A new Royal College of Physicians (RCP) report warns that the UK’s clinical academic workforce is in sustained decline, and sets out 12 recommendations to support clinical academic careers and strengthen the future pipeline of doctors working across research and clinical settings.
Clinical academics play a vital role in improving patient care, advancing medical knowledge and supporting the UK’s position as a global leader in the life sciences. They generate the evidence that drives innovation in healthcare, educate the next generation of clinicians and help ensure NHS patients benefit from world-leading research.
However, the workforce is under growing pressure. In 2024, the number of clinical academics in medicine aged under 36 fell by 25% in a single year. Clinical academics aged over 66 now outnumber those aged under 36 entering the profession, leaving the NHS with an ageing academic workforce and an increasingly fragile pipeline of future talent. Without action, this could affect future NHS research capacity, patient outcomes and the UK’s wider health and economic ambitions.
The RCP view on supporting clinical academic careers identifies a range of barriers that are making it increasingly difficult to pursue and sustain a clinical academic career. These include inflexible training and assessment processes, the erosion of protected time for research and inconsistent access to academic opportunities and progression. It also highlights the practical challenges created by fragmented employment arrangements across NHS and university employers.
The report makes 12 recommendations for organisations involved in delivering, overseeing and funding clinical academic careers, including NHSE England, deaneries, universities and research funders. Recommendations include:
- give clinical academic doctors flexible training routes with protected research time
- create a single joined-up training and assessment process for clinical academics
produce practical guidance for supervisors on how to support and assess clinical academics - ease the bottleneck at clinical lecturer and consultant level through innovative posts creatively funded by universities, NHS providers, traditional funders and industry
- develop regional research training leads to improve access to opportunities beyond traditional academic centres
- standardise NHS-university contracts and processes, including arrangements for less than full-time working and parental leave.
This document was prepared as part of the RCP’s wider submission to the medical training review phase 2, chaired by Professor Dame Jane Dacre. It was developed through an RCP short-term working group, chaired by Professor Tom Solomon, RCP academic vice president, and Dr Sacha Moore, academic Resident Doctor Committee representative. The group included resident clinical academics from a range of specialties, academic deanery representatives and representatives from the RCP education team, the Federation of the Royal Colleges of Physicians of the UK, NIHR and COPMeD.
The RCP’s career-grade committees were consulted on the recommendations. The report was approved by RCP Council prior to publication.