Research in Indian Medical Colleges: Looking Beyond Funding

Ashank Desai Centre for Policy Studies, IIT Bombay > Talking policy > Research in Indian Medical Colleges: Looking Beyond Funding

DISCLAIMER: The information and views set out in this article are those of the author(s); and do not necessarily reflect the views of the Centre for Policy Studies or the Indian Institute of Technology Bombay.

By Richeek Pradhan, MD, MS, PhD candidate, McGill University, Montreal, Canada

India ranks 135th in the world in under-five mortality rate (United Nations Human Development Programme, 2013), 128th in maternal mortality ratio (The World Bank, 2019), and 123rd in physician density per 1000 citizens (UNData, 2014). Among the emerging BRICS economies (Brazil, the Russian Federation, India, China, and South Africa), India has the lowest rate of births attended by skilled personnel, and the highest population growth rates (World Health Organisation, 2017). To manage such urgent crises, India’s policy thus far has justifiably been to channel its limited resources into the immediate delivery of healthcare. However, such prioritisation might have also led to a neglect of research and development in medicine and public health. A 2016 study reflected this, finding that 57% of the 579 accredited medical colleges in India did not have a single biomedical research paper in Scopus indexed journals (Ray, Shah, & Nundy, 2016). With the growth of the Indian economy, it is perhaps time that the country reviews its policy towards research in general and medical research in particular.

The need to invest in medical research

Around the world, medical teaching institutions serve as the epicentres of biomedical research. Faced with unanswered questions during their clinical practice, clinicians in such institutions come up with new research ideas, providing an impetus to generate new knowledge (Kuhrt, 2017). This paradigm also explains why a low research output from medical colleges in India is concerning: questions specific to the Indian context, not answered by research elsewhere, remain understudied. Yet, given the differences India has from other countries in health practices, systems, biology, culture, and socioeconomic context, much of the research conducted elsewhere may not be generalisable to the Indian experience (Tullu & Karande, 2016). A failure to recognise these differences will inevitably produce health losses. Hence one can argue that policies to encourage biomedical research at medical colleges will result in socioeconomic and health gains. 

The shortages holding us back

To that end, three overlapping shortages in the Indian medical education and research system will need addressing: that of research funds, research training, and the inclination or thrust to conduct research. Indeed, these three lacunae have been highlighted in the recently published draft National Education Policy as the motivations behind setting up a National Research Fund (NRF, Ministry of Human Resource Development, Govt. of India, 2019). Although the NRF does not specifically focus on medical science, its intent to fund research in “all disciplines across the academic landscape” includes medicine. The NRF, in the draft proposal, promises an overall allocation of Rs. 20,000 crore (roughly 0.1% of India’s GDP) in total research funds. What percentage of this fund will be directed to medical colleges, how such funding will be allocated, and how transparent and politically neutral the funding process will be, shall decide the effectiveness of the NRF in fostering medical research and encouraging researchers who specifically feel held back by a shortage of money. 

The rest of this piece will discuss possible solutions to the problems of inadequate research training and a lack of inclination to conduct research endemic to Indian medical colleges.

Training the teachers

There is an important relationship between the inclination to conduct research and the training one has, especially in the Indian medical context. A study looking at perspectives of Indian medical practitioners towards research that I was part of demonstrated this: previous research training predicted a positive outlook towards research (Choudhury et al., 2016). Indeed, given that teachers pass on their knowledge as well as their attitudes to their students, it is key that the teachers in medical institutions in India are well trained in research. Yet, few faculty members in Indian medical colleges receive formal research training (from personal experience, in my 8.5 years of being an MBBS and MD student, I can think of only two faculty members who had masters’ or PhD level research training). This provides an opportunity for intervention. 

One possible approach is to create a special cadre of medical education personnel. Physicians hired in medical colleges should fall under two categories: one, clinical staff, who would be required to see patients and teach clinics and should not be required to conduct research, and the other, clinician-scientists, who will be required to spend a stipulated portion of their time on research. Existing faculty members who take on the roles of clinician-scientists should be required to undergo diploma level research training from specialised research institutes that have expertise in the relevant research areas. Future hiring of clinician-scientists should prioritise candidates with a track record for research, and among them, those who have formal research training. This is important because if the faculty members do not know how to conduct methodologically sound and well-managed research projects, it is impossible for them to properly utilise any funding they may receive (Hunter, 2013).

