Year : 2016 | Volume
: 60 | Issue : 11 | Page : 796--800
Faculty promotions in medical institutions in India: Can we improve the criteria?
Vithal Krishna Dhulkhed1, Madhuri S Kurdi2, Pavan V Dhulkhed3, Ashwini H Ramaswamy2,
1 Department of Anaesthesiology, Krishna Institute of Medical Sciences, Karad, Maharashtra, India
2 Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, India
3 Department of Anaesthesiology, J. N. Medical College, Belgaum, Karnataka, India
Madhuri S Kurdi
Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka
Research publications are desirable for academic promotion in medical colleges as per the current rules of the Medical Council of India (MCI). These rules reflect an endeavour to improve the academic standards. We strongly believe that every medical college teacher should conduct true research and contribute to good peer-reviewed publications. However, it is felt that the MCI rule has the potential to lead to undesirable consequences, and the quality of teaching and learning could take a back-seat. There is an urgent need to adopt more objective criteria and better guidelines as followed by well-known global institutes. In our own country, the University Grants Commission has formulated specific guidelines for this purpose in the form of Academic Performance Indicators which, it appears, are not taken into consideration by the MCI. This article discusses the adverse impact of the rule and suggests ways for the adoption of a more scientific assessment system for faculty appointment and promotion.
|How to cite this article:|
Dhulkhed VK, Kurdi MS, Dhulkhed PV, Ramaswamy AH. Faculty promotions in medical institutions in India: Can we improve the criteria?.Indian J Anaesth 2016;60:796-800
|How to cite this URL:|
Dhulkhed VK, Kurdi MS, Dhulkhed PV, Ramaswamy AH. Faculty promotions in medical institutions in India: Can we improve the criteria?. Indian J Anaesth [serial online] 2016 [cited 2021 Apr 19 ];60:796-800
Available from: https://www.ijaweb.org/text.asp?2016/60/11/796/193657
Promotion to the higher academic ranks is the desire of many faculty members in medical colleges. In India, medical institutions follow the Medical Council of India (MCI) rules regarding appointment and promotion of faculty. As per the current rules of the MCI, research publications in indexed journals are mandatory for academic promotion in medical colleges. , These rules are a sincere attempt for promoting research but have the potential to create several problems such as stress for medical teachers, growth of predatory journals, evolution of manuscript writing services, transgression in scientific communication, lowering the quality of research publications and a crazy race for publications. Consequently, the quality of teaching and learning may take a back-seat. As mentioned in an editorial, nowadays, the major purpose of conducting a research project is publication.  A concerted effort has been recently made by some former and present journal editors from India to highlight the controversies and confusions surrounding the latest MCI guidelines for promotion.  This article highlights the impact of the rule to publish on scientific writing in India and suggests better methods that can be adopted by the MCI for screening suitability for faculty appointment and promotion in medical colleges and universities. The information was collected from various issues of recent journals and latest university websites (predominantly 2014 onwards) via 'Google search engine' using the words 'academic', 'Medical Council of India', 'faculty promotions', 'faculty research and publications', 'medical universities' and 'medical teachers.' Many editorials and articles reflecting the personal perspectives of the concerned authors were found in this endeavour. Their opinions and ours are amalgamated in this article.
STRESS ON MEDICAL COLLEGE TEACHERS
Many medical teachers are not properly trained in research methodology. Many of the original research articles currently published in Indian journals are a product of dissertations, wherein the student and the teacher (post-graduate guide) conduct research work and publications together; nevertheless, post-graduate course is absent in several institutes, and in such places, the teacher faces the problem of doing research as the sole investigator with no research backup.  In the low- and middle-income countries, low-quality research is being conducted and reported because of reasons such as lack of support, substandard infrastructure and limited access to current evidence.  Hence, such research is not accepted for publication in good journals.  Some institutes suffer from understaffing of teachers and consultants, and the pressure of regular teaching and clinical/administrative work falls into the hands of a few teachers, leaving them with no time for research.  In a survey on current publication-related views and practice of faculty members and consultants, it was found that the publication rule had become a burden for 46% respondents; 27% respondents felt that publications are a mandatory stress, 57.3% felt that the mandatory number of publications induces unhealthy competitions and 56.1% felt that the rule of mandatory publications exerts undue stress on editors of national and indexed journals.  This survey though portrays interesting opinions of Indian anaesthesiologists on some aspects of publications has a low response rate; nevertheless, there are currently no other survey results published in India on this topic. Often, the articles written by Indian researchers are deficient in grammar and adequate references. Poorly planned, conducted and presented research is commonly found and this leads to manuscript rejection.  For the authors, repeated manuscript submissions, resubmissions and rejections are painful. Long review publication times of several journals also increase author anxiety. 
