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Academic Clinical Careers in Geriatric Medicine
Julia L. Newton
Senior Lecturer in Ageing Medicine
Institute for Ageing and Health
Newcastle University
Outline
Academic Clinical Career Pathway
Biomedical Research Centre in Ageing
The Campus for Ageing and Vitality
Clinical Academics 2000 - 2005 2005 figures are 84% of 2000 level Below 3000 for first time - 2982 50% reduction in clinical lecturers 30% reduction in senior lecturers 7% increase in professors Particular specialities hit hardest Differences between medical schools Differences between genders
Why? Competing pressures of service, research and
teaching activities Increased length of time to complete specialist
training Lack of exposure to academia in postgraduate
training programmes Lack of flexibility in the postgraduate training
programmes e.g. p/t working Lower financial rewards than in the NHS The RAE
Funding of clinical academics
HEFCE 45%NHS 38%Other 16% - charities,
endowments, industry, etc
Varies by specialityVaries by medical school/region
Deterrents for a clinical academic career
Lack of both a clear route of entry and a transparent career structure
Lack of flexibility in balance of clinical and academic training and in geographical mobility
Shortage of properly structured and supported posts on completion of training
UKCRN/MMC
March 2005
Key signposts for recovery of clinical academia
Treasury reports: central role of applied biomedicine in economic growth
UKCRN/MMC (Walport) report: ‘Medically and dentally-qualified academic staff: recommendations for training the researchers and educators of the future’
Best Research for Best Health: restructuring NHS R&D
MMC and UKCRC
Clear route of entry to an academic career Transparent career structure Properly structured and supported posts after
training Academic Foundation posts Academic Clinical Fellowships Academic Clinical Lecturer
Academic training programmes - Walport
Academic Foundation Programme
Newcastle had the first programme in the UK
Academic Foundation Programme
3 x 4 month blocks for both F1 and F2 years
1 x 4 month block in each year is “academic”
Other blocks in F1 are medicine and surgery
Other blocks in F2 mirror academic interests
Academic Foundation ProgrammeAppointment Process
Academic domain in addition to normal foundation form
Academic domain concentrates on “why” not “what”
Presentation and interview (c30 minutes)
Interview concentrates on foundation and academicissues equally
Appoint people to the scheme not to individual subject areas
Academic Clinical Fellowship
Combination of 25% academic / 75% clinical training.
Central funding Speciality specific Central application system Now out with ‘MMC’ system Competency based Leads to application for externally funded
fellowship and Phd/MD
Academic Clinical Fellowship
13 programmes awarded in round 1 & 2, in round 3, 3 more.
ACF-Newcastle
ACFs in Newcastle /Northern
Neurology Hepatology Dermatology Reproductive Medicine Urology Paediatric Oncology Geriatric Medicine Clinical Dentistry
Psychiatry (child; adult; old age)
Ophthalmology Otolaryngology Trauma and
Orthopaedics Pathology of Ageing (Respiratory) (Rheumatology) (Clinical Pharmacology)
ACF in Geriatric Medicine
Oxford total 2 (2008-1 post) (James Kennedy)
St Georges total 4 (2008-1 post) (Emma Baker) combined with CP.
Southampton total 2 (2008-1 post) (Avan Sayer)
Newcastle total 7 (2008-1 post) (Julia Newton)
ACF in Geriatric Medicine - Newcastle
7 posts over 5 years
1ST – SpR 2nd ST1
As of now – will recruit from ST1
Academic Clinical Lecturer
ACL
50% research / 50% clinical training.
Post doc
Developing own research grouping
Leads to application for Senior fellowship
13 matching CLs awarded
Probable additional 5
ACL - Newcastle
ACL- Newcastle
3 programmes
Ageing Specialities
Dental
Psychiatry
ACL in Geriatric Medicine
Oxford total 1 (2007)
Newcastle total 5 (? 5 more) – Age related medical specialties
Academic Senior Lecturers
New blood ASL posts
4 awarded in 2006/7
Academic Senior Lecturers
Clinical Academic Career Path Committee
Academy of Medical Sciences guidance ‘Training needs to be flexible and trainee-centred, with mentoring
to ensure the attainment of both academic and clinical goals’.
