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Recent appeals to the Health Secretary to protect and expand the clinical academic workforce in the UK have pointed out that doctors who are trained in both a clinical specialty and research are crucial to the continued efficient functioning of the NHS, and the outcomes of the patients cared for within it. The argument that engagement with research can also improve retention of staff led me to reflect on my own experiences as the most junior of clinical academic trainees - an academic foundation doctor. In this post, I have two four-month research blocks alongside my clinical rotations.
My research rotations have been the best of my Foundation jobs, and this is not for lack of clinical contact - in fact, I miss seeing patients. It is for everything else surrounding the work. During my research time, I was allocated a named supervisor, who not only quickly knew me by name, but who aims to meet with me weekly to discuss progress, challenges and help me plan for the future. My supervisor introduced me first to the local team, and then wider groups of academics, and signposts to opportunities. Without the pressures of clinical work, supervisors are able to make me feel cared about and part of the team. I am encouraged to think big and don’t feel restrained by being the most junior. I take part in various facets of academic activity, including teaching on my own terms, when not bogged down with ward jobs. To a certain extent, I plan my own time, and am trusted to work as I wish. I have agency, and I am respected - two things my colleagues on the wards, and junior doctors in general, lament that they are rarely afforded.
Yes, there are challenges to balancing clinical and academic work, including having less time to complete a clinical portfolio and ensure your competencies are assessed. That said, working in research has taught me skills that have been directly beneficial to my clinical practice, including an appreciation of the difficulties that come with generating new evidence and translating this into patient outcomes. Conversely my clinical work has made me a better researcher, as I bring knowledge of the clinical world into my research teams. During my research blocks there has been a reduction in pay due to lack of out of hours work, but for me personally this has been worth the ability to, say, make plans for a weekend in March in September, as the uncertainties of last minute rotas don’t apply. As I’m not covering any out of hours shifts, annual leave can be taken much more flexibly, and in large blocks if wanted - and I’m unlikely to ever get it rejected. I feel more in control of my working life, and am able to eat better and exercise more.
I have had a particularly good experience within a supportive department, and as pointed out in the original article, experiences are variable. However, I have no doubt that had I not been on an integrated academic Foundation programme, I would be - like so many of my friends and colleagues - too burnt out to continue with clinical training in the NHS. As it stands, I am heading directly into specialty training alongside an Academic Clinical Fellowship, giving me further protected research time in my basic training. If more very junior doctors were given options to engage in protected research time if they wished, perhaps they would be happier, healthier, and more likely to continue their NHS careers.
Further, the progressive crises battering the NHS will take a toll. As an hitherto aspiring clinical academic, the immense pressure of clinical workload increasingly displaces research work (funding applications, protocol development, data collection, data analysis and writing and revising manuscripts and presentations) into the personal life. This is alongside the administrative paraphernalia of being a doctor.
Doctors, especially in training, are afforded little time to meet these competing demands. I know even those with "dedicated" academic time struggle. Put simply, how many of your days off after working a weekend are you willing to dedicate to... more work?
The estimates of how many hours of my 'own time' I have spent doing research work make for a grim calculus when I consider the potential locum rates for extra shifts. If NHS workers' salaries are suppressed, and academic work is not financially awarded, what will happen?
As well as improving outcomes and efficiency, integrated clinical academic training can be a tool for retention
Dear Editor
Recent appeals to the Health Secretary to protect and expand the clinical academic workforce in the UK have pointed out that doctors who are trained in both a clinical specialty and research are crucial to the continued efficient functioning of the NHS, and the outcomes of the patients cared for within it. The argument that engagement with research can also improve retention of staff led me to reflect on my own experiences as the most junior of clinical academic trainees - an academic foundation doctor. In this post, I have two four-month research blocks alongside my clinical rotations.
My research rotations have been the best of my Foundation jobs, and this is not for lack of clinical contact - in fact, I miss seeing patients. It is for everything else surrounding the work. During my research time, I was allocated a named supervisor, who not only quickly knew me by name, but who aims to meet with me weekly to discuss progress, challenges and help me plan for the future. My supervisor introduced me first to the local team, and then wider groups of academics, and signposts to opportunities. Without the pressures of clinical work, supervisors are able to make me feel cared about and part of the team. I am encouraged to think big and don’t feel restrained by being the most junior. I take part in various facets of academic activity, including teaching on my own terms, when not bogged down with ward jobs. To a certain extent, I plan my own time, and am trusted to work as I wish. I have agency, and I am respected - two things my colleagues on the wards, and junior doctors in general, lament that they are rarely afforded.
Yes, there are challenges to balancing clinical and academic work, including having less time to complete a clinical portfolio and ensure your competencies are assessed. That said, working in research has taught me skills that have been directly beneficial to my clinical practice, including an appreciation of the difficulties that come with generating new evidence and translating this into patient outcomes. Conversely my clinical work has made me a better researcher, as I bring knowledge of the clinical world into my research teams. During my research blocks there has been a reduction in pay due to lack of out of hours work, but for me personally this has been worth the ability to, say, make plans for a weekend in March in September, as the uncertainties of last minute rotas don’t apply. As I’m not covering any out of hours shifts, annual leave can be taken much more flexibly, and in large blocks if wanted - and I’m unlikely to ever get it rejected. I feel more in control of my working life, and am able to eat better and exercise more.
I have had a particularly good experience within a supportive department, and as pointed out in the original article, experiences are variable. However, I have no doubt that had I not been on an integrated academic Foundation programme, I would be - like so many of my friends and colleagues - too burnt out to continue with clinical training in the NHS. As it stands, I am heading directly into specialty training alongside an Academic Clinical Fellowship, giving me further protected research time in my basic training. If more very junior doctors were given options to engage in protected research time if they wished, perhaps they would be happier, healthier, and more likely to continue their NHS careers.
Competing interests: No competing interests