Medical Institutions In India Research Articles

Curricular Redundancy in Medical Undergraduate Course: Critical Insights from Various Stakeholders in Medical Institutes in India

Background Medical education is continuously evolving to keep pace with the dynamic field of medicine. This study addresses the issue of curricular redundancy in medical education, highlighting the necessity for periodic reviews to eliminate outdated or irrelevant topics. Method A descriptive qualitative approach was employed, involving participants from various medical schools across India. An online questionnaire was used to gather data on redundant topics, suggested replacements, and improvements in the curriculum for both didactic and non-didactic subjects, along with inputs related to assessment and evaluation methods. Content analysis was used for thematic identification and qualitative interpretation. Results Out of 71 respondents from a wide geographic distribution, 30% were female, and 70% were male, with an age range of 17 to 36 years. Participants expressed concerns about redundant theoretical (32%) and practical (51%) topics. Qualitative analysis highlighted the need for integrating different subjects and placing a stronger focus on practical clinical skills. Participants emphasized the importance of a curriculum that keeps pace with advancements in medicine, such as genomics and artificial intelligence, while also addressing mental health. Specifically, they suggested combining anatomy and surgery courses, incorporating more active learning techniques, and utilizing ongoing assessments to gauge progress. Conclusion The study highlights the necessity of eliminating curricular redundancy in medical education. Recommendations include developing a flexible curriculum, emphasizing region-specific content, and implementing a formative assessment system. Additionally, the importance of faculty development and stakeholder involvement in curriculum design is emphasized. Key Message Key insights for updating the medical undergraduate curriculum include the following:

Offline-to-online shift of medical education: A multi-method study of medical teachers and students from India

Objectives: The objective of the study is to explore undergraduate medical students’ and teachers’ perceptions, detailed insights and learning experiences on online medical education. Materials and Methods: This is an institution-based multi-method study conducted at three medical institutes in India. A self-prepared semi-structured questionnaire was used to extract various perspectives of teaching and assessment through online mode. A qualitative descriptive design was applied using focused group discussion (FGD). All FGDs were audio-recorded, transcribed verbatim and analysed using thematic content analysis to identify themes and subthemes regarding perceptions of online and offline education. Results: A total of 323 medical students out of 510 and 35 medical teachers out of 71 were included in the study. Most students and teachers agreed to the fact that they faced technical difficulties, were perceived as less connected, and felt difficulty in achieving desired competencies. In qualitative analysis, five major themes (Learning Environment, Technology, Competency, Health issues and Assessment) and multiple subthemes were identified. Conclusion: Improvement of the online teaching methods with appropriate technical advancement may help to reduce the gap between the online and offline teaching learning modalities.

Basic medical sciences are pre-clinical subjects, not non-clinical subjects: Say 'No' to the prefix 'Non-'.

Few medical institutions in India, such as the All India Institute of Medical Sciences (AIIMS), use the term pre-clinical in their websites and brochures, but many institutions still use the word 'non-clinical'. In my opinion, the non-clinical departments should be renamed pre-clinical departments. In western countries, the curriculum is divided into pre-clinical and clinical. For example, in Oxford University, the initial instruction in courses such as Anatomy and Physiology is regarded as pre-clinical instruction. Non-clinical departments in western countries are the departments of human resource, accounts and information technology (IT).

Quality of life among type-2 Diabetes Mellitus Patients: A Cross-Sectional Study from Eastern Indian Medical Institute

Quality of life among type-2 Diabetes Mellitus Patients: A Cross-Sectional Study from Eastern Indian Medical Institute

Empathy Among Medical Students: An Exploratory Cross-Sectional Survey.

