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Dermatology Research in Saudi Arabia: Challenges and Hopes
Journal of the Saudi Society of Dermatology & Dermatologic Surgery (2012) 16, 53–55
King Saud University
Journal of the Saudi Society of Dermatology & Dermatologic Surgery www.ksu.edu.sa www.jssdds.org www.sciencedirect.com
REVIEW ARTICLE
Dermatology Research in Saudi Arabia: Challenges and Hopes Omar M. Alakloby
*
College of Medicine, University of Dammam, Dammam, Saudi Arabia Received 9 May 2012; accepted 29 May 2012 Available online 27 June 2012
KEYWORDS Research; Saudi Arabia; Genodermatoses; Funding; Dermatology; University
Abstract Medical and clinical research in the Kingdom is still in its infancy. Dermatology research in particular is hampered by several factors, including insufficient funding and lack of collaboration across research centers. Consanguineous marriages are common and genetic disorders are substantially common. Research in these subjects should be highly encouraged. Young dermatologist should be encouraged to involve in scientific research. Only 140 dermatology research papers were published between 1966 and 2004 from research institutions in the GCC states, with Saudi Arabia being the main contributor. The number of academic dermatologists recruited to universities should be increased. More international collaboration should be established. Medical institution should reexamine research policies and planning in order to improve the quality of research to meet the Kingdom’s needs. ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.
Contents 1. 2. 3. 4. 5. 6. 7.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brief history of dermatology in Saudi Arabia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Higher education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Challenges facing dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . . . . Current status of dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . . . . Measures to improve dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . The following measures may improve the status of dermatology research in Saudi Arabia . References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* Address: University of Dammam, College of Medicine, King Fahd Hospital of the University, P.O. Box 40130, Al-Khobar 31952, Saudi Arabia. Tel.: +966 3 8580793, mobile: +966 504814962; fax: +966 3 8966708. E-mail address: [email protected] Peer review under responsibility of King Saud University.
Production and hosting by Elsevier
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1. Introduction Saudi Arabia is the largest Gulf Cooperation Council (GCC) state located in the Arabian Peninsula with a population of approximately 27 million. Medical and clinical research in the Kingdom is still in its infancy. Dermatology research in particular is hampered by several factors, including insufficient funding, interest of young
2210-836X ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.jssdds.2012.05.003
54 dermatologists in private practice, and poor integration across the research centers and universities within the Kingdom. 2. Brief history of dermatology in Saudi Arabia The first dermatologist to work in the Kingdom was Professor Dr. Lawrence M. Field, MD, who arrived in the Kingdom fifty-two years ago and worked in what is now known as Saudi Aramco (Health and disease in Saudi Arabia, 1998). Professor Field is now International Traveling Chair of Dermatologic Surgery (International Society of Dermatologic Surgery), University of California, San Francisco (Dermatologic Surgery), Emeritus 2006, Stanford University Medical School, Department of Dermatology. Academic Saudi dermatologists joined a number of universities in the Kingdom in the 1980’s. The first university to have a Saudi academic dermatologist was King Abdulaziz University in 1983, followed one year later by King Faisal University, and then King Abdulaziz University in 1985 and finally King Saud University in 1988. 3. Higher education Currently, there are 25 universities and 31 medical schools in Saudi Arabia. King Saud University, which was established in 1957, is the oldest university. Until the year 2000 there were only five medical schools and the largest medical school is at King Saud University, Riyadh, which was established in 1968 (Saudi Arabia Ministry of Higher education, 2012). Only three medical schools have dermatology training programs affiliated with other medical centers. The trainees come from within universities as demonstrators and from various medical sectors, including the Ministry of Health (Saudi Arabia Ministry of Higher education, 2012; Saudi Arabia Ministry of Health, 2006; Saudi Commission for Health Specialties, 2011).
