Talk us through the importance of clinician scientists within cancer research…
Clinician Scientists are vital to the success of cancer research.
In particular, they work at the interface between fundamental discovery science and clinical application.
Clinician Scientists frequently drive both early phase clinical investigations, especially critical experimental medicine studies, and the translational analysis of patient samples. This combination of translational research and patient intervention is vital as we endeavour to move basic science into novel treatments and biomarkers.
Last year, the UK House of Lords Science and Technology Committee reported an alarming decline in the number of clinical academics in the UK – why do you think that is?
Well, firstly it’s important to emphasise there are existing opportunities for clinicians in the UK to undertake research as part of their clinical training – including Academic Foundation Programmes, Academic Clinical Fellowships and PhD programmes for clinicians, with post-doctoral Academic Clinical Lectureships and Clinician Scientist Fellowships for the truly dedicated. These are vital and we must continue to support them.
But it’s true that there are several issues that act as barriers to academic careers for clinicians.
There is a significantly reduced emphasis on basic science in medical school, with fewer students taking an intercalated BSc during their undergraduate training. In addition, funding opportunities for clinical academics, especially following a PhD, are rare and hugely competitive and many fewer candidates can be funded than we would like.
There are also fundamental structural issues: the alternative to an academic career is an NHS job, where clinicians will have total job security, few teaching commitments and will not be dependent upon grants and publications. For budding academics who do not want a purely laboratory research career as a Clinician Scientist Fellow, the alternative is a Clinical Senior Lecturer post – the first permanent academic position for clinicians, linked with honorary consultant status in hospital specialties. However, the prospect of this may seem far less attractive than an NHS post because for these Clinical Senior Lecturer positions – with 50% NHS time and 50% university time – there is a significant teaching load and requirement to generate grant income. It’s also relevant that, given the enormous pressure on the NHS, the ‘50%’ is frequently more like 60% or 70%, which makes a research career almost impossible.
There is also the challenge that Universities and NHS hospitals are separate organisations, often with competing demands.
Finally, and at risk of being overtly political, Brexit acted as a major deterrent to talented European clinicians from coming to the UK to pursue a clinical academic career.
