After completing her PhD in immunology at Imperial College London, Dr Tamara Elliott feels fortunate to have had the support of her supervisors and to have secured the necessary funding to advance her career.
Not every doctorate student or budding clinical researcher is able to do so.
“If I hadn’t managed to secure this [funding] then I wouldn’t have been able to progress. I would have just continued along the pure clinical pathway, which is what a lot of my colleagues have done,” says Elliott, now a clinical lecturer.
“They’ve done PhDs and haven’t been able to find an academic position,” she adds. Having spent a year in Botswana treating HIV and helping build healthcare capacities, she also understands the importance of medical research to patient care and the economy.
The pressures Elliott describes have led to a significant decline in the number of people entering into medical research. Clinical researchers and academics are now raising an alarm over what the slide means for the future of innovation and patient care in Britain.
The number of medically-trained research staff in the UK declined by 6 per cent during 2012-2022, according to the latest research by the Office for Strategic Coordination of Health Research (OSCHR), a forum that brings together the public funders of health research.
“We’re seeing an exodus of talent,” says Professor Bryan Williams, chief scientific and medical officer of the British Heart Foundation.
“We’re not seeing people stay the course . . . clinical academics play a vital role in the NHS and the wider research community. They sit at the interface between innovation and healthcare and we won’t bring innovation into healthcare without them,” he added.
Within the NHS, academics hold active clinical roles alongside teaching and conducting research to improve patient care.
The life science sector, which employs clinical research staff from the NHS, universities and research institutes, contributed more than £13bn to the economy in 2023, according to the think-tank Oxford Economics.
In the autumn Budget, the government announced a £520mn investment for a life sciences innovative manufacturing fund. But despite the boost in investment, senior researchers in the sector are expressing “genuine anxiety”, according to Williams, that not enough is being done to stop the number of clinical researchers falling.
“This is a crisis and something that needs immediate action,” said Williams, “because there are plenty of other countries that will provide a home for these talented people who can lead life sciences in the future.”
A survey by Cancer Research revealed that 32 per cent of clinical research staff were considering leaving the UK sector in the next five years. Respondents cited the long bureaucratic process for setting up trials and a lack of opportunity to balance clinical work and research as reasons for leaving.
Meanwhile, less than 50 per cent of 2,000 medically qualified research staff feel confident they will continue with their research training, according to Medical Research Council data.
The drop in numbers is partly being driven by postgraduate students and recently qualified medical staff opting for different careers. One PhD student compared trying to begin a career in research to “walking through treacle” because of the competitive nature of securing research funding.
The 36-year-old cohort entering clinical academia is no longer matching the over-66 cohort, according to the Medical Schools Council clinical academic survey, suggesting the clinical research pipeline is not being refilled fast enough.
University researchers and academics believe a lack of incentives is driving students towards full-time clinical careers.
“We don’t have a very strong system for incentivising that sort of excellence in the NHS and some of those systems are being eroded steadily, so the NHS is changing,” said Professor Graham Cooke, vice-dean for research in the Faculty of Medicine at Imperial College London.
“For young clinicians coming through they are often not rewarded for what they’ve done in science whereas they used to be. This disincentivises them in terms of progression,” he added.
At the same time, financial pressures facing the university system are prompting institutions to shift funding away from long-term research posts to save money. University clinical research is typically paid for by grants or funding from research councils, government or charities.
Data from the UCU showed that just 65 per cent of university research staff were employed on fixed-term contracts, some less than a year in length. “People that are coming through need to see there are posts to go to and that there are people in those posts doing fulfilling jobs,” Cooke said.
Professor Patrick Chinnery, executive chair of the Medical Research Council, acknowledged that many researchers live “grant to grant” because of a lack of long-term posts.
“What we need to grow are career-long positions, tenured positions that provide people goals to work to so that they can have a sustained career in this space,” said Chinnery.
The sector needed to be more “proactive” about allowing people to build “flexible portfolio careers”, he added.
The Department of Science and Technology said: “We are supporting the UK’s £108bn life sciences sector to flourish. This is a key part of our Plan for Change to grow the economy, create jobs and rebuild the NHS.”
Speaking on her future, Elliott’s position is secure for now, but with the sector facing uncertainty, the path for researchers like her is not straightforward.
“There are a lot of question marks for me,” she says.
Data visualisation by Alan Smith
