A Worrying Decline in Anesthesia Journal Publications from Japan

Abstract

In Japan, a reduction in the supply of qualified physicianshas become apparent since the introduction of a newpostgraduate clinical training system in 2004. In addition,our younger generation seems to desire a medical specialistqualification but not the (research) degree of Doctor ofMedicine. Indeed, in agreement with the results of a surveyconducted by the Ministry of Health, Labour, and Welfarein 2005, 92% of medical residents desired medical spe-cialist qualifications whereas only 35% intended to obtainthe degree of Doctor of Medicine (data from the home pageof the Ministry of Health, Labour, and Welfare). As aconsequence of high clinical workload and a relative lackof interest in research degrees, medical research papersubmissions from Japan are decreasing [data from Web ofScience (Thomson Reuters)]. Judging from the presentstate of publication numbers in major medical journalsfrom our country, our world ranking in the major basicmedical journals such as Nature Medicine, Cell, andJournal of Experimental Medicine remains high (3rd–4thposition) whereas the ranking in major clinical medicaljournals such as New England Journal of Medicine, Lancet,and JAMA is declining (from 12th in 1993–1997 to 25th in2008–2011). In addition, the ranking of South Africa,Brazil, India, Poland, Israel, Argentina, and Austria werepreviously (2003–2007) lower but now (2008–2011) higherthan Japan. Overall numbers of clinical research papersfrom Japan have decreased by 8% whilst in the rest of theworld they have increased by more than 10% [data fromWeb of Science (Thomson Reuters)].What about Anesthesiology publications from Japan? Liand colleagues [1] reported that publications from Japanhave notably decreased in 17 anesthesiology journalsincluding Anesthesiology, British Journal of Anaesthesia(BJA), Anesthesia and Analgesia (A&A), Anaesthesia,Canadian Journal of Anesthesia, Acta AnaesthesiologicaScandinavica, European Journal of Anaesthesiology,Anaesthesia and Intensive Care, Journal of NeurosurgicalAnesthesiology, Pediatric Anesthesia, International Jour-nal of Obstetric Anesthesia, Journal of Clinical Anesthesia,Journal of Cardiothoracic and Vascular Anesthesia,Regional Anesthesia and Pain Medicine, Pain, EuropeanJournal of Pain, and Clinical Journal of Pain. In contrast,publications from China (including Hong Kong) andSouth Korea are increasing steadily. Using BJA Editor-in-Chief internal reports, I analyzed submission data to BJAfor my presentation entitled, ‘‘Which Type of Articlesfrom Japan Are Most Likely to Be Accepted by BJA?’’ inthe BJA Session held at the 59th Annual Meeting of theJapanese Society of Anesthesiologists (JSA). I have foundthat the total number of submissions from Japan for thelast 9 years placed 4th in the world but there was aworrying trend that submission numbers declined year byyear. As mentioned above, submissions from China andSouth Korea are increasing. Using PubMed, annualchanges in publications in BJA showed a similar trend inthese 3 East Asian countries. Annual publications in 2012from Japan were one-third of those in 2003 (Fig. 1a).Annual publications in BJA from Japan were lower thanthose from South Korea over the last 4 years. I alsoanalyzed publication data for Anesthesiology and A&Afor the last 10 years. Again, and of concern, I found thatchanges in annual publication numbers in Anesthesiology(Fig. 1b) and A&A (Fig. 1c) were similar to those of BJA.In Anesthesiology, publications from Japan decreased