Editor—Much of the correspondence on the future of academic medicine has focused on the clinical specialties.1,2 Many of the problems are common to public health. The recent survey by the Council of Heads of Medical Schools makes it clear that public health medicine faces the most severe problems.3
The first is the overall changes in post since 2000: public health is the most negatively affected of all specialties with a loss of 32%. When this is put alongside the drop in pathology, a loss of 25%, this is particularly harmful for the future of academic health protection.
The second problem is changes by grade since 2000: a 20% loss of professors; a 22% loss of readers or senior lecturers; and a 59% loss of lecturers.
The third problem is that public health medicine has also lost most in funding from outside sources.
These figures speak for themselves in describing the parlous state of academic public health. However, the chief medical officer's report, while voicing general concern about academic medicine failed to make this point. A recent report by the Well-come Foundation highlights the common problems faced by public health.4 Its recommendations are:
An overarching national strategy needs to be developed to secure the future of the public health sciences at a time when the UK health services are being refocused towards the promotion of good health and the prevention of illness
The academic infrastructure for public health sciences at all levels needs to be strengthened through coordinated, long term investment
The partnership between universities and the NHS in the public health field should be re-established, and public health centres could be established to bring together public health science, social science, and public health service delivery
The practical aspects of the regulatory framework need to be streamlined as these processes can act as a strong cumulative dis-incentive to embarking on public health research and may divert resources unnecessarily away from this area
A more informed dialogue between public health scientists, the public, policy makers and the media must be engendered to develop a better understanding of risk in relation to health.
Choosing health gives us an opportunity to do something about this. Let's hope it is taken.
Competing interests: None declared.
References
- 1.Dandona L. Academic medicine: time for reinvention. BMJ 2004;328: 47. [Google Scholar]
- 2.Academic medicine: who is it for? BMJ 2004;329: 751-808. (2 October.)15459026 [Google Scholar]
- 3.Aideen Silke. Clinical academic staffing levels in UK medical and dental schools. London: Council of Heads of Medical Schools, 2004.
- 4.Public Health Sciences Working Group convened by the Wellcome Trust. Public health sciences: challenges and opportunities. London: Wellcome Trust, 2004. Available at: http://www.wellcome.ac.uk/assets/wtd003191.pdf