FLOURISHING OF PREDATORY JOURNALS
As said by Beall, 'predatory' journals have nowadays corrupted the world of scientific publications.  They charge publication fees but deliberately omit the peer review process.  Newly launched journals exploiting the gold open access (OA) model have a much stronger interest in accepting all submissions within a short term through soft/no peer review.  Peer review is the best way to ensure quality control of scientific material.  A fall in peer review standards leads to a fall in journal scientific quality, and substandard articles gain easy access to publication.  Predatory OA journals are a strong, destructive threat to the scientific credibility of research. ,
EVOLUTION OF MANUSCRIPT WRITING SERVICES
Scientific writing involves steps such as performing literature search, gathering and analysing data and writing and improvising numerous versions of a manuscript after facing critical peer review comments. This entire process of publication teaches the author how to write a good manuscript and to develop the capacity to appreciate/criticise other scientific publications.  However, nowadays, online manuscript editing services are coming up. These can provide ready-made manuscripts after paying some amount of money. Thus, the author never takes the trouble of writing and rewriting the manuscript and thereby never develops an author's acumen.
PROMOTION OF SCIENTIFIC MISCONDUCT
The incidence of scientific misconduct is on an upswing nowadays.  The integrity and scientific merit of peer review are insecure.  In the recent years, a tenfold increase in retractions of articles for scientific fraud has been estimated with 29% due to plagiarism.  As mentioned by an author and also found in a survey, the MCI rule of mandatory publications has encouraged plagiarism. ,
A leading British medical journal recently retracted 43 published articles for scientific fraud. One of the involved authors said that he handled a lot of surgical work in a hospital and consequently had very little time left for scientific research, but the government rules were such that he would not get promoted unless he had articles published in respected medical journals.  A leading journal related to anaesthesia recently retracted an article by an Indian author after confirming that the concerned original research study had never been conducted. 
LOWERING OF THE ACADEMIC VALUE OF SOME TYPES OF PUBLICATIONS
Case reports describe new and important clinical observations, rare situations and novel techniques. However, unfortunately, the MCI does not consider case reports for promotions.  As mentioned by some authors, there will soon be a time when most medical teachers in pursuit of 'publications' will simply stop clinical reporting and many 'me too studies' - the so-called original research will come up in paid journals which will not add anything to the subject. 
Other types of publications such as letter to editors, editorial comments, special articles and brief communications are currently not given any consideration. This is extremely unfortunate since not surprisingly these publications are most of the times genuine and are true to their salt (with some exceptions). In several prestigious foreign universities, research has been given an impetus. ,, In fact, the research/scholarship criterion is given a maximum score for performance description of a professor/reader in the University of Cambridge. 
A medical college teacher in India has to do multiple roles of a classroom teacher, a clinician cum instructor, a clinical supervisor, a student facilitator cum mentor, a researcher with good publication output, a postgraduate dissertation guide, a conference delegate/speaker and an undergraduate/postgraduate examiner. Research promotes basic knowledge, develops new drugs and instruments and provides guidance in planning health policies. The quality of teaching improves if the faculty is research oriented. 
Measuring academic achievements and the quality of teachers is not an easy task, especially when individuals are assessed for promotions in several fields with differing job descriptions. Assessment by peers is prone to bias. Hence, objective criteria are required to measure the academic achievements. 
