PLASTIC AND RECONSTRUCTIVE SURGERY JOURNALS: FEASIBILITY OF ACCESS BY SURGEONS AND TRAINEES IN THE UNITED KINGDOM.

Editor,

The current surgical training system expects high levels of knowledge from trainees1. This is especially true in plastic and reconstructive surgery which is one of the most competitive specialties. Hence, surgeons in training must be familiar with the current literature in the field.

The resources available to achieve this goal reside mainly in medical journals. Access has been widely revolutionised by the novel electronic platforms.2 However, limitations imposed by subscription fees are a significant obstacle.

We conducted an electronic survey to assess availability of medical journals, in UK units to surgeons in training and analyse the pattern to make recommendation for improvement. Ten journals were selected using the Scientific Journal Ranking (SJR) index, which is a numerical value used to compare journals according to the number of citations and popularity.3 (Figure 1). A questionnaire was distributed to librarians in the respective units followed by a telephone call to units that did not respond.

Chart 1.

Plastic and reconstructive Journals included in the study and respective SJR indices 2016.

We collected responses from 52 units with 100% response rate. 45(86.5%) of them were in England, five (9.6%) in Scotland and one (1.9%) unit each in Wales and Northern Ireland.

The mean was 6.48 journals per unit whilst the overall mode was nine. One (1.9 %) unit had no access while only eight (15.3%) units subscribed to all journals.

The plastic surgery units in London and Scotland had higher access to the selected journals compared with other geographical areas in the UK. The highest number of journals accessible to trainees was in Scotland with an average of 9.2 followed by London with an average of 8.5.

The journal subscribed the most was Plastic and Reconstructive Surgery in 41(78.8%) of the units. The results show significant variation in both the number and quality of journals available to plastic surgery trainees in different units. In order to provide a level playing field, all trainees should have access to at least a core number of relevant journals.

Potential solutions include migrating to free access journals or providing shared access through a central point.

Open access journals, full or hybrid, provide free navigation without restrictions.4 Funding can take many forms including article processing charges, institutional membership scheme, volunteer labour, sponsorship, institutional subsidies and finances from other sources.5

A growing trend is the conversion of subscription-based journals to hybrid open access journals where authors pay an extra charge to make their articles freely available to readers.4 The development of open access journals may be helped by policy makers through centralised payment scheme towards the article processing charge.3 A good example of institutional support is the agreement between UK institutions and Springer to provide free access to more than 2000 subscription journals and an option for open access publication in hybrid journals.6

Another option is to provide a themed specialty specific subscription organised by professional bodies to replace the current arrangements that provide area-specific subscription organised by the relevant National Health Service trusts. Partnership between universities and NHS trusts can increase such access.