TIME TO INVEST IN OUR FUTURE CLINICIAN RESEARCHERS

Wclinical research among recent medical graduates. There has never been a better time to invest in an integrated clinician researcher training pathway.

Clinician researchers play a critical role in improving healthcare outcomes. They draw upon their clinical and research expertise to identify research priorities, lead high-quality research, keep communities safe during pandemics, and drive the innovations that are essential for high quality and sustainable clinical care.1

Despite their vital role, the number of medically qualified clinician researchers in Australia is declining. 2 This comes at a time of unprecedented investment in medical research, thanks to the maturation of the Medical Research Future Fund (MRFF). Mindful of the need to expand this vital workforce, Medical Deans Australia and New Zealand (MDANZ) is actively supporting medical schools with their work to inspire and educate future clinical research leaders.

In this paper, we showcase what MDANZ is doing to share best practice in research education and advocate for the establishment of an integrated clinician researcher training pathway.

Medical Schools And Medical Students Are Ready

Medical schools across Australia and New Zealand seek to nurture the curiosity of all medical students and educate them to be research literate. Enthused by the wealth of opportunities available at medical school (e.g., Honours degree, research projects, intercalated higher degrees by research), many students will go on to become active contributors to research, while some will be future research leaders.

Over the last few years, MDANZ has been showcasing the breadth and depth of medical student research. Its first volume of case studies featured examples of the highquality curricular research programs occurring across all Australian and New Zealand medical schools.3

1 Australian Academy of Health and Medical Sciences - Research and innovation as core functions in transforming the health system: A vision for the future of health in Australia. https://aahms.org/vision/

2 Group of Eight: Strengthening Australian Clinical Research – Group of Eight Submission to the Medical Workforce Reform Advisory Committee. https://go8.edu.au/wp-content/uploads/2020/12/Go8AICRTP-FINAL.pdf

3 MDANZ - Research in the Medical Curriculum Volume 1: A window on innovation and good practice (June 2022). https://medicaldeans. org.au/md/2022/06/Research-in-the-Medical-Curriculum-Volume-1A-window-on-innovation-and-good-practice-2022.pdf

The most recent volume focussed on good practice in regional, rural and remote communities.4

These case studies have galvanised interest and led to the creation of the Research Educator Network (REN) – a community of practice for educators who are responsible for supporting medical students to develop research capabilities. The REN aims to promote best practice in the teaching of research and critical inquiry in medical schools.

It is great to see that most medical students at the point of graduation are interested in pursuing a career involving research: the annual MDANZ survey of graduating medical students about their experiences and career intentions 5 indicates that around 60 percent of medical students in their final year are interested in pursuing a career that includes research.

Securing The Next Generation Of Clinician Research Leaders

Although interest in a career that includes research is high among medical students, this has not translated into an increase of medically qualified researchers. With the proportion of doctors identifying as clinical researchers continuing to decline and many specialties underrepresented (e.g., GP, surgery), there is an urgent need for a sustainable solution to support ongoing development of clinician researchers as they progress into postgraduate training.2

One important reason for the decline is the lack of managed career pathways for medical graduates interested in developing their research capabilities whilst they train. MDANZ is advocating for the implementation of a managed pathway to identify, nurture and train future clinician researchers across the continuum.6

The critical importance of investing in our future clinician research leaders has been recognised by the National Medical Workforce Strategy, which recommended, “Further develop pathways for Clinician Researcher trainees through a tailored program that could facilitate career progression and align with national research priorities”.7 Below we outline some of the key elements of such a tailored program.

Time To Invest In An Integrated Clinician Researcher Training Pathway

Our proposed integrated clinician researcher training pathway is set out in Figure 1. At its heart is dedicated time for the medical graduate to complete a PhD during vocational training. This enables the medical graduate to draw upon their growing clinical experience and expertise as they develop their research capabilities.

While completing a PhD is necessary, it is not sufficient. Post-doctoral protected time is required for research while the medical graduate completes their vocational training or begins work as a GP or non-GP specialist. This period is critical for the emerging clinician researcher to strengthen their research portfolio and increase their competitiveness for funding applications.

With the introduction of the new prevocational framework (i.e., PGY1 and PGY2) from 2024, there is also an opportunity to embed research opportunities into the first few years. This would enable recent medical graduates to

4 MDANZ Research in Medical Education – good practice in rural and regional areas https://medicaldeans.org.au/category/research-casestudies-volume-2/

5 MDANZ - Medical Schools Outcome Reports. https://medicaldeans.org.au/medical-schools-outcomes-database-reports/

6 MDANZ - Training Tomorrow’s Doctors: all pulling in the same direction – Discussion Paper (September 2021). https://medicaldeans.org.au/ md/2021/09/Training-Tomorrows-Doctors-all-pulling-in-the-right-direction-September-2021.pdf

7 Department of Health and Aged Care: National Medical Workforce Strategy 2021–2031. https://www.health.gov.au/resources/publications/ national-medical-workforce-strategy-2021-2031?language=en further develop their capabilities and test whether a career as a future clinician researcher is for them.

Some medical graduates enter medical school with a PhD, or complete a PhD at medical school; however, they also require a postgraduate pathway that provides protected time for research and ongoing researcher development.

We believe that we need to urgently invest in our future clinician research leaders. Medical schools are ready. We must build on the interest and skills of our medical students with a clinician researcher training pathway that integrates with postgraduate clinical training.

Author: Distinguished Professor Annemarie Hennessy, Chair, Medical Deans’ Research Committee; Dean, School of Medicine, Western Sydney University Professor Stuart Carney, Member, Medical Deans’ Research Committee, Dean of The University of Queensland Medical School in the Faculty of Medicine