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BMJ No 7108 Volume 315 Letters Saturday 6 September 1997 Careers in academic medicine It's surprising that any juniors consider careers in academic medicine Editor, Michael Rees identifies many of the concerns of senior academic staff.(1) These compound the uncertainty of many juniors who might be considering a career in research. The implications of the Calman report are far from clear for registrars embarking on a higher degree. In particular there seems to be no clear national consensus about recognition of years spent in research towards the certificate of completed specialist training. We have been fortunate in that our region's specialty deans have made the position known. Research funding is fiercely contested, and this leads to considerable anxiety about career stability and even whether an individual project will reach completion. Many funding bodies seem, paradoxically, to expect the presentation of pilot data before they will consider an application. Recent procedural changes require that certain applications for project grants must be directed from within an established research unit. These changes are perhaps detrimental to the individual effort. Given these concerns, it is surprising that any junior would consider a career in academic medicine. It will be interesting to know whether in the future a trainee with a straightforward certificate of completed specialist training will be considered equivalent to someone who holds a PhD or MD for competitive teaching hospital posts. The fact remains, however, that many doctors-ourselves included-will always be drawn to the challenge and excitement of biomedical research. Robert Baker Research fellow Andrew Ustianowski Academic lnfectious Diseases Unit, University College London Medical School, London W1P 6DB References 1 Rees M. Who wants a career in academic medicine?BMJ 1997;315:74. (12 July.) Performance in research cannot be assumed to correlate with excellence in clinical practice Editor, Michael Rees's lament for academic medicine is familiar, but is it sound?(1) Heavy NHS workloads are not universal, and both teaching and many kinds of research require an adequate clinical base. Authority should not be inversely proportional to the number of patients seen. The criterion for academic advancement is now performance in research and in obtaining grants for it. These attributes cannot be assumed to correlate with excellence in either clinical practice or teaching. Indeed, the narrow fields of research interests may seriously distort what undergraduates are taught. Whether clinical academics can be expected to be expert in all the other functions they have assumed in the NHS-consultant appointments, postgraduate training, service development, and so on-must be debatable. If academic time is under pressure perhaps the NHS should be left to run these things itself. Rees's proposal for university run hospitals, especially in inner cities, sounds likely to recreate the vices of traditional teaching hospitals-overspecialised, irrelevant to both community and student teaching, and expensive. Academic medicine's first task must be to decide what its priorities are. E J Dunstan Consultant geriatrician Selly Oak Hospital, Birmingham B29 6JD References 1 Rees M. Who wants a career in academic medicine? BMJ 1997;315:74. (12 July.) Specialist training programme in oral surgery is good model for other specialties Editor, Michael Rees rightly states that integrated clinical research and teaching programmes are necessary in academic medicine and dentistry.(1) Five years ago, senior academics in oral and maxillofacial surgery established the academic advisory committee in oral and maxillofacial surgery to develop just such a specialist training programme. The reason for this was the difficulty in recruiting lecturers and senior lecturers-a position that had arisen partly because of the time consuming dual undergraduate degrees in both dentistry and medicine and the way in which this had made it almost impossible to obtain training in research and teaching. This training pathway is now established: in 1992 the joint committee for specialist training in dentistry recognised this pathway to accreditation. The academic advisory committee in oral and maxillofacial surgery is a subcommittee of the specialist advisory committee, and there are now honorary consultants in Cardiff, Dundee, and Newcastle and at King's College Hospital, London, who have undertaken specialist training in this programme and become accredited. In addition, trainees are currently enrolled in this programme in Belfast, Birmingham, Glasgow, London, Manchester, and Sheffield. Entry criteria include a PhD or equivalent research qualification. Training programmes must include four sessions of protected research time and are four years long. Academically minded trainees have found this an attractive option compared with other undergraduate courses. Specialist training in this programme is in oral surgery rather than oral and maxillofacial surgery, which in effect means that the programme does not include training in major head and neck surgery. This is appropriate to the needs of the dental schools in which the trainees will work as honorary consultants. The Committee of Vice Chancellors and Principals would do well to consider this model in other specialties: it ensures an appropriate balance between research, teaching, and clinical training and allows academic specialists and trainees to apply specialist training to meet the needs of their patients and universities. It is certainly paying dividends for dental schools preparing for the teaching quality assessment and successive research assessment exercises. Jonathan Shepherd Chairman, academic advisory committee in oral and maxillofacial surgery University of Wales College of Medicine, Cardiff CF4 4XY References 1 Rees M. Who wants a career in academic medicine? BMJ 1997;315:74. (12 July.) Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline