One picture shows a ladder in the shape of a pencil with steps made of paper

“Publish or Perish” is a phenomenon that research around the world has gotten a grip on, for better or for worse. Each country has its own version with its own quirks, but at its base it’s the same. To move forward, you need to publish articles – sometimes lots of them.

The particularly sharp end of release or demise can be found in Chinese hospitals. Doctors in training trying to enter their profession need research. Without progress, promotion or even survival may be out of their reach. However, the medical profession is notorious for long hours and a pressure cooker environment and is unsuitable for conducting research. This has apparently led to the rise of paper mills that produce bespoke papers at a price that uses wholly manufactured results. To date, hundreds of false papers have been discovered. There are probably many more – land mines just waiting for an unsuspecting explorer to step on them.

It’s hard to feel a little compassion for an overworked junior physician in this plight. Stick to the rules and you may find your career calmed down or even over. cheat and let’s go. At the same time, loading the scientific literature with cleverly disguised junk science has real and dangerous consequences. This means that time and money are wasted as nonsense results lead nowhere and potentially fruitful scientific avenues are turned – at least temporarily – into dead ends.

Perhaps even worse is the potential loss of trust – in research from specific regions, in scientific publishing, and in public science. In the midst of a pandemic, this lack of confidence has manifested itself in conspiracy theories that 5G masts are linked to Covid-19 or that vaccines contain tracking microchips. Another serious sign of loss of confidence is the hesitation of the vaccine. Although millions have died from this pandemic, people’s confidence in medicine has been undermined to the point that they fear taking the Covid vaccines. The spread of this scientific disinformation has so alarmed a European academy that it is calling for a science communication network to address the problem.

At the end of the day, it all comes back to publish or to perish. Do clinicians in China really need to do research before they can continue their careers? Will it improve your bedside style or your diagnostic skills? I guess not. The drive to publish more and more research poses a serious threat to the scientific ecosystem, and this is a problem that all nations must grapple with. Some pressure to show something for your work isn’t inappropriate – especially if you are receiving public funding. But the world still seems to be struggling to cross the line between quality and quantity.


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