I am pleased the BMJ have given this piece the prominence it deserves. The problem of disappearing surgical research seems to me to be especially acute in cardiac surgery. Apart from projects originating in Western nations such as US, Germany and Italy, cardiac surgical research publications from emerging nations such as India, China Turkey and even Iran outnumber those that arise in the UK.
Although there are a number of reasons for the dearth of surgical research output in the UK, the two predominant ones seem to be the abandonment of research as a necessary useful step to be taken by surgical trainees and the choking, expensive bureaucracy required for completion of even the simplest of projects.
The Royal College of surgeons of England have produced an excellent monograph on the subject and they have made some very good suggestions to bring about a turnaround. There are no suggestions for simplification of the reseach process but this is included in the NHS reform bill currently going through parliament.
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