Growing the clinical academic workforce: the case for structured academic training programs for junior doctors

To the Editor: In response to an emerging mismatch between supply and demand for academic clinicians,1 several organisations have highlighted the potential value of an explicit clinical academic training pathway for Australian medical graduates.1,2 An initiative of this nature would not only increase educational capacity, but would also help realise the aspirations of the McKeon Review of Health and Medical Research — to achieve and sustain health care excellence through training and retaining a world-class medical research workforce.3

While a longitudinal academic training program spanning different specialties is unlikely to eventuate in the short term, supporting prevocational trainees to undertake research and teaching activities is a critical first step. Interest in academic medicine wanes during the early postgraduate years, and targeted initiatives are needed to break down the barriers to clinical academic careers.1,4

An instructive example is the academic stream of the United Kingdom's Foundation Programme for medical graduates, which supports around 450 junior doctors per year to develop skills in research, teaching and leadership. Academic activities are “protected” and take place either concurrently or in sequence with clinical roles. A variety of projects (from lab-based research to health leadership initiatives) are on offer, and all participants have access to supervision, mentoring and academic infrastructure. The program was strongly commended in a recent evaluation report.5

The UK academic Foundation Programme provides a model that could be adapted for Australia. Although there are important barriers to reform (including geographical diversity in models of prevocational training; competing clinical service demands; suboptimal integration between universities, health services and funding partners; and resource constraints), the impending introduction of activity-based funding for teaching, training and research might provide an opportunity to tackle some of these problems. The success of the Australian General Practice Training program's academic rotation shows that these kinds of initiatives are feasible in the local context.

Patients, senior clinicians and trainees all stand to benefit from a stronger clinical academic workforce. Although there are other important barriers to the recruitment and retention of academic clinicians (including demands of clinical practice, job insecurity and pay inequity), supporting junior doctors to undertake academic activities is a strategy worthy of strong consideration.