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Introduction
PhD theses can be seen as the highlights in academic research and as a reflection of the main scientific activities. This is also the case in the field of Tropical Medicine & International Health. By showing what is happening, this field can make their mark. In this paper the results are presented of an analysis of theses defended at Dutch universities between 2007-2013.
Tropical Medicine and International Health is not a precisely defined area. Therefore it was decided to include theses with subjects which are discussed regularly at the biannual European Congresses on Tropical Medicine and International Health (ECTMIH). In general theses have been excluded when data collection was not done in a low- or middle-income country or among multi-ethnic populations in high-income countries.
Method
The scientific agendas of the Dutch universities from 2007-2013 have been scrutinized regarding titles and advisors (promotores) that could be relevant to our goal. Controls were performed through searching PhD databases (Alba Promotorum) with keywords like chairholders in this field of research, country names, or diseases. For this analysis the theses themselves were not studied. The selected theses can be found on http://www.nvtg.org/index.php?id=117. Because of the search strategy, laboratory studies performed in the Netherlands e.g in the field of molecular biology and immunology may be underrepresented.
Results
A total of 239 theses was found. (Table 1) The majority has as subject infectious diseases and parasitology (52.3%). Theses in the field of anthropology are well-represented with 7.9%.
Over the years the number of theses has increased. The University of Amsterdam and Radboud University together produced almost 60% of all theses. (Table 2) The majority of the PhD students were women (52.3 %, data not shown).
| Subject | n | % |
|---|---|---|
| Infectious diseases1 | ||
| HIV/AIDS, incl. HIV in pregnancy | 27 | 11.3 |
| HIV co-infection | 11 | 4.6 |
| Malaria, incl. malaria in pregnancy | 24 | 10.0 |
| Tuberculosis2 | 22 | 9.2 |
| Leprosy | 8 | 3.3 |
| Dengue | 3 | 1.3 |
| Schistosomiasis | 2 | 0.8 |
| Leptospirosis | 2 | 0.8 |
| Other | 16 | 6.7 |
| Parasitology | 10 | 4.2 |
| Obstetrics and gynaecology | 11 | 4.6 |
| Pediatric diseases | 11 | 4.6 |
| Dermatological diseases3 | 6 | 2.5 |
| Mental health | 4 | 1.7 |
| Non-communicable diseases | 2 | 0.8 |
| Nutrition | 5 | 2.1 |
| Health of migrants/refugees in Europe | 10 | 4.2 |
| Travel medicine | 3 | 1.3 |
| Health economics | 11 | 4.6 |
| Health policy | 4 | 1.7 |
| Public health/health systems | 13 | 5.4 |
| Reproductive health | 10 | 4.2 |
| Medical education | 2 | 0.8 |
| Anthropology | 19 | 7.9 |
| Other | 3 | 1.3 |
¹epidemiology, control and prevention included; laboratory research in the Netherlands with referral to populations in low-income countries included; parasitology, nutrition, health economics excluded; ²non-tuberculous mycobacteria included; leprosy excluded.
| 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 20131 | Total | |
|---|---|---|---|---|---|---|---|---|
| Leiden | 1 | 3 | 3 | 4 | 6 | 17 | ||
| Groningen | 2 | 5 | 1 | 2 | 5 | 2 | 17 | |
| UvA | 11 | 11 | 8 | 12 | 19 | 18 | 25 | 104 |
| Utrecht | 3 | 1 | 5 | 1 | 10 | |||
| VU | 1 | 1 | 1 | 2 | 1 | 6 | ||
| Rotterdam | 4 | 4 | 3 | 4 | 2 | 17 | ||
| Nijmegen | 5 | 2 | 7 | 3 | 4 | 8 | 8 | 37 |
| Maastricht | 1 | 4 | 3 | 5 | 13 | |||
| Wageningen | 3 | 3 | 6 | 3 | 2 | 17 | ||
| Tilburg | 1 | 1 | ||||||
| Total | 23 | 18 | 31 | 27 | 40 | 48 | 52 | 239 |
¹from January until October
Discussion
These basic facts about the theses in tropical medicine and international health are not surprising. Over the years the number of theses has increased; the University of Amsterdam is the most important producer and infectious diseases are the most common topics.
But these facts leave many questions unanswered. They only describe, but do not explain. No information was collected about the selection of research projects, the selection of PhD candidates or the motivation of PhD candidates. Obviously these are important factors to fully understand the process.
Research projects are often part of a wider study or research programme and initiated by universities or research-related organizations. They also take the initiative to get these projects funded. Only a small part is initiated by an individual candidate. That is a difficult track and also difficult to fund.
The selection of PhD candidates is generally speaking done by the future PhD advisor (promotor).
One can expect that the advisor is interested in capable and motivated candidates with an interest in research. But in case of twinned projects the candidates may be selected on different grounds.
And finally the motivation of the candidate. It is known that a PhD often offers more career opportunities (application for medical specialist training position or partnership, academic career).
But the motivation can also be very personal (family, partner).
These questions can only be answered by studying the research programmes, questioning PhD advisors and candidates.
It is certain that experience from PhD thesis research is unique. The candidate is not only trained in many aspects of research, but has also gone through a personal development process. With this experience the candidates enter a new phase in their career. Since only 30% of all PhD candidates can stay at a university or in research-related activities (www.ru.nl/promovendi) it is clear that the majority continues with a clinical carreer or other positions in health care. At the last ECTMIH in Copenhagen it was discussed at a session organized by the German Society for Tropical Medicine and International Health, that for PhD candidates from low- and middle-income countries it is much more difficult to stay in science because of lack of funding and lack of a proper post-doc infrastructure.
In the strategic plan (2012-2016) of the Netherlands Society for Tropical Medicine & International Health (NVTG) a vision has been formulated on promoting research in this field. This overview can offer tools for a more active cooperation of the Society with certain research areas which up to now have not been well covered. Maybe doctors and tropical doctors in residence who are interested in a PhD track will be encouraged to see that annually around 40 candidates take this step.
