Anyone reading the recent Medical School Council’s report on the academic workforce will be struck by the depressingly familiar trinity of contradiction, complacency and confusion that seems to seep into every aspect of workforce planning towards academic medicine.
Whereas medical student numbers have increased from 30,600 in 2004 to 39,000 today, the number of clinical academic consultants (needed to train this rightly expanding cohort of future doctors) has stayed static since the turn of the decade at around 2,900. The position of academic trainees at lecturer level is even worse: they now represent fewer than 15% of the clinical academic workforce whereas they made up 24% in 2000. Grimly, the report states that the number of clinical academics in the 26-35 age range is insufficient to replace the number of clinical academics approaching retirement.
The conclusion is clear: soon there will be insufficient staff to educate and train the UK’s aspiring doctors. If this happens then not only do we face the possibility of falling training standards, as our workforce becomes increasingly over stretched, but the UK’s clinical research will also continue to slide as the number of top clinical researchers recedes.
However, taking pot shots from the side lines is always an easy pass time: what are the solutions to these problems?
There are some crumbs of comfort from the MSC report. The growing number of academic clinical fellows, currently employed by the NHS, are expected to move into lecturer positions, easing some of the pressure - although feedback to the BMA from these fellows suggests a certain amount of disillusionment at the lack of support from both the NHS and university employers.
This is why we are calling on both employers and employees to work with the BMA to produce clear guidance on what academic trainees should expect from their employers and, indeed, what is expected from them, with the aim of ultimately agreeing model honorary contracts.
Further, immediate work is required, and ultimately employers need to protect and enhance the terms and conditions of trainee academics. The funding regime also needs to ensure that this already diminished group is not further reduced through the effects of the forthcoming Research Excellence Framework, which will look at university funding.
We are entering austere times as the country and the world reels from a deep recession. But patients deserve a highly trained workforce and a field of homegrown clinical researchers who can meet the challenges of the coming decades.
Tags: Research
There’s an easy answer. Medicine needs to be practical. There’s too much academia in medical education….like anatomy schools teaching about the ultrastructure of cell nuclei instead of showing medical students why the radial nerve is vulnerable where it encircles the humerus.
And the best practical teachers are experienced consultants who’ve ’seen it all’. So, what the government needs to do is to give retiring consultants a 5 year ‘golden stay-on’ incentive and get them to teach at medical schools and out-stations in district hospitals on a low pressure, flexible part-time week of say 2-4 days. Retiring consultants would flock to this and in fact the standards of clinical training would rise.
I love that idea pragmatist. The most famous/infamous teachers are always the old buggers who’ve seen everything, and have a tale to attach to every lesson, an horrific example of why things are important etc. It still seems ridiculous to pension them off at their most experienced, so they go from department leader to disappear into private practice forever.
Why is it that all “academic” jobs are actually research jobs tied into RAE funding, grant income and publications? Good researchers are often hopeless clinicians, and there is nothing magically linking research and clinical education. Split the two, recognise clinical teachers as a valid entity and shove a good couple of PAs in to their job plans dedicated to teaching for good measure.
Dr Dangerfield is on to something. Isn’t this just about the terms and conditions of being in academic medicine? More money please.
Part of the problem is that in many specialties people don’t need to do reseach to become consultants anymore. There are less push factors to doing it. As Mark 2 says, the pull factors have to improve…
“Methinks the Academic doth protest too much”! We may, or may not, need more academics; who can tell until we have defined what they are supposed to do.
It is clearly just not true to calim that they are responsible for all teaching - most is done by non-academic clinicians, and rightly so. Sadly, the profession has been slow to identify the best teachers (or recognise the need for training to be teachers) and reward them properly (in terms of protected time in their contracts). Equally sadly the road to becoming a professor has become almost entirely through ‘research’ - yet, again, most of the real advances in medicine(including surgery) have come from research outside academic units (drugs from drug companies and surgical advances from practising surgeons). Even worse, once one reaches the pinacle of obtaining ‘a chair’ one then has to spend most of one’s time touting for funds!
So, before pressing for more academic ‘trainee posts’, let us try to decide what the academic departments function SHOULD be; and then what is the best training for the ‘top job’. Retired Orthopod. Swindon