International medical communications centers - why we need them

J. Patrick Barron, Raoul Breugelmans, Keiko Yamamoto

19 January 2005

Beginning with data provided by Dr. Joseph Murphy of the Mayo Clinic, the correlation between the number of papers in a given specific specialty by a single department in a medical health care institution and public perception of the institution for expertise in that specific field was demonstrated in a wide range of fields, including cardiology, gastroenterology, orthopedic surgery, endocrinology etc.

The Mayo Clinic editorial system, beginning with its history in 1908, was described. One of the reasons why the Mayo Clinic is so famous worldwide is because of its present output of about 2,000 papers in peer reviewed journals plus 5 major textbooks, many grant applications, etc. This is done with a system of 8 senior editors, 4 of whom are M.D.s and 4 Ph.D.s, 13 editorial assistants, and 4 proof readers. Because of the tremendous output of the Mayo clinical editorial services, this has enabled the Mayo Clinic to become famous worldwide, and also to attract very much financial support in terms of government grants, industry grants, bequest, etc.

The Japanese higher education system is presently faced with the problem of decreasing numbers of students. While medical schools will probably have more applicants than they have positions for students, the question is how to maintain a high level of student applicants. This problem is compounded by the fact that the amount of money that will be available for research and education in medical institutions will probably be further compromised by the increasing amount of money necessary for care of the elderly.

Enhancement of the image of a medical school should help to attract good students. This can be facilitated by increasing the quantity and quality of papers through the establishment of a communications center. Communications centers can also be useful in interacting with advocacy groups and in patient education. Patient education, through communications center-developed materials, can have two advantages: 1) time required for doctors and nurses to explain to the patients exactly what the situation is and what their options are can be minimized through development and use of video or DVD materials, 2) medical/legal problems can be minimized because the center-provided information can be used to show exactly what was explained in what manner to the patients.

The trend of globalization and standardization which is seen in many fields as well as in medicine is also beginning to be felt in the field of education of English for Medical Purposes (EMP). I gave a short history of my efforts in developing EMP at St. Mariannafs University School of Medicine beginning in 1980, with the attempt to establish the Medical Foreign Language Education Association in 1982 (unsuccessfully), together with the needs I perceived in 1989, based on the follow-up questionnaire to the 1982 questionnaire. I stated that we needed more texts, specifically for EMP and development and training of teachers, as well as better and closer communications between EMP specialists and basic, research and clinical specialists and the need for communications centers in medical schools.

A brief history of some of the main organizations that I have been involved with, including MITA which was formed about 12 years ago, JASMEE formed soon after then, and MECRA (Medical English Communications Research Association), were touched upon.

As an example for the globalization and standardization of EMP, I presented the book gEnglish for Doctorsh, originally written by Maria Gyorffy of the University of Pecs in Hungary, all in English, and the subsequent Japanese edition published through the good offices of Mr. Eguchi and Medical View, Co., and the Chinese edition which was made possible through the help of Dr. Nan Shang Zhong, and Dr. Zeng, making it probably the first text for EMP published in three different language families; Indo-European, Ural-Altaic and Sino-Tibetan.

The founding last year in Xian of the International Society for English for Medical Purposes, was mentioned as another indication of the movement towards international cooperation and development in EMP. I then gave a brief description of the activities of the International Medical Communications Center of Tokyo Medical University, outlining the main activities, our involvement with the education program of Tokyo Medical University, and development of our integrated EMP system which will be part of the organ system-based clinical education beginning at Tokyo Medical University later this year. The increase of papers by about 500% from Tokyo Medical University in Index Medicus-listed journals was also reported.

As examples of the types of topics that a communications center can educate undergraduates and graduates, I mentioned 1) the Uniform Requirements for Biomedical Manuscripts, 2) Common Pitfalls and Mistakes, 3) Effective Data Acquisition, 4) Rules that Must Be Observed to Increase Acceptance, 5) the Most Common Stylistic Criticism by Reviewers, 6) Analyzing Letters from Editors-in-Chief, 7) Techniques of Answering Reviewers, 8) Getting Published by Top Journals, 9) Oral Presentations and Handling Questions, 10) Types of Publications Other than the Original Research Paper, 11) Graphs and Tables, 12) Writing Covering Letters, 13) Recommendation Letters in Oral Communications, 14) Plagiarism and Copywriting, and 15) Acceptable Secondary Publication. In response to a question from Chris Holms, I mentioned that of course we also teach how to do good posters.

Ending with some examples of such talks, I presented my conclusion, which is that the main disadvantage of establishing an international communications center in a health care center is the cost, i.e. the annual salaries of one native Japanese speaker and one native English speaker, both qualified in medical editing, and one secretary or assistant as well as a space. But considering the advantages of establishing an international medical communications center, including 1) increasing the number of papers, 2) having papers that established in higher impact-factor journals, 3) decreasing the burden on very busy clinical/preclinical staff, 4) the ability for the staff of the center to learn from the medical staff and vice versa, 5) the help in giving support to sending paper to a journal and in handling comments from the reviewers and resubmitting documents, 6) the ability not only to help with publications but also with the education of English for Medical Purposes in the medical school to contribute to the graduate school students ability to write and publish, 7) to enhance the image of the institution to increase the number of good applicants, 8) to increase successful grant applications, 9) enhancing patient education in terms of saving time for the staff and contributing to better understanding of the activities of the institution, 10) handling inquiries from abroad about exchange programs or possible collaboration etc.

The conclusion is not whether a health care educational institution can afford an international medical communications center; the question is can it afford not to have such a center.

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