The training of the nation's doctors and dentists could be under threat unless action is taken now to ease pressures on clinical academics, says a report published this week.
Commissioned by the Committee of Vice Chancellors and Principals and compiled by an independent task force chaired by Sir Rex Richards, former vice chancellor of Oxford University, the report identifies academics in medicine and dentistry as suffering the fate of any servant with two masters.
Medics and dentists who teach students, research and treat patients are torn between the demands of the National Health Service and universities, each requiring greater efficiency and cost-effectiveness.
Launching the report, Sir Rex warned that clinical academics were under tremendous pressure. "Often it's the research which gets pushed out; research which leads to new techniques and better patient care," he said.
He added that teaching also suffers: "Doctors will be trained in the procedures of the time, and will not be equipped to apply the new developments."
"Put bluntly," says the report, "It often appears that clinical academics work under greater pressures and receive less reward than NHS doctors and dentists."
The report recommends that:
* any increase in medical student admissions must be accompanied by a corresponding increase in the numbers of clinical academic staff and the facilities to accommodate them
* more research time must be found for the most productive and innovative academic clinicians
* universities should provide clinical academic departments with contracts that clearly specify their duties with respect to teaching, research and service
* universities, trusts and the NHS executive should work together to ensure that terms and conditions of university-funded academic staff and clinical academic general practitioners match those of NHS-funded staff.
Colin Smith, chairman of the British Medical Association's conference of medical academic representatives, said: "The workload pressures and the difficulties of answering to two masters, the NHS and the university, have now been recognised as the major factor behind the recruitment crisis in university medicine, which has led to more than 50 clinical professorial posts going unfilled in the UK."
* A transparent equal opportunities policy for selecting medical school students has been proposed by the BMA which this week passed a motion for students' names, sex, age and nationality to be kept off application forms.
The BMA's annual conference in Edinburgh heard that a black female school-leaver was five times less likely to be selected than a white male. "We should be choosing people on the basis of ability and nothing else," said medical student Kate Adams. "Otherwise we won't be getting the best doctors for the job."
The conference heard how NHS funding shortfalls meant medical students were being denied crucial clinical experience. Student Tim Meekings told of a hospital cancelling all non-urgent surgery, while in another hospital, final-year students studying surgery had been assigned to a ward with only two surgical patients.
See opinion, page 11