The changing funding environment for clinical academics

Abstract

A career in clinical academia has never been more exciting. Medical science is advancing at an extraordinary pace, driven by the increasingly rapid translation of discovery science into new prevention, diagnostic, and treatment strategies. Advances in so-called omic technologies and bioinformatics are providing data and new knowledge at an astonishing rate and, in this new technological age, collaboration between clinicians and biologists with engineers, mathematicians, and physical and computing scientists is becoming increasingly common and important. Similarly, a renewed focus on disease prevention and public health has led to increasing interactions between clinical, behavioural, and social scientists.Clinical academics are crucial to ensuring that these technological advances and collaborations address the remaining health challenges and produce health and wealth gains that reap the benefit of the unprecedented investment in biomedical science made over the past decade. Since its founding in 2006, the National Institute for Health Research (NIHR) alone has provided an extra £1 billion per year for health-related research, more than doubling the amount of taxpayers' money previously directed towards medical research largely via the Medical Research Council (MRC). An increasing proportion of MRC funding is being devoted to experimental studies in human participants, to generate new understanding of human disease mechanisms, to support the identification of new therapeutic targets, and to establish proof of concept for new diagnostics and therapies. Clearly, clinical academics are essential in delivering these new translational programmes.Past difficulties arising from the lack of a clear and recognised career pathway for clinical academics have now been partly addressed by the advent of the NIHR-funded integrated academic training pathway. This pathway has funded almost 2500 academic clinical fellows and clinical lecturers in the 10 years since its inception. There is emerging evidence that a substantial proportion of these individuals have ended up in established academic posts after their training.Although undoubtedly exciting, this new environment is not without its challenges. The age-old problems of combining academic and clinical training and making the successful transition from doctoral training to an independent postdoctoral career remain. The increasing focus on interdisciplinary and team science poses two new challenges—how to gain the knowledge and skills required to engage in meaningful collaborations with disciplines outside medicine, and how to achieve individual recognition in large teams. Against this background, many of the key funders of biomedical and health research have responded to this changing environment by revamping or refreshing their funding strategies with important implications for those already in, or embarking on, a clinical academic career.In terms of priority areas, the refreshed MRC strategy1Research changes lives 2014–19, Medical Research Council.http://www.mrc.ac.uk/documents/pdf/research-changes-lives-2014-2019Google Scholar highlights lifelong brain health (including dementia), antimicrobial resistance, regenerating damaged tissue, and disease prevention; and the Wellcome Trust's new strategy2Wellcome Trust aims to increase spend to £5 billion over next 5 years, Wellcome Trust.http://www.wellcome.ac.uk/News/Media-office/Press-releases/2015/WTP059904.htmGoogle Scholar also prioritises drug-resistant infections as well as vaccinations and the effect of global food systems and urbanisation on human health. These priorities operate across all of their funding schemes including personal fellowships. Clearly, for clinicians embarking on an academic career it would be sensible to at least consider how they might contribute to these important areas.With respect to fostering interdisciplinary research, the Wellcome Trust has recently launched their Collaborative Awards in Science, Humanities and Social Science3Collaborative awards in humanities and social scienceWellcome Trust.http://www.wellcome.ac.uk/Funding/Humanities-and-social-science/Funding-schemes/Collaborative-Awards/index.htmGoogle Scholar to provide groups of researchers from different disciplines with support to pursue key questions. They also have Portfolio Awards,4Portfolio awardsWellcome Trust.http://www.wellcome.ac.uk/Funding/Innovations/Awards/Portfolio-Awards/index.htmGoogle Scholar which support collaborative research and technology development by funding programmes that require a portfolio of projects to deliver leading-edge innovations in health care. The MRC has a variety of schemes and strategies to foster interdisciplinary and team science. These include the Francis Crick Institute, opening in 2016, which will bring together clinicians and biologists with physical and computing scientists, mathematicians, and engineers from the partner universities; the Stratified Medicine Consortia, which bring together academic and industrial partners to tackle specific diseases including inflammatory and infectious diseases and mental health; and the Skills Development Fellowships5Skills development FellowshipsMedical Research Council.http://www.mrc.ac.uk/skills-careers/fellowships/skills-development-fellowshipsGoogle Scholar aimed at quantitative researchers seeking to develop new expertise and skills by applying mathematical, statistical, and computational methods to biomedical and health research. Along with other research councils they are also running a £30 million initiative to tackle antimicrobial resistance.The MRC and NIHR have also invested heavily in both