O.M. Alakloby 5. Current status of dermatology research in Saudi Arabia The Saudi population is mainly a tribal population, in which consanguineous marriages are common (Helen Chapin Metz, 1992). This is associated with several genetic diseases, including genodermatoses. Unfortunately, research in this area is limited and needs to be explored. Some dermatology diseases, such as Ichthyoses, Epidermolysisbullosae, and Keratoderma, have a genetic basis and like other genetic disorders are substantially prevalent among the Saudi population (Alakloby and Al-Zayir, 2004). Research in genetic dermatology diseases is considered a virgin field for dermatology research. Dermatologists should be encouraged to conduct research on these genetic diseases. Academic institutions in the Kingdom have begun to collaborate with international institutions and universities to conduct research, which needs to be encouraged and strengthened (Saudi Arabia Ministry of Health, 2006; Hooper, 2005; University of Dammam Deanship of Scientific Research, 2012). In order to encourage young dermatologists to become involved in research, incentives other than academic promotion should be introduced. Some institutions in Saudi Arabia are service oriented and have affiliated research centers, but these mainly focus on oncology and cardiovascular diseases rather than dermatology research. This might be attributed to the small number of dermatologists in these centers. The authorities at these centers should adopt the means to encourage scientific dermatology research. For example, based on Pubmed only 140 dermatology research papers were published between 1966 and 2004 from research institutions in the GCC states, with Saudi Arabia being the main contributor (Al-Aboud et al., 2004). Despite the high percentage of consanguinity marriages in Saudi Arabia, little research has been conducted in the area of dermatology with genetic bases. 6. Measures to improve dermatology research in Saudi Arabia
4. Challenges facing dermatology research in Saudi Arabia Dermatology practice in Saudi Arabia as in other parts of the world has been affected and dramatically shifted toward private practice. Newly graduated dermatologists may join a private institution on a part-time basis. As stated earlier, this has had a negative impact on the progress of research in the field of dermatology. Dermatology research is mainly funded by the researcher’s university or by King Abdulaziz City for Science and Technology (KACSTs) King Abdulaziz City for Science and Technology (KACST), 2012. This has contributed to the production of good quality scientific dermatology research in some of these institutions. The process of submission for research funds is lengthy and requires the approval of international referees, especially for KACSTs funded project. The main incentive for conducting research is the academic promotions that an academic dermatologist is striving for. Therefore, the promotion focused research has the disadvantage of being purely clinical research bypassing the basic medical research of dermatology (Saudi Arabia Ministry of Health, 2006; Rules and Regulations Reference of Higher Education & the Universities, 2006).
The possibility of improving dermatology research is always present if the following measures are undertaken; The number of academic dermatologists recruited to universities should be increased. Research methodology should be included as part of the medical school’s curriculum. Encourage graduate dermatology students to participate in dermatology research. Collaboration by establishing integration across research centers in Saudi Arabia and internationally. Reexamine research policies and planning in order to improve the quality of research to meet the Kingdom’s needs. Increase grants for research and streamline funding procedures.
7. The following measures may improve the status of dermatology research in Saudi Arabia
Recruit more academic dermatologists to universities.
Dermatology Research in Saudi Arabia: Challenges and Hopes Include research methodology as part of the medical school’s curriculum. Establish more international collaboration Increase grants for research and facilitate the procedures for funding research. Establish integration across research centers in Saudi Arabia. Diversify the source of research funds by encouraging private medical centers to fund and invest in scientific dermatology research. Make research a requirement for promotion to higher positions. Establish independent dermatology departments.
References Al-Aboud, F.M., Al-Aboud, K.M., Al-Hawsawi, K.A., Ramesh, V., 2004. Dermatological publications in the Gulf Cooperation Council countries. An analysis of 1966–2004 Medline papers. Saudi Med. J. 25 (11), 1652–1655. Alakloby, O.M., Al-Zayir, A.A., 2004. Clinico-epidemiological features of congenital nonbullous ichthyosiform erythroderma in the
55 eastern province of Saudi Arabia. J. Eur. Acad. Dermatol. Venereol. 18 (6), 659–664. Health and disease in Saudi Arabia: the Aramco experience, 1940s– 1990s: an oral history conducted 1996–1997 by Carole Hicke, Regional Oral History Office, 1998. The Bancroft Library, University of California, Berkeley. Helen Chapin Metz (Ed.), 1992. Saudi Arabia: a country study. GPO for the Library of Congress, Washington. (http://countrystudies.us/ saudi-arabia/). Hooper, T.I., Smith, T.C., Gray, G.C., Al Qahtani, M.S., Memish, Z.A., Barrett, D.H., Schlangen, K.M., Cruess, D.F., Ryan, M.A.K., 2005. Saudi Arabia–United States collaboration in health research: a formula for success. Am. J. Infect. Control 33, 192–196. King Abdulaziz City for Science & Technology (KACST), 2012. www.kacst.edu.sa. Rules and Regulations Reference of Higher Education & the Universities, 2006, second ed. (Arabic version). Saudi Arabia Ministry of Health, 2006. (http://www.moh.gov.sa). Saudi Arabia Ministry of Higher education, 2012. (http:// www.mohe.gov.sa). Saudi Commission for Health Specialties, 2011. (http://english. scfhs.org.sa/). University of Dammam Deanship of Scientific Research, 2012. (http:// www.ud.edu.sa/web/en/emada/36).
