Intended for healthcare professionals

Feature Doctors and Research

“It’s the duty of every doctor to get involved with research”

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6329 (Published 27 November 2015) Cite this as: BMJ 2015;351:h6329

Re: “It’s the duty of every doctor to get involved with research”

We read with interest the article by Anne Gulland and very much support the assertion that involvement with research is important for all doctors. This has become of increased significance given the recent evidence that patients admitted to research active institutions have better outcomes [1], and the commitment in Principle 3 of the NHS Constitution [2] “to the promotion, conduct and use of research to improve the current and future health and care of the population.”

Whilst we are in agreement that all doctors, and indeed all healthcare professionals, must be encouraged to both understand and participate in research to deliver this goal, we also feel it important to ensure that there are sufficient numbers of doctors developing a clinical academic career and taking up principal investigator roles. In the last decade the National Institute for Health Research (NIHR) has made great progress in this direction with the development of a clinical academic career pathway, complementary to the schemes run by the MRC, Wellcome Trust and other research charities. Nevertheless, despite all these efforts the issue of dwindling numbers of clinical academics [3] is not fully resolved, and must continue to be addressed. This is critical as doctors make significant contributions to the formulation of research questions and the translation of outcomes to patient care, contributing to this country’s international reputation for research excellence.

An area of particular concern is post-doctoral progression. Indeed, Clinical Lectureships, which enable post-doctoral clinicians to develop research independence, seem to have lower numbers of applicants than expected and, despite gradual progress nationally, each year an appreciable number of posts go unfilled. The reasons for this must be investigated and rectified where possible.

To tackle this question in 2013 we, in the Oxford University Clinical Academic Graduate School (OUCAGS), established a longitudinal study of career decision-making amongst medically qualified doctoral students registered at our institution. One of the study’s preliminary findings indicates that, 51% of UK doctors undertaking a DPhil (PhD) at the University of Oxford intend to mainly work in clinical academic posts in their long-term career. However, only 66% of these are extremely or very likely to seek a Clinical Lectureship in England (unpublished data from OUCAGS’ 2013 census).

The fact that only two thirds of this group of medically qualified doctoral students are likely to apply for Clinical Lecturer posts is somewhat surprising given their stated intent towards an academic career. The underlying issues are complex, arising, for instance, from tensions from divided time between clinical and research commitments, as Anne Gulland mentions in her article. Our study continues to explore these factors and will develop proposals on how to make post-doctoral clinical academic careers more attractive.

Given the need to support post-doctoral clinicians on the clinical academic career path, we would encourage other higher education institutions to also examine factors influencing career decisions amongst their own clinical doctoral students. UCL have recently decided to investigate this question amongst their students and are basing their questionnaire on the OUCAGS’ study, which will enable us to compare data. We would encourage other institutions to do likewise, to allow the creation of: a comprehensive national picture; evidence-based strategies for the further enhancement of clinical academic careers; and monitoring the effects of proposed contractual changes.

Denise Best, PhD
Academic Clinical Careers Manager,
Oxford University Clinical Academic Graduate School,
Room 3600 Medical Sciences Divisional Office,
Level 3, John Radcliffe Hospital, Oxford, OX3 9DU
denise.best@medsci.ox.ac.uk

Joana Lopes, MSc MBPsS
Research and Professional Development Officer,
Oxford University Clinical Academic Graduate School,
Room 3600 Medical Sciences Divisional Office,
Level 3, John Radcliffe Hospital, Oxford, OX3 9DU

Chris Pugh
Professor of Renal Medicine
Director, Oxford University Clinical Academic Graduate School
Associate Dean Academic Affairs, Oxford Deanery
Oxford University Clinical Academic Graduate School,
Room 3600 Medical Sciences Divisional Office,
Level 3, John Radcliffe Hospital, Oxford, OX3 9DU

1. Ozdemir BA, Karthikesalingam A, Sinha S, et al. Research activity and the association with mortality PLoS One2015;10:e0118253
2. Department of Health. NHS Constitution for England. 27 July 2015. www.gov.uk/government/publications/the-nhs-constitution-for-england
3. Medical Schools Council. A survey of staffing levels of medical clinical academics in medical schools as at 31 July 2014. 2015. www.medschools.ac.uk/SiteCollectionDocuments/MSC-survey-2015-web.pdf.

Competing interests: We are all involved in clinical academic training

07 December 2015
Denise Best
Academic Clinical Careers Manager
Joana Lopes, Chris Pugh
University of Oxford
Oxford University Clinical Academic Graduate School, Room 3600 Medical Sciences Divisional Office, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU