Professor Dr Tanvir Fittin Abir
Daffodil University
In Part 1 (published Nov 07, 2026), I discussed how physician-scientists (MD/PhD) are becoming a thing of the past internationally. The United States, United Kingdom and Japan have all reported problems in retaining this workforce (Jafree et al., 2026), and Japan has experienced clinical pressures that can adversely affect research (Yoo et al., 2025). It is not just the number of journal articles that is lost – it is the link between everyday patient need and the evidence needed to address the need and enhance healthcare.
What are the implications of this for Bangladesh? Persistent issues with healthcare access, non-communicable diseases, maternal and child health, and hospital management and service quality disparity pose challenges to the country. Research focused on local clinical contexts is needed to address the above issues. However, Bangladesh lacks similar long-term workforce data that would show whether physician-scientists have experienced a similar decline as in the other countries discussed above. That’s a policy issue because they’re not showing up.
We cannot be sure of the number of doctors engaged in research, when they leave, where they go or why they are leaving, without reliable information. These answers are needed and are not assumptions that can be brought in from other health systems.
Existing studies do indicate, however, that there are substantial challenges. For 626 physicians in Bangladesh, Ferdoush et al. (2022) reported that almost 88 per cent saw research as essential for becoming a specialist, but over 90 per cent reported inadequate funding and insufficient research training and strong emphasis on teaching and clinical practice as barriers.
These obstacles are also found in more recent evidence. A survey of 500 doctors at four major hospitals in Dhaka in 2023, conducted by the Department of Public Health and Informatics at Bangabandhu Sheikh Mujib Medical University, revealed that approximately 47 per cent of doctors wanted to do research, but nine out of 10 were unable to do statistical analysis and publish in international journals. The challenges most reported were professional pressure (73 per cent), no grants (68 per cent) and lack of access to research funds (64 per cent) (The Daily Star, 2023). In his discussion on these findings Haque (2024) pointed to the lack of adequate research methods, methods of data analysis, research scientific writing, inadequate funding, lack of institutional assistance and lack of research culture.
These pressures are foreseeable. A large number of physicians work in a variety of settings, such as patient care, education, supervision, administration, and private practice. If research is to be added without time, training or assistance, then it is an added burden not a part of the professional responsibility. Clinicians obviously appreciate research, but many don’t have a realistic opportunity to research in their institution.
Rigorous career structure for clinicians and researchers between medical colleges, teaching hospitals, universities, and organisations like Bangladesh Medical Research Council (BMRC) are needed in Bangladesh. These pathways should acknowledge research in job descriptions, offer credible mentorship, have clear criteria for promotion and have access to competitive and reliable funding.
First, time for research needs to be protected. Research allocation should be expressed in the amount of clinical staffing and scheduling, and not just in an appointment letter. Hospitals need to ensure that workloads are planned in a way to ensure that agreed research sessions are not regularly interrupted by the pressures of services.
Secondly, funds have to be reliable. Substantial resources are required for early career physician-scientists. Consistent funding at institutional or multi-year level can enable them to build research programmes, create teams and address clinically relevant questions that will benefit from a long-term approach.
Third, mentorship needs to be enhanced. Older, more experienced doctors who combine clinical practice with research with biostatisticians and public health academics and other disciplines to help guide younger doctors in research design, ethical approval, analysis, scientific writing and grant applications. A medical college journal-based qualitative study in north Bangladesh also highlighted that insufficient research training and mentorship of young researchers are among the issues that stem from poor quality submissions (Rahman et al., 2024). There are opportunities for a cross-disciplinary team to explore patient satisfaction, treatment adherence, digital health, chronic disease management, preventable complications.
Fourth, meaningful clinical impact should be rewarded in the academic assessment. Publication numbers, citations and grants received are good indicators but not a complete measure of value. A comprehensive study which adds value to a care pathway or minimises avoidable harm can have a significant benefit for the public. Therefore, methodologic aspects, clinical relevance, mentorship and tangible impact on patient care should be valued in a promotion system.
Fifthly, employees should be monitored. Health and education departments should track the number of physicians who go into research, stay in research, advance to full-time clinical practice or withdraw from academia and record the reasons. These data are essential if policymakers are to be able to direct the interventions or to ascertain the effectiveness of reforms.
The contents of these lessons are not specific to Bangladesh. It can be used in countries investing in hospitals and health technology, such as the UAE. Artificial intelligence and digital health tools, and modern buildings, do not automatically result in better outcomes. Appointments at a hospital and university and sustainable research pathways can be used to assess the value and impact of innovations for patients.
Cooperation will be needed for implementation to be made possible rather than individual efforts. The leaders of universities can change their promotion rules and staff allocation; the leaders of hospitals can safeguard research sessions and enhance the availability of clinical data within the proper ethical protection; the public funders can support programmes linked to clearly defined patient and health-system needs. All of these measures will fail if the clinical service demands are not taken into consideration. Any reforms must therefore be practical, measurable and be designed with the doctors who will implement them. It’s not that every doctor should become a full-time scientist, but it is important that there be a way for any doctor to pursue a clinical problem if they choose to.
Clinical research is a non-negotiable discipline that Bangladesh should not take it up as an add-on to the work of a few unusually motivated doctors. It is part of a larger health care quality system, professional development, and national research capacity system. The issue is not only about funding support for physician-scientists, but also covering the costs of their training in their respective disciplines at the university and hospital. It is if the health system can’t afford the consequences of failing to do so.
References
Ferdoush, J., Johora, F., Jeenia, F. T., Hoque, A., Sadia, H., Islam, M., Jahangir, B., Sultana, N., Sharmeen, S., & Abbasy, A. A. (2022). Challenges and attitude towards research among physicians of Bangladesh: A cross-sectional questionnaire survey. Bangladesh Journal of Medical Education, 13(1), 10–19. https://doi.org/10.3329/bjme.v13i1.57501
Haque, M. A. (2024). Fostering physicians’ research engagement in the healthcare landscape of Bangladesh. Bangabandhu Sheikh Mujib Medical University Journal, 17(1), e71905. https://doi.org/10.3329/bsmmuj.v17i1.71905
Jafree, D. J., Sun, M., Stewart, G. W., Burns, Á., Haniffa, M., Beale, R., Swanton, C., & Motallebzadeh, R. (2026). Keep medical doctors in academia — without them, health-care research will suffer. Nature, 658(8136), 604–606. https://doi.org/10.1038/d41586-026-03225-6
Rahman, M. M., Siddique, M. K. B., & Rahim, M. M. U. (2024). Challenges of medical journal publication: A case of medical college journal in Northern Bangladesh. Bangladesh Journal of Bioethics, 15(1), 1–5. https://doi.org/10.62865/bjbio.v15i1.88
The Daily Star. (2023, July 31). Majority of doctors lack skills for research. https://www.thedailystar.net/news/bangladesh/news/majority-doctors-lack-skills-research-3383331
Yoo, J.-J., Choi, H. B., Kim, Y.-S., & Kim, S. G. (2025). Korea’s 2024 reduction in medical research output amid physician residents’ resignation. Ewha Medical Journal, 48(2), e36. https://doi.org/10.12771/emj.2025.00381
