Changing the research culture at the section of psychiatry, the University of the West Indies, Mona

OBJECTIVE: To compare the medical research output of the Section of Psychiatry, The University of the West Indies (UWI), Mona, before and after the implementation of strategies aimed at stimulating research. METHOD: Specific strategies such as weekly research and journal club meetings, with an emphasis on team activities and the establishment of bi-annual targets for submission of research papers were instituted in 2000. All research outputs from the Section of Psychiatry over the period 1995 to 2005 were identified from the Departmental Reports of the University of the West Indies and the published abstracts of the UWI Faculty of Medical Sciences and the Caribbean Health Research Council annual research conferences. A number of variables were extracted from each paper and comparisons made between the five-year period before and the five-year period after the implementation of the research enhancing strategies. Statistical analyses were performed with the Statistical Package for the Social Sciences (SPSS; version 11.5) and included chi-squared and Mann Whitney U tests. RESULTS: One-hundred and sixty-two items of research output were identified for the entire period under study. In the period after the implementation of the research enhancing strategies, there were significant increases in the total research output (p = 0.008) and refereed publications (p = 0.016). CONCLUSIONS: There were considerable increases in the overall research output of the department as well as in many sub-categories of output. These strategies are presented as a model to other departments seeking to augment their output of research.     

Medical library--then and now

The paper traces the Medical Library's growth, development and its relationship with the Faculty of Medical Sciences (FMS), researchers and other users pursuing their teaching, research and patient care. The information is analyzed, synthesized and organized from the Annual Reports of the Vice Chancellor, Principal, Libraries, various Departments in the Faculty of Medical Sciences, Office of Planning, Institutional Research, and the Web Pages of University of the West Indies, Mona, Jamaica.     

From presentation to publication: the natural history of orthopaedic abstracts in the United Kingdom

Background

Up to 63% of the chapters in major orthopaedic textbooks use the results from abstracts that have been presented at international orthopaedic meetings.

Methods

Orthopaedic abstracts were reviewed that were presented at the 1997 and 1998 meetings of the British Orthopaedic Association and other specialist orthopaedic meetings. The number of abstracts that had gone on to a full text publication was assessed and changes in study design or outcome were determined.

Results

Of the 415 abstracts 137 (33.0%) went on to full text publication. Abstracts presented at the British Orthopaedic Association were significantly more likely to go on to full text publication than abstracts from the other meetings studied. The mean time to publication was 15.6 months. Sample sizes in unpublished studies were smaller (mean 129.8 subjects compared with a mean of 191.4 subjects for published studies). Of full text papers, 19.0% differed regarding study design from the abstract presented at the initial meeting and 10.9% had published different results. Randomised controlled trials had the highest rate of later full text publication (53.6%) followed by observational studies (32.8%), basic science studies (31.4%), and case reports (6.7%).

Conclusions

In comparison with a study from North America, similar numbers of abstracts presented at meetings finally became published as full text articles, the abstracts had fewer authors, more often included randomised controlled trials and follow up data, and had fewer changes to the results. It is questionable whether the inclusion of such results from abstracts presented at international meetings by major orthopaedic textbooks should be undertaken before full text publication.     

Epidemic management: a Caribbean university's response to the 2009 H1N1 outbreak

BACKGROUND: In June 2009, the World Health Organization (WHO) declared a global influenza pandemic (1). During the throes of the epidemic, the Caribbean region recorded 22 deaths and 350 hospitalizations. Jamaica reported most of the deaths in the region--7, followed by Trinidad and Tobago--5 and Barbados--3; the remaining 7 deaths occurred in other Caribbean countries (2). In June, Jamaica reported its first case (3) and some three months later in September 2009, The University of the West Indies (UWI) Mona Campus experienced an outbreak of the 2009 H1N1 virus infection. As one of the three main Campuses of the leading tertiary institution in the English-speaking Caribbean (others being in Trinidad and Tobago and Barbados in addition to an 'Open Campus' which serves the non-Campus territories), the UWI Mona Campus serves some 15 000 students. These students originate mainly from the Caribbean; North American and African students also comprise the student population. The University Health Centre provides primary care services to a community of students, staff (3000) and their dependents, retirees, visiting staff and students.     

Quality of nonstructured and structured abstracts of original research articles in the British Medical Journal, the Canadian Medical Association Journal and the Journal of the American Medical Association.

