How can we Improve the Number of Scientific Publications in General Surgery?

Dear Sir,

Clinical research is decisive for health advances to occur, to improve patient care and to increase the health expectancy of the general population. The National Plan of our Specialty published in the BOE very clearly expresses that the National Commission for the Specialty has the aim to promote specific training in this area.¹ The document proposes that residents during their first two years of training should complete 2 courses on Methods of Research and recommends that “residents should actively participate in the preparation of scientific publications, oral presentations and presentations at conferences and meetings and participation in clinical meetings in their Departments”.¹ Furthermore, at the end of the residency period, the resident should have a minimum of 6 accepted publications and have collaborated in at least 10 presentations at meetings.

Recently, Serra-Aracil et al.² have published the results of the activity of the residents of our specialty registered in the resident's log-book, “libro del residente”, by means of a prospective, observational, multicentric study. The data included a sample of 64 residents from 9 Spanish hospitals. Although the number of presentations at meetings is around 3 and 9, it is evident that the number of scientific papers published is significantly lower, with an average of 1 paper per year, and only in the last years of training. This reality not only occurs in the residents of our country.³

How can we improve the scientific production of our residents to reach the expected/desired levels according to the Specialty Program? There is no doubt that the answer is complex. First, if we design a curricular trajectory of scientific publications for our residents, the first step should be the aggressive promotion of the critical review of scientific papers.⁴ Without acquiring the habit of critical reading of scientific papers, it will be difficult to progress to being an author. For this purpose, the standardization of bibliographical sessions for residents, otherwise known as journal clubs, could be the first step.⁵

Another aspect to consider is the low rate of publication of the papers that are presented in conferences of our specialty. In different specialties, just as the recently published results, it is evident that only a third of the presentations at meetings finally become published as scientific papers.^2,6,7 Probably turning a presentation at a conference into a paper would be a way of training in becoming an author.

It would also be interesting to plan in a structured way the participation in writing different types of publications depending on the level of difficulty and the year of training. For example, the description of relevant clinical cases, presentation of remarkable clinical images or literature reviews are a good way to teach the resident in their first years of training how to write a scientific paper.

There is no doubt that the fundamental issue is to dedicate time to the practical teaching of clinical research. There should be courses and workshops where residents could learn step-by-step how to write a scientific paper. The Spanish Association of Surgeons has made an effort in this sense by organizing combined workshops with members of the editorial committee of journals of high scientific quality (for example, British Journal of Surgery) but it would be highly recommendable to plan a specific annual course, or a pre-conference course, with this purpose.

Finally, it is our responsibility to promote publications of high scientific quality, which generate knowledge and contribute to critical thinking, and not only scientific production to improve the curriculum vitae of our residents.