I am working in a non-teaching hospitals in a small island country. But writing and publishing in medical journals has been part of my career. While conducting research into betel nut chewing and its cardiovascular effects, I started writing and publishing. And I have done so ever since.
Why do I do it? Its a lot of work, there is no incentive and just take up time that you could be spending doing other pursuits. I think physicians should not be just consumers of scientific information but we have an obligation to contribute to the body of knowledge.
Doctors working in busy public hospitals like here in the Pacific are very busy! The wards are always full to capacity, there is an endless line every day in outpatient, the operating room has an endless list of patients waiting for surgery, emergency room is chaotic and full. And on top of that doctors are sometimes expected to write reports or conduct training for junior staff. Where does publishing in journals fit in? Publishing is way down the bottom of priority lists.
So even as much as I would love to see my colleagues in PNG and other pacific countries start publishing in medical journals, I understand their job demands. And I do not see this situation changing in the near future. The only time that they can publish, and this is a big maybe, is when or soon after completing their specialist training.
Having said this, I know of many doctors in my country that have a lot of experience and have unique stories to tell about how they solve clinical problems when there are no resources (one of the benefit of working with limited resources). And it would be nice to have them publish their stories. I am sure doctors in other less resource settings may fine such publication useful in their practice as well.