Indications for Publications
For many young Chinese doctors, “How’s your paper coming along?” has replaced “Hello” as the default conversation starter. Why? Because in today’s academic and professional world, publishing in Science Citation Index (SCI) journals—peer-reviewed outlets indexed for their high-quality research—often matters more to employers and policymakers than even the gratitude of patients they treat. This pressure, highlighted in prior research in The Lancet, has led some to take questionable steps to get published: running experiments with no real purpose, analyzing data unrelated to their work, or writing review articles that add nothing new to the field.
According to Shihi Chang and Qing-Guo Zhang, researchers at the Auricular Plastic and Reconstructive Surgery Center of the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, this focus on “publishing at all costs” misses the point of academic work. In a 2020 correspondence in the Chinese Medical Journal, they argue that the same rigor guiding medical decisions—known as “indications”—should apply to when and why we publish.
First, let’s clarify the problem: The pressure to publish isn’t entirely negative. It keeps doctors up to date on the latest medical advances and encourages critical thinking. But for many, especially medical graduate students who are required to publish at least one paper to complete their studies, the “need” to publish overshadows whether the work itself has value. These students, still early in their clinical training, often lack deep insight into their future specialties. Yet the demand for a publication means they might prioritize quantity over quality—even if their work doesn’t contribute to science or practice.
Chang and Zhang’s solution draws on their experience as surgeons: In medicine, you only order a test, prescribe a drug, or perform surgery if there’s an “indication”—a valid, evidence-based reason that the action will help the patient. The same logic should apply to publishing. A paper should only be written and submitted if it meets two key “indications”: It will advance medical science or clinical practice, or it will educate the readers of the target journal.
This shift would give young researchers clear direction. Instead of chasing a publication to check a box, they’d ask: Does this work have something meaningful to say? For journals, it means establishing clear “publication indications” aligned with their mission—say, a journal focused on plastic surgery might prioritize papers that improve reconstructive techniques, while a general medical journal might value work that informs public health policy. Before submitting, authors would confirm their paper meets these criteria. If not, they’d save time and energy by revising their work or pursuing a different project.
The goal isn’t to stop people from publishing—it’s to ensure that every publication serves a purpose. As Chang and Zhang write, scientific papers are meant to communicate ideas and uphold rigor, not just to earn recognition. By applying the “indication” principle, we can help young doctors and researchers focus on work that truly matters—whether that’s improving patient care, advancing research, or teaching others in the field.
Their arguments build on earlier discussions in The Lancet, where researchers highlighted the unique pressures facing young Chinese doctors (Yuan et al., 2013; Yu et al., 2013). The original correspondence was published in the Chinese Medical Journal in 2020.
doi.org/10.1097/CM9.0000000000000695
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