The Philippine Journal of Anesthesiology is Back… and the Future is in Our Hands

The Philippine Journal of Anesthesiology (PJA) is the official scientific publication of the Philippine Society of Anesthesiologists, Inc. (PSA). Established in 1977, the PJA has long served as a forum for disseminating local research, showcasing innovations, and addressing clinical challenges unique to the Filipino context. It has chronicled the advancing landscape of anesthetic practice in the Philippines, offering a voice for Filipino anesthesiologists as they navigate local realities and meet global standards. Over the course of four decades, six Editors-in-Chief have guided the publication through its various phases of growth and evolution.[1,2] Starting in 2009, the journal adopted a biannual schedule, an essential step toward meeting the criteria for inclusion in the Western Pacific Region Index Medicus (WPRIM), which we successfully achieved at one point. The journal also transitioned from traditional print to a digital-only distribution (via PDF uploaded on the PSA website). However, in the years that followed, the PJA encountered production challenges that led to an interruption in publication beginning in 2018. With nearly 5 years of inactivity, the journal risked and eventually led to the unfortunate loss of its WPRIM indexing status. During his term as PSA President, Dr. Edgard Simon reappointed Dr. Ma. Concepcion Cruz as Editor-in-Chief, with a clear directive: to revive and reinvigorate the PJA. The task was formidable. It required combing through archival submissions from past PSA research and case report forums, personally reaching out to authors to encourage submissions, recruiting a new Editorial Board, and assembling a young yet reliable pool of peer reviewers. Rebuilding the journal also meant learning – often on the fly – how to manage a modern medical publication by current standards and best practices. The revival effort was carried out under considerable constraints: a modest budget, editorial workflows reliant on Gmail and Google Drive, and a small, part-time team of dedicated volunteers who managed journal-related tasks in between their clinical and professional responsibilities, often sacrificing their personal time. Despite these challenges, under Dr. Cruz’s leadership, the PJA remained steadfast in its mission to publish only high-quality, ethically sound research. Upholding strict standards for methodological rigor, data quality, and ethical oversight was a nonnegotiable benchmark. A pivotal breakthrough came in 2023, when then-PSA President Dr. Penafrancia Cano spearheaded a landmark partnership with Wolters Kluwer Medknow. This collaboration positioned the PJA as one of the few locally produced medical journals supported by an international publisher.[3] The adoption of a dedicated journal management system brought structure and efficiency to the editorial process. It enabled seamless plagiarism detection, streamlined the reviewer selection, facilitated author communication, and ensured professional-grade copyediting. Today, the PJA operates in alignment with modern publishing standards. Articles are assigned Digital Object Identifiers, tagged with standardized keywords, and linked to author identifiers, laying the groundwork for future inclusion in international indexing platforms. The journal is now accessible worldwide through its online portal (https://journals.lww.com/pja), with articles available in both PDF and HTML formats. For Volume 29 (2024), the PJA received a total of 84 submissions, of which 14 were accepted for publication. Unfortunately, two of these were withdrawn by the authors after acceptance and did not appear in either issue. We also saw international authors submitting their papers for consideration. While case reports still comprised the majority of submissions (67%), it was encouraging to see the inclusion of high-quality original research and meta-analyses, adding to the journal’s scholarly depth. Peer review efforts were bolstered by 53 unique reviewers who submitted at least one review, for which we are very much grateful. This level of engagement was sufficient to complete two issues in our first year back. Then came the sobering reality: sustaining a journal may, in fact, be far more difficult than reviving one.[4] As we entered the cycle for Volume 30, we observed a sharp decline in submissions. Securing peer reviewers became increasingly challenging – more than half of those invited either declined outright or were unable to complete their evaluations of assigned manuscripts, even with extended deadlines. While the exact reasons behind this downturn remain unclear, it is apparent that we need to reverse this trend. The majority of submissions to the PJA come from recent graduates of anesthesiology residency or fellowship training programs, where scholarly output is considered a requirement for completion, mirroring that of other medical specialties. Are we facing competition from their local institution’s journal or publications with a multispecialty scope? Probably, some are prioritizing the entry of their abstracts for the upcoming 24th ASEAN Congress of Anesthesiologists, which is slated to take place here in Manila later this year. In many countries, there is an expectation that clinicians remain engaged in research throughout their careers, often beginning during residency and continuing into practice. Regrettably, in our local context, research activity often comes to an end once postgraduate training concludes. This represents a missed opportunity to cultivate a culture of continuous academic contribution within the specialty. For those who do persist in research, it is entirely understandable that they may prioritize submission to international, peer-reviewed journals with higher impact metrics and broader readership. However, this choice, while individually rational, collectively weakens our own publication efforts. The journal’s difficulty in attracting high-quality submissions perpetuates a vicious cycle – without robust content, we fall short of the standards required for indexation; yet without being indexed, the journal remains a less appealing venue for authors seeking visibility and academic recognition. Notably, many of the submissions we received this year were from the same hospital departments that contributed last year. This suggests that our reach may still be too narrow. More deliberate efforts are needed to raise awareness of the PJA’s renewed presence and potential. We must actively engage the PSA’s regional chapters and subspecialty societies to promote the journal within their circles and encourage submissions. The strength and sustainability of the PJA depend not on isolated efforts but on a unified commitment from the broader anesthesiology community. The peer review process relies on the commitment of knowledgeable peers who are willing to serve as reviewers. In the editorial workflow, reviewers serve not merely as gatekeepers but as independent evaluators who assess the rigor of a study’s methodology, the accuracy of its data analysis, and the validity of its conclusions based on the evidence presented. Local peer reviewers are especially well-positioned to judge whether findings are not just academically sound but also relevant and applicable to our setting. Their understanding of the nuances of our healthcare environment makes their contributions all the more essential in shaping a journal that truly reflects local realities.[5] Within the PJA, reviewers’ feedback not only ensures the integrity of what is published but also provides invaluable guidance that helps authors improve their work. This is particularly meaningful for early career researchers, for whom the review process can serve as both a learning experience and a form of mentorship. If we are to sustain and elevate the quality of the PJA, we must all recognize that the invitation to review is not a burden but a call to stewardship. Equally vital to the life of a journal are its readers. Their engagement gives the publication meaning. When an article sparks a spirited debate in a lecture hall, alters a long-standing protocol in the operating room, or inspires a resident to embark on a research project, the journal fulfills its mission. While we often turn to international journals for the best evidence and global perspectives, we must also recognize the indispensable value of local scholarship. Our patients, our health system, and our unique clinical realities deserve a dedicated platform. The PJA is that platform – a stage where Filipino anesthesiologists can share insights, challenge assumptions, and offer solutions grounded in the Philippine context. However, the continued growth of the PJA requires more than intention. It demands a sustained commitment: consistent, high-quality submissions; rigorous and timely peer review; principled editorial leadership; and, most importantly, a readership that values the importance of local scientific discourse. We call on experienced clinicians to share the wisdom earned from years at the bedside and in the operating room. We urge young investigators to bring new questions, fresh perspectives, and the energy of discovery. We invite seasoned researchers and peer reviewers to mentor the next generation in the craft of academic writing and ethical publication. We appeal to every Filipino anesthesiologist to take pride in this journal, not as a fallback, but as a proud expression of local excellence with global relevance. Let us write, review, engage, and uphold it together. The future of the PJA is in our hands.