Medicine en Route…
Medicine is a global community. It has become even more prominent with the advancement of information technology. High Wire hosted Medical Journals are online with research, reviews, case reports, news, and expert opinions from all over the world. With the increasing influx of information and rapidly changing clinical practice, the already demanding medical profession has become even more complex. Technology is important but it should not overpower the fundamental principles of medicine.
Actually they can be counterproductive i.e. a clinically challenged but technologically advanced doctor! It is wise to grasp the internet and technology putting its limitation in the back of our mind. Education and information reduce ignorance and improve our efficiency. We have to learn throughout our life and consensus is that- “I don’t know” is the healthy sense of ignorance if appropriate in time and situation. Dave Sackett, the father of Evidence Based Medicine, says “Half of what we are learning today in our medical school will be either dead wrong or out of date within five years of our graduation. To make it worse, nobody can tell us which half that will be!” So most important thing is to learn on our own i.e. build up our own “personality”, the most important therapeutic tool we will ever have. This is because, in many cases, cure is not what patient and his/ her family will be expecting. They may be just seeking support, a friendly hand and a caring soul. Definitely, medicine is not only a clinical work. This is concerned with relationships, team work, systems, communication skills, research, publishing and critical appraisal. This is really multifaceted
Medical Journals and Student Section
Currently more than half a dozen of Medical Colleges are running in Nepal and more than a dozen of Medical Journals are published in different versions. But only two of them have so far been indexed in Medline. Only one of them, Kathmandu University Medical Journal that has recently been indexed in Medline, had tried to incorporate Student section in some of their past issues. Now it is Nepal Journal of Neuroscience that has started this despite being the journal of subspecialized field. We (the student editorial team) have proudly accepted the responsibility and challenge in itself to launch it with high spirit and dignity.
The medical journalism in developing countries is carried out by the academicians and clinicians who do not have journalism training. Incorporating the student section and recruiting student editors is definitely a risky move. Somewhere someone has to start though it may seem a misadventure to some myopic high profiles. This will have an effect in the long run. Maybe a decade later when these student editors get honed and enter into the professional life. So this is a future game plan of Academic Medicine rather than a “get it published” whim. This is a carefully premeditated and boldly taken step by the Neuroscience forum. Hopefully, the tender student editorial team entangled with this holy neurological nexus will show much of maturity in the near future.
To continue to publish medical journals in developing countries such as Nepal is not an easy job as many obstacles come on the way such as operating budget, finding readership, getting quality articles or subscriptions. This is because we are yet to develop the culture of Academic perspective in medicine. The medical student section and independent medical students’ journal in the present scenario is hard to imagine. If we throw glimpses over global development of medical students’ section, it is a little sad story. Medical Student section of Journal of the American Medical Association (
msJAMA) was discontinued in 2004 whatever the reason they may have given. There are a number of medical journals published by the Medical students but they are either with ventilator or already to the grave. Those getting published are like bulletins; either annual or biannual form that too in web version only. They lack continuity, quality and clear cut policy. It is only Student British Medical Journal (
studentBMJ), supported by British Medical Association (BMA), that seems to be resistant to all the hurdles. It has taken a further mile by entering into the system of Bench Press submission in 2005. The student editors who have been trained on medical journalism and recruiting medical student advisers from all over the world are quite mature aspects of this journal. The student editorial team of Nepal Journal of Neuroscience will definitely learn from them and others. Journal of Postgraduate Medicine (JPGM) and Public Library of Science (PLoS) have also introduced and shown commitment to continue their student section. Similarly, McGill Journal of Medicine (MJM) and New Zealand Medical Student Journal (NZMSJ) are other promising student medical journals guided by the expert faculties and edited by the medical students. The Journal of Young Investigators (JYI), an online publication close to ‘Science’, is for and by the undergraduates of different discipline around the world. This is the most rigorous scientific journal that seeks research papers from the undergraduates from all over the world. Last but not the least is the student section of Nepal Journal of Neuroscience.
Medical Students and Society
Medicine is, no doubt, a ruthlessly demanding profession. The expectations from the society and peer groups are high up. On the other hand we are painfully aware of the limitations and complexities of modern medicine. The famous novelist Erich Segal thinks’ “Medical schools are the best place where Charles Darwin’s theory of natural selection applies- ‘The survival of the fittest’.” Nobody wants medical students to wear out but we must live up to the society’s demand and commitment we have ourselves made. People are so much aware that we should not be surprised if we find someone at the cold end of the stethoscope has been with the latest medical information as compared to us. He or she has equal access to the literature that we can access over the net. May be we are a week or a day late to update our knowledge. Ethical issues and consumer protection groups are also there. So what should we do? Who are our role models? What is the best way to deal with the new circumstances? Are we vulnerable all the time we touch and treat the patients? ……..Answers? We have to frame ourselves
What This Section is all about
As we said earlier, this is the student section of Nepal Journal of Neuroscience, the official journal of Neuroscience Forum, Institute of Medicine. This is edited by the student editorial team of Neuroscience Forum. So, the policy of this section is almost same as that of Nepal Journal of Neuroscience. We will strictly follow the guidelines of this journal for manuscript preparation and reference citation. It will be taken care of by the student editorial team. We will give priority to the articles featuring creative ideas, those that are thought provoking. Above all, the contributor must be a medical student and article should have neurological flavour in some way.
[b]Future: Students’ PerspectiveB]
It is all about evidence, appropriate decision and a rational approach. This is the era modern medicine where we say, “No more opinions and views please!” But there is place for ‘Expert Opinions’ from the people who have devoted themselves to the grey hair. Extrapolations are different. Biomedical researchers are going so deep to the genetics and molecular level that the scientific community has feared of becoming myopic and thereby failing to account wider picture of populations, environments and health. Reading medical journals and coming out with a concrete conclusion is just like searching a needle in a haystack. However, there are tools and guidelines developed. The meta-analysis is systematically merging the research articles and giving us a conclusion with appropriate reliability and validity.
By the same way CONSORT (Consolidated Standards of Reporting Trials) guidelines have made the Randomized Clinical Trials (RCT) reader- friendly and methodologically more transparent. In a nutshell, the meta-analysis and COSORT Guidelines have simplified and opsonized the research jargons. The recent agreement, among the members of the International Committee of Medical Journal Editors (ICMJE), on the registration of all the clinical trials from all over the world will not only make the research more systematic and reliable but also will avoid duplication. The whole idea is to develop academic way of thinking. This must be developed right through the receptive phase of student life.
Medical misadventures are no doubt discouraged but we do not believe that we should be afraid of being wrong.
Sense of humour and smiles are indispensable things that we should have no matter how bad things are.
References- Davies H: Can Mary Shelley’s Frankenstein be read as an early research ethics text? J Med Ethics; Medical Humanities 30:32-35, 2004
- De Angelis CD, Drazen JM, Frizelle FA , et al.; International Committee of Medical Journal Editors: Is This Clinical Trial Fully Registered? – A Statement from the International Committee of Medical Journal Editors 2005. N Engl J Med 352:2436-2438, 2005
- De Angelis CD, Fontanarosa PB: JAMA and Medical Students-New Opportunities. JAMA 291:2872, 2004
- Kulkarni H. Kulkarni M, Bhalerao U, et al: Student’s section and student editors of JPGM. J Postgrad Med 51:78-78, 2005
- Moher D, Schulz KF, Altman DG: The CONSORT Statement: Revised Recommendations for Improving the Quality of Reports of Parallel-Group Randomized Trials. Ann Intern Med 134:657-661, 2001
Published: Nepal Journal of Neuroscience Vol2, No. 2, July 2005 
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