Is research declining amongst gastroenterology trainees in the United Kingdom?
Editor – We read with interest the letter from Kurien at al regarding the decline in research output from trainees in the UK (Clin Med February 2013 pp118–9). Although they cite ‘reduction of time spent within training programmes’ as a reason for the decline, surely an important consideration is the colossal range of procedural hurdles the system has erected between trainees and simple research projects?
We had noted on an anecdotal basis that some patients (predominantly male) rather enjoyed a common medical procedure and some (predominantly female) did not. An interested registrar attempted to mount a small-scale study asking patients to rate their experience of the test on a linear scale from 1 to 10. We planned to collect data from around 60 patients to see if any pattern emerged.
Whether such an investigation should require ethics committee approval is surely debatable: nevertheless, we sought such approval as well as Trust R+D approval. The approval process required, inter alia: the Trust R&D application in XML and PDF format; an IRAS entry and SSI forms; curricula vitarum; patient information sheet and consent form; the actual questionnaire; data collection form; power calculations; detailed protocol; a full ethics committee application and subsequent detailed correspondence. The project was then sent out for peer review by the Trust.
Over 9 months later, we were finally given provisional permission to proceed, albeit with a patient information and consent pack on six sides of A4 paper. At this point, the study hit the problem of the requirement for the investigators to fund the stationery required to make up those packs. As the registrar had by then moved on, the project foundered.
It is no surprise to us that academic medicine is dying. As a society, we have allowed a system to develop that prevents trainees from following through a simple research project within a reasonable time scale during their training. Heaven help you if you wish to do anything so rash as a drug trial, even of an existing medication in a patient group for whom the drug is already indicated.
Footnotes
Please submit letters for the editor’s consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2013 Royal College of Physicians
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