A new study from Iran’s largest academic medical center offers a rare, quantified look at why clinicians in developing countries struggle to do research, and the findings point less to a shortage of ambition than to a shortage of working data systems, funding, and institutional support. Researchers at Tehran University of Medical Sciences (TUMS) surveyed 358 physicians, faculty members, and trainees and found that perceived barriers to medical research are not only widespread but concentrated in areas that hospitals and universities could realistically fix: access to high-quality data, financial and infrastructural resources, and the governance structures that determine who gets credit for scientific work.
The study, published as an open-access research article in Health Research Policy and Systems, was designed as a sequential, exploratory, mixed-methods, single-centre investigation. That methodological architecture matters, because the team did not simply import an existing questionnaire from the international literature. Instead, they began with qualitative interviews and focus groups at the institution, using what participants actually said to construct a 45-item instrument spanning ten domains of research barriers and motives. Only after the instrument was built was it administered as an online survey, with quota-based stratified sampling across academic roles to ensure that faculty, residents, and other position categories were proportionally represented. The approach reflects a growing recognition in global health research that instruments validated in high-income, well-resourced settings may misrepresent the lived constraints of researchers in developing countries, where even basic assumptions about electronic record availability, statistical support, and protected research time often fail to hold.
The quantitative results paint a consistent picture of moderate-to-strong endorsement of research challenges across the institution. The total questionnaire score among participants ranged from 113 to 198, with a mean of 153.66 and a standard deviation of 16.24 on the instrument’s scale. Respondents had a mean age of 28.66 years, with a standard deviation of 7.38, and 62.6 percent were male, a demographic profile typical of a large Iranian academic medical center where many respondents were early-career physicians and trainees still navigating the early stages of academic life.
Which barriers dominated? The domain-level means tell a clear story. The highest-scoring domain was data access and quality, with a mean of 27.01 and a standard deviation of 4.05, suggesting that researchers at TUMS perceive the difficulty of obtaining complete, reliable, and accessible clinical data as the single most obstructive factor in their research environment. This is a finding with considerable technical significance for health policy: in an era when data-driven research, registry-based studies, and machine learning applications in medicine are expanding rapidly, an academic medical center whose clinicians cannot readily access clean institutional data is structurally disadvantaged in producing competitive science. The second-highest domain was financial resources and infrastructure, at 23.01 plus or minus 4.10, underscoring that even motivated researchers cannot convert ideas into studies without funding for consumables, equipment, statistical software, publication fees, and, in many cases, basic laboratory or data-management capacity. The third-highest domain, authorship, ethics, and research performance, scored 17.80 plus or minus 2.95, pointing to anxieties around research governance, including questions of who is listed as an author, how ethical approvals are processed, and how research output is evaluated within the institution.
One of the study’s most consequential findings is what did not differ. Total barrier scores showed no statistically significant variation by academic position, with a P value of 0.27. In other words, senior faculty and junior trainees perceived the overall burden of research barriers to be roughly equivalent, which is notable because one might expect institutional hierarchies to shield senior researchers from some obstacles or, conversely, to burden junior staff with a disproportionate share of them. However, when the analysis turned to specific domains, differences emerged. Significant variation across academic roles was observed in the domain covering time, workload, and organizational support, and in the domain covering skills, training, and methodological consultation, with both comparisons yielding P values below 0.001. This pattern suggests that while the broad institutional environment constrains everyone, the texture of those constraints differs by career stage: trainees may lack methodological mentorship and protected time, while senior staff may face different configurations of workload and support.
The study also explored associations between perceived barriers and objective markers of research productivity. Total scores showed a weak but statistically significant correlation with years of research experience, with P below 0.001, and with the H-index, with P equal to 0.01. The H-index, a bibliometric measure combining the number of publications with their citation impact, served here as a proxy for established scholarly output. The direction and weakness of these correlations imply that even highly productive, experienced researchers continue to report substantial institutional barriers, reinforcing the conclusion that the problem is systemic rather than a matter of individual skill or motivation alone.
Beyond the survey findings, the study makes a methodological contribution by developing and preliminarily evaluating a context-specific instrument, and here the authors report their psychometrics with commendable transparency. The overall scale demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.85, indicating that the 45 items collectively measure a coherent construct of perceived research barriers. However, domain-level reliability was mostly modest, with alpha values ranging from 0.36 to 0.76, below the conventional threshold of 0.70 for several subscales. More strikingly, confirmatory factor analysis failed to reproduce the a priori ten-domain structure: the comparative fit index was 0.69 and the Tucker-Lewis index was 0.66, both well below the commonly accepted cutoff of 0.90, while the root mean square error of approximation was 0.062 and the standardized root mean square residual was 0.17, the latter exceeding the typical 0.08 criterion. Exploratory analysis instead supported a solution of five to six broader dimensions. For readers outside psychometrics, this means the questionnaire works well as a global measure of research-barrier burden but that its original fine-grained domain structure did not hold empirically in this population, likely because the barriers researchers experience are more interconnected than the initial qualitative framework assumed. The authors present these results candidly, positioning the instrument as a preliminary tool requiring further validation rather than a finished standardized scale.
