More in expectation than in hope: a new attitude to training in clinical academic medicine

Editorial by Goldbeck-Wood Education and debate pp 633, 636

There has never been a brighter prospect for medical research to improve the prevention, diagnosis, and management of disease. Furthermore, advances in information technology have provided unprecedented opportunities to bring stimulating and innovative teaching to medical education. However, despite the excitement of combining research and teaching with clinical practice, academic medicine is not widely viewed as an attractive career. Indeed, recruitment into clinical academic medicine has been so patchy that it is often impossible for medical schools to find suitable candidates to fill senior positions. More worrying still is a growing perception among our brightest young doctors that forging a career in academic medicine is simply not worth the enormous effort that seems to be required. Hard data on developing careers in academic medicine are frustratingly sparse, but we are all familiar with the power of adverse perception. Indeed, morale is so low in some disciplines that enthusiastic role models have all but disappeared.

Why should we bother about recruitment into academic medicine? Simply because clinical academics are vital for health care. Clinical academics play a key role in evolving and maintaining best practice through health services research, clinical trials, and teaching and training. Furthermore, even the best available health care currently fails to address a dauntingly large and stubborn burden of chronic ill health and untimely death. The public expect continued improvement, and this can only be achieved by investigating the causes of disease through scientific research, the major activity of many clinical academics. Because of this need to improve health care, I have no hesitation in arguing that clinical academic medicine must be research led. Young doctors with an interest in research should be encouraged that there has never been a greater chance to make a difference—to take …