Letter: Medical schools under threat

Sir: Your article "Medical schools hit by drain of doctors to NHS" (3 October) appositely points out the crisis facing our medical schools in relation to senior appointments in clinical academic departments. I believe it is wrong to suggest that this is mainly due to inadequate remuneration.

Senior clinical academics, particularly those appointed to chairs, are still appointed on a salary scale identical to that of NHS consultants and by and large parity is retained following appointment. There is major concern that this parity is under threat.

The number of professorial posts has increased without a concomitant increase in training of junior academics. Clinical chairs have been created in new departments and in institutions where they did not previously exist. This move has largely been driven by the need to boost research ratings, but has occurred in the face of decreased availability of research funds.

Because of the latter, senior academic posts are less attractive and less secure. Clinical lecturer posts in medical schools have all but disappeared in favour of more senior appointments. Adoption of the new Calman training grades for doctors is shortening clinical training, and diminishing the opportunity to develop research and teaching interests. The career path to an NHS consultant post is better defined and more easy to follow than that to a senior academic post.

The current need is not only to secure pay and conditions for medical academics, but also to implement suitable training schemes which allow junior doctors to develop research and teaching skills. The close relationship between academic and clinical medicine has traditionally been one of the great strengths of our system. Without an urgent investment in junior academic posts this cross-fertilisation, and the future of our medical schools, is under threat.

Professor R LEE KENNEDY

Durham