OBJECTIVE: To assess and compare the quality of nonstructured and structured abstracts of original research articles in three medical journals. DESIGN: Blind, criterion-based observational study. SAMPLE: Random sample of 300 abstracts (25 abstracts per journal each year) of articles published in the British Medical Journal (BMJ), the Canadian Medical Association Journal and the Journal of the American Medical Association (JAMA) in 1988 and 1989 (nonstructured abstracts) and in 1991 and 1992 (structured abstracts). MAIN OUTCOME MEASURES: The quality of abstracts was measured against 33 objective criteria, which were divided into eight categories (purpose, research design, setting, subjects, intervention, measurement of variables, results and conclusions). The quality score was determined by dividing the number of criteria present by the number applicable; the score varied from 0 to 1. RESULTS: The overall mean quality scores for nonstructured and structured abstracts were 0.57 and 0.74 respectively (p < 0.001). The frequency in meeting the specific criteria was generally higher for the structured abstracts than for the nonstructured ones. The mean quality score was higher for nonstructured abstracts in JAMA than for those in BMJ (0.60 v. 0.54, p < 0.05). The scores for structured abstracts did not differ significantly between the three journals. CONCLUSIONS: The findings support recommendations that promote the use of structured abstracts. Further studies should be performed to assess the effect of time on the quality of abstracts and the extent to which abstracts reflect the content of the articles.     

Publication rates of presentations at the Irish Orthopaedic Association annual meeting

Background

Presentation of scientific research at national and international meetings is an important forum for the dissemination of knowledge. Subsequent publication of a full-text paper in a peer-reviewed journal is the expected outcome of such presentations. The publication rate from these meetings is highly variable.

Aims

To determine the publication rate of abstracts presented at the Irish Orthopaedic Association’s Annual Conference and to determine which factors are associated with progression to full-text publication.

Methods

We reviewed the proceedings from the Irish Orthopaedic Association’s National Meeting over a 4 year period. We searched the Pubmed database using author names, institution names, and keywords from each abstract’s title, to determine how many presented articles progressed to full-text publication.

Results

Sixty-six of 203 were published, 97 % within 5 years of presentation. Laboratory based studies presenting novel or innovative findings were more likely to be published than clinical studies. Clinical studies were more likely to be published if they were prospective and had a longer period of follow-up. Retrospective audits were less likely to be published, even with a large cohort size. Changes in authorship of presented papers were related to a longer delay in time to full-text publication.

Conclusions

Thorough planning of research studies is essential to ensure a timely progression to full-text publication in a peer-reviewed journal. Most studies will be published within 5 years of initial presentation.     

期刊与学术会议论文摘要中报告随机对照试验的CONSORT声明：说明与详述

背景：对于与随机对照试验（randomized controlled trial. RCT）有关的学术会议论文或期刊中发表的文章来说，清楚、明了、信息、量充足的摘要是十分重要的，因为读者经常仅仅根据报告的摘要对一个临床试验作出评价。句此，我们需要对“临床试验报告的统一标准（Consolidated Standards of Reporting Trials,ials-CONSORT）声明”进行扩充，制定一个期刊与学术会议论文摘要中报告RCT的必备条目清单。争后在任阿期刊发表的论文或学术会议论文摘要中，怍者对RCT结果的报告都要包含这些内容。 方法与结果：我们根据现有的质量评价工具和基于经验的证据总结出一个条目清单。运用三轮修正式德尔菲法（modified-Delphi process）进行条目筛选。邀请共计109人参与电子网络调查，反馈率为61%。调查结果干2007年1月在加拿大蒙特贝罗举行的CONSORT小组会议中公布，与会的26人中有临床试验实施人员、统计学家、流行病学家以及生物医学编辑。经过讨论最终确定条目，随后对其进行修订以保证这些条目体现了会议期间以及会后的讨论思路。摘要CONSORT建议RCT报告的摘要需要有一个结构化的格式，其中立该包括具体的试验目的、试验设计（随机分配的方法、盲法或遮蔽等）、研究对象（对象描述、随机分组的样本量以及用于分析的样本量）、每组实施的干预、实施的干预对主要疗效结果的影响及其危害、试验结论、试验注册名称和编号以及资金来源。本文对每一条能够找到例子的纳入条目都配有良好报告范制、基本原理以及证据等。十分明了易懂，因此我们建议与清单同时使用。     

Annual College of Medicine Research Dissemination Conference,Blantyre, November 12th, 2005

