The challenges of an academic career seem to be better known about than the rewards. This article tries to redress the balance.
Australia and New Zealand (ANZ) have an outstanding record in research and medical education in reproductive health, but we struggle to interest Trainees to enter academic careers in O and G. The lack of suitable ANZ-trained academics has forced universities to recruit from overseas (luckily for some of us).
What is an academic?
Generally, an academic is someone who holds a university appointment on a full- or part-time basis. Typically, a clinical academic will also hold a part-time appointment with a public hospital and may also run their own private practice. Honorary academic titles are also conferred by universities on clinicians who are employed on a full-time basis by a local health district. The university may then ‘buy back’ part of that person’s time for teaching and research. Having such an adjunct appointment does not necessarily mean these academics are any less involved in research or teaching.
Generally, the career path in academia starts with a research higher degree then appointment at lecturer level progressing to senior lecturer, associate professor and then full professor. Career progression is not related to length of service, but to achievement in research, teaching and leadership. The balance between these areas often varies over a career and between individuals. Some academics will have a research-only role, but even here they are expected to provide training and mentorship to early-career researchers. Some academics will have a large teaching role, but will still be expected to publish and engage in scholarship of some form (for example, in curriculum development).
What are the sacrifices?
The main drawback to a career in academia is the additional time needed to complete training. A research higher degree (usually a PhD or MD) is essential, which means taking time out from clinical training to do this. This can take three years or more on a full-time basis, longer if part-time. The new academic pathway introduced by the College will make this easier by reducing the length of clinical training for academics to five years and by extending the maximum time in program by three calendar years. Building a profile as a researcher is essential for attracting funding and for promotion. This means travelling to present your work at conferences. On the face of it this might not seem such a ‘sacrifice’, but it does make running a private practice difficult and means being away from family. Academics have fewer fixed commitments so are often in a position to undertake administrative and leadership roles within their discipline groups or clinical services. At the same time, they still have to meet performance targets for teaching and publication and what happens, in practice, is that much of this work gets done at weekends and evenings, further impinging on personal and family time.
What are the challenges?
Clinical academics need to maintain their clinical skills – a particular challenge for a procedural speciality such as ours – at the same time as competing for research funding with ‘full-time’ scientists. External grant funding is highly competitive with less than 20 per cent of applications for project funding to the National Health and Medical Research Council (NHMRC), the main funding body for medical research in Australia, being successful. Teaching loads can be significant and although responsibility for face-to-face teaching is shared with colleagues, academics are expected by medical schools to be responsible for course coordination, assessment and student welfare. Both teaching and research governance have become increasingly complex and time consuming in recent years.
What are the rewards?
If you are interested in financial rewards as the main benefit of an academic career, you should probably stop reading now! The rewards of an academic career are more in terms of personal and professional satisfaction. There are opportunities to travel, to meet and work with colleagues from around the world, and, through the results of your research or leadership, to influence the future direction of the speciality. No two weeks are the same. You have the immediate satisfaction of being able to practise your craft as a doctor combined with the excitement of new discoveries through research and the reward of seeing those ‘light-bulb’ moments as you teach students. For me, there is still a real excitement in learning new things and then being able to pass this knowledge on to others. As clinicians we have the privilege to touch the lives of thousands of patients over a career, but as a teacher and researcher that can be multiplied a hundred times over.
Box 1. College initiatives to support academic development
- The encouragement of applications into the training program from Trainees with proven academic ability, by recognition of previous academic achievement in the selection process.
- Support for research by funding through the RANZCOG Research Foundation.
- Including key learning outcomes in teaching and research in the curriculum for all Trainees.
- The inclusion of a mandatory research project as part of the FRANZCOG requirement for all Trainees.
- The development of learning materials, such as the research methods and supervision training modules available as part of CLIMATE, for Trainees.
- The development of training modules in medical education and research for the Advanced Trainees.
- The option for Trainees to take up to three additional years to complete a research higher degree at Doctoral level and have the requirement for the total length of ‘clinical training’ reduced by 12 months: the Academic Stream.
How do I get started?
There is no single career path into academic medicine. I was fortunate enough to go to a medical school that included a six-month research project as part of the core curriculum and gave me my first taste for research, but it was not until I took three years out of my clinical training before starting work as a registrar to do my MD that knew I wanted to be an academic.
The College has recognised the need to nurture academic development through a range of initiatives including a more structured career pathway for academic Trainees that will allow them to undertake a research higher degree as part of the Integrated Training Program (ITP) (see Box 1). As a research project is now part of the ITP requirements this offers one potential starting point, but the key is really to sustain the interest and find someone to mentor you. If you have had previous research experience you may be able to build on that, but more often it’s a question on seizing an opportunity presented to do a research degree. This will provide you with the training to develop a research project and, in turn, to supervise your own research students. The publications and presentations you do as part of this will be invaluable in helping you get academic positions later and by the time you have finished your PhD you will probably know more about the subject you have been researching than anyone else in the world. The key challenge is to pick the right time to do this. Too early and you run the risk of losing academic momentum when you return to complete your clinical training, too late and the drop in income is more difficult to manage.
The next step is normally to apply for an academic position as a senior lecturer or lecturer. There a relatively few of these, but the pool of applicants is even smaller in Australia and New Zealand. Indeed, one of the advantages of an academic career is that once you demonstrate an ability to produce results and attract funding universities will come looking for you.
After many years of bench-top focused research in health, the emphasis (and therefore funding) is now shifting to more ‘translational’ research, with a clearer need to link scientific endeavour to clinical outcomes. Clinical academics, with a foot in both the clinical and laboratory ‘camps’, will be at the forefront of this and are likely to be greater demand than ever. The increasing demand for leadership and high-quality medical education at both postgraduate and undergraduate levels presents similar opportunities for academics whose talents lie more in the scholarship of teaching and learning. With better support for academic training in O and G there are more reasons than ever to consider this path. Personally, I cannot imagine a career more varied, more stimulating and ultimately more rewarding.