Research run down puts patient care under threat

STANDARDS of care in United Kingdom hospitals could slip if the erosion of the clinical medical research base is allowed to continue, according to the British Medical Association.

The BMA's Junior Doctors' committee is concerned at the decline in the numbers of students undertaking research in clinical medicine. Although there is a lack of firm figures, widespread anecdotal evidence points strongly to a slump in numbers.

Steve Hajioff, an executive member of the committee, believes that part of the problem lies in the difficulty students have in securing funding for clinical research projects. He said that much of the available funding goes to those undertaking pure medical science research rather than those wishing to research ways in which patient care can be improved.

Mr Hajioff, currently doing his MD in clinical research at St Bartholemews, said: "There is a pressure on clinical research. When I was applying for the junior clinical lecturer post at Barts there were only three applicants for the two posts available.

"Recruitment appears to be poor and standards of care which, at the moment, are excellent will slip behind other nations as we lose this research base."

The knock-on effects are potentially severe for the NHS. Mr Hajioff fears that if the clinical research base declines it may not be long before there is a generation of hospital specialists who, due to a lack of training, are less able to interpret clinical studies and so keep themselves abreast of the latest developments.

He said: "There is a potential problem for those planning careers in the NHS in that they may no be exposed to the right sort of subject matter in training. It may mean that they cannot properly evaluate evidence from clinical studies later in life."

Likewise, those planning academic careers may find that they have less training in clinical research than they might wish for.

Peter Dangerfield, anatomy lecturer at Liverpool University and deputy chairman of the BMA's medical academic staff committee, said clinical research has been affected by the research assessment exercises.

He said: "Basic science generally does better out of the RAE scoring. If one looks at the medical schools then clinical medical research is relatively underfunded. This creates a potential for distortion of the profile of research in medicine."

He said selective funding for research tended to favour projects which are "easily quantifiable".