Context In the context of healthcare, effective communication and empathy are fundamental skills for physicians, as empathy correlates positively with patient satisfaction, compliance, treatment adherence, and lower rates of physician burnout, depression and anxiety. This study aimed to assess empathy levels and related factors among undergraduate medical students. Methods A cross-sectional study in a Central Indian medical institute examined empathy levels and factors associated with it among medical students, utilizing various scales and statistical analyses. Results This study found that while empathy levels were relatively high among undergraduate students, there was a decline as they progressed through medical education, particularly after the first year of clinical exposure. The study identified several factors associated with empathy levels, including perceived stress, emotional separation, and social support. Notably, individuals experiencing higher levels of stress and emotional separation tended to have higher empathy levels. Conclusions The study's findings suggest that medical education should incorporate interventions to enhance empathy, including addressing stress, providing social support, and exposing students to the emotional aspects of patient care.

Strengthening research capacity of early-mid career researchers: Implementation and evaluation of the Excellence in Non-COmmunicable disease REsearch (ENCORE) program.

High-quality training and networking are pivotal for enhancing the research capacity of early- to mid-career researchers in the prevention and control of non-communicable diseases. Beyond building research skills, these professionals gain valuable insights from interdisciplinary mentorship, networking opportunities, and exposure to diverse cultures and health systems. Despite the significance of such initiatives, their implementation remains underexplored. Here, we describe the implementation and evaluation of the Excellence in Non-COommunicable disease REsearch (ENCORE) program, a collaborative initiative between Australia and India that was launched in 2016 and spanned a duration of 3 years. Led by a consortium that included the University of Melbourne and leading Indian research and medical institutions, ENCORE involved 15 faculty members and 20 early-mid career researchers. The program comprised various elements, including face-to-face forums, masterclasses, webinars, a health-technology conference, and roundtable events. ENCORE successfully trained the early-career researchers, resulting in over 30 peer-reviewed articles, 36 conference presentations, and the submission of seven grant applications, three of which received funding. Beyond individual achievements, ENCORE fostered robust research collaboration between Australian and Indian institutions, showcasing its broader impact on strengthening research capacities across borders.

A survey on practices of embalming techniques and usage of soft embalming methods in Indian medical institutes

BackgroundSoft cadavers are becoming increasingly popular for surgical skills development in competency-based medical education curricula. However, few studies evaluate this strategy's viability, dependability, and validity, particularly in India. This study intends to investigate embalming procedures and procedural skills practices at medical institutions. MethodsA validated questionnaire gathered information on demographic details, embalming practices, surgical skill training, willingness to adopt modern embalming techniques and awareness and practice of soft embalming methods. A total of 350 Indian medical institutions were forwarded the questionnaire via email. Responses were analyzed using SPSS version 16, and the Chi-square test was used to examine the association between the two categorical variables. ResultsA study of 350 Indian medical institutions found a 62% response rate. In the studied population, 53.5% (N = 116) of institutes demonstrated procedural skills in undergraduate education as a part of early clinical experience. A total of 54.4% (N = 118) of institutes conducted hands-on surgical training. For postgraduates in surgical departments, voluntary cadaver dissection was offered at 53.9% (N = 117) of institutes. In 78.3% (N = 170) of the institutes, surgical training was performed on formaldehyde-embalmed cadavers. Institutions used proprietary solutions, fresh frozen approaches, Thiel solution, phenol, and saturated salt solutions for embalming. ConclusionThe study highlights disparities in undergraduate teaching and surgical skill training in medical institutes, emphasizing the need for re-evaluating embalming practices to ensure the safety and educational quality. It also highlights underutilization of soft embalming methods, highlighting need for improved training programs and strategies to enhance medical education quality.

Stationary Scholars: The Looming Health Crisis Among Preclinical and Paraclinical Doctors in India.

This letter highlights the critical issue of sedentary lifestyles among preclinical and paraclinical doctors in India, which poses significant health risks that are often overlooked. This manuscript reviews research demonstrating the links between prolonged sitting and increased risks of cardiovascular disease, musculoskeletal disorders, mental health issues, and impaired cognitive function in this population. The COVID-19 pandemic is also discussed as a factor that may have exacerbated sedentary behavior. The letter calls for Indian medical institutions, policymakers, and stakeholders to urgently implement strategies to promote healthier work environments for preclinical and paraclinical doctors, including active workstations, structured activity breaks, tailored wellness programs, and educational campaigns. Advocating for policy changes and further research in this area are also emphasized as key priorities to address this overlooked occupational health concern and improve the well-being of these essential members of India's medical academic community.