The theme for the 9th annual conference of the College of Medicine was “Research addressing poverty-related disease in Malawi”. The conference was opened by the Principal of the College of Medicine, Professor Robin Broadhead. He welcomed participants and explained why this annual meeting, fixed each year to coincide with the completion of the academic year, is such an important day in the calendar of the College. He introduced the invited guest speaker, Dr Davison Gwatkin, an international expert on issues of equity in health systems and currently a consultant for DFID in Lilongwe.There were 68 abstracts submitted for presentation and following peer review, 40 accepted for oral presentation and 27 for poster presentation (see abstracts below). Abstracts were peer-reviewed and I thank COM staff for their assistance. Presentations were of a high standard and covered a wide range of topics relevant to the health issues of Malawi. There were presentations covering maternal health, child health, HIV/AIDS, malaria, bacterial disease, cancer and the first session of the day was devoted to “reaching” the poor. This was the first year that parallel sessions were introduced due to the high number of abstracts submitted. One session of the day included five oral presentations from year 4 medical students and many were impressed by the high quality of their work and of their presentation. The quality of the posters was also to a high standard and reflected a similar range of topics and research activity as the oral presentations.There were almost 200 participants who registered for this year''s conference. Efforts to raise funds for the event were not particularly successful. The only major external sponsor was the Malawi-Liverpool-Wellcome Trust Clinical Research Programme and we are very grateful for their support. Particular thanks to Ms Mary Bwanali and Elizabeth Kadangwe of COM postgraduate office for the work they did in preparing for the conference throughout the year.The COM Annual Research Dissemination Meeting is the major health research dissemination meeting in the Malawian calendar. It is encouraging to see that the quality of and interest in this important vehicle of dissemination of health research in Malawi continues to improve and grow. We look forward to next year''s event which will be the 10th dissemination meeting.

• Malawi Med J. 2005 Dec; 17(4): 132–158.
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• DCON/05/01 - A Randomised Trial to Compare Efficacy and Safety of Intranasal Lorazepam and Intramuscular Paraldehyde in the Treatment of Convulsions in Children

Malawi Med J. 2005 Dec; 17(4): 132–158.

DCON/05/01 - A Randomised Trial to Compare Efficacy and Safety of Intranasal Lorazepam and Intramuscular Paraldehyde in the Treatment of Convulsions in Children

S Ahmad, J Ellis, H Kamwendo, and EM MolyneuxAuthor information Copyright and License information DisclaimerDepartment of Paediatrics, College of Medicine, University of MalawiCopyright © 2005, Malawi Medical Journal     

A review of medicinal plant research at the University of the West Indies, Jamaica, 1948-2001

This review summarizes research carried out on Jamaican medicinal plants at the Faculty of Pure and Applied Science, The University of the West Indies (UWI), Mona, Jamaica, between 1948 and 2001. The plants identified as being medicinal are listed along with their folk use and a summary of the scientific research done at UWI leading to the identification of natural products (NPs) and determination of their bioactivity. Natural product research on Jamaican medicinal plants began with the inception of UWI in 1948, leading to many postgraduate degrees being awarded (22 MPhil and 31 PhD). At least 334 plant species growing in Jamaica have been identified as having medicinal qualities, 193 of these have been tested for their bioactivity. Crude extracts from 80 of these plants have reasonable bioactivity and natural products (NP) have been identified from 44 plants. At least 29 of these NPs were found to be bioactive. Only 31 of the plants tested at UWI are endemic to Jamaica. Of these 23% were bioactive, as compared to 11% of the non-endemics. Based on these results, patents have been obtained and drugs have been developed. This review represents the first attempt to gather this information together in one place.     

Motivation for and concerns about entering a medical programme

The motivation for and concerns about studying medicine and future career plans of students at the Faculty of Medical Sciences, The University of the West Indies (UWI), were studied using a cross-sectional survey that included Year 1 medical students at both the Mona (Jamaica) and St Augustine (Trinidad and Tobago) medical schools of the UWI. The data were collected using a self-administered questionnaire containing structured questions on demographics and family background, motivation for and concerns about studying medicine and future career preferences. A total of 193 students took part in the study, 103 from Mona and 90 from St Augustine (88% response rate). Seventy per cent of the students were between 18 to 22 years of age with 59% being females. The highest rated motives for studying medicine were the 'opportunity for working with people' and an 'interest in human biology'. Female students scored significantly higher for the motive of an 'opportunity for working with people', while males rated the 'social prestige/status' significantly higher. The greatest concerns of the students were 'fear of failure' and 'contracting diseases'. The female students had a greater concern for dealing with the long hours involved in medical training than their male counterparts. Surgical specialties (43%), family medicine (38%) and paediatrics (34%) were the top choices of the students for future specialty and more women than men chose obstetrics. Although the motives that students have reported are varied, there was a reasonable spread of desirable motives. This study provides a baseline for observing possible changes as students advance through medical training. A programme of study that strives to maintain these well-placed motives while providing opportunities for dealing with the concerns of the students will assist in creating caring, empathetic physicians for the Caribbean.     

