Small medical journals and the 10/90 problem: Educatione ad excellentiam

We read with great interest your editorial on Western medical journals and the 10/90 problem.1 Working in a relatively less developed environment and editing a small medical journal, we fully agree that “journals are not merely publications but sites of action.” In line with your call to conceive of biomedical education as an “international enterprise,” we would like to emphasize the role of journal editors in developing countries. We believe that they can and should be educators within their scientific communities.2^,3

In our 10 years of working with authors from a region that has experienced a devastating war and the economic crisis of post-communist market transition,4 we have learned that it is possible to build bridges between the scientific periphery and mainstream science. During the war in Croatia, we saw that our colleagues had important knowledge to share with the global medical community but lacked the skills to present that knowledge.5 We therefore introduced an author-friendly policy to assist them to publish good articles in our journal, as well as in international medical journals.4^,5 Our educational activities with authors grew into a structured teaching program involving most members of the journal's office: a mandatory course on research and writing for medical students, continuing education courses on evidence-based medicine for physicians, research electives for medical students ending in peer-reviewed publication in our Student Croatian Medical Journal and an international workshop on scientific writing for authors in southeast Europe.6 We believe that our activities have contributed substantially to the development of a critical mass of researchers in our region who will be able to join the mainstream research community.

Perhaps the most effective way for Western medical journals to overcome the 10/90 problem is to join hands with local journals and their editors to build research and publishing capacity in small and underdeveloped scientific communities.3 The smaller journals would publish better articles and thus increase their visibility, and the bigger journals would be better able to cover global issues and open avenues for high-quality submissions.

Ana Marusic Matko Marusic Editors in Chief Croatian Medical Journal Zagreb, Croatia