medical bioinformatics and health informatics, with the MRC-funded Farr Institute coordinating the work of four Health Informatics Research Centres across the UK and the NIHR–MHRA-funded Clinical Practice Research Datalink providing anonymised primary care records for public health research. Prompted by the recommendations from the Maxwell report,6The importance of engineering and physical sciences research to health and life sciencesEngineering and Physical Sciences Research Council.http://www.epsrc.ac.uk/newsevents/pubs/the-importance-of-engineering-and-physical-sciences-research-to-health-and-life-sciencesGoogle Scholar commissioned by the Engineering and Physical Sciences Research Council (EPSRC), the Biotechnology and Biological Sciences Research Council, EPSRC, and MRC have recently published the results of the Technology Touching Life consultation.7Technology Touching Life Consultation 2015Engineering and Physical Sciences Research Council.https://www.epsrc.ac.uk/files/newsevents/news/ttlsummary/Google Scholar Technology Touching Life is a potential joint research council initiative to foster interdisciplinary technology development research across the engineering, physical, and life sciences (both biomedical and biological)—so watch this space for many new calls and schemes from these three research councils.Meanwhile Cancer Research UK (CRUK) has recently announced its Grand Challenge Awards,8Grand Challenge AwardsCancer Research UK.http://www.cancerresearchuk.org/grandchallengeGoogle Scholar providing up to £20 million to interdisciplinary teams to tackle the most important unanswered questions in cancer research. As with the MRC Stratified Medicine Consortia, this CRUK scheme encourages commercial collaboration. Schemes to foster collaborations between industry and academia now account for an increasing proportion of the funding portfolio of both public and charitable organisations, with the MRC–Innovate UK Biomedical Catalyst Fund9Biomedical catalystMedical Research Council.http://www.mrc.ac.uk/funding/science-areas/translation/biomedical-catalystGoogle Scholar and the MRC Industry Asset Sharing Schemes10MRC-industry asset sharing initiativeMedical Research Council.http://www.mrc.ac.uk/funding/browse/mrc-industry-asset-sharing-initiativeGoogle Scholar being particularly prominent examples. In this latter scheme researchers can use compounds provided by the scheme's seven industrial partners in experimental medicine studies to understand disease mechanisms and explore treatment opportunities. Industry partnerships can be included in any of the MRC's current grant and fellowship schemes and provide clinical academics with the opportunity to collaborate with, and better understand the needs and perspectives of, the commercial sector, sometimes leading to careers within the sector.The problem of individual researchers getting recognition in team science is currently receiving a lot of attention, with the Academy of Medical Sciences shortly to publish a report on the topic, which will be likely to have, among its recommendations, a requirement for research outputs and grants to include open transparent, standardised, and structured contribution information.Finally, the issues of transitioning from doctoral training to independence and postdoctoral fellowships and flexibility in the postdoctoral fellowships to allow for parallel clinical training have been addressed by a number of new or revamped schemes for clinical academics. The Academy's Starter Grants for Clinical Lecturers Scheme11Starter grants for clinical lecturersAcademy of Medical Sciences.http://www.acmedsci.ac.uk/careers/funding-schemes/starter-grants/Google Scholar has been replicated by CRUK's Post-Doctoral Research Bursary for Clinical Trainees12Postdoctoral research bursary for clinical traineesCancer Research UK.http://www.cancerresearchuk.org/funding-for-researchers/our-funding-schemes/postdoctoral-research-bursary-for-clinical-traineesGoogle Scholar and to some extent by the Wellcome Trust's Seed Awards in Science and Humanities and Social Science,13Seed awards in scienceWellcome Trust.http://www.wellcome.ac.uk/Funding/Biomedical-science/Funding-schemes/Seed-Awards/index.htmGoogle Scholar although these latter awards are open to all investigators. The Wellcome Trust has also consolidated its two postdoctoral clinical schemes into a single, flexible Postdoctoral Clinician Scientist Fellowship scheme.14Director's update: refreshing our offer to cliniciansWellcome Trust.http://blog.wellcome.ac.uk/2015/07/15/directors-update-refreshing-our-offer-to-clinicians/Google Scholar This new scheme will allow the opportunity of longer-term support and greater accommodation for balancing research and clinical training. Perhaps most encouragingly, if the recommendations of the Shape of Training review led by David Greenaway are fully implemented, junior doctors undertaking research training will no longer be regarded as being out of programme, with research training competitively awarded by UK funders incorporated as an integral part of postgraduate training and Annual Reviews of Competence Progression. This should also ensure that academic trainees do not lose out financially.So, what are you waiting for? There has never been a better time to embark on a career in clinical academic medicine. The funding and flexible schemes are there, and the opportunities and shear breadth of medical science appears to be growing exponentially. All that is needed is a little inspiration and curiosity and a lifelong passion for science.Prof Christopher Day is the Vice-President (Clinical) of the Academy of Medical Sciences and Pro-Vice-Chancellor for the Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. A career in clinical academia has never been more exciting. Medical science is advancing at an extraordinary pace, driven by the increasingly rapid translation of discovery science into new prevention, diagnostic, and treatment strategies. Advances in so-called omic technologies and bioinformatics are providing data and new knowledge at an astonishing rate and, in this new technological age, collaboration between clinicians and biologists with engineers, mathematicians, and physical and computing scientists is becoming increasingly common and important. Similarly, a renewed focus on disease prevention and public health has led to increasing interactions between clinical, behavioural, and social scientists. Clinical academics are crucial to ensuring that these technological advances and collaborations address the remaining health challenges and produce health and wealth gains that reap the benefit of the unprecedented investment in biomedical science made over the past decade. Since its founding in 2006, the National Institute for Health Research (NIHR) alone has provided an extra £1 billion per year for health-related research, more than doubling the amount of taxpayers' money previously directed towards medical research largely via the Medical Research Council (MRC). An increasing proportion of MRC funding is being devoted to experimental studies in human participants, to generate new understanding of human disease mechanisms, to support the identification of new therapeutic targets, and to establish proof of concept for new diagnostics and therapies. Clearly, clinical academics are essential in delivering these new translational programmes. Past difficulties arising from the lack of a clear and recognised career pathway for clinical academics have now been partly addressed by the advent of the NIHR-funded integrated academic training pathway. This pathway has funded almost 2500 academic clinical fellows and clinical lecturers in the 10 years since its inception. There is emerging evidence that a substantial proportion of these individuals have ended up in established academic posts after their training. Although undoubtedly exciting, this new environment is not without its challenges. The age-old problems of combining academic and clinical training and making the successful transition from doctoral training to an independent postdoctoral career remain. The increasing focus on interdisciplinary and team science poses two new challenges—how to gain the knowledge and skills required to engage in meaningful collaborations with disciplines outside medicine, and how to achieve individual recognition in large teams. Against this background, many of the key funders of biomedical and health research have responded to this changing environment by revamping or refreshing their funding strategies with important implications for those already in, or embarking on, a clinical academic career. In terms of priority areas, the refreshed MRC strategy1Research changes lives 2014–19, Medical Research Council.http://www.mrc.ac.uk/documents/pdf/research-changes-lives-2014-2019Google Scholar highlights lifelong brain health (including dementia), antimicrobial resistance, regenerating damaged tissue, and disease prevention; and the Wellcome Trust's new strategy2Wellcome Trust aims to increase spend to £5 billion over next 5 years, Wellcome Trust.http://www.wellcome.ac.uk/News/Media-office/Press-releases/2015/WTP059904.htmGoogle Scholar also prioritises drug-resistant infections as well as vaccinations and the effect of global food systems and urbanisation on human health. These priorities operate across all of their funding schemes including personal fellowships. Clearly, for clinicians embarking on an academic career it would be sensible to at least consider how they might contribute to these important areas. With respect to fostering interdisciplinary research, the Wellcome Trust has recently launched their Collaborative Awards in Science, Humanities and Social Science3Collaborative awards in humanities and social scienceWellcome Trust.http://www.wellcome.ac.uk/Funding/Humanities-and-social-science/Funding-schemes/Collaborative-Awards/index.htmGoogle Scholar to provide groups of researchers from different disciplines with support to pursue key questions. They also have Portfolio Awards,4Portfolio awardsWellcome Trust.http://www.wellcome.ac.uk/Funding/Innovations/Awards/Portfolio-Awards/index.htmGoogle Scholar which support collaborative research and technology development by funding programmes that require a portfolio of projects to deliver leading-edge innovations in health care. The MRC has a variety of schemes and strategies to foster interdisciplinary and team science. These include the Francis Crick Institute, opening in 2016, which will bring together clinicians and biologists with physical and computing scientists, mathematicians, and engineers from the partner universities; the Stratified Medicine Consortia, which bring together academic and industrial partners to tackle specific diseases including inflammatory and infectious diseases and mental health; and the Skills Development Fellowships5Skills development FellowshipsMedical Research Council.http://www.mrc.ac.uk/skills-careers/fellowships/skills-development-fellowshipsGoogle Scholar aimed at quantitative researchers seeking to develop new expertise and skills by applying mathematical, statistical, and computational methods to biomedical and health research. Along with other research councils they are also running a £30 million initiative to tackle antimicrobial resistance. The MRC and NIHR have also invested heavily in both medical bioinformatics and health