Sir, I congratulate Al-Maawali et al.1 for their efforts to identify the factors that influence the publication record of the Gulf Cooperation Council (GCC) countries. This analysis will help plan ways to improve the current situation. As a colleague who has lectured in all the GCC countries and who strongly believes that they can improve their scores I would like to make a few comments. First, one indicator of research output can be monitored with very little effort. The Institute for Scientific Information’s (ISI) Essential Science Indicators provides a list of ranking by country. The results listed below represent the status on 1st March 2012 in the field of Clinical Medicine. These “metrics” are updated every 2 months and reflect performance over the past 11 years. Greece is added for comparison being a small and relatively poor country when compared with the GCC members. The population of Greece is 11.3 million (2010 census).2 This is less than one third of the population of the GCC countries combined (2010 censuses).3-8 Second, as Al-Maawali and colleagues1 correctly state many factors influence research performance as can be clearly seen from the results listed above. Additional factors are experience in research. Possibly, this can be acquired by collaboration with established groups. Several decades ago there may have been a need to import clinical expertise to the region and to export trainees. I do not think that there is now much need to improve clinical expertise because of the high local standards. In contrast, it may be time to expand and improve research performance. Third, it is regrettably necessary to mention that the performance of some GCC countries, in terms of citations, is lower than that of several thousand individual researchers listed in the ISI’s Essential Science Indicators. This observation confirms the need for progress as stated by Al-Maawali et al.1 Fourth, Al-Maawali et al.1 make several perceptive comments concerning local journals and the recognition of work carried out in GCC countries. For local journals, an extensive international editorial board is mandatory. For recognition, collaborative research would compensate for the inappropriate negative bias shown by some editors/reviewers based in other countries. This suggestion can include joint supervision of doctoral degrees and even conjoint awards with universities abroad. I would also recommend a thesis SQU Med J, August 2012, Vol. 12, Iss. 3, pp. , Epub. Submitted 12th Feb 12 Accepted 22nd Feb 12 رد على: شاكلة املنشورات الطبية احليوية وإجتاهاهتا يف ُدَول جملس الّتعاون اخلليجي Re: Biomedical Publications Profile and Trends in Gulf Cooperation Council Countries LETTER TO EDITOR Rank Country Publications Citations Citations/publication 44 Saudi Arabia 6,505 32,150 4.94 68 Kuwait 1,995 12,441 6.24 72 UAE 1,348 9,659 7.17 103 Oman 741 3,287 4.44 105 Qatar 616 3,058 4.96 25 Greece 25,702 271,094 10.55 Dimitri P Mikhailidis Letter to Editor | 385 programme based on publications to ensure high standards.2 Such theses would be based on peer reviewed published work and would therefore stand firm against any international scrutiny. A key factor determining success is enthusiasm. This factor is already present because I met many colleagues in the region who share my enthusiasm! Dimitri P Mikhailidis Department of Clinical Biochemistry, Royal Free Hospital, London, UK E-mail: mikhailidis@aol.com References 1. Al-Maawali A, Al Busadi A, Al-Adawi S. Biomedical publications profile and trends in Gulf Cooperation Council countries. Sultan Qaboos Univ Med J 2012; 12:41–7. Epub 2012 Feb 7. PubMed PMID: 22375257; PubMed Central PMCID: PMC3286715. 2. Census information Greece. From: http://en.wikipedia.org/wiki/Greece. Accessed May 2012. 3. Census information Saudi Arabia. From: http://en.wikipedia.org/wiki/Saudi_Arabia. Accessed May 2012. 4. Census information Kuwait. From: http://en.wikipedia.org/wiki/Kuwait. Accessed May 2012. 5. Census information United Arab Emirates. From: http://en.wikipedia.org/wiki/United_Arab_Emirates. Accessed May 2012. 6. Census information Oman. From: http://en.wikipedia.org/wiki/Oman. Accessed May 2012. 7. Census information Qatar. From: http://en.wikipedia.org/wiki/Qatar. Accessed May 2012. 8. Census information Bahrain. From: http://en.wikipedia.org/wiki/Bahrain. Accessed May 2012. 9. Breimer LH, Mikhailidis DP. A thesis for all seasons. Nature 1991; 353:789–90.