Why does a single-centre study in Tehran matter to the broader scientific community? First, because developing countries carry a substantial share of the global disease burden while producing a disproportionately small share of the world’s research output, and understanding the institutional bottlenecks behind this asymmetry is a prerequisite for policy intervention. Prior studies in settings as varied as Thailand, China, and conflict-affected Syria have documented similar dynamics among medical students and young physicians, but the TUMS study is distinctive in its mixed-methods design, its relatively large sample of 358 participants, and its explicit attempt to build an instrument grounded in local realities rather than transplanted from abroad. Second, because the findings identify modifiable targets. Data access and quality, funding and infrastructure, and authorship and ethics governance are not immutable features of academic life; they can be reshaped by institutional policy, investment in electronic data systems, streamlined ethics review, transparent authorship guidelines, and dedicated research support services.
The authors’ conclusion, drawn from their data, is that perceived research barriers at TUMS are broadly endorsed and appear concentrated in modifiable institutional domains, particularly data access and quality, resource constraints, and governance-related factors. They argue that institutional strategies strengthening data systems, improving access to evidence, and enhancing organizational support may improve the feasibility and sustainability of research engagement in similar academic medical settings. In practical terms, this could mean investments in hospital data warehouses with researcher-facing interfaces, dedicated biostatistics and methodological consultation units, protected research time embedded in clinical schedules, transparent and efficient ethical approval pathways, and equitable funding mechanisms accessible to junior researchers.
The study does have limitations that temper generalization. As a single-centre investigation, its findings reflect conditions at one large Iranian university hospital and may not transfer directly to other institutions or countries, although the authors suggest the patterns are relevant to similar academic medical settings in developing countries. The cross-sectional survey design captures perceptions at a single point in time and cannot establish causal relationships between institutional factors and research output. And the instrument itself, while internally consistent as a whole, requires further psychometric refinement at the domain level, as the factor analysis results make clear. The research was funded by Tehran University of Medical Sciences, including support for the survey platform, under ethics grant number IR.TUMS.SHARIATI.REC.1404.119, and the authors declare no competing interests.
Still, the study’s central message is likely to resonate far beyond Tehran: where research participation is low, the cause is rarely a lack of interest among clinicians. It is the friction of the systems around them. When accessing one’s own patients’ data is difficult, when funding channels are opaque, and when authorship and performance evaluation feel arbitrary, even the most motivated physician-researcher rationally disengages. The TUMS findings suggest that the highest-yield investments for unlocking medical research capacity in developing countries may be unglamorous ones: better databases, better infrastructure, and better governance. For policymakers in low- and middle-income countries searching for leverage points, that may be the study’s most valuable contribution, a data-driven map showing exactly where the friction lies and, implicitly, where the first dollars should go.
Subject of Research: Perceived barriers, facilitators, and motives affecting medical research engagement among clinicians and academics at Tehran University of Medical Sciences, assessed through a mixed-methods single-centre study with a newly developed 45-item survey instrument
Subject of Research: Medicine
Article Title: Medical research barriers, facilitators, and motives in a developing country: a mixed-methods single-centre study
Article References: Abed, M., Rashidi, F., Bagheri, M. H., Meysamie, A., & Shafizadeh, M. (2026). Medical research barriers, facilitators, and motives in a developing country: a mixed-methods single-centre study. Health Research Policy and Systems. https://doi.org/10.1186/s12961-026-01517-x
Image Credits: AI Generated
DOI: 10.1186/s12961-026-01517-x
Keywords: medical research barriers, research engagement, Tehran University of Medical Sciences, developing countries, mixed-methods study, data access and quality, research infrastructure, authorship and ethics, research governance, psychometric validation, academic medicine, health research policy
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Ophelia Keating. (September 11, 2026). Barriers, facilitators, and motives for medical research in a developing country. Scienmag. https://scienmag.com/barriers-facilitators-and-motives-for-medical-research-in-a-developing-country/
Ophelia Keating. “Barriers, facilitators, and motives for medical research in a developing country.” Scienmag, 11 September 2026, https://scienmag.com/barriers-facilitators-and-motives-for-medical-research-in-a-developing-country/. Accessed 11 September 2026.
Ophelia Keating. “Barriers, facilitators, and motives for medical research in a developing country.” Scienmag. September 11, 2026. https://scienmag.com/barriers-facilitators-and-motives-for-medical-research-in-a-developing-country/
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