Training medical students

To develop research capacity among future medical students, more needs to be done. In my opinion, conducting experiments prescribed by the Medical Council of India in biochemistry or physiology labs, or receiving introductory concepts of epidemiology and clinical trials in community medicine and pharmacology classes provide inadequate exposure to the respective subjects. Often considered a chore undertaken to pass examinations by students and teachers alike, the current practice does little to stimulate any interest in research. 

Instead, research training needs to be a formal, structured undertaking where every medical student takes a course, for at least six months, in different dimensions of medical research such as the wet lab, data science, and clinical research. Here she will be taught research methods and ethics, along with approaches to the critical appraisal of published research. Even if such students do not ever engage directly in research, they will benefit from such training because their profession mandates that they become discerning consumers of research literature. 

Students should be required to associate with research units in the parent colleges and collaborating institutions. They will be encouraged to conduct short-term research projects, and students with publications in peer-reviewed journals should receive priority in selection processes for postgraduate degrees. Furthermore, publications in peer-reviewed journals should be requirements for completion of postgraduate degrees. Through these interventions, one may expect to incentivise and support medical students to engage with research in a meaningful way. 

Creating a collaborative research milieu 

As medical colleges develop in-house research capacity, a key strategy to increase research output and quality is to encourage collaboration between medical colleges and established research institutes. For research to be competitive and acceptable on the world stage, projects will often need a level of methodological rigour that requires specialisation. Collaboration between experts from research institutes and clinicians in medical colleges can be a cost-effective way to answer clinically relevant questions with state-of-the-art methodology. (Blevins, Farmer, Edlund, Sullivan, & Kirchner, 2010) Such efforts should be encouraged by awarding funds to projects that have multidisciplinary teams involving both medical colleges and other research institutes, and well-laid out cooperative strategies. Indeed, research collaborations lead to innovations (Coresh & Platz, 2016) and have been strategically adopted to enhance national research output in countries like China (Science and Technology Commission of Shanghai Municipality, 2018).

The promise of increased funds is an important but insufficient step in ensuring that Indian medical colleges produce quality research. Policymakers need to put an equivalent amount of focus on the fact that what isn’t working is more than just a lack of monetary resources. It is the lack of a research culture, changing which will require creative and cost-effective strategies. This way India will not only be able to answer questions unique to its health system and practices but also enable its medical practitioners to become agents of social change.


Blevins, D., Farmer, M. S., Edlund, C., Sullivan, G., & Kirchner, J. E. (2010). Collaborative research between clinicians and researchers: A multiple case study of implementation. Implementation Science, 5(1), 76.

Choudhury, Supriyo, Pradhan, Richeej, Dubey, Lily, Barman, Lisa, Biswas, Tanmay, Das, Manisha, & Chatterjee, Suparna. (2016). Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study. Perspectives in Clinical Research, 7(2), 94–99.

Coresh, Joseph., & Platz, Elizabeth. (2016). The George W. Comstock Center for Public Health Research and Prevention: A Century of Collaboration, Innovation, and Translation. American Journal of Epidemiology, 183(5), 362–366.

Hunter, Phillip. (2013). Research funding is not enough. EMBO Reports, 14(2), 140–142.

Kuhrt, Matt. (2017). Clinician-driven innovation on the rise. Retrieved 23 September 2019

Ministry of Human Resource Development, Govt. of India. (2019). Draft of National Education Policy, 2019. Retrieved 23 September 2019

Ray, Samrat, Shah, Ishan, & Nundy, Samiran. (2016). The research output from Indian medical institutions between 2005 and 2014. Current Medicine Research and Practice, 6(2), 49–58.

Science and Technology Commission of Shanghai Municipality. (2018). Research collaboration drives innovation. Retrieved 23 September 2019

The World Bank. (2019). Maternal mortality ratio (modeled estimate, per 100,000 live births). Retrieved 23 September 2019

Tullu, Millind & Karande, S. (2016). Quality research in Indian medical colleges and teaching institutions: The need of the hour. Journal of Postgraduate Medicine, 62(4), 213–215.

UNData. (2014). Physicians density (per 1000 population). Retrieved 23 September 2019

United Nations Human Development Programme, & Human Development Reports. (2019). Under-five mortality rate (per 1,000 live births). Retrieved 23 September 2019

World Health Organization. (2017). BRICS Health and WHO: Country Presence Profile. Retrieved 23 September 2019

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