Reforming the Culture of Medical Faculty Promotion and Appointment

A fairly recent paper published in the Annals of the National Academy of Medical Sciences attempted to provide improved and refined suggestions, based on a survey with a limited number of respondents (n = 182), on how to improve the faculty promotion criteria as suggested by the Medical Council of India (MCI).¹ The objectives of that paper were noble, providing a finer-scale “reward” scale for different manuscript types, and attempting to provide greater equity to additional authors, thereby giving them a fairer chance of more equal promotion opportunities. This letter encourages reflection on additional issues that the erstwhile MCI and Indian medical practitioners could consider to better or additionally assess faculty promotion.

The first suggestion may be controversial. In Table 4 of the article by Patra et al, only positive scores are assigned to each manuscript category, but no attention is paid to corrective measures or misconduct. Consequently, an additional fractional positive score (e.g., +0.1) could be awarded for select corrective measures in the literature that correct errors,² while a punitive score (–1) be assigned to any paper category that has been retracted due to misconduct such as guest authorship, plagiarism, data fabrication, or other forms of fraud. This supplemental set of scores would encourage the correction of erroneous literature and would also send a clear message that misconduct would have a negative impact on career prospects and employment security, allowing medical practitioners to reflect more carefully before engaging in any nefarious or unethical activity.

The MCI promotion criteria focus heavily on a scientist's achievements. I propose a wider focus on science, society, and scientists, in a balanced or equal proportions (the “triple-S” approach). In this approach, research and research papers that collectively display a responsible attitude toward the integrity of science, such as through principles of open science and reproducibility,³ are rewarded a bonus +1 point per paper. Similarly, research that tangibly benefits either local or international communities,⁴ or that accommodates robust and ethical international collaboration, could also be rewarded. Finally, a bonus for research and publication practices, including authorship attribution, that take into consideration a fair (i.e., considering qualifications) and balanced approach to gender equity⁵ would endow the research institute and country with additional reputational benefit.

Some of these suggestions might be considered liberal or progressive, but ultimately a reflection on them is to make medical faculty promotion and appointment fair, balanced, equitable, and based on more realistic principles and criteria.