Clinical academic medicine: the way forward.

The UK has an excellent record of producing physician scientists who have become international leaders and achieved major breakthroughs in both the clinical and scientific arenas. Indeed, it is the very combination of training in both the clinical and scientific disciplines that has been the core strength of academic medicine in the UK, and which has enabled UK universities to maintain their leading positions internationally. This is well exemplified in many areas, for example in molecular medicine, cancer biology, infectious diseases, vaccine development, inflammatory diseases, clinical trials and epidemiology. The quality of research by UK academic medicine comes second only to that of the USA, despite the great difference in resources, and it has attained this position by addressing challenges with enthusiasm and by being innovative in providing solutions. Such challenges emanate in part from the research field where, for example, the translation of advances from the genome projects to the clinical setting could provide immense benefit to patients. However, they also stem from the limited funding for research, teaching and healthcare and, for clinical academics, from the time pressures of competing demands from research, teaching and clinical practice. The way in which these issues are addressed is clearly important for present and future clinical academics in all specialties. The challenges facing academic medicine are now widely recognised and feature prominently in the Chief Medical Officer’s Annual Report 2003.1 However, there has not previously been a coordinated view on clinical academic careers from all of the Medical Royal Colleges. For this reason, at the suggestion of the Academic Medicine Committee of the Royal College of Physicians of London, a Forum on Academic Medicine was established in 2003 under the auspices of the Academy of Medical Royal Colleges. The aim of the Forum was to allow crossdiscipline discussion of the issues facing academic medicine in the UK and to propose solutions – both general and specific to each of the clinical specialties. A particular task of the Forum was to define academic career pathways for members of each of the Colleges wishing to pursue a career in research and teaching. The work of the Forum has recently been published as a report, Clinical academic medicine: the way forward,2 which makes key recommendations on the general issues facing UK academic medicine and provides specific advice about training pathways for academic trainees from all 14 Medical Royal Colleges (see Box 1).