Employment pressure and the burden of publication in China
Although the pressure to publish might seem to be one that affects medical students and doctors everywhere, in China it is generally considered a “must have” for employment by large hospitals. This requirement, however, affects not only the credibility of China’s body of scientific research. but also the career paths of China’s young doctors, and access to healthcare for China’s rural population. An article by Yuan and collegues recommends a change in China’s healthcare system, stating that publishing articles should not be a top priority for young doctors. The article has prompted heated discussions on Chinese internet forums, with many backing the call to eliminate publication pressure. Removing the publication requirement for employment will not solve the problem, however.
China’s healthcare system is mainly composed of public teaching hospitals that not only provide healthcare services and clinical education, but also carry out research. These hospitals usually prioritise employing doctors with research backgrounds, hiring people with a higher academic degree and numerous scientific publications. Because of this, many young Chinese doctors do not apply for residency programmes after graduating from medical school. Instead they take postgraduate courses that involve doing research and publishing papers. Often those taking these courses are not interested in research, and find the pressure to publish huge. And while doctors compete to stay in large teaching hospitals, healthcare facilities in rural China lack necessary services because of staff shortages.
Research is crucial in teaching hospitals, but the pressure to publish means that fabricated results are becoming more common because research with “positive” results is more likely to be published. Young doctors who are not passionate about research should consider taking a residency in rural hospitals, which need them, rather than pursuing a postgraduate degree that does not engage them. In doing so, the vicious cycle that has resulted in increased pressure on junior doctors and the submission of fraudulent data might be stopped.Jiaywei Tsauo, postgraduate student, gastroenterology and hepatology
1West China Hospital of Sichuan University
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
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Cite this as: Student BMJ 2013;21:f7064