King Saud University
Journal of the Saudi Society of Dermatology & Dermatologic Surgery www.ksu.edu.sa www.jssdds.org www.sciencedirect.com
REVIEW ARTICLE
Dermatology Research in Saudi Arabia: Challenges and Hopes Omar M. Alakloby
*
College of Medicine, University of Dammam, Dammam, Saudi Arabia Received 9 May 2012; accepted 29 May 2012 Available online 27 June 2012
KEYWORDS Research; Saudi Arabia; Genodermatoses; Funding; Dermatology; University
Abstract Medical and clinical research in the Kingdom is still in its infancy. Dermatology research in particular is hampered by several factors, including insufficient funding and lack of collaboration across research centers. Consanguineous marriages are common and genetic disorders are substantially common. Research in these subjects should be highly encouraged. Young dermatologist should be encouraged to involve in scientific research. Only 140 dermatology research papers were published between 1966 and 2004 from research institutions in the GCC states, with Saudi Arabia being the main contributor. The number of academic dermatologists recruited to universities should be increased. More international collaboration should be established. Medical institution should reexamine research policies and planning in order to improve the quality of research to meet the Kingdom’s needs. ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.
Contents 1. 2. 3. 4. 5. 6. 7.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brief history of dermatology in Saudi Arabia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Higher education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Challenges facing dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . . . . Current status of dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . . . . Measures to improve dermatology research in Saudi Arabia . . . . . . . . . . . . . . . . . . . . . . The following measures may improve the status of dermatology research in Saudi Arabia . References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* Address: University of Dammam, College of Medicine, King Fahd Hospital of the University, P.O. Box 40130, Al-Khobar 31952, Saudi Arabia. Tel.: +966 3 8580793, mobile: +966 504814962; fax: +966 3 8966708. E-mail address: [email protected] Peer review under responsibility of King Saud University.
Production and hosting by Elsevier
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53 54 54 54 54 54 54 55
1. Introduction Saudi Arabia is the largest Gulf Cooperation Council (GCC) state located in the Arabian Peninsula with a population of approximately 27 million. Medical and clinical research in the Kingdom is still in its infancy. Dermatology research in particular is hampered by several factors, including insufficient funding, interest of young
2210-836X ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.jssdds.2012.05.003
54 dermatologists in private practice, and poor integration across the research centers and universities within the Kingdom. 2. Brief history of dermatology in Saudi Arabia The first dermatologist to work in the Kingdom was Professor Dr. Lawrence M. Field, MD, who arrived in the Kingdom fifty-two years ago and worked in what is now known as Saudi Aramco (Health and disease in Saudi Arabia, 1998). Professor Field is now International Traveling Chair of Dermatologic Surgery (International Society of Dermatologic Surgery), University of California, San Francisco (Dermatologic Surgery), Emeritus 2006, Stanford University Medical School, Department of Dermatology. Academic Saudi dermatologists joined a number of universities in the Kingdom in the 1980’s. The first university to have a Saudi academic dermatologist was King Abdulaziz University in 1983, followed one year later by King Faisal University, and then King Abdulaziz University in 1985 and finally King Saud University in 1988. 3. Higher education Currently, there are 25 universities and 31 medical schools in Saudi Arabia. King Saud University, which was established in 1957, is the oldest university. Until the year 2000 there were only five medical schools and the largest medical school is at King Saud University, Riyadh, which was established in 1968 (Saudi Arabia Ministry of Higher education, 2012). Only three medical schools have dermatology training programs affiliated with other medical centers. The trainees come from within universities as demonstrators and from various medical sectors, including the Ministry of Health (Saudi Arabia Ministry of Higher education, 2012; Saudi Arabia Ministry of Health, 2006; Saudi Commission for Health Specialties, 2011).
