FROM THE CEO

A new vision for the SAMJ - and a call for papers

Medical journals, unlike their basic science cousins, are the link between medical science and practice.^[1] Not only do they seek to disseminate new knowledge, but they also intend to influence outcomes - the application of new knowledge to the treatment of patients. But this laudable goal creates a dilemma: who are medical journals actually for? The scientists or the doctors? Or perhaps the small group of specialists who are both?

This question is crucial because it influences every aspect of a journal's operations. What content to publish; how to present information; the policies and procedures that govern decision-making; and, in the internet age, even the choice of publication medium.

The SAMJ and, by extension, its publisher the Health and Medical Publishing Group (HMPG), a wholly owned subsidiary of the South African Medical Association (SAMA), has historically addressed this challenge by trying to do it all: to be a scientific journal that targets researchers to publish their work, but with an editorial policy that favours mostly general-interest, non-academic doctors who are members of SAMA.^[2] The problem is that these constituencies have distinctly different needs.

Doctors generally read medical journals in a similar way to how they might approach a newspaper: to be informed, interested and kept up to date.^[1,3] Researchers, however, read the content in a different way. For scientists, a journal is not read as a monthly digest; instead they identify content through online searches to use in their work. This latter approach renders the printed issues into which journals are carefully arranged all but irrelevant.

During the past 5 years and more, the calls for the SAMJ to do better at serving both these audiences, with their divergent needs, have grown louder. Recommendations for change were most clearly articulated in a 2009 report^[2] published by the Academy of Sciences of South Africa. The report summarised the conclusions of a panel chaired by Prof. Bongani Mayosi, convened to consider the future of South Africa (SA)'s clinical research. Devoting an entire chapter to scholarly journals, the report issued a strong call to action to SAMA to ensure that the SAMJ and its daughter titles better support both medicine and science, including building capacity of the next generation of researchers.

Since that call was made, the need for reform has become even more pertinent. SA has moved into a phase where, with the National Health Insurance programme,^[4] it is grappling with one of the most ambitious health reforms ever conceived. Decisions that affect the way healthcare is delivered, regulated and funded are being made every day. In the absence of a robust evidence base of contextually relevant, locally conducted research studies, disseminated through a strong local academic publishing industry, the risk is that this reform will roll on without properly incorporating the extensive knowledge and expertise of the professions that will determine its success.

As the only general medical journal in the country, there is no more appropriate champion for evidence-based decision-making in health than the SAMJ. This realisation, coupled with the very clear recommendations of academic medical communities,^[2] has led to a concrete plan of action - proposed by HMPG and endorsed by SAMA - for implementing change. Henceforth, the SAMJ will respond to researchers' stated priorities: fast publication; robust and efficient peer review; wide dissemination of published findings; and, crucially, no editorially imposed limit on the numbers or type of papers accepted, as long as quality criteria are met.

The journal will expand its remit, not just actively seeking 'general' content, but instead capturing the spectrum of medical and health sciences, grouped by relevance to the country's burdens of disease. To accommodate the anticipated volume increase, the online version of the journal will be far more extensive than it has been in the past. Accepted papers will be edited and published online as soon as they are ready, without being held up by the print schedule. The print edition will also be changing: its focus, in recognition of the priorities of its mainly practising-physician readership, will be to provide a platform for education and debate, distilling the most crucial practice-relevant findings from the research content published rapidly online, and complementing it with many more commissioned reviews, commentaries and editorials that provide valuable context and highlight learning points.

While much of the internal restructuring underpinning this reform is already complete, the most crucial aspect is the recruitment of an expanded Editorial Advisory Board, led by the Editor-in-Chief, to strengthen the relationship between the journal and its audiences. Over the coming weeks, we will be announcing a series of appointments that we hope will provide the expanded SAMJ - and HMPG - with the academic direction and passion it needs.

With this new approach, building on the consensus of influential medical academics while staying true to its practice-changing aims, the SAMJ intends to ensure that the ancient medical journal paradox of how to combine science and practice is resolved in favour of building the necessary solid evidence base to support SA though its ambitious health transition - and, by doing so, to become the natural home for SA's health and medical research that the Academy of Sciences has acknowledged that the country desperately needs.

Call for papers

To accompany the new vision of the SAMJ, the journal is launching its first Call for Papers targeting health and medical research that relates to SA's quadruple burden of disease. The best of the submissions for each of the four burdens will be published in special themed issues that will also highlight policy-relevant research gaps. Please send your submissions, including a covering letter introducing the work, to submissions@hmpg.co.za by 30 April 2016.

Hannah Kikaya

CEO and Publisher, Health and Medical Publishing Group, South Africa

References

1. Smith R. The trouble with medical journals. J R Soc Med 2006;99(3):115-119. DOI:10.1258/jrsm.99.3.115        [ Links ]

2. Mayosi B, Dhai A, Folb P, et al. on behalf of the Academy of Sciences of South Africa. Revitalising Clinical Research in South Africa: A Study on Clinical Research and Related Training in South Africa. Pretoria: Academy of Sciences of South Africa, 2009. http://www.assaf.org.za/files/2009/09/ASSAf-Clnical-Report-Summary.pdf (accessed 22 March 2016).         [ Links ]

3. Van Niekerk JP. Our journals in flux. S Afr Med J 2010;100(4):189.         [ Links ]

4. National Department of Health of South Africa. National Health Insurance for South Africa: Towards Universal Health Coverage. Pretoria: National Department of Health, 2015.         [ Links ]