Research is not for somebody else

It is not possible to solve a problem unless it and its causes are properly understood. Last December, the Committee of the SECOT Research Agency asked its members to respond to a survey which attempted to asses the feelings of orthopedic surgeons regarding research in their specialty in Spain. We wish to express our gratitude to the 445 colleagues who dedicated 10 min of their time to sharing their impressions on this important issue.

Throughout history we have repeatedly witnessed anomalous situations which have been thoroughly criticized, discussed and investigated but which, unfortunately, civil society lacked the means to resolve. A similar situation is currently taking place in Spain regarding research. We are aware that it is the main foundation on which development is built; we see it in the leading countries in terms of culture and science and even inactive politicians can see it clearly. But it also seems obvious that we cannot expect the State to become the engine that drives research; this is not going to happen. PISA reports are devastating for our country and there are no Spanish universities among the top 200 worldwide. But in spite of this, at a time of such an intense activity in politics and the media, there have been no proposals aimed at improving the present situation. It is up to us to take a step forward and assume the responsibility. Like our compatriot Severo Ochoa once said: “in principle, research requires more brains than means.”

The i-SECOT survey was completed by a sample of surgeons of all ages, mainly occupying positions as department specialists (FEA), representing 62% of the population. The first question was “How important do you consider research to be in your professional development?” and the mean score out of a maximum of 10 points was 7.1, with the groups of physicians aged over 65 years and those aged under 35 years assigning the highest scores. Similar scores were recorded in connection with the importance of a doctoral thesis, with those aged under 35 assigning the greatest importance to this issue. One third of respondents were doctors and half of those who did not have the intention of pursuing this project in the future. There are not many disciplines not directly linked to universities in which such a high proportion of professionals aspire to attain academic excellence. This is very encouraging and clearly reflects that the problem does not lie in a lack of interest among Spanish orthopedic surgeons. Indeed, half of respondents were involved in a clinical research project and one third in a basic research project; 1 out of 3 had participated in a clinical trial in the past 2 years and 7 out of 10 would be interested in participating in one. There are many professionals with the motivation and capacity to contribute to science. Evidently, there may be some bias, since those who responded to the survey are probably those most interested in the research aspect of the profession. We must not forget that over 3500 members did not complete the survey.

On the other hand, the need to interact with colleagues in other countries is very clear. The majority of respondents considered it very important to participate in international gatherings (7.4 points) and read international journals (88%). The availability of grants covering travel and training at foreign centers was also very important for our orthopedic surgeons, as it obtained the highest score in the survey (8.21). The scores were not as high regarding national congresses or our own journal, and if we do not consider ourselves as leaders, then it is highly unlikely that others will. Herein lays a challenge for the immediate future.

In the section relating to obstacles for the development of a research vocation we noted a lack of knowledge of the scientific method by members of SECOT and the demand for more courses which teach it. On the other hand, the question of who should lead research obtained responses which mainly pointed to the research units of each center, and also to SECOT (Table 1).

Table 1.

The opinion of SECOT members regarding who should lead research.

Therefore, this is the main challenge for our society. Its members, that is, ourselves, demand that SECOT contributes to help familiarize us with the scientific method and ask for its support whenever we have an idea, a project, and/or an interest. As members of SECOT, we believe that our society is essential to providing that impulse but, interestingly, at this moment we do not consider it as a scientific leader (6.6 points).

Research is not for somebody else. As a scientific society, SECOT must assume the responsibility of leading the research impulse of Spanish Traumatology and Orthopedic Surgery. It must be able to detect the most talented researchers and the best ideas in order to support them. It must also provide training for those who express an interest in learning to investigate and place them in a position to become part of the aforementioned group of researchers. Rigorous research, with practical repercussions for patients, must be the foremost issue in congresses and meetings hosted by SECOT. Only quality will allow us to become models for ourselves and, subsequently, for foreign surgeons.

All this must not be done simply by the initiative of successive management boards or i-SECOT, but rather because those who make up our scientific society, its engine, demand it. That is our challenge.