Medical Journalism and Role of Accreditation in Enhancing Quality of Medical Journals in Pakistan

Usman Waheed*^1,2, Khalid Hassan³

¹Managing Editor, Journal of Islamabad Medical and Dental College, Islamabad, Pakistan; ²Department of Allied Health Sciences, Islamabad Medical and Dental College, Islamabad, Pakistan; ³Editor-in-Chief, Journal of Islamabad Medical and Dental College, Islamabad, Pakistan

At present, extensive research in medicine is undertaken globally, and medical journalism serves as a medium for disseminating the findings. The publication of pertinent manuscripts can avoid redundant research and facilitate more comprehensive study designs. Consequently, high-quality medical journals are regarded as authoritative resources for advanced knowledge and further research.
Medical journalism has many aspects and mirrors its readership. The primary classification is into: (a) medical journalism aimed at the general community, covering medical reporting in mainstream news outlets and specialized medical publications, and (b) medical journalism directed towards physicians and other experts, frequently found in peer-reviewed journals.¹
Presently, the role of medical journalism has broadened to incorporate investigative journalism, advocacy, and public health awareness. Medical reporters are responsible for elucidating intricate medical research, examining healthcare policy, and ensuring accountability within the healthcare sector, all while upholding journalistic ethics and precision.² Contemporary medicine would be inconceivable without its journals as they are actively involved in the rapid growth of nearly all aspects related to medicine and healthcare. In recent years, medical journalism has had to traverse a swiftly evolving media environment, especially during the COVID-19 pandemic, reconciling the necessity for expedience with precision in reporting.³ Public confidence in medical journalism is essential, as the disseminated knowledge can profoundly impact healthcare decisions and policies.⁴
Medical reporting dates back to ancient civilizations, with figures like Hippocrates and Galen writing extensively on medical theories and practices.⁵ Although not reflective of present-day journalism, these texts established the basis of medical knowledge for centuries. Modern medical journalism originated in the 17th century with the establishment of academic journals such as the 'Philosophical Transactions of the Royal Society' in London (1665) and the 'Journal des Scavans' in Paris (1665).⁶ Later, the inaugural peer-reviewed compilation of medical essays was released by the Royal Society of Edinburgh in 1731, titled 'Medical Essays and Observations'.⁷ In the USA, the inaugural medical publication was the Medical Repository (1797).⁸
The 19th century experienced a proliferation of medical journalism,⁹ with prominent journals such as ‘New England Journal of Medicine’ (1812, published by the Massachusetts Medical Society),¹⁰ ‘The Lancet’ (1823, published by Elsevier),¹¹ and the ‘British Medical Journal’ (1840, published by the British Medical Association)¹² significantly influencing healthcare and public comprehension.
Pakistan currently has around 80-90 medical journals, although comprehensive records of the publication details for certain older journals are lacking. The emergence of the internet and online open access publishing has resulted in a surge in the volume of publications, accelerated by the requirement for compulsory publication among academics and the expanding publishing market's interests.
The first medical journal in pre-partition sub-continent was published in 1825 as ‘Transactions of the Medical and Physical Society of Calcutta’ (ceased publication in 1845).^13,14 It was followed by ‘Indian Journal of Medical Research’ (1913), ‘Journal of the Indian Medical Association’ (1930), ‘Indian Journal of Surgery’ (1938), and ‘Medical Journal Armed Forces India’ (1945). After partition, Journal of the Indian Medical Association became ‘Journal of Pakistan Medical Association’, first published in 1953. Likewise, Medical Journal Armed Forces India transitioned into ‘Pakistan Armed Forces Medical Journal’ (1956), and the Indian Journal of Medical Research transitioned into ‘Pakistan Journal of Medical Research’ (1958).
Medical journalism in Pakistan is an emerging discipline that emphasizes the reporting of health-related news, scientific breakthroughs, public health concerns, and medical innovations. This branch of journalism connects the medical community with the general public, guaranteeing the availability of accurate and reliable information to enhance health literacy and public awareness.
Accreditation is essential for enhancing the quality and credibility of medical journals. Accreditation bodies establish explicit standards to verify that journals comply with ethical, scientific, and editorial best practices, thereby enhancing the integrity and dependability of published research. Numerous accreditation agencies operate internationally, including, but not limited to, DOAJ (Directory of Open Access Journals), Scopus, COPE (Committee on Publication Ethics), ICMJE (International Committee of Medical Journal Editors), and MEDLINE Indexing conducted by the National Library of Medicine (NLM).
