Making it Count

Medical journals have always been important in guiding and shaping the present and future of medicine, but there are also key influences that guide and shape the direction of medical journals. Dr. Jeffrey Drazen is one such influencer, having been at the forefront of the New England Journal of Medicine (NEJM) as its Editor-in-Chief since 2000. In a recent  interview, DocThoughts founder, Nirmal Gosalia (UIC Honors College ‘16 and current UIC medical student), sat down with Dr. Drazen to discuss recent developments in research. All students at Chicago’s only public research university, the University of Illinois at Chicago (UIC), know that research is a crucial part of their campus, and opportunities are all over the place for students to experience research themselves. Thus, it is important for UIC students to not only be aware of the changes in research, but also, as Dr. Drazen outlines, how to make the most of their time as researchers.

Changes from 2000 to now 

One of the most interesting phenomenons Dr. Drazen has observed in his time as Editor-in-Chief, is the increase in publications of international research in American journals. In 2000, 60% of the articles submitted were from small groups in North America. A recent statistic from 2017 reports 40% of submitted articles are from North American, in addition to mostly being from larger groups now. Tables have turned, and now there are articles from all over the world, including but not limited to, South America, Africa, and Asia, to make up for the rest of the 60%. Dr. Drazen attributes this trend to many immigrant researchers in the U.S. taking back research tools and methods to their home countries, resulting in novel ways of answering medical questions. Dr. Drazen notes, “I think it’s a positive thing – research is now an international game rather than one from just a first world.”

Future of research journals 

When Dr. Drazen took over in 2000, NEJM had 200,000 paper issues printed with 20,000 people that looked at NEJM content through their website every week. Now, Dr. Drazen reports that the numbers have shifted to 150,000 printed issues and more than 2,000,000 people every week. As NEJM is, as Dr. Drazen calls it, “an information source” the importance of how widespread and accessible NEJM content has become through digitalization is not lost on Dr. Drazen. Therefore, he hopes that journals continue to take on a dispassionate view. “Anybody that is a successful researcher is really passionate about his or her work…they see all sorts of ways that their research can change the world…,” he notes. “But when it comes down to actually making a statement about what you actually learned and how that information can be used, we have to be very conservative.” Researchers can be too invested in their research, too close to their work to truly see the greater picture, and Dr. Drazen expects journals to hold researchers accountable to their claims. He finds that researchers actually appreciate this careful and thorough examination of their work. As the journal is one of the first groups of people to seriously consider every line of their work, Dr. Drazen observes that researchers invite the intellectual challenge that comes with such detailed critique of their research.

Quality over quantity 

Although NEJM’s high standards of meaningful and reproducible research have led to many no’s to submitted articles, Dr. Drazen stresses the importance of selectivity in the context of quality over quantity. With the digitalization of publications, people seem to now believe that unlimited Internet space should translate into unlimited content. But Dr. Drazen disagrees, commenting that no one wants hundreds of articles bombarding them every morning. This not only reduces the value of any singular piece as it gets lost in a mass of information, but also shifts the goals of journals and researchers. Dr. Drazen critiques that starting in 2000, “The goal became publishing papers, not getting it right and the criteria for promotion is where your work was published, not whether your work was reproducible or not…publishing something that’s right, that changes your field, that other people can use, that is what should be the goal. Getting it right is what counts.”

How to make your research count 

Throughout the interview, Dr. Drazen continually emphasized that the value of research lies in it reproducibility and applicable meaning. Making research reproducible is a simple matter of keeping accountable with other researchers; when they look over the protocol does it make sense, could they follow it, where are some areas that could be clarified, these are all good questions to ask colleagues and mentors. As a lab director, Dr. Drazen witnesses mistakes all the time and he impresses upon researchers to repeat their experiments with purpose and thoroughness, work out all the kinks, and “don’t quit because you have the answer you want, quit because you have the answer you know is right,” he explains.

As for the matter of having applicable and meaningful research, he advises researchers to research only what they are truly interested in. These days, so many people mill over to the “hottest” areas in science that have the most potential for development and findings. Dr. Drazen cautions researchers to not fall into mob mentality and only seek out areas that will illuminate the question they really want to ask and explore. “It’s a really hard game, so at least you should enjoy playing it,” he exclaims. He further urges researchers to stick with one problem and immerse themselves in it, using advancements in technology and methods to learn even more about their research, instead of jumping from one thing to the next. Dr. Drazen encourages that whatever the area of specialization, there is always something to discover for the larger picture of advancing humankind; do not dismiss true interest for something that is deemed as a more relevant interest.