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May 2012, Volume 62, Issue 5

Letter to the Editor

How to improve medical reading in Pakistani doctors?

Madam, we have read "Readers are leaders in publishing"1 by Ejaz et al with interest. They have highlighted an aspect that is generally not emphasized at the undergraduate and post graduate medical education system in Pakistan. But this problem is not limited to Pakistan alone. Even in the USA residents and consultants report that they did not read as much as they would like to read.2 Most of them were rarely able to completely read the most relevant journals in their field and only scanned the table of contents and read the most important abstracts.3,4
Based on our experiences as residents and then faculty members in our respective fields we would like to point out the determinants of poor reading habits in Pakistani doctors and suggest some remedial measures.
* Supervisors and faculty are a source of guidance and inspiration for the medical students and residents. With hundreds of medical journals available in every field of medical science it becomes very difficult for them to decide the best option for reading. It is absolutely necessary that teaching faculty themselves are in the habit of reading and are able to guide medical students and young doctors on reading the right kind of journal and articles.
* Journal club meeting (JCM) is a powerful educational tool and has played an active role in medical education for over a century.5 JCM helps in dissemination of knowledge, promoting evidence based medicine, discussion of recent advances, improvements in critical appraisal skills, better understanding of bio-statistics and improved reading habits.6,7 JCM is not a regular feature in most of the training programs in Pakistan. The medical reading culture in the country can be improved by conducting regular JCM lead by the residents and facilitated by the supervisors and faculty.
* Another hindering issue towards medical reading is the problem with full text access of articles in Pakistan. Hundreds of medical journals are available online, but most (if not all) of the highly cited and scientifically sound journals (e.g. British Medical Journal, Lancet, Clinics of North America series, Journals published by American and British Medical Associations, Nature Journal series etc.) require a subscription to access the full text. The subscription cost of these journals is in hundreds of US dollars (1 USD= 91 PKR) and even a single article may cost up to 60 USD (Pak Rupees 5460). This is financially not feasible for a young doctor or resident who are in their early stages of career development. This issue can be addressed by buying an institutional subscription to the journal or medical database which will benefit all the Health care professionals (HCP) in a medical institute or setting up the Higher Education Commission (HEC) Digital library.8 In addition we have found that writing an email to the corresponding author requesting for a PDF article reprint is another useful alternative.
* Useful academic habits like medical reading and writing are more likely to gain acceptance if they are associated with academic incentive. This can be in the form of a young researcher award from the medical school that should help medical students develop interest in this area. This can be given each year or at the end of medical school during the convocation ceremony. Regular workshops on research methodology with small feasible projects at hand can be another useful strategy. This should also be part of the internal assessment. Seminars and conferences should be arranged so that the students get adequate opportunity to share their work along with the experienced faculty to polish their skills of medical writing.
* As rightly pointed out by the Authors, the HCP should not restrict their medical reading to their respective subject alone. Medical education, biomedical ethics, responsible research, and biostatistics are now intermingled with every branch of medical science and have transformed the practice of medicine in the last four decades. There are journals dedicated to each of these subjects and it is necessary to learn more about these aspects too.
* HCP should not consult medical journals alone to improve medical reading. The health sections of leading global newspapers, medical websites and academic blogs (Table) are also an important form of acquiring new knowledge in different fields of medicine. They often present a diverse and different point of view that sometimes cannot be found in the scientific journals. Discussion on important medical topics is often answered by different HCP around the globe thus adding to the overall pool of knowledge.
 
Fareeha Farooq,1 Farooq Azam Rathore2
Park View Town, Park Road, Islamabad,1 Department of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi.2
Corresponding Author: Farooq Azam Rathore.
Email: farooqrathore@gmail.com

References

1. Ejaz K, Naqvi H. Readers are leaders in publishing. J Pak Med Assoc 2012; 62: 303.
2. Burke DT, DeVito MC, Schneider JC, Julien S, Judelson AL. Reading habits of physical medicine and rehabilitation resident physicians. Am J Phys Med Rehabil 2004; 83: 551-9.
3. Saint S, Christakis DA, Saha S, Elmore JG, Welsh DE, Baker P et al. Journal reading habits of internists. J Gen Intern Med 2000; 15: 881-4.
4. Burke DT, Judelson AL, Schneider JC, DeVito MC, Latta D. Reading habits of practicing physiatrists. Am J Phys Med Rehabil 2002; 81: 779-87.
5. Linzer M. The journal club and medical education: over one hundred years of unrecorded history. Postgrad Med J 1987; 63: 475-8.
6. Ebbert JO, Montori VM, Schultz HJ. The journal club in postgraduate medical education: a systematic review. Med Teach 2001; 23: 455-61.
7. Kleinpell RM. Rediscovering the value of the journal club. Am J Crit Care 2002; 11: 412, 4.
8. Digital Library. Higher Education Commission of Pakistan. (Online) (Cited 2012 March 8). Available from URL: http://www.digitallibrary.edu.pk/eligibility.html.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: