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10/90 Student Journal
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| Student research in a medical school in Western Nepal |
| Medical Education |
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P. Ravi Shankar
Affiliation: Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal. Address for correspondence: Dr. P. Ravi Shankar, Manipal College of Medical Sciences, P.O.Box 155, Deep Heights, Pokhara, Nepal. Phone: 00977-61-440600, Fax: 00977-61-440260, E-mail: ravi.dr.shankar@gmail.com Published: November 25, 2007 Copyright: © 2007 P. Ravi Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abbreviations: MCOMS, Manipal College of Medical Sciences; Citation: Shankar PR. Student research in a medical school in Western Nepal. Pro Res 2007. 1 (1): e1. |
Summary:
The number of researchers and research publications from South Asia are lower as
compared to the developed countries. Student research projects are common in developed
countries but are a rarity in this part of the world.
In the developing world initiatives to encourage student research are now being carried
out. Medical student journals are being published and many medical journals have student
sections.
At the Manipal College of Medical Sciences MCOMS the major emphasis is on applied
research. Students have carried out drug utilization studies and studies in the community.
They have also analyzed various educational initiatives from a student perspective and
have written about social issues.
Student research should be strongly supported. Financial initiatives and consideration of
student research during post graduation and assessments are required. Online discussion
forums can help to encourage research. Medical student research projects can provide
students with an opportunity to learn research methodology and the skill for critical
analysis of published articles.
The number of researchers and research publications from South Asia are lower as
compared to the developed countries. Student research projects are common in developed
countries but are a rarity in this part of the world.
In the developing world initiatives to encourage student research are now being carried
out. Medical student journals are being published and many medical journals have student
sections.
At the Manipal College of Medical Sciences MCOMS the major emphasis is on applied
research. Students have carried out drug utilization studies and studies in the community.
They have also analyzed various educational initiatives from a student perspective and
have written about social issues.
Student research should be strongly supported. Financial initiatives and consideration of
student research during post graduation and assessments are required. Online discussion
forums can help to encourage research. Medical student research projects can provide
students with an opportunity to learn research methodology and the skill for critical
analysis of published articles.
Introduction
Nepal is a small developing country in South Asia sandwiched between two giants, China and
India. The number of researchers in the developing countries of South Asia is low compared
to the figure in developed countries. Nepal has 59 researchers per million inhabitants. (1)
The United States (US) in comparison has 4,605 researchers per million inhabitants.(2)
Health researchers from South Asia accounted for only 1.2% of all papers in the Institute for
Scientific Information database during the period from 1992-2001.(3)
The Manipal College of Medical Sciences:
The Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal admits students from
Nepal, India, Sri Lanka and other countries to the undergraduate medical (MBBS) course.
The college is affiliated to the Kathmandu University. The revised curriculum of Kathmandu
University emphasizes problem-based, self-directed learning. (4)
Student Research:
Student Research in the Developed World:
Medical student research projects can provide students with an opportunity to learn
research methodology and the skill for critical analysis of published articles. (5) Student
research projects are common in developed countries. Two examples are the ‘Critical
Enquiry’ elective at the Queen’s University, Ontario, Canada (6) and the program conducted
by the department of Family medicine at the University of Colorado, United States. (7)
Student Research in South Asia and other Developing Countries:
In South Asia, medical student research is not well developed in most of the institutions. In a
study done in India, 91% of interns reported that they had gained no research experience
from medical school. (8) In Pakistan, more than two-thirds of postgraduates at one
institution, reported reading scientific journals only once in six months or more. (9)
Other better examples include that of Croatia where during the period of undergraduate
study, 23% of students were involved in research projects. (10) Students have also been
involved in conducting case-control and community-based epidemiological studies in some of
the medical colleges in India. (11) Similarly, in a medical college in Western Nepal, student
research projects have been used as an aid to learning pharmacology. (12) These, though
encouraging, are a rarity and represent only a handful of examples.
Representation of Students’ Works in Journals
Medical Student Journals:
Medical student journals are a common phenomenon in developed countries but again a
rarity in our part of the world. Some of these are the student BMJ (www.studentbmj.com),
the New Zealand medical Student Journal (www.otago.ac.nz/nzmsj), the McGill Journal of
Medicine (www.medicine.mcgill.ca/mjm/) and the Journal of Young Investigators (www.jyi.
org).
A good student journal from Asia called the Asian Medical student Journal is however, no
longer online. Recently the Forum for Promoting Research (www.promotingreserach.com)
has launched the 10/90 student journal.
Student Sections in other journals:
Other medical journals have started student sections. This is something which I personally
welcome strongly. Students can publish with and learn from peers and senior doctors. PLoS
Medicine (www.plosmedicine.org) has started a student forum. The Journal of Postgraduate
Medicine (www.jpgmonline.com) now has a students section.
In Nepal, the Kathmandu University Medical Journal (www.kumj.com.np) and the Nepal
Journal of Neuroscience (www.neuroscienceforum.org.np) has student sections.
Other journals which often highlight student work is the Journal of Pakistan Medical
Associations’ Students Section (JPMA - http://jpma.org.pk), the Journal of College of
Physicians and Surgeons Pakistan (JCPSP - http://www.cpsp.edu.pk/journals) and the
Journal of Ayub Medical College (JAMC - http://www.ayubmed.edu.pk/JAMC).
Student Research at our Institution:
At MCOMS for a variety of reasons, the emphasis has been on applied research. (13)
There are various examples of work done by students at our institution. A group of students
have been actively involved in research. They had studied the morbidity profile and
prescribing patterns among outpatients in our teaching hospital. Certain lacunae were
observed and the authors’ recommended prescriber education to encourage and strengthen
rational prescribing. (14) A student along with me had explored faith healing practices in
Western Nepal. (15) We concluded that a trained and motivated ‘shaman’ (faith healer)
aware of his role and limitations can be an important agent for change in rural Nepal.
Pharmaceutical promotion is becoming increasingly aggressive in South Asia. The
department of pharmacology conducts educational indicatives to teach students to critically
appraise promotion. The educational initiative was described in PLoS Medicine’s student
forum. (16) Other similar initiatives are also being taken to promote a culture of research at
our institution. (17, 18, 19, 20)
Other programs include the emergence of online discussion forums. In Nepal, there is an
online student forum called ‘Xenomed’ (www.xenomed.com) which facilitates exchange of
views and information among medical students. Recently, an online discussion group called
Nepal Health Research Network (NHRN) (http://groups.google.com/group/nhrn) has been
started and the group also includes medical students.
Future Perspectives
In our institution, like in many others in South Asia, medical student research is a voluntary
activity pursued by interested students and faculty members. Summer and vacation
research programs can be considered. Research into the health problems of Nepal should be
actively pursued. Financial incentives should be given to students to actively pursue
research. (21) A culture of publication in scientific journals should be created. Future doctors
equipped with the skills to investigate health problems and suggest solutions are required.
References:
1) United Nations Educational Scientific and Cultural Organization Institute for Statistics. Country profile:
Nepal. Quebec: United Nations Educational Scientific and Cultural Organization Institute for Statistics. http:
//stats.uis.unesco.org/unesco/TableViewer/document.aspx?
ReportId=124&IF_Language=eng&BR_Country=5240&BR_Region=40535. Accessed on August 19, 2007.
2) United Nations Educational Scientific and Cultural Organization Institute for Statistics. Country profile:
United States of America. Quebec: United Nations Educational Scientific and Cultural Organization Institute for
Statistics. http://stats.uis.unesco.org/unesco/TableViewer/document.aspx?
ReportId=124&IF_Language=eng&BR_Country=8400&BR_Region=40500. Accessed on August 19, 2007.
3) Sadana R, D’ Souza C, Hyder AA, Chowdhury AMR. Importance of health research in South Asia. BMJ 2004;
328:826-830.
4) Kathmandu University. Curriculum for Bachelor of Medicine and Bachelor of Surgery (MBBS) Part One Basic
Sciences. Third version. Dhulikhel: 2001.
5) Greenberg RN. An argument for research in the medical school curriculum. JAMA 1978;239:1162-1163.
6) Houlden RL, Raja JB, Collier CP, Clark AF, Waugh JM. Medical students’ perceptions of an undergraduate
research elective. Med Teach 2004;26:659-661.
7) Gonzales AO, Westfall J, Barley GE. Promoting medical student involvement in primary care research. Fam
Med 1998;30:113-116.
8) Chaturvedi S, Aggarwal OP. Training interns in population-based research: Learners’ feedback from 13
consecutive batches from a medical school in India. Med Educ 2001;35:585-589.
9) Aslam F, Qayyum MA, Mahmud H, Qasim R, Haque IU. Attitudes and practices of postgraduate medical
trainees towards research – A snapshot from Faisalabad. J Pak Med Assoc 2004;54:534-536.
10) Koliec I, Polasek O, Mihalj H, Gombac E, Kraljevic V, Kraljevic I et al. Research involvement, specialty choice,
and emigration preferences of first year medical students in Croatia. Croat Med J 2005;46:88-95.
11) Soudarssanane MB, Rotti SB, Roy G, Srinivasa DK. Research as a tool for the teaching of epidemiology. World
Health forum 1994;15:48-50.
12) Shankar PR, Dubey AK. Student research projects as an aid to learning pharmacology. Med Educ 2005;39:
1075.
13) Giri BR, Shankar PR. Student research in Nepal. PLoS Med e-letter. http://medicine.plosjournals.
org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020322#r1073 Accessed on August 19,
2007.
14) Lamichhane DC, Giri BR, Pathak OK, Panta OB, Shankar PR. Morbidity profile and prescribing patterns
among outpatients in a teaching hospital in Western Nepal. McGill Journal of Medicine 2006;9:126-133.
15) Giri BR, Shankar PR. Faith healing in Western Nepal. Nep J Neuroscience 2006;3:54-55.
16) Giri BR, Shankar PR. Learning how drug companies promote medicines in Nepal. PLoS Med 2005;2:e256.
17) Giri BR, Shankar RP. Disease mongers in a nation in transition? Rural and Remote Health 2007;7:621.
18) Shankar PR, Giri BR, Palaian S.Fairness Creams in South Asia—A Case of Disease Mongering? PLoS Med 2006;
3:e315.
19) Giri B, Shankar PR. Community-based learning in a time of conflict. PLoS Med 2006;3:e115.
20) Shankar P, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley,
Western Nepal: a questionnaire-based study. BMC Fam Pract 2002;3:17.
21) Shankar PR, Chandrasekhar TS, Mishra P, Subish P. Initiating and strengthening medical student research:
Time to take up the gauntlet. Kathmandu Univ Med J 2006;4:135-138.
Nepal is a small developing country in South Asia sandwiched between two giants, China and
India. The number of researchers in the developing countries of South Asia is low compared
to the figure in developed countries. Nepal has 59 researchers per million inhabitants. (1)
The United States (US) in comparison has 4,605 researchers per million inhabitants.(2)
Health researchers from South Asia accounted for only 1.2% of all papers in the Institute for
Scientific Information database during the period from 1992-2001.(3)
The Manipal College of Medical Sciences:
The Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal admits students from
Nepal, India, Sri Lanka and other countries to the undergraduate medical (MBBS) course.
The college is affiliated to the Kathmandu University. The revised curriculum of Kathmandu
University emphasizes problem-based, self-directed learning. (4)
Student Research:
Student Research in the Developed World:
Medical student research projects can provide students with an opportunity to learn
research methodology and the skill for critical analysis of published articles. (5) Student
research projects are common in developed countries. Two examples are the ‘Critical
Enquiry’ elective at the Queen’s University, Ontario, Canada (6) and the program conducted
by the department of Family medicine at the University of Colorado, United States. (7)
Student Research in South Asia and other Developing Countries:
In South Asia, medical student research is not well developed in most of the institutions. In a
study done in India, 91% of interns reported that they had gained no research experience
from medical school. (8) In Pakistan, more than two-thirds of postgraduates at one
institution, reported reading scientific journals only once in six months or more. (9)
Other better examples include that of Croatia where during the period of undergraduate
study, 23% of students were involved in research projects. (10) Students have also been
involved in conducting case-control and community-based epidemiological studies in some of
the medical colleges in India. (11) Similarly, in a medical college in Western Nepal, student
research projects have been used as an aid to learning pharmacology. (12) These, though
encouraging, are a rarity and represent only a handful of examples.
Representation of Students’ Works in Journals
Medical Student Journals:
Medical student journals are a common phenomenon in developed countries but again a
rarity in our part of the world. Some of these are the student BMJ (www.studentbmj.com),
the New Zealand medical Student Journal (www.otago.ac.nz/nzmsj), the McGill Journal of
Medicine (www.medicine.mcgill.ca/mjm/) and the Journal of Young Investigators (www.jyi.
org).
A good student journal from Asia called the Asian Medical student Journal is however, no
longer online. Recently the Forum for Promoting Research (www.promotingreserach.com)
has launched the 10/90 student journal.
Student Sections in other journals:
Other medical journals have started student sections. This is something which I personally
welcome strongly. Students can publish with and learn from peers and senior doctors. PLoS
Medicine (www.plosmedicine.org) has started a student forum. The Journal of Postgraduate
Medicine (www.jpgmonline.com) now has a students section.
In Nepal, the Kathmandu University Medical Journal (www.kumj.com.np) and the Nepal
Journal of Neuroscience (www.neuroscienceforum.org.np) has student sections.
Other journals which often highlight student work is the Journal of Pakistan Medical
Associations’ Students Section (JPMA - http://jpma.org.pk), the Journal of College of
Physicians and Surgeons Pakistan (JCPSP - http://www.cpsp.edu.pk/journals) and the
Journal of Ayub Medical College (JAMC - http://www.ayubmed.edu.pk/JAMC).
Student Research at our Institution:
At MCOMS for a variety of reasons, the emphasis has been on applied research. (13)
There are various examples of work done by students at our institution. A group of students
have been actively involved in research. They had studied the morbidity profile and
prescribing patterns among outpatients in our teaching hospital. Certain lacunae were
observed and the authors’ recommended prescriber education to encourage and strengthen
rational prescribing. (14) A student along with me had explored faith healing practices in
Western Nepal. (15) We concluded that a trained and motivated ‘shaman’ (faith healer)
aware of his role and limitations can be an important agent for change in rural Nepal.
Pharmaceutical promotion is becoming increasingly aggressive in South Asia. The
department of pharmacology conducts educational indicatives to teach students to critically
appraise promotion. The educational initiative was described in PLoS Medicine’s student
forum. (16) Other similar initiatives are also being taken to promote a culture of research at
our institution. (17, 18, 19, 20)
Other programs include the emergence of online discussion forums. In Nepal, there is an
online student forum called ‘Xenomed’ (www.xenomed.com) which facilitates exchange of
views and information among medical students. Recently, an online discussion group called
Nepal Health Research Network (NHRN) (http://groups.google.com/group/nhrn) has been
started and the group also includes medical students.
Future Perspectives
In our institution, like in many others in South Asia, medical student research is a voluntary
activity pursued by interested students and faculty members. Summer and vacation
research programs can be considered. Research into the health problems of Nepal should be
actively pursued. Financial incentives should be given to students to actively pursue
research. (21) A culture of publication in scientific journals should be created. Future doctors
equipped with the skills to investigate health problems and suggest solutions are required.
References:
1) United Nations Educational Scientific and Cultural Organization Institute for Statistics. Country profile:
Nepal. Quebec: United Nations Educational Scientific and Cultural Organization Institute for Statistics. http:
//stats.uis.unesco.org/unesco/TableViewer/document.aspx?
ReportId=124&IF_Language=eng&BR_Country=5240&BR_Region=40535. Accessed on August 19, 2007.
2) United Nations Educational Scientific and Cultural Organization Institute for Statistics. Country profile:
United States of America. Quebec: United Nations Educational Scientific and Cultural Organization Institute for
Statistics. http://stats.uis.unesco.org/unesco/TableViewer/document.aspx?
