Giles Cattermole offers some hints.

Of making many books there is no end, and much study wearies the body.
(Ecclesiastes 12:12)

I suspect that many students think much the same of medical journals. And the writer of Ecclesiastes didn't have FPAS scores to worry about. FPAS is the Foundation Programme Application System, by which final year medical students are allocated to Foundation Programme posts. Students are scored, with a maximum of 50 points for the Situational Judgement Test (SJT – a two hour, 20 minute written test), and 50 points for the Educational Performance Measure (EPM). Up to 43 points of the EPM are awarded for 'medical school performance' according to the student's decile ranking; up to five for additional degrees; and a maximum of two points for publications, presentations and prizes. (1)

It doesn't sound like it's worth much: one point for a peer-reviewed research article on Medline, one point for a national prize, one point for a presentation at a national conference. But of course, one point might change your ranking dramatically.

But should this be our only motivation for academic publication? The number of citations we have in journals with a high impact factor? Our personal H-index? Luke is probably the most cited medical author in history, but that wasn't his reason for writing his Gospel and Acts!

We shouldn't write stuff if we have nothing to say. Research papers, editorials, keynote speeches at international conferences – all of these can be really beneficial to the advance of medical practice. But unfortunately for students, it's very unlikely you'll be at this stage yet! Consider instead whether you might be able to contribute something to the literature that might influence people to consider a Christian perspective on medicine. Or at the very least, let people realise that Christians have not disappeared and are not silent; that the secular consensus is not absolute; that there are Christian medics who value real spiritual care  of patients, missionary medicine in the name of Christ, and Christian ethics; medics who value these things enough not just to practise them secretly in the privacy of their own consciences, but enough to tell others about them. And where better to tell other medics about Christian medical practice than in the medical literature?

letters in journals

OK, but does anybody read the literature? Probably few people read whole articles. We skim the abstracts, the letters page, the obituaries. But the great thing about a letter in a journal is that if someone finds the topic at all interesting, they'll often read the whole thing, because it's short. And the other thing is, it's so easy to write.

• Choose a journal – either one of the big 'general' journals that lots of people read (eg BMJ, The Lancet, The Journal of the American Medical Association, New England Journal of Medicine), or the 'house journal' of the specialty you're most interested in (eg Men).
• Skim through the contents to find an article that might be worth commenting on.
• Read the article.
• Write a short response to it that presents a Christian understanding of the issue.
• Get someone to check it over for you.
• Submit it to the journal.

Many journals now have an online, rapid response system for letters. If so, it's remarkably easy to submit. Unless defamatory or bizarre, most journals publish all e-responses online. They then select the best few for paper publication. For some journals, like the BMJ, about 10% of e-responses reach that stage. For other journals, the hit-rate is much higher. Even if the letter isn't published, it will still have been good practice.

If the letter is published in a Medline-indexed journal, it will receive a 'PMID' (PubMed ID). But letters are not peer-reviewed research articles, and won't meet the criteria to merit a point for FPAS. However, as a student, you're more likely to write a letter that gets published, than complete a multi-centre randomised controlled trial. If it's all about getting FPAS points, letters won't help. But if you want to get a Christian perspective out there in the medical literature, a letter is almost certainly the easiest and quickest way to do it!

posters at conferences

Another thing that a student could realistically achieve is a poster presentation at a national or international conference. And as long as the conference is organised by a recognised medical professional or medical educational body (but not the BMA, and not student/trainee meetings), this can count as a point for FPAS. However, poster presentations are often the Cinderellas of conferences. Few people read them unless they know the author, but if the poster is attractive enough, some people might be persuaded to skim through it. Posters are also good training for writing up projects, and can be the basis for a subsequent peerreviewed research article.

To do a poster, you first need to do a project.

• Choose a specialty and topic you're interested in, for which you think you could present a Christian perspective.
• Get advice from a Christian doctor in that specialty.
• Do the project.
• Discuss with your adviser about where to submit the abstract.
• Submit it.
• If accepted, discuss with your adviser how to write it up.
• Write up the poster.

The project itself can be relatively small. Many posters that are accepted even for international conferences are little more than case reports. They do not have to describe clinical trials! For example, you could write up an SSC, or your elective experience, or a survey of your colleagues' understanding of medical ethics, or a literature review.

'God talk' and 'faith flags'

Even if you're unlikely to produce groundbreaking medical research or get invited to speak at conferences, it's still very possible for students to write material which could help present a Christian understanding of healthcare. Why not counter the assumption that it is only acceptable to present work that ignores anything other than the secular? Hopefully, it will bring a Christian perspective to people who'd never considered it before. And by God's grace, an increased Christian voice in the medical literature might be a catalyst for change in our profession.

The Australian evangelist John Dickson wrote: 'I want to suggest that from time to time we consciously allow our faith-vocabulary to rise to the surface. This is not to be done in a forced manner. It is simply allowing what is real within us to find verbal expression without, regardless of who's listening. We could call this 'God-talk' (2) – brief, casual, passing references to your faith in everyday conversation...

It encourages you to throw off the 'corporate inferiority complex' and allows those around you to see that you have a confident faith, one that is worth looking into. In the Saline Solution course, a 'faith flag' is a similar idea: 'A brief statement in the course of natural conversation in which you identify yourself as someone to whom the Bible or prayer is important.' (3)

We can do this in letters to journals, and posters at conferences. I've had a letter published in the Saudi Medical Journal which I wrote so I could quote Jesus! (John 15:13). Just little comments, little bits of God-talk and faith flags, which just might make someone ask, seek, knock; which remind people that Christians aren't ashamed to mention their faith in their professional life too.

conclusion

I know we often worry about our CVs and our job applications. I know we want our work to 'count'. And it can be a good thing to want to get those points for FPAS – it may help get the job that will help you serve Christ and his kingdom most effectively. It may help you get the training you need to be the doctor God wants you to be, in the place he wants you. But what 'counts' is not our careers for their own sakes. We shouldn't be doing this for ourselves; whatever you do, do it all for the glory of God (1 Corinthians 10:31).