I’m not a big fan of identity politics, where, in my opinion, allegations of racism are too often used as a political cudgel to bludgeon an opponent. But sometimes it really is important to call out blatant racism, especially when there is a greater societal good at stake, such as in this case protecting the integrity of peer-reviewed science. I had this very “opportunity” thrown at me just last week.
To introduce our journal, and its unique crowd sourced quality score (SIQ) to new physician authors, Cureus utilizes email to reach specific communities of authors who have published articles in other Open Access journals, inviting them to promote the scoring of their articles via social media and email. While away on business in Beijing last week, I was surprised to see one email and two voicemails on my phone from a (unknown to me) senior and accomplished author in other journals. His messages quickly revealed a surprising anger over having his article promoted by Cureus. I replied with a brief email explaining how the Creative Commons copyright system supported such fair usage by Cureus, but this merely precipitated yet another profanity-laced email volley. Not wanting to inflame matters further, and even more so wanting to understand the true source of his angst, I decided to call the author. To say the call was unpleasant would be an understatement. I am a neurosurgeon and have fairly tough skin but it is never fun to have all kinds of profanity thrown at you, especially when you’re sure it is unjustified.
I let him vent a little, as my primary goal was figuring out why he was so upset. No matter how patiently I asked this guy to explain the source of his anger, he repeatedly deflected. Finally, after having asked multiple times, this rather accomplished researcher frustratingly blurted out that he did not want his article promoted “alongside the University of Pakistan.” In that instant, everything became clear. There is no institution named The University of Pakistan. Cureus, however, recently published several articles from South Asian-based institutions, namely India and Pakistan. What I suddenly realized is that this person was merely pissed (and seemingly offended) that his “aristocratic” article (allow me some artistic license here) might appear alongside “unworthy” South Asian articles. To put it more bluntly, this otherwise truly accomplished author was just a racist old fool.
In an effort to defuse the situation I complied with his request to remove his article. Upon further reflection I now feel a deep sense of gratitude to this old racist for providing me the opportunity to expose how racism—implicit and overt (like this case), sadly lurks in the background of all peer-reviewed journals. Truthfully I am amazed that so many in this day and age are still clueless about what is happening in medical science. As I sit writing this in a world-renowned Chinese hospital, I am surrounded by the very type of medical excellence that my racist critic deems unworthy of his association. A close American friend of mine (and Cureus editorial board member) is one of the premier pediatric cardiac surgeons in the world, having invented several important heart operations. He has visited several South Asian hospitals that have refined his original operation, enabling them to operate on vastly more patients than him, and do so at less than 10% the price of a U.S. hospital. In light of this, it strikes me as complete foolishness to restrict such important medical knowledge. Scholarly racism is utterly self-defeating for authors, readers and the world at large.
Although I could find no formal studies documenting the extent of racism within scholarly journals, there is a modest body of research and other evidence pointing towards the existence of sexism, as well as prejudice against non-academic physicians, in the world of academic publishing [1-3]. Perhaps it is time to formally study the extent of racial bias in peer-reviewed journals. Any takers?
Recently, the CEO of an authoritative digital health website shared an interesting statistic with me: 40% of the articles published in the New England Journal of Medicine, arguably the most important medical journal, originate within a 200 mile radius of the journal’s headquarters. No one would disagree that Boston, New York and New Haven are centers of academic excellence, but the medical community that dominates the NEJM represents but a tiny fraction of world physicians, thus excluding an immense amount of clinical experience and knowledge. Although such willful blindness or elitism is not as blatant as the prejudice exhibited by my new acquaintance, does a hugely influential and even entitled societal institution like the NEJM not have a responsibility to open itself up to more of the world of medicine?
While I will continue to respect the world’s leading medical journals for the important work they publish, I remain proud that Cureus serves the vast numbers of physicians truly in the trenches of medicine who have been disenfranchised through what might be best termed “scholarly elitism.” Lastly, I want to thank this narrow-minded dolt for reminding me yet again why Cureus’ mission is so important to the world of medicine.
References:
1). Pololi LH, Civian JT, Brennan RT, Dottolo AL, Krupat E. “Experiencing the Culture of Academic Medicine: Gender Matters, A National Study.” J Gen Intern Med. 2012 Aug 31; [Epub ahead of print] PMID: 22936291. [PMC free article] [PubMed]
2) http://www.sciencemag.org/news/2015/05/plos-one-ousts-reviewer-editor-after-sexist-peer-review-storm
3) From abstract to impact in cardiovascular research: Factors predicting publication and citation. Eur Heart J. 2012 Winnik S, Raptis DA, Walker JH, Hasun M, Speer T, Clavien PA, et al. From abstract to impact in cardiovascular research: Factors predicting publication and citation. Eur Heart J. 5 June 2012 [Epub ahead of print] PMID: 22669850. [PMC free article] [PubMed]
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I am a neurosurgeon from Mexico. I have authored about 15 articles in international journals.All of them as first author, and most of them as single author. In the last years, I have observed some sort of racism from editors of top neurosurgery journals. These editors prefer papers from renowned authors and institutions, even if these papers are not outstanding. This situation occurs because very likely they think that by doing this, the journal will keep a higher degree of prestige. It is frustrating to see low-quality articles in these journals, only having the authors name as the prime criteria for publication. Very often the reviewers from these journals are tendentious when they review an article, applying different criteria depending on the author’s origin.
This is an example. Several months ago, I sent a paper to a top neurosurgery journal, this was a systematic review of a very rare condition. Due to the rarity of this condition, only case reports or case series were found for the review, so performing comparative analysis was not possible . I felt that the review was well performed and had a good quality for publication; however, it was rejected. All reviewers mentioned that the lack of statistical analysis was the cause of rejection. They wanted a metaanalysis when this was not possible to perform. Curiously, none of them criticized what really is important in a manuscript, the content. Next month, the article was accepted for publication in another very important neurosurgery journal.
Hope to hear some remarks regarding this issue from different authors.
Completely agree. Yes, the impact factors make us to think about submitting to the other journals.
I am a neurology resident in Mexico. As a resident it seems impossible to publish articles on high quality journals except for the rare third country disorders (eg. Neurocysticercosis). Every year medical students and residents from different specialties have to graduate by creating a research project. Most of this work is never published, or may just reach local medical journals with low impact. Cureus makes it easier for students wanting to pursue an academic career to get a much needed boost.