Academic Clinicians Research Articles

IMP2ART: development of a multi-level programme theory integrating the COM-B model and the iPARIHS framework, to enhance implementation of supported self-management of asthma in primary care

BackgroundSupported asthma self-management, incorporating an asthma action plan and annual clinical review, has been recommended by UK/global guidelines for over three decades. However, implementation remains poor, as only around a third of individuals receive basic asthma care, according to the UKs leading respiratory charity Asthma and Lung UK. A systematic review of implementation studies recommended that a whole systems approach targeting patients, healthcare professional education, and organisations is needed to improve implementation of supported asthma self-management in primary care. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) is a national Hybrid-II implementation cluster randomised controlled trial that aims to evaluate such an approach. This paper describes the development of the implementation strategy for IMP2ART with particular focus on the integration of multiple level theories.MethodsThe Medical Research Council design and evaluation of complex interventions framework and the Person-Based Approach to intervention development were used as guidance for stages of strategy development. Specifically, we (i) set up a multidisciplinary team (including practicing and academic clinicians, health psychologists, public health and patient colleagues), (ii) reviewed and integrated evidence and theory, (iii) developed guiding principles, (iv) developed prototype materials, and (v) conducted a pre-pilot study before final refinement.ResultsThe implementation strategy included resources for patients, team-based and individual healthcare professional education, practice audit and feedback, and an asthma review template, as well as a facilitator role accessible to primary care practices for 12 months. The synthesis of the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) and Capability, Opportunity, Motivation and Behaviour (COM-B) frameworks led to an evolved framework bringing together important implementation and behaviour change elements which will be used as a basis for the study process evaluation.ConclusionsA description of rigorous implementation strategy development for the IMP2ART study is provided along with newly theorised integration of implementation and behaviour change science which may be of benefit to others targeting implementation in primary care.Trial registrationISRCTN15448074. Registered on 2nd December 2019.

Engaging undergraduate medical and dental students with academic medicine: The Aberdeen INSPIRE summer school.

UK medical and dental school curricula limit opportunities for students to gain experience in research. This parallels a decline in the number of clinical academics. To address this at grass roots level, we organised and arranged a residential summer taster week; INSPIRE (Introducing New Skills to Promote Inspirational Research Experience)-Aberdeen). The purpose was to give first and second year medical and dental students who wished to explore a potential clinical academic career a taste of wet laboratory research and to gain experience in basic research skills. Seventeen students from eight different UK medical and dental schools attended this free residential course and were exposed to various laboratory techniques with clinical translation and application in diagnostic and therapeutic medicine. Students were given access to relevant online learning tools of the techniques being used beforehand and seminar style presentations were used to emphasise their clinical application. Students met daily with clinical academics from different specialities to give them a flavour of potential clinical academic career pathways and options. All students felt that the summer school helped them consider academic medicine as a career thus achieving our aim to inspire clinical academics of the future.

The South West Clinical School model: an initiative to transform clinical academic career pathways.

The Clinical School Model connects professorial staff from the university directly to practitioners in the National Health Service to promote evidence informed practice and develop clinical academic careers. These are promoted widely, but strategic adoption into organisational culture and workforce plans are challenging to overcome. To describe the development of the Clinical School Model in Cornwall and explore how it generates impact through staff engagement activities to support clinical academic career pathways. Structure, process and outcomes developments over the last 3-years are reported. Donabedian's framework (structure, process and outcome) was used to report on the development and impact of the Clinical School Model. Structural and process activities are reported, illustrating strong foundations to embed clinical academic career pathway opportunities. In the absence of empirical reporting standards for such developments, quantitative and qualitative outcomes are reported against the Clinical School's 5-year strategic plan. This paper responds to the lack of reported evidence on developing organisational infrastructure to address the clinical academics aspirations of nurses and their employers. This important contribution leads a call for more organisations to report to the evidence base, enabling shared learning and shaping future research.

