Speech from the Chairman of the Medical Academic Staff Committee
Professor Michael Rees
Tuesday 29 June 2004
The NHS is one of the world's largest employers, we know that the UK is grossly under-doctored and to respond to this there has been the creation of a number of new medical schools and a virtual doubling of the intake of medical students. However, at the time when the need for medical academic staff is at its greatest we have seen a decrease in the number of medical academics. We have to ask, where has the money gone that‘s been pumped into our medical schools and where will the money go from those top up fees that will push our students into such large debt.
The last time I gave a major speech at the ARM was over 20 years ago as Chairman of the JDC. There are striking parallels between the state of junior staff then and medical academic staff now. Junior doctors' lives have been transformed by the positive action of the BMA fighting against vested interests to maintain the status quo. The same action is now needed in medical academia.
I recently met with a group of predominantly female, high-flying doctors in critical specialties such as obstetrics and paediatrics. The meeting I found very shocking: three things were made very clear to me. Firstly, that many clinical specialties in academia are under threat of extinction. The second thing is that many female academic staff are failing to progress in our medical schools and that thirdly many of our academic staff are under such extreme pressure, despite excellent international track records, that they are concerned about their jobs. The threat of redundancy in medical academic life is very real. This should be unheard of in a sane system where we are desperately short of doctors let alone medical academics.
At the other end of the scale, what about the career prospects for younger academics? It’s quite clear that we have an abundance of skills and enthusiasm. The problem is that few young academics want, or are able, to pursue career jobs in academia.
Dr E is a typical academic with whom I discussed a research project a few days ago. She undertook an intercalated BSC and decided laboratory medicine was not for her. However, she undertook a teaching certificate in medical education, completed an MSc in medical science and is now finishing her PhD in clinical research as part of a Welcome fellowship. She was enthused to carry out research in a district general hospital. It’s unlikely that she’ll pursue a career in academic medicine because she wanted to do clinical research and not laboratory research. It’s a fact that only 20% of doctors doing these fellowships go on to academic careers.
Another doctor I spoke to recently has a distinction in his masters in medical education. He is a fantastic teacher, with glowing reviews from students. But he is finding it difficult to get a job in the university to teach those students. The reason for that is because many of our medical schools will only take on doctors who will score highly in the next research assessment exercise, irrespective of the harm this is doing to medical education and clinical research.
It is therefore clear that the crisis in academic medicine is actually largely caused by factors within academia itself.
In challenges such as fair treatment, access and diversity and careers, the medical academic establishment has much to do. In fact it has recently been commented that “the socio-economic makeup of UK medical schools is stuck in a time warp”.
In contrast, the BMA stands out as the organisation which is actually trying to do something about these problems. Over the last year MASC has successfully negotiated a new and unique contract for medical academic staff which binds the Universities and the NHS together in creating, with the academic, an integrated job plan.
This contract is now being used by progressive medical schools to enhance and protect academic staff from overwork and it is a mechanism for positive change. This contract will also enhance co-operation between the NHS and the University sector.
In other areas too MASC has come up with fresh ideas for academic medicine; these ideas are now being incorporated into the new careers structures under Modernising Medical Careers. MASC has highlighted the issue of treatment of female academic staff and are about to undertake an exercise with the BMA on pressure and bullying in academia – something that shouldn’t exist but it does. This issue has been publicised recently in an academic journal.
Over the last year we have come a long way. MASC this year is a team of hardworking academics who feel strongly about the issues facing academic medicine. We have received enthusiastic support from academics who previously have regarded the BMA with scepticism and now feel something positive is being done for them. We have supported our members, which is paramount to us.
Finally I should thank our secretariat. We have been helped enormously in our task by our secretariat who despite being a very small team have worked well above the odds in the last year to take our committee forward.
We in MASC believe that medical academia and all that flows from it; the careers of our present and future academic staff, are dependant on you for support. We know you, the BMA, will not let us down. Thank you.
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