In Pakistan, national journals are persistently working hard to make significant contributions to global medical research. The national medical journals have progressively conformed to international publishing standards due to local and international accrediting initiatives. The national accreditation entities comprise the Pakistan Medical and Dental Council (PMDC) and the Higher Education Commission (HEC), which are crucial in upholding the quality of medical publications. The PMDC sets the standards that medical journals must fulfil to obtain accreditation. These standards encompass editorial quality, peer review procedures, research integrity, and compliance with ethical requirements. The PMDC conducts periodic evaluations of the performance and quality of recognized journals to verify compliance with defined criteria. Likewise, the HEC has a Journal Recognition System (HJRS) that categorizes journals into W, X, and Y, according to their quality, peer-review procedures, and impact factor. This ranking system motivates journals to enhance their editorial procedures, peer-review mechanisms, and publication ethics.
The accreditation of Pakistani medical journals by these two national bodies increases the likelihood of being indexed in international databases such as PubMed, Scopus, and Web of Science. This would ultimately enhance their visibility, augment citation rates, and enable Pakistani research to contribute to the worldwide existing body of medical knowledge.
To address the key challenges in enhancing the quality and accreditation of medical journals, the Islamabad Medical and Dental College (IMDC) in collaboration with the PMDC organized an interactive seminar titled ‘The Role of Accreditation in Enhancing Quality of Medical Journals.’ The seminar aimed to present an overview of national and international accrediting criteria for medical journals and to examine the significance of compliance with these standards in maintaining the credibility and quality of medical research. The event aimed to address the challenges experienced by medical journals in Pakistan concerning accreditation and quality development, proposing solutions through regulatory reforms, capacity building, and international engagement.
The one-day event brought together editors and reviewers of medical journals mainly from Islamabad Capital Territory (ICT), Rawalpindi, and Azad Jammu & Kashmir (AJK), to explore critical aspects of journal accreditation and its impact on enhancing the standards of medical journalism. The seminar underscored the importance of maintaining quality in medical publications, a cornerstone for advancing research and clinical practices. A total of 150 participants attended the seminar including 52 online participants connected via zoom. The Chief Guest on the occasion was President, PMDC, Prof. Dr. Rizwan Taj. The seminar began with registration, succeeded by the arrival of distinguished guests, presenters, and editors from many prominent medical journals. A brief visit to the poster exhibition area was thereafter arranged, offering attendees an opportunity to acknowledge the research initiatives by students and early-career researchers from IMDC.
The proceedings commenced with a recitation from the Holy Quran, followed by a welcome note by Prof. Dr. Muhammad Aslam, Designate Vice Chancellor, City University Islamabad, who welcomed the guests and underscored the significance of accreditation in preserving journal integrity.
The Chief Guest, Prof. Dr. Rizwan Taj, President of PMDC, thereafter in his address articulated his views on journal accreditation and the future direction of medical publishing in Pakistan. He underlined the need for rigorous research and publications as essential to evidence-based medical practice. Prof. Taj praised the IMDC's efforts in arranging this significant seminar, which convened specialists from throughout the region. He additionally emphasized that PMDC is strongly promoting a research-focused culture in all affiliated medical colleges, with the objective of preparing future medical graduates with the requisite abilities to engage in evidence-based medicine and compete internationally.
The technical session began with a presentation by Mr. Shaukat Ali Jawaid, Chief Editor, Pakistan Journal of Medical Sciences, who provided an in-depth overview of the ‘Salient Features of Criteria Used for Assessment and Evaluation of Journals by PMDC’, thereby equipping participants with a comprehensive understanding of the assessment frameworks utilized by PMDC. The talk emphasized the preservation of high-quality standards in medical journal publications. It included multiple phases of the publication process, including internal evaluations, formatting, peer assessments, and post-acceptance revisions. Transparency concerning journal policies, ethical principles, and the management of conflicts of interest was highlighted. The significance of adhering to ICMJE criteria was underlined, especially regarding authorship and ethical considerations. The talk discussed the role of editors as custodians of the profession's integrity, providing insights into optimal techniques for journal management and staff retention.
One of the most interesting lectures was delivered by Prof. Dr. Akhtar Sherin, Chief Editor, Khyber Medical University Journal, who presented ‘Demystifying Journal Accreditation: Insights into Scopus and Web of Science.’ The talk offered a detailed examination of the journal certification process, emphasizing Scopus and Web of Science (WoS). It underlined the significance of journal certification for visibility, authenticity, and the attraction of high-quality submissions. The presentation outlined the assessment standards for indexation, covering editorial rigour, peer review, and citation measures such as Journal Impact Factor (JIF) and CiteScore. The presentation also addressed the ongoing curation methods employed by Scopus and WoS to uphold quality standards, as well as their distinct functions in scientific indexing, including instruments such as Web of Science’s Core Collection and Scopus’s RADAR tool. Scopus, a product of Elsevier, involves a broad spectrum of fields, excels in citation metrics and search functionalities, and offers CiteScore; yet it is criticized for its commercial motivations. The WoS, owned by Clarivate Analytics, is more selective, emphasizing peer-reviewed publications and offering robust citation and bibliometric capabilities. It primarily offers Journal Impact Factor (JIF), h-index, and citation metrics.
