India has the best and the worst medical education in the world, according to a review of the world’s largest database of peer-reviewed literature.
Four medical colleges in India are among the top 10 global institutions that published the most research between 2004 and 2014, while around 60% of the country’s 579 medical institutions have published no research in a decade.
Only 25 (4.3%) institutions published more than 100 papers a year and, among them, accounted for 40.3% of India’s total research output of a little over 100,000 papers in the decade.
In comparison, the annual research output of t he Massachusetts General Hospital was more than 4,600 and the Mayo Clinic was 3,700. The All India Institute of Medical Sciences, with more than 1,100 annual publications, ranked third.
“What’s most shocking is that 332 (57.3%) medical colleges had not a single publication during this period. The states with the largest number of private medical colleges did the worst, with more than 90% of the medical colleges in Karnataka and Kerala having no publication at all,” says study author Dr Samiran Nundy, dean, Ganga Ram Institute For Postgraduate Medical Education & Research (GRIPMER), which was ranked 11th in the list of institutions that published the most research.
India’s total research output — including original articles, reviews, case reports, and reports of conferences and symposia — was 101,034 papers between 2005 and 2014, according to the journal Current Medicine Research & Practice. All the institutions surveyed were either recognised by the Medical Council of India (MCI) or the National Board of Examinations, the two bodies that regulate medical education in India.
“To bring medical education across states at par, India needs to incentivise quality research, which is an indicator of an institute’s quality of education and clinical care. Research doesn’t affect promotions, which is based on seniority and clinical practice, or income. And with doctors running private clinics in many medical colleges in their free time, research suffers,” says Dr K Srinath Reddy, president, Public Health Foundation of India.
The few attempts to encourage relevant and applied research are not enough. The MCI’s 2015 guidelines require at least four research publications for the post of an associate professor and eight for the post of a professor.