The Royal College of Physicians (RCP) is calling for urgent action to safeguard clinical academic careers, warning that government ambitions to expand patient access to clinical trials will be at risk unless the doctors who design and deliver the research are better supported.
Clinical academics design and run studies, bring research into day-to-day care and help patients access innovative and potentially life-saving treatments. However, clinical academics now make up just 3% of the senior clinical workforce; in 2012, it was double that. The number of clinical academics aged under 36 fell by 25% between 2024 and 2025 – and they are now outnumbered by those nearing retirement.
In its new report, Supporting clinical academic careers the RCP says the clinical academic workforce faces significant and sustained pressure and its future is under threat. The college warns fragmented training pathways, a lack of protected time for research and too few posts are making it increasingly difficult for doctors to combine patient care and research.
The government's 10 year health plan commits to expanding access to clinical trials and speeding up research delivery, promising millions more people the opportunity to participate in studies of cutting-edge diagnostics and treatments. However, the RCP warns these ambitions cannot be delivered if the pipeline of clinical academics continues to decline at the current rate.
Professor Tom Solomon, RCP academic vice president, said:
“A clinical trial does not run itself. It depends on doctors having the time, skills and support to ask the right questions, recruit patients and translate discoveries into better care.
“Almost every major treatment we celebrate today, from new cancer therapies to treatments for neurodegenerative diseases and serious infections, exists because previous governments built the workforce needed to develop and test promising discoveries in patients. That workforce is now at severe risk.
“This is not only about improving health; clinical research is a major driver of economic growth. UK industry clinical trials generate billions of pounds for our economy and substantial income for the NHS. British discoveries such as Sir Greg Winter’s pioneering techniques for the humanisation of monoclonal antibodies have led to some of the world’s most successful medicines, created thriving companies and generated enormous economic value for the UK.
“The government is right to want more patients to benefit from clinical research. But that ambition cannot be delivered if we allow the clinical academic workforce to wither. We need to make these careers possible, sustainable and attractive now, before the pipeline runs dry. Otherwise, we will lose not only the next generation of leading clinical researchers, but also the treatments, companies and economic benefits their discoveries could create.”
In its Supporting clinical academic careers report, the RCP’s recommendations include:
- Give clinical academic doctors flexible training routes with protected research time
- Create a single joined up training and assessment process for clinical academics
- Produce practical guidance for supervisors on how to better support and assess clinical academics
- Ease the bottleneck at clinical lecturer and consultant-level through innovative posts creatively funded by universities, NHS providers, traditional funders, and industry in partnership
- Develop regional research training leads to improve access to opportunities beyond traditional academic centres
- Standardise NHS-university contracts and processes, including less than full-time working and parental leave.
Dr Sacha Moore, RCP Resident Doctor Committee clinical academic representative, said:
“Resident doctors want to build careers that combine looking after patients with improving the care they receive. But too often we are forced to choose between meeting the immediate demands of clinical training and pursuing the research that will change that future practice.
“The treatments patients rely on tomorrow are shaped by the research that doctors lead today. If the pathway into clinical academia continues to narrow, that will be lost.
“Phase two of the postgraduate medical training review is the opportunity to change course on this. It must build in the practical solutions set out by the RCP, including protected pathways, greater flexibility, and innovative new posts, so that talented doctors are not pushed away from clinical academic careers.”