Report calls for action to improve careers in academic medicine
http://www.100md.com
《英国医生杂志》
Urgent action is needed to make clinical academic medicine—combining teaching and research with care of patients—a more attractive career path for doctors, as the lack of people going into the field is threatening medical education and new research, warned a UK report published last month.
The report warned that the number of junior academic staff in the United Kingdom had gone down by 23% over the past three years. Universities had reported difficulties in recruiting and retaining clinical academics and less funding for academic posts over the past few years. The potential lack of staff to teach medicine was considered particularly acute because medical student numbers were projected to rise by 40% by 2005.
Professor Charles Pusey, chairman of the Forum on Academic Medicine, a group of representatives from the medical royal colleges and the Academy of Medical Sciences that developed the report, and academic registrar for the Royal College of Physicians, London, said: "This is a major problem. If we don抰 encourage more people into clinical academic medicine there is a grave threat to standards of patient care, without enough people to educate doctors or to carry out translational clinical research."
He acknowledged that a lack of clinical academics was a problem throughout Europe and the United States but considered that it was particularly acute in Britain because of the low overall ratio of doctors to the population, making the number of academics even lower.
Potential clinical academics faced many obstacles that accounted for the lack of people pursuing this type of career, the report found. Little flexibility in training posts made it difficult for trainee doctors to fulfil their specialist training requirements at the same time as undertaking research; they often took longer to train and could generally expect a lower income than someone working in a full time clinical post. Furthermore, opportunities in many specialties for fully funded academic posts were limited, leading to job insecurity.
To solve these problems the Academy of Medical Royal Colleges and the Academy of Medical Sciences worked together for the first time to produce a series of recommendations, which will be taken forward by the academic careers subcommittee of the government抯 "modernising medical careers" initiative and the UK Clinical Research Collaboration.
The overall aim is to make the academic career path a more attractive and achievable option and so increase the number of academics in clinical medicine. The reports considered that a key factor was more flexibility in training, more clinical lectureships, more academic national training posts, and the formulation of personalised academic training programmes.
The report called for a coherent strategy for the development of academic medicine in the United Kingdom, requiring participation of the Postgraduate Medical Education and Training Board, universities, NHS trusts, postgraduate deaneries, the Academy of Medical Sciences, the Academy of Medical Royal Colleges, and research funding bodies.
It recommended that a single group should coordinate this work and take responsibility for implementation. "We welcome the recent establishment of the academic careers subcommittee of modernising medical careers and the UK Clinical Research Collaboration, which is well placed to do this," said Professor Pusey.
As part of the report, each medical royal college developed clinical academic training and career pathways that they considered should be adopted by other bodies responsible for medical education and training. The report also recommended expanding the clinician scientist scheme, with an increased number of clinical lecturers, and said that all clinical academics should be involved in teaching at undergraduate or postgraduate level and that teaching should be given a higher profile.
Finally, changes should be made to the research assessment exercise, which looks at the volume of papers published in high impact factor journals and so could reduce the value of time spent in teaching or clinical research. The report considered that, despite some benefits, the exercise had an adverse effect on numbers of clinical lecturers and the extent of clinical research.
The report has been published a year after the BMJ, the Lancet and 40 other organisations launched the International Campaign to Revitalise Academic Medicine (ICRAM), prompted by a belief that academic medicine is in crisis around the world (BMJ 2004;328:597, 13 March).
Clinical Academic Medicine: The Way Forward is available on the Royal College of Physicians?website (www.rcplondon.ac.uk). Printed copies can be bought from the RCP Publications Department, tel 020 7935 1174 ext 358 (price ?4).(London Susan Mayor)
The report warned that the number of junior academic staff in the United Kingdom had gone down by 23% over the past three years. Universities had reported difficulties in recruiting and retaining clinical academics and less funding for academic posts over the past few years. The potential lack of staff to teach medicine was considered particularly acute because medical student numbers were projected to rise by 40% by 2005.
Professor Charles Pusey, chairman of the Forum on Academic Medicine, a group of representatives from the medical royal colleges and the Academy of Medical Sciences that developed the report, and academic registrar for the Royal College of Physicians, London, said: "This is a major problem. If we don抰 encourage more people into clinical academic medicine there is a grave threat to standards of patient care, without enough people to educate doctors or to carry out translational clinical research."
He acknowledged that a lack of clinical academics was a problem throughout Europe and the United States but considered that it was particularly acute in Britain because of the low overall ratio of doctors to the population, making the number of academics even lower.
Potential clinical academics faced many obstacles that accounted for the lack of people pursuing this type of career, the report found. Little flexibility in training posts made it difficult for trainee doctors to fulfil their specialist training requirements at the same time as undertaking research; they often took longer to train and could generally expect a lower income than someone working in a full time clinical post. Furthermore, opportunities in many specialties for fully funded academic posts were limited, leading to job insecurity.
To solve these problems the Academy of Medical Royal Colleges and the Academy of Medical Sciences worked together for the first time to produce a series of recommendations, which will be taken forward by the academic careers subcommittee of the government抯 "modernising medical careers" initiative and the UK Clinical Research Collaboration.
The overall aim is to make the academic career path a more attractive and achievable option and so increase the number of academics in clinical medicine. The reports considered that a key factor was more flexibility in training, more clinical lectureships, more academic national training posts, and the formulation of personalised academic training programmes.
The report called for a coherent strategy for the development of academic medicine in the United Kingdom, requiring participation of the Postgraduate Medical Education and Training Board, universities, NHS trusts, postgraduate deaneries, the Academy of Medical Sciences, the Academy of Medical Royal Colleges, and research funding bodies.
It recommended that a single group should coordinate this work and take responsibility for implementation. "We welcome the recent establishment of the academic careers subcommittee of modernising medical careers and the UK Clinical Research Collaboration, which is well placed to do this," said Professor Pusey.
As part of the report, each medical royal college developed clinical academic training and career pathways that they considered should be adopted by other bodies responsible for medical education and training. The report also recommended expanding the clinician scientist scheme, with an increased number of clinical lecturers, and said that all clinical academics should be involved in teaching at undergraduate or postgraduate level and that teaching should be given a higher profile.
Finally, changes should be made to the research assessment exercise, which looks at the volume of papers published in high impact factor journals and so could reduce the value of time spent in teaching or clinical research. The report considered that, despite some benefits, the exercise had an adverse effect on numbers of clinical lecturers and the extent of clinical research.
The report has been published a year after the BMJ, the Lancet and 40 other organisations launched the International Campaign to Revitalise Academic Medicine (ICRAM), prompted by a belief that academic medicine is in crisis around the world (BMJ 2004;328:597, 13 March).
Clinical Academic Medicine: The Way Forward is available on the Royal College of Physicians?website (www.rcplondon.ac.uk). Printed copies can be bought from the RCP Publications Department, tel 020 7935 1174 ext 358 (price ?4).(London Susan Mayor)