Introduction
There have been recent concerns that medical research may be in decline.1,2 While changes in postgraduate medical training, reduction in funding and expansion in consultant posts are plausible explanations for this outcome, there is a paucity of data supporting an actual decline in UK research output. This study evaluates research trends amongst gastroenterology trainees over a 17-year period by assessing publication rates and number of higher degrees attained by trainees at the time they are appointed to NHS consultant posts.
Methods
All consultant appointments and their previous place of training were identified between February 1993 and December 2010. The number and type of publications of each consultant was collected using PubMed and Embase databases. An 18-month lag time was allowed following consultant appointment to allow for potential time delays between submission and publication. The consultant name was then either matched with their entry in the British Society of Gastroenterology (BSG) handbook medical directory or an individuals' department was contacted and their higher degree noted. Consultant appointment to either a teaching hospital (TH) or district general hospital (DGH) was collected.
Statistical analysis was undertaken using Microsoft Excel, producing a linear regression line and correlation coefficient (r) to show the trend and strength of any relationship in median publication rates over the time sampled. A χ2 test and a Mann-Whitney U test were used to identify any significant differences between groups, with a p-value of less than 0.05 deemed statistically significant.
Results
1,031 consultant appointments were made over the 17-year period. We excluded consultant-to-consultant transfers, appointments to or from academic posts, trainees who had subsequently left the UK medical register and also individuals appointed to consultant posts from overseas (n=313). In addition, individuals were excluded where data was difficult to obtain due to name and centre similarities (n=60). Of the remaining 658 appointments, 315 (48%) were appointed to TH posts. 48% (316/658) were trained within the same region that they were appointed.
With regard to research output, there is a significant decreasing trend in the median number of publications by gastroenterology trainees prior to their NHS consultant appointment: from 19 in 1993 to 2 in 2010, with correlation co-efficient R2 = 0.78 (r=−0.88, df=15, p=<0.001; Fig 1). The mean publication rates of consultants appointed to TH posts (9.7, n=315) were higher than DGH consultants (6.9, n=343) (p=0.0027). Differences were also seen when comparing higher degrees of TH consultants with DGH consultants (48.9% vs 39.9%, p=0.03).
The number of publications written by gastroenterology trainees prior to their NHS consultant appointment has been significantly decreasing.
Conclusion
This study demonstrates a significant decreasing trend in the number of publications obtained by a gastroenterology trainee at the time of their appointment to an NHS consultant post. While gastroenterology trainees demonstrate a desire to engage in research,3 actual output seems to be diminishing, possibly reflecting the reduction in time spent within training programmes. Our data would support interventions to promote research and academic training within postgraduate medical training programmes.
Acknowledgments
We would wish to thank Chris Romaya (executive secretary, British Society of Gastroenterology) for her invaluable help in the collection of this data.
Footnotes
Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references.
- © 2013 Royal College of Physicians
