mentors and role Only when students are sensitized 3. United Nations Educational, Scientific and
Cultural Organization Institute for Statistics
models. Medical training in general in this way—and provided that they (2005) Country profile: Pakistan. Quebec:
in South Asia does not emphasize the also have sufficient flexibility and United Nations Educational, Scientific and
Cultural Organization Institute for Statistics.
importance of research to medical security to pursue a career in academic Available: http:⁄⁄[Link]/
practice. More than two-thirds of the medicine—will they choose career countryprofiles/html/EN/
postgraduate trainees at one Pakistani paths involving research. countryProfile_en.aspx?code=[Link].
Accessed 26 September 2005.
institution, for example, reported 4. United Nations Educational, Scientific and
reading scientific journals only once in Conclusion Cultural Organization Institute for Statistics
six months or more [14]. (2005) Country profile: United States. Quebec:
At our own medical schools, we believe United Nations Educational, Scientific and
that medical students are becoming Cultural Organization Institute for Statistics.
Taking Action more enthusiastic about getting involved Available: http:⁄⁄[Link]/
countryprofiles/html/EN/
What can be done to increase medical in research, which is encouraging. Some countryProfile_en.aspx?code=[Link].
students’ involvement in research efforts to promote student research Accessed 26 September 2005.
in South Asia (Figure 1)? First and 5. Sadana R, D’Souza C, Hyder AA, Chowdhury
are already underway in South Asia. AM (2004) Importance of health research in
foremost, the research infrastructure For example, student conferences and South Asia. BMJ 328: 826–830.
needs extensive improvement, and research workshops are being held 6. Buddha Basnyat, Rajapaksa LC (2004)
Cardiovascular and infectious diseases in South
the meager funding for research must in major cities of Pakistan, and some Asia: The double whammy. BMJ 328: 781.
be boosted, so that there will be a medical journals, including the Journal 7. Segal S, Lloyd T, Houts PS, Stillman PL,
healthier research culture in which Jungas RL, et al. (1990) The association
of Postgraduate Medicine (India) and the between students’ research involvement in
students can participate. There also Journal of the College of Physicians and medical school and their postgraduate medical
need to be effective international Surgeons of Pakistan, have introduced
activities. Acad Med 65: 530–533.
8. Reinders JJ, Kropmans TJ, Cohen-Schotanus
agreements to halt the “brain drain” of student sections. The students at Aga J (2005) Extracurricular research experience
academic clinicians from low-income to Khan University in Pakistan, which has a of medical students and their scientific output
high-income countries [15], since this after graduation. Med Educ 39: 237.
well-established research infrastructure, 9. Cursiefen C, Altunbas A (1998) Contribution
migration robs medical students of role have won awards for their projects of medical student research to the Medline-
models. indexed publications of a German medical
at international student conferences faculty. Med Educ 32: 439–440.
In addition, students need to be
and have published widely in indexed 10. Houlden RL, Raja JB, Collier CP, Clark
“sensitized” to research—that is, AF, Waugh JM (2004) Medical students’
journals. Given the right amount of perceptions of an undergraduate research
they should be made aware of why
support, medical students’ interest in elective. Med Teach 26: 659–661.
research is so crucial to health care. 11. Frishman WH (2001) Student research projects
research can be successfully nurtured.

The medical curriculum must begin to and theses: Should they be a requirement
incorporate and emphasize evidence- for medical school graduation? Heart Dis 3:
Acknowledgments 140–144.
based medicine. To stimulate students’ 12. Diez C, Arkenau C, Meyer-Wentrup F (2000)
We are grateful to Fahim Jafary for critically
interest in research, we believe that reviewing the manuscript and being a
The German medical dissertation—Time to
change? Acad Med 75: 861–863.
they should undertake a mandatory worthy mentor. We are also thankful to our 13. Chaturvedi S, Aggarwal OP (2001) Training
course on research skills, along with a colleagues Abdul Waheed and Abdul Moiz interns in population-based research: Learners’
compulsory community project. Such feedback from 13 consecutive batches from a
Khan for providing valuable input.
medical school in India. Med Educ 35: 585–589.
projects undertaken in the primary-care 14. Aslam F, Qayyum MA, Mahmud H, Qasim
setting will allow students to execute References R, Haque IU (2004) Attitudes and practices
1. Global Forum for Health Research (2004) of postgraduate medical trainees towards
all the steps of a research project, from 10/90 report on health research 2003–2004. research—A snapshot from Faisalabad. J Pak
conception to final report writing, Geneva: Global Forum for Health Research. Med Assoc 54: 534–536.
thereby narrowing the gap between Available: http:⁄⁄[Link]. 15. Dovlo D (2005) Taking more than a fair share?
org/site/002__What%20we%20do/ The migration of health professionals from
theory and practice. Elective slots 005__Publications/001__10%2090%20reports. poor to rich countries. PLoS Med 2: e109. DOI:
should be available to those students php. Accessed 26 September 2005. 10.1371/[Link].0020109

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