‘The academic component of the training period must include preparation of an application for a competitive peer-reviewed research training fellowship or educational training programme leading to the award of a higher degree, the completion of which is considered as the end-point of the ACF period’.
‘It is essential that ACFs have the opportunity to develop competencies that enable them, in Year 1, to define a research question, and in Year 2, to develop a research proposal. The Academic RITA should record the ACF’s progress specifically in relation to these training goals’.
Criteria for the Assessment of Academic Progress
Academic educational supervisor separate individual from the clinical educational supervisor usually be an established clinical academic formal mentoring role responsible for drawing up an Academic Training
Programme with the trainee, and a realistic/achievable timetable for delivery.
required to identify training goals relating to generic academic competencies and specific academic goals for each individual as appropriate. These targets will be summarised within the Personal Development Plan (PDP) for the trainee, which should be agreed within a month of commencing work and annually thereafter.
RITA
The academic component will be an integral part of the RITA process for the Academic Clinical Fellows (ACFs) and Clinical Lecturers (CLs)
MMC & UKCRC.
Generic academic competencies
Three domains: 1) Research Experience, 2) Research Governance, 3) Communication/Education.
Academic progress is to be assessed in relation to each of these domains.
Academic Competencies and Outputs 1) Generic and applied research skills Examples include: Identifying a research supervisor Identifying a research topic Defining a research question Observational and experimental research design Developing a research proposal Writing a grant application Critical appraisal of a paper or topic Carrying out an experiment Data interpretation and statistical analysis Writing a research paper or thesis Commercialisation of research outputs
Academic Competencies and Outputs 2) Research Governance Examples include: Information storage and retrieval Patent and Intellectual Property issues Laboratory safety Clinical trials / clinical trials legislation Research ethics and how it is monitored (including COREC processes) Home Office and Animal Licences Animal husbandry Storage of human tissue NHS structure and regulations Fraud/Scientific misconduct Research and Integrity (awareness of complex dilemmas in scientific
research).
Academic Competencies and Outputs 3) Communication/Education Examples include: Writing skills Verbal presentation skills Electronic media / audio-visual presentation skills Poster presentations Teaching skills/experience Supervision skills/experience Science and the Media Effective networking and collaboration Collegiality/ability to work co-operatively and creatively with
colleagues Assertiveness skills
Outputs
Significant outputs should be recorded on the Assessment of Academic Progress form, and supporting evidence should be provided.
Presentation at national / international research meetings
Submitting an application for a grant or fellowship
Publishing a peer-reviewed article Delivering an educational lecture or seminar
Assessment of Academic Progress – documentation Training record Records of 6-monthly (or more frequent) progress review
meetings Educational Supervisor’s report (to have been shared with and
signed by trainee at least 2 weeks before meeting). This should include a listing of the academic competences achieved in the period under review, listed under the 3 headings:
generic and applied research skills research governance communication / teaching skills
Record of academic outputs (provided by trainee) Research proposals Academic placements / modules Publications/ Courses Personal Development plan Miscellaneous
Assessment of Academic Progress - process
The trainee should be asked to comment on progress through the year, competences gained, significant milestones and future aspirations.
The panel will discuss the achievements, comment on any deficiencies and make recommendations about the training goals for the next 6 months.
They will complete the “Assessment of Academic Progress” Form, which should be agreed and signed by the trainee.
Overview of the programme
Newcastle Academic Clinical Career Pathway committee
Chaired by Dean of Clinical Medicine Brings together the University, Trust and Postgraduate
Deanery
Academic Interviews in addition to the same clinical interview
Academic RITA / Progress assessment in addition to the same clinical interview
Academic Lead for Programme Lead on RITA panel Active and effective mentorship programme
National Institute for Health Research
NIHR Academic Links
■ Virtual National Research Facility
■ Position, manage and maintain the research, the research staff and the infrastructure of the NHS.
■ Enable the NHS to become an organisation that supports
outstanding individuals (both leaders and collaborators), working in world-class
facilities (both NHS and university), conducting
leading-edge research focused on the needs of patients and the public.