Exploring individual character traits and behaviours of clinical academic allied health professionals: a qualitative study

BackgroundClinical academic allied health professionals can positively impact patient care, organisational performance, and local research culture. Despite a previous national drive to increase these roles, they remain low in number with no clear strategy for growth. Reported barriers to this growth cite organisational and economic factors with little recognition of the challenges posed to individuals. There is a lack of research to help allied health professionals understand the personal challenges of clinical academic training and practice. The aim of this study is to explore the character traits and behaviours of clinical academic allied health professionals to understand the individual attributes and strategies taken to pursue a career in this field.MethodsA semi-structured interview study design was used to collect data from aspiring and established clinical academic allied health professionals. Participants were recruited voluntarily through social media advertisement (aspiring) and purposively through direct email invitation (established). Participants were asked about their experience of pursuing a clinical academic career. The interviews were conducted virtually using Zoom and were audio recorded. The data were transcribed verbatim prior to reflexive thematic analysis. Informed consent was gained prior to data collection and the study was approved by the university’s research ethics committee.ResultsTwenty participants from six allied health professions were interviewed. We developed five themes: risk and reward, don’t wait to be invited, shifting motivations, research is a team sport, and staying the course. Clinical academic allied health professionals demonstrated traits including inquisitiveness, intuition, motivation, and resilience. The source of their motivation was rooted in improving clinical services, conducting research, and personal achievement.ConclusionClinical academic allied health professionals describe personal traits of high inquisitiveness, opportunism, motivation, and determination in pursuing their career ambitions. The tolerance of rejection, failure, and risk was considered important and viewed as an essential source for learning and professional development. Future research should concentrate on ways to reduce the over-reliance on individual strength of character to succeed in this field and explore programmes to increase the preparedness and support for clinical academics from these professions.

Development of Anterior Segment Focused Biologic Therapies to Regenerate Corneal Tissue for the Treatment of Disease: Drug Development Experience.

On February 24-27, 2021, the Association for Ocular Pharmacology and Therapeutics (AOPT) held its 15th biennial scientific meeting online. The meeting was organized by Dr. Sanjoy Bhattacharya of the University of Miami in conjunction with the board of trustees of the AOPT. The 3-day conference was attended by academic scientists, clinicians, and industry and regulatory professionals. The theme of the meeting was Restoring Vision through Regeneration and it was sponsored, in part, by the National Institutes of Health, Bright Focus, Regeneron, and Santen (USA). During the 3 days of the meeting, presentations from several sessions explored different aspects of regenerative medicine in ophthalmology, including optic nerve regeneration, drugs and devices in glaucoma, retinal neuroprotection and plasticity, visual perception, and degeneration of trabecular meshwork. This article summarizes the proceedings of the session on corneal regenerative medicine research and discusses emerging concepts in drug development for corneal epithelial and endothelial regeneration. Since the meeting in 2021, several of these concepts have advanced to clinical-stage therapies, but so far as of 2023, none has been approved by regional regulatory authorities in the United States. One form of corneal endothelial cell therapy has been approved in Japan and only for bullous keratopathy. Ongoing work is proceeding in the United States and other countries. Clinical Registration No: National Clinical Trials 04894110, 04812667; Japan Registry for Clinical Trials a031210199.

872 Two Years of Levelling the Playing Field. Challenges in Sustainability Providing a Free Online National Webinar Series and Mock Interview Scheme

Abstract Aim The Specialised Foundation Programme (SFP) is a competitive training programme for UK medical graduates providing opportunities to pursue academic, educational, or managerial roles alongside clinical work. SFP interviews require knowledge of research methods and critical appraisal, applicants are also assessed in their approach to managing unwell patients. Information and guidance around the SFP vary greatly between medical schools. Where institutional support is lacking, expensive and poorly evidenced preparation courses have flourished, exploiting applicants, and creating a barrier to access. We sought to address this inequality by providing a free, national, structured teaching programme and running mock interviews. Method For two application cycles we conducted a virtual preparation programme followed by mock interviews with clinical academics, aiming to improve perceived preparation and confidence. Outcomes were assessed using questionnaires following webinars and mock interviews. Results In each cohort, >120 students from 33 Universities, attended webinars. On average, students found the webinars helpful (4.75/5) and interesting (4.72/5). Following the webinars students felt more prepared (p<0.0001) and confident (p<0.0001). Similarly, confidence was significantly improved (p<0.001) by mocks for both cohorts. Recruitment of mentors or interviewers from cohort one for the second cohort was only 7%. Conclusions We have demonstrated that SFP applicant confidence and competence for interview can be improved via delivery of a free virtual preparation programme. Such a programme can be delivered through recruitment of a cohort of motivated clinical academics at zero cost. However, despite the clear benefits reported by applicants, retainment of interviewers and thus sustainability of this programme remain challenging.