Prof. Dr. Saira Afzal, Editor-in-Chief, Annals of King Edward Medical University, presented on ‘Best Practices for Constructive Peer-Reviews’, a critical area in journal management. Her insights into frequent challenges with peer reviewing and solutions for betterment were invaluable, offering the audience practical guidance to improve the quality and equity of peer-review processes (single-blind, double-blind, open, and transparent). The talk highlighted the significance of delivering objective, explicit, and considerate feedback while circumventing common challenges such as bias, insufficient expertise, and unconstructive criticism. The lecture emphasized the threat of predatory journals and methods for their identification, underscoring the necessity for reviewer training and the contribution of technology in improving peer review procedures. Future developments, like open and post-publication peer reviews, were discussed to enhance transparency and collaboration.
Prof. Dr. S. H. Waqar, President, Pakistan Association of Medical Editors, further contributed to the seminar’s discussions by sharing the ‘Art of Medical Writings, Key Skills and Attributes for Success.’ The talk discussed that medical writing is both an art and a science, acting as a conduit between intricate scientific research and the general audience. Essential competencies include clarity, precision, meticulousness, time management, and scientific comprehension. Medical writers must possess robust communication and research abilities, alongside elevated ethical standards and flexibility to advance medical knowledge. The presentation emphasized the necessity of clear article structuring, audience comprehension, and compliance with the IMRD format (Introduction, Methods, Results, and Discussion) for scientific publications, ultimately underscoring the vital significance of medical writing in evidence-based medicine.
This was followed by a session on ‘Challenges in Medical Journalism’ by Prof. Dr. Khalid Hassan, Editor-in-Chief, Journal of Islamabad Medical and Dental College, who highlighted the growing difficulties faced by medical editors in Pakistan in maintaining journal quality amidst increasing pressure for rapid publications. It addressed the significance of medical journalism in the delivery of health information and its impact on public health decisions. The talk highlighted the insufficient international recognition of numerous Pakistani medical journals attributable to quality, financing, and indexing challenges. Key challenges include ghost authorship, article mills, and inadequate peer-review procedures. Proposed solutions included raising research quality, providing superior training for authors and reviewers especially on OJS (open journals system), complying with international criteria, and improving journal indexing. The future of medical journalism is anticipated to depend on digital platforms, artificial intelligence, and enhanced ethical practices to guarantee transparent, high-quality research that significantly contributes to public health and medical knowledge.
The last presentation titled ‘Clinical Research Service’ was delivered by Mr. Ali Nasir, Manager, Research Services, Getz Pharma. He informed that the Department of Research Services at Getz Pharma has significantly contributed to the advancement of medical research by providing services, such as data analysis, scientific editing, article review, and SPSS training. The SIGMA program workshops are designed to improve healthcare professionals' competencies in research methodology and medical writing. The journals may collaborate to facilitate training and capacity-building workshops. A poster session, where research was presented and certificates distributed, added an interactive dimension to the seminar, further celebrating academic contributions from students, and emerging scholars of IMDC.
The valedictory session presided over by Yasir Khan Niazi, CEO of IMDC, summarized the event's effectiveness in generating healthy conversation on enhancing the quality of medical journals via accreditation. He stated that the talks conducted today were not merely significant but crucial to the future of medical research and its dissemination in our country. The significance of medical journals in promoting healthcare, education, and clinical research is paramount. Quality research is intrinsic to IMDC's identity; it stimulates innovation, enhances patient care, and establishes global healthcare standards. Accreditation, as discussed in the seminar, is fundamental to ensuring that our journals meet and beyond worldwide standards of reliability, integrity, and transparency. Collectively, we are enhancing the calibre of our medical publications and influencing the future of healthcare in Pakistan and beyond. May this seminar operate as a catalyst for enduring advancement, as it is through our collective dedication to excellence that we will have a significant influence. Finally, he expressed appreciation to all the speakers, panelists, and organizers who facilitated the seminar's success.
In conclusion, the seminar was a significant success, characterized by its diversified and renowned lineup of speakers and the engaged participation of medical editors and academics across the country. As the medical research environment develops, events such as these are essential for ensuring that journals adhere to the demanding quality standards required to progress science and enhance patient care. Participants departed the seminar with increased knowledge, practical insights, and a renewed dedication to advancing the standards of medical journalism in Pakistan.
The day concluded with a group photograph, followed by a working lunch where participants continued to network and exchange ideas. The discussions initiated at the seminar are sure to resonate in the academic community for years to come.

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