ReportId=124&IF_Language=eng&BR_Country=8400&BR_Region=40500. Accessed on August 19, 2007.
3) Sadana R, D’ Souza C, Hyder AA, Chowdhury AMR. Importance of health research in South Asia. BMJ 2004;
328:826-830.
4) Kathmandu University. Curriculum for Bachelor of Medicine and Bachelor of Surgery (MBBS) Part One Basic
Sciences. Third version. Dhulikhel: 2001.
5) Greenberg RN. An argument for research in the medical school curriculum. JAMA 1978;239:1162-1163.
6) Houlden RL, Raja JB, Collier CP, Clark AF, Waugh JM. Medical students’ perceptions of an undergraduate
research elective. Med Teach 2004;26:659-661.
7) Gonzales AO, Westfall J, Barley GE. Promoting medical student involvement in primary care research. Fam
Med 1998;30:113-116.
8) Chaturvedi S, Aggarwal OP. Training interns in population-based research: Learners’ feedback from 13
consecutive batches from a medical school in India. Med Educ 2001;35:585-589.
9) Aslam F, Qayyum MA, Mahmud H, Qasim R, Haque IU. Attitudes and practices of postgraduate medical
trainees towards research – A snapshot from Faisalabad. J Pak Med Assoc 2004;54:534-536.
10) Koliec I, Polasek O, Mihalj H, Gombac E, Kraljevic V, Kraljevic I et al. Research involvement, specialty choice,
and emigration preferences of first year medical students in Croatia. Croat Med J 2005;46:88-95.
11) Soudarssanane MB, Rotti SB, Roy G, Srinivasa DK. Research as a tool for the teaching of epidemiology. World
Health forum 1994;15:48-50.
12) Shankar PR, Dubey AK. Student research projects as an aid to learning pharmacology. Med Educ 2005;39:
1075.
13) Giri BR, Shankar PR. Student research in Nepal. PLoS Med e-letter. http://medicine.plosjournals.
org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020322#r1073 Accessed on August 19,
2007.
14) Lamichhane DC, Giri BR, Pathak OK, Panta OB, Shankar PR. Morbidity profile and prescribing patterns
among outpatients in a teaching hospital in Western Nepal. McGill Journal of Medicine 2006;9:126-133.
15) Giri BR, Shankar PR. Faith healing in Western Nepal. Nep J Neuroscience 2006;3:54-55.
16) Giri BR, Shankar PR. Learning how drug companies promote medicines in Nepal. PLoS Med 2005;2:e256.
17) Giri BR, Shankar RP. Disease mongers in a nation in transition? Rural and Remote Health 2007;7:621.
18) Shankar PR, Giri BR, Palaian S.Fairness Creams in South Asia—A Case of Disease Mongering? PLoS Med 2006;
3:e315.
19) Giri B, Shankar PR. Community-based learning in a time of conflict. PLoS Med 2006;3:e115.
20) Shankar P, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley,
Western Nepal: a questionnaire-based study. BMC Fam Pract 2002;3:17.
21) Shankar PR, Chandrasekhar TS, Mishra P, Subish P. Initiating and strengthening medical student research:
Time to take up the gauntlet. Kathmandu Univ Med J 2006;4:135-138.
| Editor’s Note "With respect to student research and the initiatives that are being taken by various institutions in the developing world, I would like to highlight some of the steps taken by the Aga Khan University (AKU) in Pakistan to act as a catalyst to promote further research in the region (http://www.aku.edu). During the first and second year of the medical study, students are now actively encouraged to pursue research electives at the institution as well as in other parts of the country. Along with this, several departments have made it mandatory to do one research project as a student group during the rotation. These include the department of community health sciences and recently the department of Psychiatry. Work done by students has been published in one of the best journals of the world. This is highly encouraging and shows that medical students can perform very good and high quality research if given the opportunity. Hopefully, other institutions in the country and abroad would take an example to initiate similar programs to promote a culture of research in the region." |
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