Core protocol development for phase 2/3 clinical trials in the leukodystrophy vanishing white matter: a consensus statement by the VWM consortium and patient advocates

BackgroundThe leukodystrophy “Vanishing White Matter” (VWM) is an orphan disease with neurological decline and high mortality. Currently, VWM has no approved treatments, but advances in understanding pathophysiology have led to identification of promising therapies. Several investigational medicinal products are either in or about to enter clinical trial phase. Clinical trials in VWM pose serious challenges, as VWM has an episodic disease course; disease phenotype is highly heterogeneous and predictable only for early onset; and study power is limited by the small patient numbers. To address these challenges and accelerate therapy delivery, the VWM Consortium, a group of academic clinicians with expertise in VWM, decided to develop a core protocol to function as a template for trials, to improve trial design and facilitate sharing of control data, while permitting flexibility regarding other trial details. Overall aims of the core protocol are to collect safety, tolerability, and efficacy data for treatment assessment and marketing authorization.MethodsTo develop the core protocol, the VWM Consortium designated a committee, including clinician members of the VWM Consortium, family and patient group advocates, and experts in statistics, clinical trial design and alliancing with industries. We drafted three age-specific protocols, to stratify into more homogeneous patient groups, of ages ≥ 18 years, ≥ 6 to < 18 years and < 6 years. We chose double‐blind, randomized, placebo-controlled design for patients aged ≥ 6 years; and open-label non-randomized natural-history-controlled design for patients < 6 years. The protocol describes study populations, age-specific endpoints, inclusion and exclusion criteria, study schedules, sample size determinations, and statistical considerations.DiscussionThe core protocol provides a shared uniformity across trials, enables a pool of shared controls, and reduces the total number of patients necessary per trial, limiting the number of patients on placebo. All VWM clinical trials are suggested to adhere to the core protocol. Other trial components such as choice of primary outcome, pharmacokinetics, pharmacodynamics, and biomarkers are flexible and unconstrained by the core protocol. Each sponsor is responsible for their trial execution, while the control data are handled by a shared research organization. This core protocol benefits the efficiency of parallel and consecutive trials in VWM, and we hope accelerates time to availability of treatments for VWM.Trial registrationNA. From a scientific and ethical perspective, it is strongly recommended that all interventional trials using this core protocol are registered in a clinical trial register.

The Cost of Being a Woman in Academic Cardiothoracic Surgery: Joint Collaboration of The Society of Thoracic Surgeons Workforces on Diversity, Equity, and Inclusion and Cardiothoracic Surgery Practice Models

BackgroundGender disparity in the cardiothoracic surgery workforce is challenging to enumerate and quantify. The purpose of our work is to use the most current data to quantify the percentage of women in academic cardiothoracic surgery and salary disparity between women and men. MethodsWe performed a cross-sectional analysis of data collected by the Accreditation Council for Graduate Medical Education Data Resource Book 2021 and Association of American Medical Colleges Faculty Data for U.S. Medical School Faculty 2019, 2020, and 2021. We used descriptive analysis of the number of faculty and mean salaries of academic cardiothoracic surgeons according to academic rank and gender. Salary disparity in cardiothoracic surgery was compared with salary disparities seen among surgical specialties and academic clinicians. ResultsOver the past 3 years, women comprised 11.5% of the cardiothoracic workforce. In 2021, cardiothoracic surgeons who were women earned $0.71 to $0.86 for every $1.00 earned by cardiothoracic surgeons who were men. Ascending academic rank correlated with greater gender salary disparity; women professors earned less than men of equal and lower academic rank. From 2019 to 2021, women of the academic ranks of associate professor, professor, and chief of cardiothoracic surgery experienced a decrease in mean salaries, whereas men of equivalent academic ranks experienced an increase in mean salaries. ConclusionsGender disparity in cardiothoracic surgery persists, with low representation of women and salary disparity at every academic rank.

Clinical research in the NHS: a cross-sectional study of research engagement during the monkeypox pandemic

BackgroundRecruitment and retention of clinical academics in the UK is under threat. Acute clinical crises can increase opportunities for clinical research. We aimed to examine research involvement among clinicians working...

Validation of a French Translation of the Altruism Scale for Children

Abstract. Altruistic behavior is a subset of prosocial behavior, aimed at intentionally benefitting another while incurring a cost to the actor. It develops throughout childhood as underlying social–emotional and cognitive mechanisms become mature. Prosocial behavior in childhood is considered as a predictor of later well-being and academic achievement, yet educators and clinicians have few means of measuring it. This study aimed to translate and validate a French version of the Altruism Scale for Children originally developed in English by Swank et al. (2020) that focuses on altruistic behavior with individuals varying in closeness and animals. Children aged 7 through 11 from public and private elementary schools in France ( N = 743), all following the same core curriculum, completed the 30-item questionnaire. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on the obtained data. The final French version of the Altruism Scale for Children contains 20 questions and distinguishes two facets of altruistic intention, namely, toward close and more distant social contacts. It can be considered as a useful instrument to gain a better understanding of a child’s prosocial behavior throughout contexts.