According to the University Grants Commission (UGC) Guidelines, the promotion of teachers in most universities in India is governed by the Career Advancement Scheme. It has developed a system of Academic Performance Indicators (APIs) in this scheme. The API scores are based on the teacher's self-assessment. The self-assessment scores are based on objectively verifiable criteria and are finalised by the promotion screening/selection committee.  There are different categories for calculating the API scores. Category I includes teaching, learning and evaluation related activities. Category II includes co-curricular, extension and professional development related activities. Category III includes research and academic contributions. 
Several prestigious top ranking foreign universities have excellent criteria and guidelines for appointment and promotion of faculty.
• Noted Institutions such as Harvard Medical School, Stanford Medical University, The John Hopkins School of Medicine and the University of Utah follow their set guidelines for faculty promotions. Scholarly achievement for promotion in these institutions includes the documentation of primary contributions/co-authorship to the following in no particular order-peer reviewed papers, case reports, letters to the editor, syllabus materials, evidence-based guidelines, review articles, book chapters, textbooks, handbooks, films, videos, exhibits and web-based material. The impact of these scholarly works on the health-care delivery and not the number is considered. The Hirsch (H) index is used for assessing the quality of publications. Outstanding teaching is assessed by the quality of education provided and its impact on one's trainees, mentoring and teaching trainees and initiating projects that address important questions having the potential to change the practice of medicine or education. Clinical achievements include being known regionally or nationally as an expert clinician.  At Stanford University School of Medicine, faculty is appointed at the ranks of Assistant Professor, Associate Professor and Professor in separate categories/lines: Teaching/research/medical centre line. There is no requirement for formal teaching or clinical care in the research line. However, there must be acceptable performance in any teaching roles as well as excellence in clinical care. The faculty in the teaching line do not have any formal research obligation and is discouraged from significant time commitments. However, since teaching and scholarship are inter-related, the university anticipates that many faculties will make strong scholarly contributions in the form of peer-reviewed articles. Chapters, commentaries and case reports are also considered if they are of acceptable quality. Implementation of novel teaching methodologies/shaping a core curriculum/creating educational software are other scholarly contributions which are considered. The reappointments in these lines are based on evidence of continuing outstanding contributions and excellence in the concerned fields. 
Faculty may thus be education/research/clinical practice oriented. Unfortunately, the MCI faculty appointment and promotion rule does not give due consideration and weightage for teaching, administrative and clinical achievements. It does not give due consideration to the true quality and the different types of publications, other important criteria involving teaching, ability to guide the student, student satisfaction, patient care, clinical expertise, educational innovation, innovations and patents, involvement in various academic activities, community programmes and service to the college and university. These qualities are extremely important for achieving excellence in teaching. Instead of giving undue importance to publications, these criteria, too, should be considered as being followed in several prestigious Indian and foreign universities. In every field, nowadays, sets of quality indicators or guidelines are used to assess the quality. Hence, criteria for faculty appointment and promotion should not be based solely on one or two criteria such as publications. Assessment of a good teacher to promote him solely on these criteria is an injustice. In a set of criteria such as API, due weightage can be given to publications; nevertheless, it should not be the sole criteria.
As far as publications are concerned, all types of publications should be considered and a scoring system depending on their weightage based on the level of evidence has to be devised. Weighted importance to all authors depending on their contribution to the research work needs to be given.
Nevertheless, we urge the MCI to consider early reconstruction of the current promotion criteria and to adopt better and more objective criteria such as API scores as devised by the UGC and guidelines as followed by well-known global institutes. It should form a suitable committee consisting of academicians from various institutes and invite suggestions from all the stakeholders to formulate criteria for appointment and promotion of teaching faculty.
The MCI is doing yeoman service in upholding the quality of medical education in our country. However, we feel that the current rule regarding promotion of faculty in medical colleges could be misused and lead to several unhealthy practices. There is an urgent need to curb these unhealthy consequences and to adopt a more scientific assessment system for faculty appointment and promotion. This would go a long way in raising the academic standards for teaching, learning and scientific research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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