Publication requirement for faculty promotion in medical institutions in India: 'Mind the gap'.

Background . We assessed the balance between the number of publications required by medical teachers and the publication space available in the Indian medical journals. Methods . The Medical Council of India (MCI) website, its guidelines and documents were searched and we extracted data on the number of medical colleges, undergraduate and postgraduate seats and faculty requirement. The required number of assistant professors and associate professors was calculated. The publication requirements were estimated according to MCI's February 2020 guidelines. A publication which satisfied the above guidelines for promotion was counted as 'eligible publication'. Indian medical journals indexed in any of the MCI-permitted databases were identified, and the number of eligible articles in them in 2019 was counted. Results . India has a total of 79 798 MBBS seats, 33 025 postgraduate seats and 4231 superspecialty seats in MCI-certified medical institutions and to teach them 35 285 assistant professors and 23 116 associate professors are required. Assuming that each publication could serve a maximum of 3 teachers, we will need approximately 50 696 eligible publications in the next 7 years. A search of applicable databases, identified 162 unique Indian medical journals of which 79 were indexed in PubMed/PubMed Central. Among the remaining 63 were indexed in DOAJ, 14 in EMBASE, 3 in Scopus and 3 were indexed only in WOSSCIE. These journals cumulatively published a total of 8508 eligible publications in 2019. Conclusion . The publication space in Indian medical journals is limited, thus there is a need to have a national medical repository such as MedRxiv to prevent publication in predatory journals.

A-188 Managing a Fully-automated Paperless Laboratory During a Cyber-attack

Abstract Background On 23rd Nov, 2022 a tertiary care apex medical institute in India was subject to cyberattack which disrupted the Hospital Information system (HIS) and the Laboratory Information system (LIS) servers. The services from the SmartLab, an end-to-end integrated total-lab-automation system, designed to run on paperless mode got disrupted. This is the main service laboratory with an average daily sample load of approx. 5000 including hematology, coagulation, clinical chemistry, immunoassays and serology services. Methods All lab operations were immediately shifted to manual mode. Standard operating protocols (SOPs) were designed for manual processing and circulated to OPD and IPD staff through WhatsApp. Instructions were issued to use previously used paper test-request-forms (TRFs) for sending samples. Previous stock of TRFs were retrieved from Stores and distributed to the IPD and OPDs. Staff from other areas of the hospital were mobilized.In OPD sample collection area, patients’ registrations were done by writing Patient-Id, Name, Age, Sex, Sample-Id, Treating department and Test requests in registers. A small sticker was introduced and pasted on the blood collection tubes capturing minimal relevant patient details, treating department codes and sample Id. Duplicates were pasted on OPD cards of respective patients. Traceability of patient Ids and sample Ids were maintained through data entry in registers. In the lab, the LIS were shut down on a precautionary note. Test requests corresponding to each sample Id were programmed directly on the analyzers. When done, print-outs of test results were obtained from the analyzers and hand-written results were entered by data entry operators on the TRFs. Reports were then segregated as per the treating department codes and dispatched to respective places. This continued till partial restoration of HIS services on and from 12th December, 2023. Results Despite best efforts, turn-around-time (TAT) for reports got compromised. IPD reports were prioritized and about 60% of the same could be dispatched by 9 PM same day, rest being delivered by 9 AM, next morning. TAT for OPD reports stretched up to 36 h. Inspite of introducing separate numbering systems with codes for different OPDs and IPDs, about 40% reports could not be traced to the respective OPDs. These reports were collected by the patients’ attendants from the lab itself. Manual report retrieval counters were set up outside the lab. At least 20% reports of the approx. 3000 reports generated per day remained unclaimed even after 30 days. The utilization of lab services also came down by 20%–25% during this period. About 5% reports had to be repeated with fresh samples due to inability to retrieve previous reports. The data generated during this 20-days period could not be stored electronically and hence are not available in our database now. Conclusion Cyberattacks may happen to any institution. Having a strict cyber-security protocol is a must for all institutions. However, having a back-up plan for handling such a crisis should be also in place in case of any eventuality. Sharing our experience is an endeavour to create awareness regarding the prerequisites of such a plan.