Platform evolution in large inter‐organizational collaborative research programs

AbstractWe examine the role of platform sponsors and program managers in evolving a platform to stimulate inter‐organizational collaboration in large research programs. Through a 5‐year longitudinal case study, we analyzed a large inter‐organizational collaborative research program in England, underpinned by the CLAHRC platform, sponsored by the NIHR. The research program attracted clinical academics in universities and clinical practitioners in a range of healthcare providers to collaborate in an ensemble of projects to drive evidence‐based care for patients with long‐term health conditions. Program managers struggled to facilitate collaboration through the platform, despite a highly decentralized governance approach. Our study identifies three mechanisms through which the platform sponsor and program managers revised the platform's governance strategies to enhance collaboration: (i) they instituted “interruptive events,” which routinely stopped projects, and analyzed if and why organizations struggle to collaborate; (ii) they expanded, rather than restricted, access rules for collaboration through “platform renting”; (iii) they re‐distributed, rather than re‐centralized, governance, to reduce unnecessary interdependences across collaborators attracted by the platform.

Early-career Academic Clinicians at the Intersection of Medicine, Research and Policy – Lessons Learned from the COVID Pandemic

The COVID pandemic enforced unprecedented pressure upon the academic clinician workforce globally. While in some aspects this has been a time of opportunity for academic clinicians, it has also exposed the vulnerabilities of this career path and the challenges early-career academic clinicians face. These challenges include the lack of dedicated training programmes, obstacles to international recognition of their career paths, and the remuneration gap between academic clinicians and their clinical counterparts. Addressing these issues will require a concerted effort from policymakers, funding agencies, and the medical community. However, investing in increasing the pool of academic clinicians in the long term is essential to advancing medical knowledge and improving the wellbeing of all of society.

Abstracts from the Lancaster Clinical Academic Trainee Symposium 2023

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Priorities in Chronic nonbacterial osteomyelitis (CNO) – results from an international survey and roundtable discussions

ObjectiveChronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that predominantly affects children and young people. The pathophysiology and molecular mechanisms of CNO remain poorly understood, and diagnostic criteria and biomarkers are lacking. As a result, treatment is empiric and follows personal experience, case series and expert consensus plans.MethodsA survey was designed to gain insight on clinician and patient experiences of diagnosing and treating CNO and to collate opinions on research priorities. A version containing 24 questions was circulated among international expert clinicians and clinical academics (27 contacted, 21 responses). An equivalent questionnaire containing 20 questions was shared to explore the experience and priorities of CNO patients and family members (93 responses).ResultsResponses were used to select topics for four moderated roundtable discussions at the “International Conference on CNO and autoinflammatory bone disease” (Liverpool, United Kingdom, May 25-26th, 2022). The group identified deciphering the pathophysiology of CNO to be the highest priority, followed by clinical trials, necessary outcome measures and classification criteria. Surprisingly, mental wellbeing scored behind these items.ConclusionsAgreement exists among clinicians, academics, patients and families that deciphering the pathophysiology of CNO is of highest priority to inform clinical trials that will allow for the approval of medications for the treatment of CNO by regulatory agencies.

