Academic Clinical Careers in
Geriatric Medicine
Julia L. Newton
Senior Lecturer in Ageing Medicine
Institute for Ageing and Health
Newcastle University
Outline
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Academic Clinical Career Pathway
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Biomedical Research Centre in Ageing
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The Campus for Ageing and Vitality
Clinical Academics 2000 - 2005
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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?
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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 speciality
 Varies by medical school/region
Deterrents for a clinical academic
career
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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
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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
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Clear route of entry to an academic career
Transparent career structure
Properly structured and supported posts after
training
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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 Programme
Appointment 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 academic
issues equally
Appoint people to the scheme not to individual subject
areas
Academic Clinical Fellowship
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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
ACF-Newcastle
13 programmes awarded
in round 1 & 2, in round 3,
3 more.
ACFs in Newcastle /Northern
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Neurology
Hepatology
Dermatology
Reproductive Medicine
Urology
Paediatric Oncology
Geriatric Medicine
Clinical Dentistry
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Psychiatry (child; adult;
old age)
Ophthalmology
Otolaryngology
Trauma and
Orthopaedics
Pathology of Ageing
(Respiratory)
(Rheumatology)
(Clinical Pharmacology)
ACF in Geriatric Medicine
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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
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7 posts over 5 years
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1ST – SpR
2nd ST1
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As of now – will recruit from ST1
Academic Clinical Lecturer
ACL
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50% research / 50% clinical training.
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Post doc
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Developing own research grouping
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Leads to application for Senior fellowship
ACL - Newcastle
13 matching CLs awarded
Probable additional 5
ACL- Newcastle
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3 programmes
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Ageing Specialities
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Dental
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Psychiatry
ACL in Geriatric Medicine
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Oxford total 1 (2007)
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Newcastle total 5 (? 5 more) – Age related
medical specialties
Academic Senior Lecturers
Academic Senior Lecturers
New blood ASL posts
4 awarded in 2006/7
Clinical Academic Career Path Committee
Academy of Medical Sciences
guidance
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‘Training needs to be flexible and trainee-centred, with mentoring
to ensure the attainment of both academic and clinical goals’.
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‘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’.
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‘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
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Academic educational supervisor
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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
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The academic component will be an integral
part of the RITA process for the Academic
Clinical Fellows (ACFs) and Clinical Lecturers
(CLs)
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MMC & UKCRC.
Generic academic
competencies
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Three domains:
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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
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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
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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
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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
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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:
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generic and applied research skills
research governance
communication / teaching skills
Record of academic outputs (provided by trainee)
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Research proposals
Academic placements / modules
Publications/ Courses
Personal Development plan
Miscellaneous
Assessment of Academic
Progress - process
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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
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Newcastle
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Academic Clinical Career Pathway committee
 Chaired by Dean of Clinical Medicine
 Brings together the University, Trust and Postgraduate
Deanery
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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.”
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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.”
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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 patientorientated research.”
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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 Centres
NHS Organisation
Academic Partner
Cambridge
University of Cambridge
Guy's & St Thomas‘
King's College London
Hammersmith & St Mary's
Imperial College London
Oxford Radcliffe
University of Oxford
University College London
University College London
"Specialist" Biomedical Research Centres
NHS Organisation
Academic Partner
Specialism
Great Ormond Street
Moorfields Eye Hospital
Newcastle
Royal Liverpool & Broadgreen
Royal Marsden
South London and Maudsley
UCL Inst. of Child Health
UCL Inst. of Ophthalmology
Newcastle University
University of Liverpool
Institute of Cancer Research
KCL Institute of Psychiatry
Paediatric/Child Health
Ophthalmology
Ageing
Microbial Diseases
Cancer
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.
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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:
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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:
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Wolfson Research Centre
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Henry Wellcome Biogerontology Building
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Newcastle Magnetic Resonance Centre
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NHS Centre for the Health of the Elderly
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IAH Research Laboratories
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Clinical Ageing Research Unit
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NHS Falls Unit
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Regional Medical Physics
Planning in progress for:
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Translational Research Building, including new
laboratories (biomarkers and nutrition), clinical and
social science facilities, incubator space and
opportunities for new commercial linkages
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PET molecular imaging
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Centre for Assistive Technology
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Teaching and public engagement space
Campus for Ageing and Vitality 2004
Newcastle MR Centre
Campus for Ageing and Vitality 2006
Edwardson Building
(new IAH Labs)
Campus for Ageing and Vitality 2007
Clinical Ageing Research Unit
- CARU
Campus for Ageing and Vitality 2008
Translational Research
Facility
Campus for Ageing and Vitality 2010
Further development
proposed
Campus for Ageing and Vitality 2012
There has never
been a better and
more exciting
time for a career
in Academic
Geriatric
Medicine
julia.newton@nuth.nhs.uk