Evidence and global health equity (2) BMJ Global: A bibliometric analysis of author distribution in top medical education journals

29 June, 2023

This year's Evidence-Based Health Care day looks at Evidence and global health equity [ worldebhcday.org/ ]. One aspect of this is to look at inequities within the global evidence system, another (related) aspect is to assess how the global evidence ecosystem can be strengthened to better serve global health equity. This BMJ Global Health paper explores inequities in terms of author representation, and ask questions about how this might impact on the translation and implementation of health research.

Below are the citation, abstract and a comment from me.

CITATION: Wondimagegn D, Whitehead CR, Cartmill C, et al. Faster, higher, stronger – together? A bibliometric analysis of author distribution in top medical education journals. BMJ Global Health 2023;8:e011656.



Introduction: Medical education and medical education research are growing industries that have become increasingly globalised. Recognition of the colonial foundations of medical education has led to a growing focus on issues of equity, absence and marginalisation. One area of absence that has been underexplored is that of published voices from low-income and middle-income countries. We undertook a bibliometric analysis of five top medical education journals to determine which countries were absent and which countries were represented in prestigious first and last authorship positions.

Methods: Web of Science was searched for all articles and reviews published between 2012 and 2021 within Academic Medicine, Medical Education, Advances in Health Sciences Education, Medical Teacher, and BMC Medical Education. Country of origin was identified for first and last author of each publication, and the number of publications originating from each country was counted.

Results: Our analysis revealed a dominance of first and last authors from five countries: USA, Canada, UK, Netherlands and Australia. Authors from these five countries had first or last authored 70% of publications. Of the 195 countries in the world, 43% (approximately 83) were not represented by a single publication. There was an increase in the percentage of publications from outside of these five countries from 23% in 2012 to 40% in 2021.

Conclusion: The dominance of wealthy nations within spaces that claim to be international is a finding that requires attention. We draw on analogies from modern Olympic sport and our own collaborative research process to show how academic publishing continues to be a colonised space that advantages those from wealthy and English-speaking countries.


COMMENT (NPW): The authors say their 'study provides support for academics, academic institutions and academic publishers in establishing policies that prioritise the inclusion of authors from LMICs and from countries in which English is not the dominant language'. From a HIFA perspective, it would be interesting to assess not only whether there are inequities in authorship, but how these inequities might impact on the global evidence ecosystem. The authors ask some interesting questions: 'Is it possibly a conceit to think that medical education research in its current form is truly globally relevant? To what extent is the new knowledge being shared in academic publications able to be implemented and evaluated in lower resource settings? Are important knowledges excluded from currently accepted content in medical education journals? How relevant is the content of top medical education journals in diverse contexts?' These questions are left hanging and I encourage HIFA members to comment. Meanwhile I have invited the authors to join us.

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org