The residency program in Children’s Cancer Hospital-Egypt is one of its kind in Egypt. As a developing country, it was anticipated that the program would confront certain challenges in the graduation projects, particularly because most the pharmacy schools do not include the research process as part of their curricula. Few studies exist assessing the perceived value of the residency project.16 The residency program at the Children's Cancer Hospital-Egypt (CCHE) has recognized the importance of addressing the challenges faced in project publication and has implemented several strategies to support the residents in overcoming these obstacles. The study included 24 residents and 29 preceptors. The rate of publication among the residents from 2019 till 2022 is 29% which is considered low and aligned with the fact of low publication rate of residency projects.7,10 Also, the rate of publishing for pharmacy abstracts across numerous professional events was just 19.8%, which was lower than the rate for other health disciplines.17 One of the main challenges reported by residents is the difficulty in completing the project within one year. This is a common issue in residency programs, as the limited duration of the program often poses a constraint on conducting comprehensive research. 5,11,12,18 To address this, the residency program could consider extending the duration of the program or implementing a more structured timeline that allows residents to start their projects earlier. This would provide them with more time to conduct research, analyze data, and complete the manuscript.
Due to time restrictions, many programs choose to engage residents in small scale retrospective research, such as DUEs or quality projects, which are more difficult to publish. The majority of the residents began their project process in the midst of the residency year, which may have contributed to the inability to complete the project on time. The delay of the start is due to the time taken to pick the idea, writing the proposal, and taking the hospital scientific committee and institutional review board approvals.
Furthermore, the lack of protected time for research is another significant challenge faced by residents. Balancing their everyday activities and patient care responsibilities with research activities can be demanding and overwhelming. This was matched with a pilot research conducted multicenter, the interviewers reported that balancing between their job responsibilities and research activities is difficult.19 Another study was done among postgraduate trainees in Pakistan with the same results.20 Introducing research rotations as electives within the residency program could help alleviate this challenge. By allocating dedicated time for research, residents can focus on their projects without the distractions of their regular duties. This would enable them to make significant progress towards completing their research and facilitate the publication process.
Writing the manuscript is often a daunting task for residents, particularly if they lack prior familiarity with the publishing process or if English is not their first language.19 According to Kapp et al. (2011), fear of rejection is a key barrier to publication, in addition to challenges with the writing process, a lack of time, and ambiguity regarding topic selection.21 To address this challenge, the residency program at CCHE has already taken steps by organizing research workshops for all residents. These workshops provide valuable guidance on research methodology, study design, and manuscript writing. As stated by Shoko et al., researchers in poor or low-income countries frequently lack adequate writing abilities, and workshops can help to enhance these skills.22 By enhancing the residents' writing skills and providing them with the necessary knowledge and tools, they can overcome this challenge and produce high-quality manuscripts for publication. Having a designated mentor fosters a supportive and collaborative environment for residents. Mentorship plays a crucial role in supporting residents throughout the research process.23 The residency program at CCHE recognizes this and assigns dedicated mentors to residents who have experience and expertise in research and publication. These mentors serve as valuable resources, providing guidance, feedback, and assistance in study design, data analysis, and manuscript preparation. They create a supportive and collaborative environment that fosters the residents' growth as researchers and increases their chances of successful publication.
In addition to the internal support provided by the residency program, external resources can also contribute to improving the publication rate. Journals such as the American Journal for Health-System Pharmacist (AJHP) and other pharmacy journals with special resident issues offer a platform for residents to submit their projects. This not only increases the visibility and dissemination of their work but also provides recognition for their efforts. Encouraging residents to submit their projects to these journals can further motivate them to complete their research and increase the publication rate. Overall, the residency program at CCHE acknowledges the challenges faced by residents in project publication and has implemented various strategies to address these issues. By extending the program duration, introducing research rotations, organizing research workshops, providing dedicated mentors, and encouraging submission to specialized journals, the program aims to enhance the research capabilities of residents, improve their publication rate, and contribute to the advancement of pharmaceutical research in Egypt.
Limitation of the study
Generalizability
The study primarily focuses on the specific context of the residency program at CCHE. The challenges and strategies mentioned may not fully reflect the experiences and practices of residency programs in other institutions or countries.
Lack of evidence
The study is based on hypothetical scenarios and general recommendations rather than specific empirical evidence. Although references to relevant studies and best practices are provided, the effectiveness of the strategies in improving the publication rate at CCHE or similar institutions has not been directly measured or evaluated.
Resource constraints
While the strategies discussed, such as extending the program duration or introducing research rotations, can be effective in addressing time constraints and providing dedicated research opportunities, they may require additional resources, including funding, infrastructure, and faculty support. These resources may not always be readily available, especially in resource-limited settings, which could limit the feasibility of implementing these strategies.
Long-term outcome evaluation
The study primarily focuses on the immediate strategies implemented to improve project publication. However, the long-term impact of these strategies on the residents' research skills, career development, and the overall advancement of pharmaceutical research in Egypt is not fully explored. It is important to evaluate the effectiveness of these strategies over an extended period to assess their sustained impact.
Publication bias
The study emphasizes the importance of publishing projects as an indicator of success and contribution to the field. However, it is essential to recognize that publication bias exists, and the publication rate alone may not fully capture the value and impact of the residents' research efforts. Other forms of dissemination, such as presentations at conferences or local initiatives, may also contribute to knowledge sharing and professional development.