Medical academia is experiencing a “deepening crisis” that calls for immediate action, the outgoing acting president of the Academy of Medical Sciences has warned.
In a letter to academy fellows, Paul Stewart said that the number of clinical academics in the UK across the healthcare workforce was falling at an alarming rate. “With the ageing demographic of the current clinical academic workforce, and the imminent expansion in the numbers of doctors that we will train, we are at a critical point where immediate action is essential,” he wrote.
Fewer medical clinical academics were employed in UK universities than in 2010, he added. Between 2010 and 2022 there was a 25% reduction at senior clinical lecturer grades. Overall, clinical academics now represent just 5.7% of the consultant workforce, down from 8.6% in 2011. For GPs the situation was starker, he said, with clinical academics comprising just 0.4% of the primary care workforce.
Women are underrepresented in more senior positions, holding only 41% of senior lecturer positions and 24% of professorships. Clinical academics from ethnic minority backgrounds make up a fifth of lecturers but only 12% of professors.
Stewart said that clinical academics had been crucial in developing breakthrough treatments, such as TNFα inhibitors for inflammatory diseases, CAR-T cancer treatments, and covid-19 vaccines, and they have helped create a culture of research in the NHS that is linked to better patient outcomes and lower mortality. “Without concerted action, we risk losing a unique cadre of researchers who collectively provide immense impact to our NHS, [and] our wider society and economy,” his letter says.
Stewart said several factors had contributed to the decline in clinical academics, including rigid training structures that made it difficult for those who wanted to carry out research alongside clinical work. And although investment has come from organisations such as the National Institute for Health and Care Research for clinical PhD students, there was much less support available at the postdoctoral career stages. Other problems included concerns over pensions, pay disparity between clinical academics and NHS colleagues, and the widespread challenges arising from low staff morale and financial pressure on the NHS.
In May 2023 the academy published a report, Future-proofing UK Health Research,1 which said the current system was no longer fit for its purpose. The academy is calling on decision makers, including the next government, to implement the report’s recommendations.
The letter also called on academy fellows to champion and support clinical academics in their own institution and get involved in the academy’s “inspire” scheme. Steward urged them to seek out barriers to clinical academic careers and work to reform policies.
“Despite the challenges, it has never been a more exciting time to embark on a clinical academic career and make a difference. The opportunities are immense and far-reaching—from cell therapies to the convergence of digital-data-AI with health technologies to a renewed emphasis on public health, early diagnosis, and prevention,” the letter said.
Andrew Morris, professor of medicine and vice principal of data science at the University of Edinburgh, was elected the next president of the Academy of Medical Sciences and took up the role on 25 April.