Direct Observation of Procedural Skills: A Formative Assessment Tool for Postgraduate Training in Obstetrics and Gynecology

Background: Direct observation of procedural skills (DOPS), a method of workplace-based assessment helps the students to shape their learning. DOPS requires direct observation and assessment of students while performing in a real-life setting using a structured checklist with constructive feedback for improvement. Most of the medical institutes in India still assess the students on the basis of traditional methods, where theoretical knowledge is mainly assessed as a summative assessment. This study was conducted to bridge this gap by introducing DOPS as a formative assessment tool for PG students in obstetrics and gynecology and to explore the perspectives of faculty and students for DOPS as a formative assessment tool. Materials and Methods: In the department of obstetrics and gynecology at a tertiary care teaching institute in Central India, this prospective interventional research was conducted for a period of 1 year. Eighteen 2nd year and final year postgraduate students and nine faculty from the obstetrics and gynecology specialty were identified for inclusion in this study using convenient sampling. IEC approval (NKPSIMS and RC and LMH/IEC/09/2021) and informed consent were taken. Postgraduate students were assessed for 5 procedures using a validated structured checklist: (1) per speculum and per vaginal examination, (2) Pap’s smear collection, (3) conduction of artificial rupture of membrane, (4) introduction of intrauterine contraceptive device, and (5) episiotomy repair. Feedback after assessment was given by the faculty. There were 3 DOPS assessment sessions for each procedure. Perception of students and faculty was collected using a prevalidated questionnaire using 3-point Linkert’s scale. Descriptive statistics of response was considered to calculate percentages. Using thematic analysis, the responses of open-ended questions were analyzed based on the quantitative data form. Results: Perception of students were positive as effective teaching learning tool (94%), skill improvement (100%), constructive feedback (100%), time provided for feedback (100%), confidence gain (100%), assessment in nonthreatening environment (100%), motivation (94%), Faculty responded positively regarding improved attitude toward teaching (100%), in depth assessment of skill (78%), useful teaching learning tool (100%), improves student–teacher relationship (78%), identifies developmental needs of student (100%). Themes identified were DOPS provide more systematic learning, personal attention to each student, better understanding, learn proper steps of procedure, one on one interactive method of learning, improvement of clinical skills, and more confident. Challenges perceived by students were time constraint and person who grades is not the same teacher and by faculty were more time and dedication needed and more paper work is required. Conclusion: DOPS was considered as an effective teaching learning and assessment tool and can be incorporated as a formative assessment tool during residency in Obstetrics and Gynecology (OBGY) by both faculty and students. Time for assessment is a challenge considered by Faculty as well as by students.

The Impact of Periodic Formative Assessments on Learning Through the Lens of the Complex Adaptive System and Social Sustainability Principles.

