Addressing the challenges of COVID-19 second wave or another pandemic
Clinical Academic Training Forum: Working Group to support returning clinical academics during a further (COVID-19) pandemic
This document sets out overarching principles and practical actions in response to future significant disruption to clinical academic training due to a second wave of COVID-19, locally or nationally, or due to a future pandemic. All UK institutions and organisations responsible for supporting and progressing the careers of trainee clinical academics in medicine and dentistry should consider their future response to these issues.
The career development of clinical academics is of strategic importance to the NHS and to all funders of health-related research; an importance that has been underlined by the recent and current challenge of COVID-19. It is accepted that developing a clinical academic career is challenging, with a need to balance research with postgraduate clinical training. It is, therefore, essential that clinical academic trainees are appropriately supported at critical stages and transitions in their careers. (Ref: MRC A Cross-Funder Review of Early-Career Clinical Academics: Enablers and Barriers to Progression and Wellcome: UK clinical academic training in medicine and dentistry: principles and obligations)
The COVID-19 pandemic has resulted in extraordinary challenges for medicine in the UK and worldwide. Clinical academic trainees, both those in full-time research and those in posts combining clinical and academic training, e.g. clinical lecturers and academic clinical fellows, responded to the health emergency in large numbers by voluntarily returning to full-time clinical duties. Estimates suggested that over 1,500 academic trainees in England alone were deployed to clinical duties, representing over 90% of all trainees on the Integrated Academic Training (IAT) pathway. Similar responses were seen from those in out of programme research and across the four UK nations. Many have made exceptional contributions to service and/or to COVID-19 related research.
The UK Clinical Academic Training Forum (CATF) and COPMED have together established a working group (membership below) to bring together representatives of postgraduate training, research funders, medical and dental schools and others across the UK to agree high-level principles to support future decision making and to support a consistent approach across the United Kingdom. Our aim was to enable local, practical and timely advice for academic trainees, their clinical and research supervisors, HEI and their postgraduate deanery/HEE regional office.
All clinical academic trainees will benefit from a considered and co-ordinated approach to managing any potential disruption to their research and clinical training needs due to Coronavirus or a similar situation.
All parties must undertake the discussions needed in a transparent manner, following a process for a return to clinical service agreed by the Postgraduate Deanery.
It is emphasised that the return of academic trainees to support the clinical service is on a voluntary basis.
Due consideration should be given to issues of equality, diversity and inclusion and, specifically, to health, shielding or caring issues relevant to individual trainees.
Following a period of disruption trainees should be supported in their future planning and to make any adjustments to their academic and clinical education appropriate for their stage of training.
Actions for Postgraduate Deans and Training Programme Directors:
To provide oversight of the process, with the aim of balancing the optimal research and clinical outcomes for trainees against the need to support exceptional NHS clinical service need
To provide a framework for maximum flexibility for periods of academic/research training where possible
The Postgraduate Dean, or nominated deputy, should have oversight of the process and be in discussion with training programme directors, directors of medical education and HEI leads to determine whether, when and where academic trainees who volunteer should be supported to return to clinical service. This will include consideration of their specific specialty, skills and level of experience and also the time needed to suspend their research without unnecessary loss of research resources
All trainees will be allocated an educational supervisor and receive any required skills training during their clinical placement
At the end of the emergency period the Postgraduate Dean will ensure that clinical academic trainees are returned to research training in a timely way, bearing in mind research training capacity in universities as well as any exceptional ongoing service need
Actions for Universities and Research Institutes:
To provide clear host support and mentorship and infrastructure to all academic trainees to continue their career pathway with the minimum possible interruption
To optimally manage opportunities for those on time-limited research funding and depending upon access to research infrastructure, whether laboratory or clinical
Where a return to clinical service is anticipated, to support the trainee to suspend their research programme so as to minimise loss of data and resources
To give particular attention to the consequences of caring responsibilities and any potential gender disadvantages in advising and supporting individual trainees
To advise and support trainees following a period of disruption to ensure successful completion of research training
Actions for Funders:
To work together from a very early stage and provide consistent communications messages
Funders will endeavour to provide support to ensure successful completion of research training, recognising that research plans may need to change to accommodate individual and local constraints
To support those trainees who are their fellows and provide advice on who best to contact
Actions for Trainees:
Not to arrange any clinical placements outside of the agreed local deanery process. Neither the return to clinical service and the subsequent return to research should occur without the approval of the Postgraduate Deanery
To carefully plan, in discussion with the Postgraduate Dean (or their nominated deputy), TPDs and research supervisors, any voluntary return to clinical service and then back to academic roles
To discuss with their research funder regarding changes to research plans as soon as possible
To consider whether some research activity can be continued that can add value to research experience and training
Working Group members, in addition to members of the Clinical Academic Training Forum, included representatives from the Conference of Postgraduate Medical Deans of the United Kingdom (COPMED), Medical Schools Council (MSC), and National Institute for Health Research (NIHR).
Professor Moira Whyte, Head of the College of Medicine and Veterinary Medicine, University of Edinburgh and Chair of CATF (co-Chair).
Professor Bill Irish, Postgraduate Dean HEE and COPMED (co-Chair).
Professor Dave Jones, Dean for NIHR Academy.
Professor Keith Gardiner, Chief Executive /Postgraduate Dean, Northern Ireland, Medical and Dental Training Agency.
Professor Rowan Parks, Deputy Medical Director, NHS Education for Scotland.
Dr Tom Lawson - Postgraduate Medical Dean, Health, Education and Improvement Wales (HEIW).
Dr Ian Steele, Associate Postgraduate Dean, Northern Ireland, Medical and Dental Training Agency.
Dr Lisa Cotterill, CEO NIHR Academy.
Dr Katie Petty-Saphon, Medical Schools Council.
Dr Peter Thompson, Director NIHR Academy.
Professor Lorraine Harper, Associate Dean, NIHR Academy.
Dr James Fenton, Assistant Director, NIHR Academy (secretariat).