The Role of the Practising Physician in Medical Student Recruitment

The role that the practitioner of medicine can play in assisting recruitment to medical schools is examined. Although the total enrolment in universities has increased sharply in the past decade, the group applying to enter medicine has decreased. The output of Canada's 12 schools of medicine—850 graduates per year-falls significantly short of the number of new physicians required to maintain the present physician:population ratio. With the expanded output of physicians required in future, an active program of recruitment will be necessary. The recruitment program organized by the practising physicians of British Columbia and the Faculty of Medicine at the University of British Columbia is outlined.     

The Compliance of Healthcare Workers with Universal Precautions in the Emergency Room at the University Hospital of the West Indies

Objectives:

The study assessed compliance among health workers in the Emergency Room at the University Hospital of the West Indies with universal precautions. This was done by determining the knowledge, practices and perceptions of staff of universal precautions and by assessing compliance. Reported adherence with universal precautions was compared with observed practice.

Methods:

This was a cross-sectional study conducted over a one-year period. It was approved by the University Hospital of the West Indies/University of the West Indies/Faculty of Medical Sciences Ethics Committee. Data were analysed using Stata version 11.1.

Results:

During the study period, 67 persons gave consent for the study; data were obtained for 62 of these participants and 52 of the respondents were observed. All of the participants were aware that universal precautions related to blood. Eighty-six per cent erroneously thought that universal precautions applied to urine. Seventy-nine per cent of the participants reported always washing their hands after performing a procedure and 43.5% reported always washing their hands before a procedure.Just over half of the participants reported always wearing gloves while doing procedures (56.5%). Only 9% reported always using a gown with a trauma patient. However, 31% and 43.3% reported wearing a gown when placing a chest tube and when anticipating splashes, respectively. Of those participants who reported washing their hands often after a procedure, over 30% did not perform hand-washing when observed. Fifty per cent of persons that reported never recapping needles were observed to recap needles by hand.

Conclusion:

The study revealed that compliance among staff in the Emergency Room with universal precautions was unsatisfactory. The need for education in this area was recognized.     

The improving outcomes of coronary artery bypass graft surgery in Ontario, 1981 to 1995

BACKGROUND: There is continuing uncertainty over the relative contribution of outcomes monitoring to changes in surgical outcomes over time. The authors studied temporal trends in the clinical characteristics and short-term outcomes of patients who underwent coronary artery bypass grafting (CABG) in Ontario before and after the implementation, in 1993, of a province-wide program to provide feedback on cardiac surgery outcomes. METHODS: The authors analysed data from hospital discharge abstracts on the clinical characteristics and in-hospital death rates of all 67,784 patients who underwent isolated CABG in Ontario between Apr. 1, 1981, and Mar. 31, 1996. RESULTS: Death rates were relatively stable during the first half of the 1980s, then declined gradually in the second half of the decade; this decline continued into the first half of the 1990s. In the 1990s patients were older than those in the 1980s, and a higher proportion had coexisting diseases. Between 1986/87 and 1995/96 the unadjusted death rate decreased by 52% (5.0% v. 2.4%) (p < 0.001). The annual relative rate of decline was approximately 6% (95% confidence interval 5% to 7%) in the period before the outcomes feedback program was implemented and about 9% (95% confidence interval 7% to 11%) in the period after implementation. INTERPRETATION: Rates of death after CABG have been declining steadily in Ontario since the mid-1980s. Outcomes-based quality improvement interventions may facilitate; but are not a prerequisite for, improvements in the quality of surgical care.     

Some practical results of the London Medical Group conference on iatrogenic disease.

Although many conferences stimulate a great deal of discussion and practical interest at the time, not so many are followed up to try and estimate what, if any, practical results followed the meeting. This the authors of this study have done. (In Britain the 'medical groups' are voluntary groupings of students at medical schools who meet to discuss ethical problems related to their profession). Sixty-five participants (not all of them students) in the conference on iatrogenic disease replied to the questionnaire, and from the answers it was clear that not only the attitudes of those responding had in some cases been changed but in some positive action had resulted, for example, in the matter of prescribing. This analysis may provide an answer to those who criticize conferences as being a waste of time and money, because much more than could be evaluated from the responses to this survey must have affected all the participants.     

