Is MCI over emphasising publication for promotion of medical teachers?

Over the past year, there has been constant debate in various journals on the circular issued by the Medical Council of India (MCI) in September 2015, regarding the requirements for promotion of teaching faculty. The lack of a time-bound promotion system of medical faculty results in higher stress, dissatisfaction, lower productivity and quality of life and work. The critics have highlighted several issues in assessment of publication for teacher’s promotion, eg the exclusion of publications in “electronic-only” journals, awarding points only to “original research” papers and first or second authors, listing of indexing databases for journals, categorising journals as national or international (1, 2). The relevance of a journal’s impact factor as a measure for assessment of publication has also been appraised (1). Thereafter, the Indian Association of Medical Editors has recommended revised guidelines which include a revised list of indexing databases, types of papers and authorship as criteria for assessment of publications (2). Recently, serious issues in research infrastructure and funding and lack of uniformity in medical education in the country have been reported. About 57.3% medical colleges did not have a single publication in the decade 2005-2014, whereas only 4.3% institutes have published 40.3% of the total publications (3). Despite a scarcity of research publications, India has been ranked highest for the rate of research misconduct globally (4). Surprisingly, even scientists at the premier institutes in the country have been implicated in such activities (4). Mandatory publication for promotion may give rise to more plagiarism, unethical research reporting practices, authorship controversies and burn out of researchers. Further, publication as the only accountable incentive for teachers may take them away from academic and clinical duties. Teaching and clinical skills were given the highest weightage for promotion of medical teachers in the US and Canada (5).

There is a need for more comprehensive assessment for teaching faculty in terms of teaching activities, clinical skills, research, mentoring and role-modeling; and social reputation and extracurricular qualities. Such assessment may be done by including teaching awards, student and peer feedback, number of publications and citations in indexed journals, grants awarded for projects, number of presentations at national and international meetings, invited papers, chair sessions, membership in organising committees of meeting and conferences, and of institute committees and professional associations, and participation in faculty exchange programmes, etc. Some similar steps have already been taken by the University Grants Commission by framing an objective scoring “Academic Performance Indicator (API)” for promotion of teachers. In addition to the recommendations made by Aggarwal and colleagues (2015) (2), we suggest the inclusion of number of citations in indexed journals in their guidelines. Further, we suggest that MCI should develop a multipronged objective assessment guideline for a comprehensive assessment of clinical-academic-research abilities of medical teachers; rather than over-emphasising research publication. This may be cumbersome but is essential for bringing productivity and uniformity into the medical education system of our country.