To the best of our knowledge, this study is the first attempt in Pakistan that looked at characteristics of physicians and challenges in research faced by early to mid career level physicians working in different academic settings (both private and public sector universities). This study is also the first attempt to highlight differences in attitudes and barriers towards research in physicians active in research versus those who are not.
Overall, majority of physicians sampled, were not involved in research. However, the number of physicians currently involved in research was surprisingly comparable, if not better, to similar studies [7
] conducted in more developed parts of the world.
As expected, the number of male physicians working at a postgraduate level was higher in our institutes compared to females. Among the female faculty, involvement in research was significantly lower compared to males. This finding is similar to some studies done in the US [6
], one of which [6
] cites low self-ability as a major barrier toward involvement in research. No distinct reason was identified in our study to explain this occurrence. However, this difference may be due to different cultural and social expectations and responsibilities faced by females in our setting in contrast to males: like household and marital responsibilities.
Historically staff training, infrastructure, and resources are considered stronger in the private as compared to public or government run hospitals in Pakistan. Thus it was a surprising finding in our study that a higher number of physicians from the public sector were currently involved in research compared doctors in to private universities. This may be explained by a recent influx of funds and support provided to our public sector universities through large grants by Higher Education Commission of Pakistan. The quality of research being done in both the public and private sectors however was not assessed in this study.
Another important finding of this study was an almost lack of undergraduate training in research provided to our medical students. A similar study from India reported that 91% of interns had no research experience in medical schools [18
]. Exposing medical trainees at an earlier stage in their careers to the basics of medical research not only improves knowledge and attitudes toward research but also helps to improve their skills in searching and critically appraising medical literature, independent learning and writing [19
]. This training may translate into an increased interest in research at a post-graduate level and generation of research not only as mandatory projects but also as an additional if not exclusive arm of their careers. Most of the research training of our participants was obtained at a postgraduate level, which in turn was one of the most important factors associated with current involvement in research. Physicians with prior research experience, publications and presentations were more likely to have ongoing research projects. This may be explained by an increased experience and know how in performing literatures searches, data collection, analyses and interpretation. Appropriate rewards like promotions and publications have also been found to be strong motivators and predictors for researcher productivity [10
]. This may very well explain the greater involvement in active research of such participants, also a significant finding of this study.
This study was also able to identify differences in attitudes toward research among study participants very clearly. There were statistically significant differences between faculty actively involved in research, who had a more positive outlook towards research both at a patient care and personal professional level as compared to faculty not involved in ongoing projects.
Another main objective of our study was assessment of barriers of which, a lack of research training was only barrier to have statistically significant difference between those involved in research versus not. This barrier was also cited in another study done earlier in Pakistan [21
]. Allocation of time is identified as one of the characteristics of research productivity among faculty at US medical schools [15
]. Majority of study participants also pointed out lack of time as one of the barriers for not doing research. This barrier is also reported by other researchers as well [7
]. Even though no statistically significant differences were found between the two groups of physicians involved and not involved in research, other barriers selected by both groups were considerable in number and fairly similar. Of note was that lack of financial incentives was the least selected by both groups.
One limitation of this study was that we did not look at the type of research done by the study participants. Even though not a study objective, information of the quantity and quality of research would have given more information of research output and reflected on adequacy of research. Secondly, a larger sample size would have allowed for a stronger analysis than the one performed in this study. Statistical validation of the data collection tool was done, nevertheless its face and content validity was well conducted. Despite these limitations, this study was able to capture a wider sample across four academic institutions allowing for a better representation than in previous local studies.