Medical institutions in India have employed different periodic formative assessment (FA) methods with variable impact. The formative evaluation must incorporate feedback to improve learning. Formative assessment has helped inexperienced students apprehend their weaknesses, make choices, prepare for summative exams, and allow teachers to identify regions wherein students may also need aid. This study attempts to quantify the impact of the weekly, monthly, and semesterformative assessments and view it retrospectively through the lens of complex adaptive systems and social sustainability principles. We used a post-exam survey and statistical analysis to compare the students' performance between the timely periodic formative assessments in a competency-based curriculum. The cohort consisted of 2018 (semester), 2019 (weekly), and 2020 (monthly) first-year medical students. Cronbach alpha, spearman's correlation coefficient, descriptive statistics, and repeated measure analysis of variance were used to explore the reliability and relationship between formative assessment and summative scores of each cohort and find any significant difference. The authors also analyzed the accordance between the FA exam performance and students' perceptions, deduced broad themes, and discussed the appropriateness and feasibility of students' suggestions for changes. A significant correlation was found only between the weekly formative assessment and summative scores (r=0.74, p=0.01). Theanalysis of variance established significant differences betweenall summative scores of respective periodic formative assessments. The weekly formative assessment showed the highest mean summative examination scores. This study helped comprehend preclinical students' apprehension after the intervention of periodic formative assessments. The students found this intervention helpful in driving and detecting gaps in learning but preferred focused feedback, clinically oriented practices, and countered mental health issues. The continuous periodic formative assessment model had a valid educational impact but was not sustainable according to social sustainability principles. A complex adaptive framework can be utilized to make it sustainable.

International Physician Migration: A Comparative Study of Healthcare in the US, UK, & India

Physician migration patterns are a phenomenon that affects the healthcare system within developing countries, but there is no strong evidence to show why doctors migrate to the West after getting an education from elite Indian medical institutions. This study aims to explain why physicians from India choose to leave given the different push and pull factors. Prior research shows that better opportunities for higher education, socioeconomic status, upward mobility, and equitable healthcare systems contribute to why physicians are attracted to the US and the UK. This leads to the next main question: which country do doctors prefer after moving away from India, the US or the UK? With further investigation through interviews, it becomes evident that there is no actual preference for one country. Each country has unique assets within the types of healthcare and lifestyles offered. Physicians note that social networks, support systems, and recruitment are all reasons for moving to the West. Female and lower caste/class doctors with adequate resources who left India discuss that they were able to feel more valued for their merit outside of the country. Some upper caste/class physicians were privileged enough to have more autonomy when deciding where to go; for them, the West was just another option. Upper-caste narratives also shed light on the politics they fled from, such as the medical education quota system for undergraduate and postgraduate institutions. To summarize: physicians didn’t worry too much about the destination. Rather, they just wanted to leave India.

Impact of Life Cycle Costing in Procurement of Robotic Track-Based Central Laboratory at Apex Medical Institute in India.

Introduction Life cycle costing is an important management tool that takes into account the implications of planning, acquiring, operating, maintaining, and disposing of an asset during its complete life cycle. A major hindrance to the procurement of expensive equipment in developing countries is the lack of a reliable framework combining and integrating all the equipment life cycle aspects into procurement process. Methods The study was conducted from the data collected from the bids that were received for procurement of two robotic track-based central laboratories which were installed at All India Institute of Medical Sciences (AIIMS), New Delhi. The procurement was done as per the guidelines laid down under General Finance Rules (GFR) 2017 following the two bid systems: technical bid and price/commercial bid. Results A complete financial analysis of the robotic laboratory was done that involved gathering of all the pertinent financial information into one place and then using that data to analyze the feasibility of the bid. The life cycle costs of both the labs were calculated by assuming the life of equipment as 10 years and by factoring in cost of equipment including 5-year warranty, comprehensive maintenance from years 6 to 10, indicative cost of all reagents for 10 years, and indicative cost of all other consumables for 10 years. Conclusion Results showed that the cost of equipment alone should not be the sole predictor of making purchase decisions of equipment. Further research may additionally explore differences between processes being followed in government versus private organizations, as well as national guidelines and subnational practices.

Vaccination coverage and breakthrough infections of COVID-19 during the second wave among staff of selected medical institutions in India.

India experienced the second wave of SARS-CoV-2 infection from April 3 to June 10, 2021. During the second wave, Delta variant B.1617.2 emerged as the predominant strain, spiking cases from 12.5 million to 29.3 million (cumulative) by the end of the surge in India. Vaccines against COVID-19 are a potent tool to control and end the pandemic in addition to other control measures. India rolled out its vaccination programme on January 16, 2021, initially with two vaccines that were given emergency authorization-Covaxin (BBV152) and Covishield (ChAdOx1 nCoV- 19). Vaccination was initially started for the elderly (60+) and front-line workers and then gradually opened to different age groups. The second wave hit when vaccination was picking up pace in India. There were instances of vaccinated people (fully and partially) getting infected, and reinfections were also reported. We undertook a survey of staff (front line health care workers and supporting) of 15 medical colleges and research institutes across India to assess the vaccination coverage, incidence of breakthrough infections, and reinfections among them from June 2 to July 10, 2021. A total of 1876 staff participated, and 1484 forms were selected for analysis after removing duplicates and erroneous entries (n = 392). We found that among the respondents at the time of response, 17.6% were unvaccinated, 19.8% were partially vaccinated (received the first dose), and 62.5% were fully vaccinated (received both doses). Incidence of breakthrough infections was 8.7% among the 801 individuals (70/801) tested at least 14 days after the 2nd dose of vaccine. Eight participants reported reinfection in the overall infected group and reinfection incidence rate was 5.1%. Out of (N = 349) infected individuals 243 (69.6%) were unvaccinated and 106 (30.3%) were vaccinated. Our findings reveal the protective effect of vaccination and its role as an essential tool in the struggle against this pandemic.

Why Re-Orientation of Medical Education is an Essential and Needed Program to the Medical Institutions in India?

Why Re-Orientation of Medical Education is an Essential and Needed Program to the Medical Institutions in India?

Perceptions about controlled human infection model (CHIM) studies among members of ethics committees of Indian medical institutions: A qualitative exploration.

Introduction: Controlled Human Infection Model (CHIM) studies provide a unique platform for studying the pathophysiology of infectious diseases and accelerated testing of vaccines and drugs in controlled settings. However, ethical issues shroud them as the disease-causing pathogen is intentionally inoculated into healthy consenting volunteers, and effective treatment may or may not be available. We explored the perceptions of the members of institutional ethics committees (IECs) in India about CHIM studies. Methods: This qualitative exploratory study, conducted across seven sites in India, included 11 focused group discussions (FGD) and 31 in-depth interviews (IDI). A flexible approach was used with the aid of a topic guide. The data were thematically analyzed using grounded theory and an inductive approach. Emerging themes and sub-themes were analyzed, and major emergent themes were elucidated. Results: Seventy-two IEC members participated in the study including 21 basic medical scientists, 29 clinicians, 9 lay people, 6 legal experts and 7 social scientists. Three major themes emerged from this analysis-apprehensions about conduct of CHIM studies in India, a perceived need for CHIM studies in India and risk mitigation measures needed to protect research participants and minimize the associated risks. Conclusion: Development of a specific regulatory and ethical framework, training of research staff and ethics committee members, and ensuring specialized research infrastructure along with adequate community sensitization were considered essential before initiation of CHIM studies in India.

A review medicinal and traditional uses on Tulsi plant (Ocimum sanctum L.)

Tulsi (Ocimum santum L.), which is native to the Indian subcontinent, is highly revered for its therapeutic use in both ayurveda and siddha medicine. Numerous in vitro and human studies have shown that tulsi has a variety of functions, including antibacterial and cardioprotective ones. On the clinical security of tulsi, there have been no accurate assessments of human studies to yet. We oversaw a thorough written review of human examinations that described a clinical outcome following tulsi ingestion. We searched databases from PubMed, Science Direct, and Indian medical institutions for studies, theories, and information that was distributed in print. Without any note-worthy hostile events being revealed through testing, all research described optimal clinical results. To explore activity, explain the dose, and explain portion size, more research is necessary. The research suggests that tulsi is a potential therapy option for way of life and is stronger than conventionally utilised methods.

Comparative and quantitative study of three premier medical institutes in India so as to suggest baseline of key performance indicators for medical colleges

Introduction: There has been substantial increase in the number of medical colleges along with student enrollment necessitate a need for improving the quality of medical education in India. This led to the development of accreditation and ranking system for medical institutions. Key performance indicators (KPIs) for medical institutions can be determined by parameters considered for accreditation and ranking of medical institutes. KPIs for medical institutions are set of quantifiable measurements used to analyze long-term performance and progress of the medical institutions. KPIs provide a focus for strategic and operational improvement, create an analytical basis for decision-making, and help focus attention on parameters that matter most in improving the quality of teaching and learning resources and patient care services provided by the medical institutes.Methodology: A descriptive and quantitative study was conducted to compare secondary data of three premier medical institutions of India, namely, All India Institute of Medical Sciences, New Delhi; Post Graduate Institute of Medical Education and Research, Chandigarh; and Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. Baseline for KPIs was designed based on the parameters included in external accreditation and ranking, namely, National Accreditation and Assessment Council Accreditation, National Institutional Ranking Framework Ranking, National Accreditation Board for Hospitals and Healthcare Providers Accreditation, and National Accreditation Board for Testing and Calibration Laboratories Accreditation.Observations and Results: Teaching and training identify four KPIs, annual intake of undergraduate students per hospital beds, annul intake of postgraduate students (DM/MCh/MD/MS degree, DNB, Diploma, Certificate programs, Fellowships, PhD) per hospital beds, annual intake of nursing students expressed as ratio of available hospital beds, and annual intake of paramedical and allied students (diploma, degree, pharmacy, etc.) expressed as ratio of available hospital beds. Patient care includes annual outpatient department consultations including casualty (old + new) expressed as ratio of available clinical faculty, annual In-Patient Department (IPD) admission expressed as ratio of available hospital beds, and annual surgeries conducted (operations and procedures) expressed as ratio of available surgeons. Research and publications include total number of extramural projects currently running expressed as ratio of faculty, total amount of extramural grant expressed as ratio of faculty, and total number of indexed research publications per faculty.Conclusion: The KPIs are absolute necessity due to increase in number of medical colleges across the country. KPIs provide a focus for strategic and operational improvement, create an analytical basis for decision-making, and help focus attention on what matters most to enhance the quality and performance of the medical institutes and subsequently uplift the quality of health-care services across the country.

Returns on library investment: seeking causative relationship between the library investment and the institutional research output

PurposeThis study aims to seek the causative relationship between the library budget and research output with the ranking of 20 leading medial institutes in India. More so, the study also attempts to find out whether the libraries associated with academic and research institutes in general and medical institutes in particular have turned redundant or irrelevant, or have become more relevant in the changing times by embracing technology in its every new form.Design/methodology/approachThe study is based on the secondary data retrieved from the official website of the Ministry of Education, Government of India and research output against each institution under study has been retrieved from Scopus. The study is limited to Indian medical institutions that participated in the 2019 National Institutional Ranking Framework (NIRF), conducted by the Ministry of Education, India each year. The findings of the study can be generalized to all the medical institutions of the country.FindingsOn average, INR 160.90m were spent by each medical institute on the procurement of library resources at an average of INR 0.104m on procurement of resources against each individual published research article. Of the total research articles published by medical institutes under study, 26.39% of research articles were published by researchers from AIIMS, New Delhi, alone.Research limitations/implicationsFinancial aid or funding is very vital for the survival, sustenance and excellence of research institutions, and this funding becomes more important when the investigation is aimed toward the furtherance of medical advances. Any medical advancement is hell-bent to influence the overall welfare and betterment of society at large, whereby the benefit of any investment made in medical science is bound to be reaped by one and all alike.Originality/valueIn India, a good number of studies have been undertaken on the NIRF data to dive deeper to assess the role and importance of libraries in the overall ranking of institutions like universities, management institutes, engineering and technology institutes, but no major study has been so far conducted covering leading medical institutes in India. The study is the original and first of its kind undertaken in India.