Analysis of publication output of internal medicine faculty members

The number of publications per year produced by a department of internal medicine faculty is analyzed. The output of the younger faculty members (40 years or less) averaged 1.4 publications a year, and the annual output of the older faculty (over 40 years) averaged 2.3 publications (p less than 0.05). The site of their primary clinical responsibilities did not significantly affect their publication productivity. In all subspecialty sections, the output of older faculty members correlated well with that of younger faculty members (p less than 0.005). The productivity of section chiefs correlated well with the productivity of younger faculty members in their respective sections (p less than 0.001). Younger faculty members who later entered private practice had a lower (p less than 0.02) publication output than those who left for another academic position. The output of faculty members is related to the age of the faculty members, overall sectional productivity, and productivity of the section chief.     

Diabetes and atherosclerosis: epidemiology,pathophysiology, and management

CONTEXT: Complications of atherosclerosis cause most morbidity and mortality in patients with diabetes mellitus. Despite the frequency and severity of disease, proven medical therapy remains incompletely understood and underused. OBJECTIVE: To review the epidemiology, pathophysiology, and medical and invasive treatment of atherosclerosis in patients with diabetes mellitus. DATA SOURCES: Using the index terms diabetes mellitus, myocardial infarction, peripheral vascular diseases, cerebrovascular accident, endothelium, vascular smooth muscle, platelets, thrombosis, cholesterol, hypertension, hyperglycemia, insulin, angioplasty, and coronary artery bypass, we searched the MEDLINE and EMBASE databases from 1976 to 2001. Additional data sources included bibliographies of identified articles and preliminary data presented at recent cardiology conferences. STUDY SELECTION: We selected original investigations and reviews of the epidemiology, pathophysiology, and therapy of atherosclerosis in diabetes. We selected randomized, double-blind, controlled studies, when available, to support therapeutic recommendations. Criteria for data inclusion (168 of 396) included publication in a peer-reviewed journal or presentation at a national cardiovascular society-sponsored meeting. DATA EXTRACTION: Data quality was determined by publication in peer-reviewed literature. Data extraction was performed by one of the authors. DATA SYNTHESIS: Diabetes mellitus markedly increases the risk of myocardial infarction, stroke, amputation, and death. The metabolic abnormalities caused by diabetes induce vascular dysfunction that predisposes this patient population to atherosclerosis. Blood pressure control, lipid-lowering therapy, angiotensin-converting enzyme inhibition, and antiplatelet drugs significantly reduce the risk of cardiovascular events. Although diabetic patients undergo revascularization procedures because of acute coronary syndromes or critical limb ischemia, the outcomes are less favorable than in nondiabetic cohorts. CONCLUSIONS: Since most patients with diabetes die from complications of atherosclerosis, they should receive intensive preventive interventions proven to reduce their cardiovascular risk.     

北京市西城区月坛社区卫生服务中心医务人员继续医学教育情况分析

背景　继续医学教育（CME）可以不断提高医务人员的专业知识和技能水平，但存在组织形式单一、满意度低等问题，通过统计分析北京市西城区首都医科大学附属复兴医院月坛社区卫生服务中心（月坛社区）医务人员CME现状、发现CME实施过程中存在的主要问题，可有效提高CME效果。目的　统计分析月坛社区医务人员的CME情况，探讨影响医务人员参加CME的主要原因，为促进开展在线CME项目、解决工学矛盾、提高效率和质量提供理论依据。方法　对2015年11月-2018年10月月坛社区561例参加CME医务人员的情况进行分析，主要包括以下内容：必修课程（包括市级必修课、区级必修课和全员必修课）、课程项目（区级慢性病课程、区级传染病课程和单位自管课程）、培训/会议（包括培训、会议或交流，分别统计主动参加类和被动参加类）、主办或承办项目（国家级、市级、区级CME项目）。由2名研究员独立统计，并将统计结果合并，如存在不一致，则重新核对。采用非结构访谈法对参加过CME的10例医务人员进行访谈，内容为影响医务人员参加CME的主要原因。结果　必修课包括市级必修课、区级必修课和全员必修课，3年共计561人次参加课程，其中市级必修课总时长为8 376学时（面授课程221学时，在线课程8 155学时），区级必修课3 366学时（均为面授课程），全员必修课3 366学时（均为在线课程）。课程项目包括区级慢性病课程、区级传染病课程和单位自管课程，全部以面授课的形式开展。共开展课程79次，平均2.2次/月，其中慢性病课程57次（72.2%），传染病课程22次（27.8%）。共计4 068人次医务人员参加课程，平均52人次/次，慢性病课程34人次/次，传染病课程96人次/人。每年第三季度（5月、6月和7月）为CME黄金期，开展CME项目较多，且签到率较其他季度高。培训/会议分为被动参加类、主动参加类，均为面授项目。参加培训/会议共计104项，平均4.3项/月，共计244人次参加。2017年度被动参加类29次（85人次）、主动参加类17次（26人次），2018年度被动参加类38次（92人次）、主动参加类20次（67人次）。主办（承办）项目21项，均以面授形式开展.接受小组访谈的 10 例医务人员均认为工学矛盾为影响其参加CME的主要原因。结论　月坛社区CME项目丰富，以传统面授课程为主，医务人员参加CME项目积极性高，工学矛盾为医务人员面临的主要问题，建议适当开展在线CME项目以提高效率和质量。     

江苏省肿瘤医院2006~2010年发表论文统计分析

为了解南京医科大学附属江苏省肿瘤医院的科研现状?学术水平以及在科研论文产出方面存在的不足,对医院近5年所发表的论文在论文数量?基金论文率?论文期刊分布?作者职称?学历及主要临床重点科室发表论文情况进行统计分析?医院近5年每年发表论文总数基本持平,SCI期刊论文发表数量呈上升趋势,但作者群体人数不足,主要临床重点科室及不同职称与不同学历人员之间所发表论文的数量与质量存在差异?加强学科建设与人才培养,积极申请科研课题,加大科技论文奖励力度,建立有效的考核机制是提高医院论文数量与质量的关键?     

Some clinical factors contributing to the development of the diabetic foot

Clinical neurological studies, blood pressure measurements and some haematological investigations were performed on a random sample of forty-four patients, at the Diabetes Out-Patient Clinic of the University Hospital of the West Indies (UHWI), to examine some of the factors that predispose to the development of the diabetic foot. Our results revealed that 86% of the patients had elevated glycosylated haemoglobin (HbA1 > 9.0%), 82% had clinical signs of peripheral sensory neuropathy, 29% had signs of autonomic neuropathy in addition to peripheral sensory neuropathy. Sixty-one per cent (61%) of the patients had ankle/arm systolic blood pressure ratio less than 1.0 and were diagnosed as having peripheral vascular disease (PVD). The group with neuropathy was found to have a significantly lower diastolic blood pressure (p < 0.0005) than the group without neuropathy. We believe that hyperglycaemia-induced vasodilation (indicated by a lower diastolic blood pressure) in a significant number of diabetics resulted in compensatory shunting of blood from the deeper tissues, including nerves, to the periphery. The resulting endoneural hypoxia could be responsible for the unusually high incidence of peripheral sensory neuropathy detected in this sample of diabetic patients. Metabolic factors may also play a role.     

Research output of Australian general practice: a comparison with medicine, surgery and public health

OBJECTIVES: To compare the productivity of Australian general practice in terms of research publications with the productivity of other medical disciplines. DESIGN: A survey of Australian general practice, medicine, surgery and public health publications carried out by manual searching of specific journals and an electronic search of the US National Library of Medicine's "PubMed" database. MAIN OUTCOME MEASURES: The number of original research publications by Australian general practitioners, physicians, surgeons and public health physicians during 1999; the relative publication rate of Australian general practice, medicine, surgery and public health over the period 1990-1999. RESULTS: Of original research articles published in 1999, GPs authored 65% (17/26) in Australian Family Physician and 3% (3/90) in the Medical Journal of Australia; physicians published 4% and 37%, respectively. The electronic search identified 54 research articles relating to Australian general practice published in 1999 in 21 different journals, only two of which were primary care journals. Over the period 1990-1999, there was a publication rate of one general practice [discipline] article per 1000 GPs in practice per year. Corresponding rates for medicine, surgery and public health were 105/1000, 61/1000 and 148/1000, respectively. CONCLUSIONS: There is considerable disparity between the level of research output of general practice and that of the disciplines of medicine, surgery and public health. If we are to have effective general practice research, we urgently need to develop research skills, a supportive infrastructure and a culture that nurtures research.