Academic medicine: time for reinvention

Editor—I share the hopes and concerns that Stewart expresses in his article.¹ I will illustrate a wider context that medicine as a profession needs to consider in promoting effective medical research.

• Should research methods be a core subject of undergraduate training rather than an uneasy bolt-on?

• Might consultants often now functioning with diminishing support be less interested in research spanning 20 years than surviving to retirement in 10?

• Is research funding being spent wisely and placed with clinicians who have the expertise to deploy it effectively and who do not have the ulterior motive of simply escaping the sometimes unattractive clinical arena?

• Are researchers with a clinical commitment best placed to regulate the gradient osmosing funding from the research to the clinical domain? A clinical responsibility makes it difficult to be more than semipermeable.

I support Stewart's desire to return research findings to the patient, with the aim of improving outcome. Isn't this why we are here as a profession?

But let us take a trip forward a little. As a grumpy old man I often air my concerns about falling standards. I am able to illustrate my concerns by wondering about the level of care that will be afforded me in my dotage.

How relevant to me then will be the research that has kept me lucid and so painfully aware of the lack of empathy offered to me by the carer who fails to smile warmly and bolster my dignity as he or she wipes my arse? Time may tell.