O.M. Alakloby 5. Current status of dermatology research in Saudi Arabia The Saudi population is mainly a tribal population, in which consanguineous marriages are common (Helen Chapin Metz, 1992). This is associated with several genetic diseases, including genodermatoses. Unfortunately, research in this area is limited and needs to be explored. Some dermatology diseases, such as Ichthyoses, Epidermolysisbullosae, and Keratoderma, have a genetic basis and like other genetic disorders are substantially prevalent among the Saudi population (Alakloby and Al-Zayir, 2004). Research in genetic dermatology diseases is considered a virgin field for dermatology research. Dermatologists should be encouraged to conduct research on these genetic diseases. Academic institutions in the Kingdom have begun to collaborate with international institutions and universities to conduct research, which needs to be encouraged and strengthened (Saudi Arabia Ministry of Health, 2006; Hooper, 2005; University of Dammam Deanship of Scientific Research, 2012). In order to encourage young dermatologists to become involved in research, incentives other than academic promotion should be introduced. Some institutions in Saudi Arabia are service oriented and have affiliated research centers, but these mainly focus on oncology and cardiovascular diseases rather than dermatology research. This might be attributed to the small number of dermatologists in these centers. The authorities at these centers should adopt the means to encourage scientific dermatology research. For example, based on Pubmed only 140 dermatology research papers were published between 1966 and 2004 from research institutions in the GCC states, with Saudi Arabia being the main contributor (Al-Aboud et al., 2004). Despite the high percentage of consanguinity marriages in Saudi Arabia, little research has been conducted in the area of dermatology with genetic bases. 6. Measures to improve dermatology research in Saudi Arabia
4. Challenges facing dermatology research in Saudi Arabia Dermatology practice in Saudi Arabia as in other parts of the world has been affected and dramatically shifted toward private practice. Newly graduated dermatologists may join a private institution on a part-time basis. As stated earlier, this has had a negative impact on the progress of research in the field of dermatology. Dermatology research is mainly funded by the researcher’s university or by King Abdulaziz City for Science and Technology (KACSTs) King Abdulaziz City for Science and Technology (KACST), 2012. This has contributed to the production of good quality scientific dermatology research in some of these institutions. The process of submission for research funds is lengthy and requires the approval of international referees, especially for KACSTs funded project. The main incentive for conducting research is the academic promotions that an academic dermatologist is striving for. Therefore, the promotion focused research has the disadvantage of being purely clinical research bypassing the basic medical research of dermatology (Saudi Arabia Ministry of Health, 2006; Rules and Regulations Reference of Higher Education & the Universities, 2006).
The possibility of improving dermatology research is always present if the following measures are undertaken; The number of academic dermatologists recruited to universities should be increased. Research methodology should be included as part of the medical school’s curriculum. Encourage graduate dermatology students to participate in dermatology research. Collaboration by establishing integration across research centers in Saudi Arabia and internationally. Reexamine research policies and planning in order to improve the quality of research to meet the Kingdom’s needs. Increase grants for research and streamline funding procedures.
7. The following measures may improve the status of dermatology research in Saudi Arabia
Recruit more academic dermatologists to universities.
Dermatology Research in Saudi Arabia: Challenges and Hopes Include research methodology as part of the medical school’s curriculum. Establish more international collaboration Increase grants for research and facilitate the procedures for funding research. Establish integration across research centers in Saudi Arabia. Diversify the source of research funds by encouraging private medical centers to fund and invest in scientific dermatology research. Make research a requirement for promotion to higher positions. Establish independent dermatology departments.
References Al-Aboud, F.M., Al-Aboud, K.M., Al-Hawsawi, K.A., Ramesh, V., 2004. Dermatological publications in the Gulf Cooperation Council countries. An analysis of 1966–2004 Medline papers. Saudi Med. J. 25 (11), 1652–1655. Alakloby, O.M., Al-Zayir, A.A., 2004. Clinico-epidemiological features of congenital nonbullous ichthyosiform erythroderma in the
55 eastern province of Saudi Arabia. J. Eur. Acad. Dermatol. Venereol. 18 (6), 659–664. Health and disease in Saudi Arabia: the Aramco experience, 1940s– 1990s: an oral history conducted 1996–1997 by Carole Hicke, Regional Oral History Office, 1998. The Bancroft Library, University of California, Berkeley. Helen Chapin Metz (Ed.), 1992. Saudi Arabia: a country study. GPO for the Library of Congress, Washington. (http://countrystudies.us/ saudi-arabia/). Hooper, T.I., Smith, T.C., Gray, G.C., Al Qahtani, M.S., Memish, Z.A., Barrett, D.H., Schlangen, K.M., Cruess, D.F., Ryan, M.A.K., 2005. Saudi Arabia–United States collaboration in health research: a formula for success. Am. J. Infect. Control 33, 192–196. King Abdulaziz City for Science & Technology (KACST), 2012. www.kacst.edu.sa. Rules and Regulations Reference of Higher Education & the Universities, 2006, second ed. (Arabic version). Saudi Arabia Ministry of Health, 2006. (http://www.moh.gov.sa). Saudi Arabia Ministry of Higher education, 2012. (http:// www.mohe.gov.sa). Saudi Commission for Health Specialties, 2011. (http://english. scfhs.org.sa/). University of Dammam Deanship of Scientific Research, 2012. (http:// www.ud.edu.sa/web/en/emada/36).