Research and The Physician:
The journey from JHO to FRACP
Fostering “Next Generation” Clinician Scientists
Professor Nicholas J. Talley
Pro Vice Chancellor and Professor, University of Newcastle
President of the Royal Australasian College of Physicians
Summary
• Patient focused care
• “Next Generation”
• Reforms to patient
care & approach to
training
Clinician scientists
“Next Generation”
“Every patient you see
is a lesson in much
more than the malady
from which he suffers”.
Sir William Osler
My journey
Research success is largely about mentorship excellence
Mayo Clinic, Rochester, MN
Medical research: we are not attracting trainees
• AMA, 1/3 wanted to be involved in
research (2013)
• 20% holding either an honours
degree or another postgraduate
degree; and a further 8% holding
either a Masters or PhD degree
• RACP only 3% higer degree
• 40% of trainees said they had NO
intention of undertaking research
training
RACP data
So what is the problem?
“Research activity among
health professionals is in
decline. In the past, clinician
researchers dominated the
Health and Medical Research
field, but in the last decade
there has been a steady shift
to non-clinician researchers.”
The McKeon Review
So what is the problem?
“The physician-scientist has a very special role
both in posing relevant medical questions and in
applying new knowledge to the investigation of
disease and the teaching of students. These roles
cannot be adequately filled by PhD scientists,
however seminal and essential their contributions
may be. The future of clinical science depends
on the quality and the numbers of new leaders
in the field.”
Dr James Wyngaarden, New England Journal of Medicine
“The clinical investigator as an endangered species”
The McKeon Review
“The aim of embedding
research in healthcare
delivery is to facilitate overt
involvement of the healthdelivery workforce in
research, with the result that
it would be a routine and
universally accepted
component of healthcare.”
The McKeon Review
Training: too long and our fault
• College and University administration are separate
• Leaves the trainee vulnerable with competing demands, poor
funding and financial stress
• Extends the years of training required
• Combining this training with a PhD adds another two years
• 12 months maximum recognition (“non-core” time) for research
Average age for RACP Basic Trainee is now 31
Average age of a new RACP Fellow, a specialist (last 12 months) is now
38 years
Encouraging more clinician scientists is a
RACP priority
RACP research awards 2013
AWARD
ELIGIBILITY
NUMBER OF
APPLICATIONS
RECEIVED
NUMBER OF
AWARDS
AVAILABLE (2013)
Research
RACP Fellows or advanced
Entry
trainees who wish to pursue
Scholarships a higher degree by research
(HDR) such as Masters by
Research, or PhD
99 (75% for PhD, 15
15% for Master
by Research,
10% other)
Research
75
RACP Fellows
20
Patient focused care – changing nature
of medicine
Patient focused care – changing nature
of medicine
“The expert knows more
and more about less and
less until he knows
everything about nothing.”
Mahatma Gandhi
“Specialist—A man who
knows more and more
about less and less.”
William Mayo
Specialist ping pong
Medical student bulge
Conclusion
Thank you