informatics, with the MRC-funded Farr Institute coordinating the work of four Health Informatics Research Centres across the UK and the NIHR–MHRA-funded Clinical Practice Research Datalink providing anonymised primary care records for public health research. Prompted by the recommendations from the Maxwell report,6The importance of engineering and physical sciences research to health and life sciencesEngineering and Physical Sciences Research Council.http://www.epsrc.ac.uk/newsevents/pubs/the-importance-of-engineering-and-physical-sciences-research-to-health-and-life-sciencesGoogle Scholar commissioned by the Engineering and Physical Sciences Research Council (EPSRC), the Biotechnology and Biological Sciences Research Council, EPSRC, and MRC have recently published the results of the Technology Touching Life consultation.7Technology Touching Life Consultation 2015Engineering and Physical Sciences Research Council.https://www.epsrc.ac.uk/files/newsevents/news/ttlsummary/Google Scholar Technology Touching Life is a potential joint research council initiative to foster interdisciplinary technology development research across the engineering, physical, and life sciences (both biomedical and biological)—so watch this space for many new calls and schemes from these three research councils. Meanwhile Cancer Research UK (CRUK) has recently announced its Grand Challenge Awards,8Grand Challenge AwardsCancer Research UK.http://www.cancerresearchuk.org/grandchallengeGoogle Scholar providing up to £20 million to interdisciplinary teams to tackle the most important unanswered questions in cancer research. As with the MRC Stratified Medicine Consortia, this CRUK scheme encourages commercial collaboration. Schemes to foster collaborations between industry and academia now account for an increasing proportion of the funding portfolio of both public and charitable organisations, with the MRC–Innovate UK Biomedical Catalyst Fund9Biomedical catalystMedical Research Council.http://www.mrc.ac.uk/funding/science-areas/translation/biomedical-catalystGoogle Scholar and the MRC Industry Asset Sharing Schemes10MRC-industry asset sharing initiativeMedical Research Council.http://www.mrc.ac.uk/funding/browse/mrc-industry-asset-sharing-initiativeGoogle Scholar being particularly prominent examples. In this latter scheme researchers can use compounds provided by the scheme's seven industrial partners in experimental medicine studies to understand disease mechanisms and explore treatment opportunities. Industry partnerships can be included in any of the MRC's current grant and fellowship schemes and provide clinical academics with the opportunity to collaborate with, and better understand the needs and perspectives of, the commercial sector, sometimes leading to careers within the sector. The problem of individual researchers getting recognition in team science is currently receiving a lot of attention, with the Academy of Medical Sciences shortly to publish a report on the topic, which will be likely to have, among its recommendations, a requirement for research outputs and grants to include open transparent, standardised, and structured contribution information. Finally, the issues of transitioning from doctoral training to independence and postdoctoral fellowships and flexibility in the postdoctoral fellowships to allow for parallel clinical training have been addressed by a number of new or revamped schemes for clinical academics. The Academy's Starter Grants for Clinical Lecturers Scheme11Starter grants for clinical lecturersAcademy of Medical Sciences.http://www.acmedsci.ac.uk/careers/funding-schemes/starter-grants/Google Scholar has been replicated by CRUK's Post-Doctoral Research Bursary for Clinical Trainees12Postdoctoral research bursary for clinical traineesCancer Research UK.http://www.cancerresearchuk.org/funding-for-researchers/our-funding-schemes/postdoctoral-research-bursary-for-clinical-traineesGoogle Scholar and to some extent by the Wellcome Trust's Seed Awards in Science and Humanities and Social Science,13Seed awards in scienceWellcome Trust.http://www.wellcome.ac.uk/Funding/Biomedical-science/Funding-schemes/Seed-Awards/index.htmGoogle Scholar although these latter awards are open to all investigators. The Wellcome Trust has also consolidated its two postdoctoral clinical schemes into a single, flexible Postdoctoral Clinician Scientist Fellowship scheme.14Director's update: refreshing our offer to cliniciansWellcome Trust.http://blog.wellcome.ac.uk/2015/07/15/directors-update-refreshing-our-offer-to-clinicians/Google Scholar This new scheme will allow the opportunity of longer-term support and greater accommodation for balancing research and clinical training. Perhaps most encouragingly, if the recommendations of the Shape of Training review led by David Greenaway are fully implemented, junior doctors undertaking research training will no longer be regarded as being out of programme, with research training competitively awarded by UK funders incorporated as an integral part of postgraduate training and Annual Reviews of Competence Progression. This should also ensure that academic trainees do not lose out financially. So, what are you waiting for? There has never been a better time to embark on a career in clinical academic medicine. The funding and flexible schemes are there, and the opportunities and shear breadth of medical science appears to be growing exponentially. All that is needed is a little inspiration and curiosity and a lifelong passion for science. Prof Christopher Day is the Vice-President (Clinical) of the Academy of Medical Sciences and Pro-Vice-Chancellor for the Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.