NIHR Infrastructure“The UK is at the international forefront of developments in basic biomedical research that have the potential to transform patient care. It is vital that we turn that potential into reality.”
Biomedical Research Centres“We will create Research Centres within our leading NHS / university partnerships to drive progress on innovation and translational research in biomedicine and NHS service quality and safety.”
Experimental Medicine Facilities“We will support purpose-built, cutting-edge clinical research facilities and specialist clinical, research and support staff in locations where universities and NHS Trusts can work together on dedicated programmes of patient-orientated research.”
Technology Platforms
“Access to technology platforms is increasingly essential for the conduct of leading edge health research. Current access to these platforms is inadequate across the NHS in England. The initial focus will be on diagnostic imaging, the area identified as most critical in scoping work conducted by the Academy of Medical Sciences and our recent survey of NHS providers.”
Biomedical Research Centres
Eleven Biomedical Research Centres have recently been created to drive forward innovation and translational research.
"Comprehensive" Biomedical Research CentresNHS Organisation Academic PartnerCambridge University of CambridgeGuy's & St Thomas‘ King's College LondonHammersmith & St Mary's Imperial College LondonOxford Radcliffe University of OxfordUniversity College London University College London
"Specialist" Biomedical Research CentresNHS Organisation Academic Partner SpecialismGreat Ormond Street UCL Inst. of Child Health Paediatric/Child HealthMoorfields Eye Hospital UCL Inst. of Ophthalmology OphthalmologyNewcastle Newcastle University AgeingRoyal Liverpool & Broadgreen University of Liverpool Microbial DiseasesRoyal Marsden Institute of Cancer Research CancerSouth London and Maudsley KCL Institute of Psychiatry Mental Health
Clinical Research Facilities for Experimental Medicine
£84 million joint initiative including Wellcome Trust, Wolfson Foundation, British Heart Foundation, Cancer Research UK and MRC. MRI key component of funding.
Cambridge: … nutrition and appetite laboratory to study genetic disorders and obesity. Dublin: neuropsychiatric disease, cancer, and infection and immunity – inflammatory
bowel disease, hepatitis and HIV infection. Edinburgh: inflammation in cardiovascular and central nervous system conditions and
work on metabolism in a range of tissues. Oxford: patients admitted as emergency cases after heart attacks or strokes. Belfast: cancer, nutrition and metabolism, and vision science. Newcastle: new Clinical Ageing Research Unit - dementia and cognitive decline, and
basic mechanisms of cell and tissue damage during ageing. Manchester: biomarkers for cancer prognosis. Birmingham: gene- and cell-based therapy for cancer and immune diseases, as well as
on heart disease, high blood pressure and obesity. Four centres in London:
Imperial College: drug development and early clinical trials in Alzheimer's disease, Parkinson's disease, arthritis and cancer.
King's College: neuroimaging and development of treatments for mental illness along with the study of drug addiction and use of stem cell therapy for neurological disease.
University College London Institute of Cancer Research
Institute for Ageing and Health
Campus for Ageing and Vitality
The Campus for Ageing and Vitality
Existing and in the pipeline: Wolfson Research Centre Henry Wellcome Biogerontology Building Newcastle Magnetic Resonance Centre NHS Centre for the Health of the Elderly IAH Research Laboratories Clinical Ageing Research Unit NHS Falls Unit Regional Medical Physics
Planning in progress for: Translational Research Building, including new
laboratories (biomarkers and nutrition), clinical and social science facilities, incubator space and opportunities for new commercial linkages
PET molecular imaging Centre for Assistive Technology Teaching and public engagement space
Campus for Ageing and Vitality 2004
Campus for Ageing and Vitality 2006
Newcastle MR CentreNewcastle MR Centre
Campus for Ageing and Vitality 2007
Edwardson BuildingEdwardson Building
(new IAH Labs)(new IAH Labs)
Campus for Ageing and Vitality 2008
Clinical Ageing Research Unit Clinical Ageing Research Unit - CARU- CARU
Translational Research Translational Research FacilityFacility
Campus for Ageing and Vitality 2010
Campus for Ageing and Vitality 2012
Further development Further development proposedproposed
There has never been a better and
more exciting time for a career
in Academic Geriatric Medicine
