Conversion of theses submitted to the National Board of Examinations for postgraduate degrees into published papers

INTRODUCTION

There are two types of postgraduate residency programmes in India: Doctor of Medicine (MD) and Master of Surgery (MS) degrees are awarded by medical colleges (government or private) and Diplomate National Board (DNB) degree, the training for which is done by National Board of Examinations in Medical Sciences (NBEMS) accredited institutes (usually private hospitals, trust run establishments or government hospitals).

Among the many scholarly activities in the postgraduate curriculum, writing a dissertation or thesis is a mandatory requirement for degrees such as MD/MS or DNB in India.^1,2 The acceptance of the thesis is necessary towards the fulfilment of the requirements for the degree. Students are typically encouraged to present their original work at one of the major national or international conferences during the 3-year course, which is part of the NBEMS postgraduate curriculum.³ They are also instructed to convert the thesis into a research paper to disseminate the scientific data collected during their residency period.

With this background, we analyzed data on how many theses conducted in our institution were published and how many were presented at conferences by postgraduate students in 7 departments at our hospital.

METHODS

Sir Ganga Ram Hospital is a not-for-profit private hospital and a premier institute that conducts NBEMS courses in 47 specialties. All teaching departments were contacted for data regarding the conversion of postgraduate theses into published articles. The data from 8 departments (Internal Medicine, Family Medicine, General Surgery, Obstetrics and Gynaecology, Anaesthesia, and Haematology) were received and cross-checked from our library as all the theses submitted to the NBEMS are housed there. The data on Neonatology were incomplete and were excluded. ‘PubMed’ and ‘Google Scholar’ search was done if the thesis was published using the keywords and student name. Cross-checking was done by the thesis guide and co-guide to determine whether the thesis had been converted into a research paper or not. Our hospital runs a multi-specialty journal, Current Medicine Research and Practice (CMRP), since 2011 which is indexed in Directory of Open Access Journals (DOAJ) and EMBASE/Excepta Medica. Publication of the thesis was also verified in our Journal office. The thesis paper was considered published if it appeared in PubMed, Google Scholar, and in our journal (CMRP) within 2 years of submission of the thesis.

For data regarding presentations of the thesis at a conference, students were contacted telephonically or in person, and confirmation of their oral and poster presentations at the conference was obtained from them.

All statistical data were analyzed using the Statistical Package for the Social Sciences Version 28. Results were reported as frequency and percentages.

RESULTS

Data from 434 students admitted under the DNB programme in 7 specialties were available. The conversion rate of the thesis into a published research paper was 33.2% (Table 1). The data for oral or poster presentation were available for 313 students, of which 146 students had presented. The Department of General Surgery and Chest Medicine did not have this data available.

DISCUSSION

The NBEMS was established in 1975 in New Delhi as an autonomous institution under the Ministry of Health, Government of India, to standardize postgraduate medical education and examinations in India. In 2021, 36 192 seats were available for pursuing MD/MS, and 8000 seats were available for DNB. The majority of seats available in the NBEMS were in private hospitals. Private hospitals are an essential part of the healthcare system in India, and it is predicted that 80% of patients seen in the outpatient department and 60% of the indoor patients are taken care of by private hospitals and clinics.⁴

Our study yielded results comparable with other studies from India^5–7 (Table 2). In a recent publication from our hospital, the research output of 579 medical teaching institutes in India was analyzed. It was observed that 57 medical institutions had not published a single paper in the Scopus index system between 2005 and 2014. Our hospital was ranked second in the private healthcare system in India.⁸ With such a publication rate, if we can tap the potential of our younger residents and stimulate them to increase the number of manuscripts, we can match the top colleges in India that have a high research output.

Many of these topics in our clinical setting lack a strong research question. The guide and the student need to work within the available clinical framework to consider a thesis topic that is feasible in their set up. The NBEMS has given a guideline that ‘the students are not expected to do/undertake experimental or clinical work involving new techniques, not hitherto perfected or the use of chemicals or radioisotopes not readily available. They should, however, be free to enlarge the scope of their studies or undertake experimental work on their initiative, but all such studies should be feasible within the existing facilities.’⁹ With this limitation, writing a thesis is possible, but publication is not always feasible.

Major conferences in various specialties encourage student participation, and the registration fee is also lower for students compared to that for regular participants who are called for oral or poster presentations. There are no data available on this topic, and in our study, we found that during their residency, 46.6% of students presented their research either as an oral or a poster presentation. We should encourage postgraduate students, as it has been seen that 27% of the abstracts presented at conferences are ultimately published as full-text articles within the next 5 years.¹⁰

Often, articles are initially rejected, and the authors can resubmit them in another specialty journal with modifications. Many authors become disappointed with initial rejections and are unsure of how to handle them. In a study, 37.5% of thesis papers were rejected by multiple journals.⁶

Our study provides the first data from a NBEMS-accredited hospital regarding the scholarly activities of postgraduate students. The carrot (reward) and stick (punishment) approach has been recommended to increase research output from academic institutions. It may require a policy change to transition from the thesis to a ready-to-submit paper for publication. However, it may not be the quantity of publications but the quality of the thesis that is important. Thus, writing theses should not be a customary exercise for students.