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Clinical Academic Training: Progress so far - A conference for clinical academic trainees

Saturday 17 November 2007: BMA House London
December 2007

The Association’s Medical Academic Staff Committee (MASC) held ‘Clinical Academic Training: Progress so far’, a conference for clinical academic trainees, on Saturday 17 November 2007 at BMA House in London. The conference attracted in excess of 100 delegates from a wide grades of disciplines including Academic Foundation Years, those undertaking Academic Clinical Fellowships, Clinical Lecturers and Clinical Research Fellows as well as Foundation year 1 and 2 doctors. Senior academics also attended the event. The conference aimed to give practical advice to trainees interested in a career in academic medicine and also to engage with trainees and get their view on the new career pathway and on areas of uncertainty.

Presentations
Delegates received a number of presentations throughout the day. The full text of all presentations can be found by using the links on the right.

• ‘The role of postgraduate deaneries in academic training’ - Professor Jacky Hayden
  Covered areas including the deanery’s role in managing the quality of academic training and supporting academic trainees, the importance of cooperation between the deanery, the Strategic Health Authority and the University, the need for trainees to develop leadership skills and have mentoring.
• ‘The structure of academic training’ - Professor Geraint Rees
  Gave an overview of the different types of academic careers and positions available and some of the difficulties currently being faced by the profession, particularly in light of the recent MMC and MTAS situations. Supported the principle that training schemes need to facilitate a wider range of pathways as no two academic careers are the same. Advice was given on both pay and funding.
• ‘Employment and Equality Issues’ - Dr Anita Holdcroft
  Provided information on the ‘Women in Academic Medicine’ (WAM) project (carried out by the BMA, the Higher Education Funding Council and others) to highlight some of the barriers to progression contains recommendations. A copy of the WAM report can be found at: http://www.bma.org.uk/ap.nsf/Content/WAM2007
• ‘Academic contracts’ - Professor Michael Rees
  The presentation covered the different types of contracts currently in existence for clinical academics, along with the organisations employing clinical academics – the NHS and universities - and what an individual might be expected to demonstrate in order to receive a contract of employment. It was noted that principles for integrated academic training contracts are a top priority for MASC. Delegates were also reminded that the MASC produced an employment guide to universities see http://www.bma.org.uk/ap.nsf/Content/Uniemployment
• ‘Academy of Medical Science mentoring programme’ - Professor Peng T Khaw
  Information was given on the Academy of Medical Sciences (AMS), its aims and objectives and current policy areas. Delegates were advised on the importance of mentoring and the different schemes that were available through the AMS and what these could offer. More information on the AMS mentoring scheme can be found at http://www.acmedsci.ac.uk/p55.html
• ‘Research Programmes at the Wellcome Trust’ - Dr John Williams
  An introduction into the work of the Wellcome trust was given, covering the work that was carried out and how clinical academics could fit into this. Advice was given on potential funding and training opportunities and how these could be achieved. Funding information about the Wellcome Trust can be found at http://www.wellcome.ac.uk/funding/index.html

Interview with a ‘Role Model’
Professor Amanda Howe, Professor of Primary Care and MB/BS Course Director at the University of East Anglia was interviewed by the Chair of the conference, Dr Peter Dangerfield. Professor Howe had been nominated as a role model in the BMA report ‘Role Models in Academic Medicine’, and spoke about her career, what had made her choose to pursue a career in academic medicine and how she had overcome any obstacles along the way. A copy of the Role Model’s report can be found at http://www.bma.org.uk/ap.nsf/Content/Rolemodels

Issues arising from group discussion
Facilitated group discussions allowed delegates to discuss the topics which had been covered throughout the morning, along with their own personal experiences and opinions of academic careers and training. This was then fed back to the main conference.

Some of the key issues raised in the discussion groups included concerns over the current contractual arrangements for clinical academics. Delegates felt that there was a significant amount of variation between the different contracts which were held by academics throughout the range of different positions available in academic medicine. This could be determined by factors such as who was providing the funding for an individual’s research. The complexity of an academic’s contract increased the potential for problems.

Delegates were concerned that salary scales for clinical academics were not equitable to those of other junior doctors and did not contain the same increments, banding systems and provision for on-call work to be carried out. This led to a loss of income being associated with a career in academic medicine. There was a need for financial security, a stable job and a stable contract. It was suggested that a lead organisation could take on the responsibility of bringing together all of the components of the contract, possibly with the National Institute of Health Research as an umbrella organisation.

Universities should provide honorary contracts for clinical academic trainees which allowed them the access to the university the facilities which were imperative to them being able to carry out research. There was also concern about pension arrangements for medical academics and delegates called for more information and eligibility to stay on an NHS pension and greater information about the elements of the University Superannuation Scheme.

There was discussion surrounding the 25% research time incorporated into an Academic Clinical Fellowship post and the effect that this could have on an individual’s clinical skills. The majority of delegates believed that 25% was sufficient time for them to undertake their research, however there were concerns that academic trainees may fall behind their clinical colleagues in their clinical experience. This could prevent clinical academics from being recognised as having the same clinical competencies and could even be detrimental should an individual decide that they no longer wished to pursue a career in academic medicine and applied for a clinical post. It was felt that there was a need to better synchronize academic and clinical progression.

The benefits of having a good research supervisor were noted both in the development of an individual and when looking for funding. It was a concern that there were some posts which were not of the same standard as others, and that some supervisors were not as helpful as others.

Delegates were agreed that the academic component of some foundation year programmes was beneficial and should be retained, although there should not be undue pressure put on a trainee to produce something which could then be used to get funding for research. For ACF posts, it was suggested that interviews were a useful part of the recruitment process and should be used to a greater extent and that job descriptions must be thorough, fully explaining what the post would entail, as there had been some cases in which the applicant had not fully understood what they were applying for. There was overwhelming support from the conference that ACFs should have multiple entry points, not only at ST1 as recommended by the Tooke report..

Finally, Dr John Williams, Professor Jeremy Pearson, British Heart Foundation and Dr Simon Vincent, Cancer UK took questions from delegates on ‘What do funding bodies want from PhD studentships’. Advice was given on funding for individuals who had studied for a PhD and then undertaken medicine and alternative ways to secure funding.