Where have we been and where are we going? Contributions of the Canadian Journal of Surgery to the greater surgical community

Colleagues have submitted an interesting, granular, and near-complete bibliometric analysis, published in this issue, of the academic output from the Canadian Journal of Surgery (CJS).¹ The stated mission of CJS has always been to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. CJS aims to elevate the standard of scientific reporting of surgical endeavours in Canada and thereby influence both Canadian medical and surgical care.

In addition to this goal, CJS also has a long history of offering surgeons in Canada a national platform to discuss health policy, health system challenges, and provocative opinions that help to move health care forward on a timely and thoughtful pathway. The breadth of contributors to CJS has also been extensive. This has included not only individual surgeons, but also surgical programs, universities, national surgical organizations, international consensus groups, and even government. The journal was originally founded through a collaboration of the Royal College of Physicians and Surgeons of Canada and the Canadian Medical Association. Its first editor was Robert Janes, president of the Royal College. The first editorial board consisted of the heads of surgery from each Canadian university.² As a result, it is not surprising that CJS continues to represent a Canadian-centric outlook on health care.

Since its inception in 1957, CJS has published nearly 7000 peer-reviewed manuscripts. Wiseman and colleagues have offered an in-depth analysis of nearly every publication since the indexing of CJS in 1968.¹ Interestingly, but not surprisingly, surgeons in Canada have contributed approximately half of all articles published in CJS (49.2%), with a particularly notable influence from the University of Toronto. While the most common article topics are related to general surgery, numerous other surgical specialties, including orthopedic surgery, have also heavily contributed to the academic and thought-leading output of CJS.

It is also apparent in reviewing Wiseman and colleagues’ bibliometric analysis that CJS has been privileged to publish a number of articles that are not only highly cited on an international stage, but have also helped to substantially advance the field of surgery as a whole.¹ Authors have generated a host of articles that offer specific tools to surgeons, both technique-and epidemiology-based, that continue to improve their ability to ensure high-quality care for patients worldwide, from the clinic to the bedside to the operating room. Although this content is often important, the studies are occasionally unwanted in American surgical journals, as content from Canada is often rooted in a universal care framework that is frequently misaligned with a pay-for-care system.

While CJS is always looking to improve, diversify, and evolve in all areas of surgical practice, similar to our country as a whole, CJS clearly punches above its weight on an international scale. Wiseman and colleagues¹ have helped remind us of where we have been and the impact of that history on patient outcomes, and, most importantly, reinforced the importance of the Canadian perspective as a significant and relevant contributor moving into a rapidly changing future.