P-373 Low-Dose Vaginal Misoprostol Application Before Office Hysteroscopy

Abstract Study question In gynecological interventional procedures what should be the minimum misoprostol dose for achieving cervical maturation? Summary answer 50mcgr vaginal misoprostol before office hysteroscopy; decreases the VAS score, bleeding and the total procedure time. What is known already Misoprostol has been on the World Health Organization (WHO) essential drugs list since 2005 due to its uterotonic effect.FIGO (The International Federation of Gynecology and Obstetrics) published a posology table in 2017 that does not cause side effects in off-label use of misoprostol in the obstetric field.There are many publications that misoprostol facilitates interventional gynecologic procedures by allowing cervical maturation . However, no guidelines have yet been published on the dose and route of administration Study design, size, duration This Prospective Randomized Clinical Research was approved by Ankara City Hospital Clinical Research Ethics and Academic committee . Then, 100 women who underwent office hysteroscopy in Ankara City Hospital Gynecology and Obstetrics Clinic gynecology-infertility outpatient clinic between 01/12/2021-01/05/2022 were included in the study after their informed consent was obtained. Participants/materials, setting, methods 50 women who self-administered 50 mcg vaginal misoprostol the night before the office hysteroscopy procedure and 50 women who did not administer the drug were compared. The primary outcome of the study was the duration of the procedure, with the pain score during the procedure used being the (VAS) score system. The secondary outcome was procedure and drug-related side effects Statistical evaluation of the data was performed using the SPSS for Windows version 20.0 Main results and the role of chance In the medicated group the mean of VAS scores during and after the procedure, and the transition and the total time of the procedure were significantly lower than non-medicated group. Limitations, reasons for caution In Turkey, there is only one misoprostol product (CYTOTEC Ali Raif İlaç Sanayi A.Ş) with the 200 mcg posology Off label use of misoporostol in obstetrics is legal since 2021 but not for gynecological practice. We do not have country guidelines on misoprostol posology in obstetrics and gynecology usage also Wider implications of the findings In gynecological interventional procedures especially before office hysteroscopy, it is important to apply a minimum dose of misoprostol for cervical maturation due to its bleeding-increasing effect in patients whith endometrial polyps or hyperplasia .Because bleeding is the most important factor affecting image quality and procedure efficacy during hysteroscopy. Trial registration number E2-21-1068 dated 24.11.2021

Developing an application for the UK Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF): the collective experience of a community of physiotherapists

For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both for clinicians and patients. One way to embark on research is to apply for a personal fellowship such as the National Institute for Health and Care Research (NIHR) Pre-Doctoral Clinical Academic Fellowship (PCAF). While the NIHR has guidance on how to complete the application form, it can be difficult to implement this guidance and understand what a competitive application looks like. As a group of physiotherapists and academic supervisors, who have applied for NIHR PCAFs, what follows is a supportive resource, to inform others who might be thinking of applying. Contribution of paper•This is the first paper to report a collective reflection on the experience of a community of physiotherapists and their academic supervisors of applying for NIHR PCAFs•A description of the process is provided which will be beneficial to other physiotherapists aspiring to develop their application for an NIHR PCAF

Predictors of self-reported research productivity amongst medical students in the United Kingdom: a national cross-sectional survey

BackgroundThe number of academic clinicians in the UK is declining and there are demographic inequalities in the clinical-academic workforce. Increased research productivity by medical students is believed to reduce future attrition in the clinical-academic workforce. Thus, this study investigated the association between student demographics and research productivity amongst UK medical students.MethodsThis is a national multicentre cross-sectional study of UK medical students in the 2020/21 academic year. We appointed one student representative per medical school, and they disseminated a 42-item online questionnaire over nine weeks, through departmental emails and social media advertisements. The outcome measures were: (i) publications (yes/no) (ii) number of publications (iii) number of first-authored publications (iv) abstract presentation (yes/no). We utilised multiple logistic and zero-inflated Poisson regression analyses to test for associations between the outcome measures and predictor variables at a 5% significance level.ResultsThere are 41 medical schools in the UK. We received 1573 responses from 36 UK medical schools. We failed to recruit student representatives from three newly formed medical schools, whilst two medical schools prohibited us from sending the survey to their students. Women had lower odds of having a publication (OR: 0.53, 95% CI: 0.33–0.85) and on average had fewer first-author publications than men (IRR: 0.57, 95% CI: 0.37–0.89). Compared to white students, mixed-ethnicity students had greater odds of having a publication (OR: 3.06, 95% CI: 1.67–5.59), an abstract presentation (OR: 2.12, 95% CI: 1.37–3.26), and on average had a greater number of publications (IRR: 1.87, 95% CI: 1.02–3.43). On average, students who attended independent UK secondary schools had a higher rate of first-author publications compared to those that attended state secondary schools (IRR: 1.97, 95% CI: 1.23–3.15).ConclusionOur data suggest that there are gender, ethnic and socioeconomic inequalities in research productivity among UK medical students. To tackle this, and potentially improve diversity in clinical academia, we recommend that medical schools should facilitate targeted high quality research mentorship, funding and training, especially for under-represented-in-medicine students.

Physical activity in young children across developmental and health states: the ActiveCHILD study.

