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How to COPE with research misconduct
Medical-school admissions limited in Italy
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ew legislation concerning access to Italian schools of medicine, dentistry, and veterinary medicine was approved last month. The Ministry of Universities and Scientific and Technological Research will now establish the number of candidates that can be admitted annually to each medical school in Italy. Other Ministries will help set the number of students to be enrolled, which will be based upon each school’s capacity and will “take into account the social and productive system’s demand”. Admission tests, whose subjects and dates will be established by the Ministry of Universities and Scientific and Technological Research, will be announced at least 2 months in advance; results are to be given within 15 days of the tests. This autumn, 6932 candidates will be admitted to Italian medical schools under the new procedure. Access to medical schools in Italy was originally open only to students completing formative—typically classical—secondary studies (liceo), not informative (technical) studies.
How to COPE with research misconduct
In the 1970s, access began to be granted to all those completing secondary school, regardless of what they studied and with what proficiency the studies were completed. Admissions blossomed, doctors proliferated, and Italy attained the highest ratio of doctors to population in the world. Unemployed physicians accumulated—they still number tens of thousands. So for the past decade, universities have tried to limit admissions to medical schools by selecting candidates by means of admission tests. Rejected candidates, however, only had to appeal to regional administrative juries in order to gain admission. Thousands of students started their medical studies this way, the legal position being that only national legislation, not the universities, could limit such students access to medical schools. Italy now has such a law. Candidates already admitted after appeal are not retrospectively affected by the new law.
n Sept 8, the UK’s Committee on Publication Ethics (COPE) launched its first set of guidelines Good Publication Practice. The guidelines are intended to advise authors and editors on what constitutes research misconduct, and how it should be handled. The guidelines were developed after consultation with journals worldwide. They address: study design and ethical approval, data analysis, authorship, conflict of interest, the peer-review process, redundant publication, plagiarism, duties of editors, media relations, advertising, and how to deal with misconduct when it arises. COPE is a voluntary body that was founded in 1997 to address breaches of research and publication ethics. “Intellectual honesty should be actively encouraged in all medical and scientific courses of study, and used to inform publication ethics and prevent misconduct”, the guidelines state.
Bruno Simini
Sarah Ramsay
O
WHO launches integrated health services study centre in Spain n Sept 8, WHO launched the European Centre for Integrated Health Services in Barcelona, Spain. The centre will analyse health-care services of European countries specifically from a management perspective. Mila García-Barbero, director of the centre, told The Lancet that its specific function is “to perform a detailed analysis of the health-care services’ management strategies carried out in the 51 countries attached to WHO’s Copenhagen-based European Regional Office in order to give professional advice to the different governments”. The centre is linked to the Health Policies and Health Care Services Department of the European Regional Office where García-Barbero has worked on health-management programmes. The centre will at first concentrate on management of primary and home health care, hospitals, emergency facilities, and human resources. A database will be developed for each topic, based on data from questionnaires that will be sent to relevant parties. The databases will be analysed with the help of outside experts. Regular meetings will bring
O
930
together health-management officials from the various countries involved.
Under scrutiny in Europe
The primary health-care programme, for example, is intended to analyse existing European primary health-care centres in order to produce definitions of the functions of primary health care and to find out, for instance, which functions might benefit from being transferred to specialist services. Work will also be done on how primary and hospital health care can be better coordinated. Another of the centre’s programmes will assess non-hospitalbased emergency services to discover examples of best practice. In a study of hospital emergency facilities, the focus will be on the effectiveness of
the various payment systems used in Europe. García-Barbero says that the recommendations will vary according to the different geographical areas. She points out that the proposals to improve management strategies cannot be equally effective in all the countries belonging to WHO’s European Regional Office because of the wide variation in cultural and socioeconomic factors. The new WHO office, with a starting staff of seven professionals, will be funded jointly by WHO and the Catalonian government. The agreement will last initially for 5 years, renewable upon agreement of both parties for a further 3–5 years. Staff at the centre will also study the effectiveness of the treatment of some acute diseases at home, after an early discharge from hospital. Finally, the human-resources programme has the task of clarifying which aspects of the above issues should be taught in undergraduate, postgraduate, and continuing medical training, since WHO considers that this is currently not clearly defined. Xavier Bosch
THE LANCET • Vol 354 • September 11, 1999
N
ew legislation concerning access to Italian schools of medicine, dentistry, and veterinary medicine was approved last month. The Ministry of Universities and Scientific and Technological Research will now establish the number of candidates that can be admitted annually to each medical school in Italy. Other Ministries will help set the number of students to be enrolled, which will be based upon each school’s capacity and will “take into account the social and productive system’s demand”. Admission tests, whose subjects and dates will be established by the Ministry of Universities and Scientific and Technological Research, will be announced at least 2 months in advance; results are to be given within 15 days of the tests. This autumn, 6932 candidates will be admitted to Italian medical schools under the new procedure. Access to medical schools in Italy was originally open only to students completing formative—typically classical—secondary studies (liceo), not informative (technical) studies.
How to COPE with research misconduct
In the 1970s, access began to be granted to all those completing secondary school, regardless of what they studied and with what proficiency the studies were completed. Admissions blossomed, doctors proliferated, and Italy attained the highest ratio of doctors to population in the world. Unemployed physicians accumulated—they still number tens of thousands. So for the past decade, universities have tried to limit admissions to medical schools by selecting candidates by means of admission tests. Rejected candidates, however, only had to appeal to regional administrative juries in order to gain admission. Thousands of students started their medical studies this way, the legal position being that only national legislation, not the universities, could limit such students access to medical schools. Italy now has such a law. Candidates already admitted after appeal are not retrospectively affected by the new law.
n Sept 8, the UK’s Committee on Publication Ethics (COPE) launched its first set of guidelines Good Publication Practice. The guidelines are intended to advise authors and editors on what constitutes research misconduct, and how it should be handled. The guidelines were developed after consultation with journals worldwide. They address: study design and ethical approval, data analysis, authorship, conflict of interest, the peer-review process, redundant publication, plagiarism, duties of editors, media relations, advertising, and how to deal with misconduct when it arises. COPE is a voluntary body that was founded in 1997 to address breaches of research and publication ethics. “Intellectual honesty should be actively encouraged in all medical and scientific courses of study, and used to inform publication ethics and prevent misconduct”, the guidelines state.
Bruno Simini
Sarah Ramsay
O
WHO launches integrated health services study centre in Spain n Sept 8, WHO launched the European Centre for Integrated Health Services in Barcelona, Spain. The centre will analyse health-care services of European countries specifically from a management perspective. Mila García-Barbero, director of the centre, told The Lancet that its specific function is “to perform a detailed analysis of the health-care services’ management strategies carried out in the 51 countries attached to WHO’s Copenhagen-based European Regional Office in order to give professional advice to the different governments”. The centre is linked to the Health Policies and Health Care Services Department of the European Regional Office where García-Barbero has worked on health-management programmes. The centre will at first concentrate on management of primary and home health care, hospitals, emergency facilities, and human resources. A database will be developed for each topic, based on data from questionnaires that will be sent to relevant parties. The databases will be analysed with the help of outside experts. Regular meetings will bring
O
930
together health-management officials from the various countries involved.
Under scrutiny in Europe
The primary health-care programme, for example, is intended to analyse existing European primary health-care centres in order to produce definitions of the functions of primary health care and to find out, for instance, which functions might benefit from being transferred to specialist services. Work will also be done on how primary and hospital health care can be better coordinated. Another of the centre’s programmes will assess non-hospitalbased emergency services to discover examples of best practice. In a study of hospital emergency facilities, the focus will be on the effectiveness of
the various payment systems used in Europe. García-Barbero says that the recommendations will vary according to the different geographical areas. She points out that the proposals to improve management strategies cannot be equally effective in all the countries belonging to WHO’s European Regional Office because of the wide variation in cultural and socioeconomic factors. The new WHO office, with a starting staff of seven professionals, will be funded jointly by WHO and the Catalonian government. The agreement will last initially for 5 years, renewable upon agreement of both parties for a further 3–5 years. Staff at the centre will also study the effectiveness of the treatment of some acute diseases at home, after an early discharge from hospital. Finally, the human-resources programme has the task of clarifying which aspects of the above issues should be taught in undergraduate, postgraduate, and continuing medical training, since WHO considers that this is currently not clearly defined. Xavier Bosch
THE LANCET • Vol 354 • September 11, 1999