AMJAD MEHMOOD
Many Pakistanis working in the field of clinical research would say that the unfortunate episode was waiting to happen.
Research is a word reviled in Pakistan, and the lack of it has come back to haunt Pakistani doctors working in the Gulf.
Saudi Arabia, Qatar, Bahrain and the United Arab Emirates recently showed the mirror to Pakistan’s medical community by sacking hundreds of Pakistani doctors who had secured jobs on account of their MD/MS degrees. These doctors have now been issued deportation orders. Most of them had been working in the Arab countries since 2016.
Pakistani doctors working in clinics (patient treatment and care) are excellent, but that’s not the case with those working in clinical research. And, it is the second group that has brought ignominy to Pakistan.
In the past, Saudi Arabia was more concerned about the clinical aspect of medicine, but it has recently invested heavily in clinical research, especially in the area that focuses on cause of a disease and application of drugs in patients.
In response to this, some medical universities in Pakistan developed certain MS and MD programmes to ensure the skilled force gets opportunities in Saudi Arabia and other Gulf countries, but the strategy seems to have backfired.
First Saudi Arabia and now others have alleged that Pakistan’s postgraduate degrees in medicine are lacking in structured training programmes.
There are four main reasons for such criticism.
No concept of research
First, Pakistan’s medical universities are alien to the concept of research. Professors themselves violate research rules with impunity and the same malpractice trickles down to the student researchers. Garbage in, garbage out.
For instance, a former vice-chancellor of government-run University of Health Sciences in Lahore, after assuming the position, had circulated his CV wherein he claimed that he had 120 research articles published in the field of reproductive endocrinology and high-altitude physiology in a career spanning 35 years.
Going by the sheer number of articles, an entire book on medical research would have been published. Similarly, with such vast experience in medical research, one would assume there were several discoveries (patent rights) against his name. Unfortunately, there was none. No standard book on medical research included his name as a contributor to appreciate his scientific work.
Stealing ideas
Second, medical researchers in Pakistan are not careful about the validity of their research. They overlook the fact that the steps taken to conduct research are more important than the conclusion drawn. Every step has to be recorded in a logbook. There is a tendency among Pakistani researchers to steal the objectives and conclusion of a research performed in some other part of the world and replicate the same in the context of Pakistan to claim a scientific credit. This explains why the conclusion drawn often doesn’t flow from the research conducted.
For instance, in 1991, P. Laurberg et al published the result of their study conducted at Aalborg University Hospital (Denmark) on high incidence of multinodular toxic goiter in the elderly population in a low iodine intake area in East Jutland, Denmark. In 2013, a team of Pakistani researchers in Rawalpindi replicated the same study in northern region of Pakistan among the elderly population. Without following the requisite steps of research, they arrived at the same conclusion to earn a scientific credit. Steps for conducting research were not followed because the team of researchers already knew the conclusion they would arrive at.
Similarly, in 2005, at the Osaka University in Japan, A. Fukukara et al conducted a study on humans to examine the effect of a secreted protein (Visfatin) on the testosterone levels in insulin-resistant diabetic males. Interestingly, in 2013, a team of Pakistani clinical researchers based in Rawalpindi reinforced the same findings by conducting a study on male rats to earn a scientific credit.
Across the world, experiments are conducted first on animals and based on their success, clinical trials are conducted on humans. In Pakistan, the reverse pattern is followed just to earn a scientific credit, making a mockery of research. News of such virtuosity has reached foreign countries that now view the achievement of Pakistani researchers with doubt.
No reliability of research
Third, medical researchers in Pakistan are incautious about the significance of the reliability of research. Any research whose results are not replicable is unreliable research. There are several examples where unreliable data have been produced to only serve the purpose of the researcher.
For instance, a head of the department at the government-run medical university in Lahore declared a couple of years ago that he had discovered a ‘Pakistani type-II diabetes’. To publicise his findings, the professor published four research articles (in 2013, March 2014, September 2014 and 2015) in four different research journals of Pakistan. The articles indicated that each time he got the approval of the ethical committee of the university to collect the samples.
Interestingly, the blood samples of 212 patients were reportedly collected from November 2009 to January 2012 during his PhD studies. It is still not known how he cryopreserved the samples or if he used the same samples for more than three years since the date of the sample collection. It also not known how and why the ethical committee of the university would allow him to declare in each article that the samples used were fresh.
No independent or third-party researcher has been able to successfully repeat the experiments to confirm the authenticity of the findings.
A culture of condoning
Fourth, Pakistani researchers practice a culture of condoning – you overlook my faults and I will overlook yours. They do not challenge each other because they mutually conduct research malpractices.
There are other silent participants in this malicious activity of research quackery. Every medical university in Pakistan has hired the services of media managers who secure hefty salaries from the university and penetrate the media to forestall the publication of any news, which is against the interests of the university. These media managers also offer the reporters covering the medical beat a direct access to medical facilities of the attached hospitals as a sop to stay tightlipped.
Above all, medical universities, especially those run by the government, are supervised by the chancellor who happens to be governor of the province. Governors, mostly from non-science background, do not wish to interfere in the universities’ research issues.
There are, for instance, several complaints against research malpractices pending with the office of the Governor of Punjab. Registrars of medical universities are also known to propitiate the governors with different favours to keep the issues suppressed.
Thorough probe needed
The news of expulsion of Pakistani doctors from the Gulf countries might have taken many Pakistani by surprise, but to many Pakistanis working in the field of clinical research, the unfortunate episode was waiting to happen. When teachers (or trainers) are involved, students (or trainees) cannot escape research malpractices.
A thorough inquiry into the matter is required to root out the malpractices of research quackery and research misconduct, which are rampant in Pakistan’s medical universities and hospitals. These malpractices are spoiling the future of young clinical researchers in Pakistan and bringing disgrace to the country.
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