Evidence about physical activity of young children across developmental and health states is very limited. Using data from an inclusive UK cohort, ActiveCHILD, we investigated relationships between objectively measured physical activity, child development, social context, and health-related quality of life (HRQoL). Children (12-36 months), purposively sampled across health pathways, developmental abilities, and sociodemographic factors, were recruited through thirteen National Health Service organisations in England. Data were collected from 07/2017 to 08/2019 on: weekly physical activity (3-7 days) using waist-worn accelerometer (ActiGraph 3GTX); sociodemographics, parent actions, child HRQoL, and child development using questionnaires; and child health conditions using clinical records. A data-driven, unsupervised method, called hidden semi-Markov model (HSMM) segmented the accelerometery data and provided estimates of the total time spent active (any intensity) and very active (greater intensity) for each child. Relationships with the explanatory factors were investigated using multiple linear regression. Physical activity data were obtained for 282 children (56% females, mean age 21 months, 37.5% with a health condition) covering all index of multiple deprivation deciles. The patterns of physical activity consisted of two daily peaks, children spending 6.44 (SD=1.39) hours active (any intensity), of which 2.78 (SD=1.38) hours very active, 91% meeting WHO guidelines. The model for total time active (any intensity) explained 24% of variance, with mobility capacity the strongest predictor (β=0.41). The model for time spent very active explained 59% of variance, with mobility capacity again the strongest predictor (β=0.76). There was no evidence of physical activity explaining HRQoL. The findings provide new evidence that young children across developmental states regularly achieve mainstream recommended physical activity levels and challenges the belief that children with development problems need lower expectations for daily physical activity compared to peers. Advancing the rights of all children to participate in physical activity requires inclusive, equally ambitious, expectations for all. Niina Kolehmainen, HEE/NIHR Integrated Clinical Academic Senior Clinical Lecturer, NIHR ICA-SCL-2015-01-00, was funded by the NIHR for this research project. Christopher Thornton, Olivia Craw, Laura Kudlek, and Laura Cutler were also funded from this award. Tim Rapley is a member of the NIHR Applied Research Collaboration North East and North Cumbria, with part of his time funded through the related award (NIHR200173). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS, or the UK Department of Health and Social Care. The work of Kianoush Nazarpour is supported by Engineering and Physical Sciences Research Council (EPSRC), under grant number EP/R004242/2.

Current landscape of academic neurosurgical training in the United Kingdom: analysis by the Society of British Neurological Surgeons

Objective Little is known about the impact of academic training on Neurosurgery in the United Kingdom (UK). The aim was to understand the early career clinical and research training journeys of potential future clinical academics, with a view to informing future policy and strategy to improve career development for academic neurosurgical trainees and consultants in the UK. Methods An online survey from the Society of British Neurological Surgeons (SBNS) academic committee was distributed to both the SBNS and British Neurosurgical Trainee Association (BNTA) mailing lists in early 2022. Neurosurgical trainees for any period between 2007 and 2022 or who had done any dedicated academic or clinical academic placement were encouraged to complete the survey. Results Sixty responses were received. Six (10%) were females and fifty-four (90%) were males. At the time of response, nine (15.0%) were clinical trainees, four (6.7%) were Academic Clinical Fellows (ACF), six (10.0%) were Academic Clinical Lecturers (ACL), four (6.7%) were post-CCT fellows, eight (13.3%) were NHS consultants, eight (13.3%) were academic consultants, eighteen (30.0%) were out of the programme (OOP) pursuing a PhD potentially returning to training, whilst three (5.0%) had left neurosurgery training entirely and no longer performing clinical neurosurgery. The mentorship was sought in most programmes, which tended to be informal. Self-reported success on a scale of 0 to 10 with 10 being the most successful, was greatest in the MD and the “Other research degree/fellowship group” which does not include a PhD. There was a significant positive association between completing a PhD and having an academic consultant appointment (Pearson Chi-Square = 5.33, p = 0.021). Conclusions This study provides a snapshot to better understand the opinions of academic training in neurosurgery within the UK. Establishing clear, modifiable, and achievable goals, as well as providing tools for research success, may contribute to the success of this nationwide academic training.

Developing a career as a GP educationalist: contemporary challenges and workforce solutions

ABSTRACT GP educationalists are crucial in training the future medical workforce and in developing and advancing the field of primary care medical education, yet opportunities in the UK are patchy and varied. In this article, a group of GP educationalists summarise the challenges facing the sustainability of this particular group of clinical academics and outline opportunities available at each career stage, from medical students through to senior GP educationalists. Recommendations to support the growth of this workforce include the development of a nationally recognised framework for GP educationalist careers, collaboration with professional and educational bodies and taking steps to level out opportunities in order to reduce existing inequity.