Academic medicine: time for reinvention

Editor—As surgical trainees teaching anatomy at a leading university, we welcome the recent editorial highlighting the current crisis faced by academic medicine.¹

This crisis has serious consequences beyond research and its practical application.² Basic medical sciences must inform evidence based medicine to optimise clinical management. All doctors need a firm and comprehensive basic science education. As experts, academic medical staff are integral in providing this education.

Non-academics should possess skills such as the critical appraisal of papers to lessen the gulf between academics and other doctors. Otherwise a two tier profession is created with a generation of doctors devoid of specialist intellectual interests and less inclined to think as they practise.

The crisis threatens postgraduate medical education. Trainees wishing to undertake a formal research period or pursue an academic career are denied designated posts approved for training. Basic science jobs such as anatomy demonstrating are not officially recognised by the surgical royal colleges as training posts.³ Specialist training reforms have left academia undervalued in the target based culture that dictates medical practice.

Trainees wishing to undertake research, teaching, and writing should be encouraged to develop and nurture these skills throughout their career. Academic consultants are desperately needed in the United Kingdom: 10% of posts are unfilled.⁴ Recruitment problems will remain if research is poorly paid with insecure funding.

We believe that a change in infrastructure and in attitude towards the value of academic medicine must accompany improved funding and facilities. The profession and society at large should encourage and reward innovation, scientific imagination, and creative thinking among doctors if a system of medical education of international renown and a vibrant first class research community are to be maintained in the United Kingdom.