At present, scientific medical journals are the basis for the development of clinical practice. Medical science is changing and grows from the in-depth study of methodology, discussion and the dissemination of knowledge, with the ultimate aim of providing solutions to local problems that arise in clinical practice.
This theory indicates that there is a directly proportional association between the number of articles that are read and the best clinical decisions that are made. That is, the best doctors are those who read and write the most.
This is true as long as users understand and properly interpret what they read. Here the importance of live journals, those that are not satisfied only with the publication of original articles, those that care about editorials, clinical cases and the best: letters to the editor.
In the same way, local medical journals have an important role in each and every one of these CME processes.
- Although medicine teaching can be done in a tutorial way and training in clinical research can be done in the classroom, the most important transversal competences of modern doctors are regular reading, the development of a critical sense, the performance of protocols and the writing of articles. In each of these steps the common factor is the medical journals; these provide novel material for reading that serves to solve clinical problems. They promote critical thinking by publishing comments and criticisms of studies in the letters to the editor section. They receive texts that are reviewed blindly and by peer review, which increases the validity of those texts. In order to promote this exercise, the institutions develop medical journals and create a fertile ground for the development of the skills described above. At least four main actors participate in this virtuous circle: institutions, universities, professors and users in general; however, if these actors do not work on the same work, the opposite can occur: a vicious cycle of publication. In this vicious circle, institutions and universities require their researchers to publish in foreign journals and rate their work based on the impact factor or number of citations and not on the quality or usefulness of the work. Universities do not require theses to be published. Teachers prefer foreign articles and ignore national magazines. The quality of the article is not evaluated and it is preferred to believe in the quality of the journals only because they are foreign, because they have a high impact factor (IF) or because they are published in English. This is striking if we take into account the number of contracted researchers and the large number of users (doctors, nurses, residents, etc.) who do research throughout the country. Suffice it to say that each of the resident physicians and master’s students graduate with a thesis. The problem is that not all these are published and this is multi causal; among the main causes is the difficulty of writing the medical article, the lack of multivariate statistical analysis or the lack of sample size. On the other hand, magazines have the problem of poor publication or low quality of publications.
- The next entities involved are the universities. These could require that the theses of residents or of masters and doctoral students be published in national scientific journals. They could also prevent them from being published in thesis format without peer review or adequate dissemination. Unfortunately, these two actors depend on political decisions rather than personal decisions. Those who do have the freedom of choice to support the development of the virtuous circle of journals are researchers, graduate teachers and users in general, and this editorial is directed to them. Researchers can support national scientific journals in two ways: the first is the publication of their best work in national journals. While this practice could impact your career by lowering your impact factor or H-index or fame, publishing your best products in national scientific journals would attract international citations. Graduate professors certainly play an important role in journal adherence. The oxymoron of current education is that the development and teaching of local research is carried out with international texts. It is a custom that, in general, basic doctors teach using international texts; graduate professors teach using classics like Feinstein or Sackett. This could be improved if teachers wrote or consulted, of course in national journals, exegesis of the methodology adapted to the themes and national realities.
- Another way could be to motivate their students to formal analysis and criticism (in the form of letters to the editor) of the studies published in these journals. Finally, the bottom of the pyramid and the most important judges are the readers. By reading the journal, they are instructed in solving local issues, thereby improving the quality of patient care.
It is essential to understand that responsibility for the interpretation and use of research results is not the responsibility of the editors, nor the researchers, but the health professional that is in front of the patient and makes day-to-day decisions.