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Academic Clinical Careers in Geriatric Medicine

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Institute for Ageing and Health. Newcastle University. Outline. Academic ... Varies by medical school/region. Deterrents for a clinical academic career ... – PowerPoint PPT presentation

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Title: Academic Clinical Careers in Geriatric Medicine


1
Academic Clinical Careers in Geriatric Medicine
  • Julia L. Newton
  • Senior Lecturer in Ageing Medicine
  • Institute for Ageing and Health
  • Newcastle University

2
Outline
  • Academic Clinical Career Pathway
  • Biomedical Research Centre in Ageing
  • The Campus for Ageing and Vitality

3
Clinical Academics 2000 - 2005
  • 2005 figures are 84 of 2000 level
  • Below 3000 for first time - 2982
  • 50 reduction in clinical lecturers
  • 30 reduction in senior lecturers
  • 7 increase in professors
  • Particular specialities hit hardest
  • Differences between medical schools
  • Differences between genders

4
Why?
  • Competing pressures of service, research and
    teaching activities
  • Increased length of time to complete specialist
    training
  • Lack of exposure to academia in postgraduate
    training programmes
  • Lack of flexibility in the postgraduate training
    programmes e.g. p/t working
  • Lower financial rewards than in the NHS
  • The RAE

5
Funding of clinical academics
  • HEFCE 45
  • NHS 38
  • Other 16 - charities, endowments, industry, etc
  • Varies by speciality
  • Varies by medical school/region

6
Deterrents for a clinical academic career
  • Lack of both a clear route of entry and a
    transparent career structure
  • Lack of flexibility in balance of clinical and
    academic training and in geographical mobility
  • Shortage of properly structured and supported
    posts on completion of training

UKCRN/MMC March 2005
7
Key signposts for recovery of clinical academia
  • Treasury reports central role of applied
    biomedicine in economic growth
  • UKCRN/MMC (Walport) report Medically and
    dentally-qualified academic staff
    recommendations for training the researchers and
    educators of the future
  • Best Research for Best Health restructuring NHS
    RD

8
MMC and UKCRC
  • Clear route of entry to an academic career
  • Transparent career structure
  • Properly structured and supported posts after
    training
  • Academic Foundation posts
  • Academic Clinical Fellowships
  • Academic Clinical Lecturer

9
Academic training programmes - Walport
10
Academic Foundation Programme
Newcastle had the first programme in the UK
11
Academic Foundation Programme
3 x 4 month blocks for both F1 and F2 years 1 x
4 month block in each year is academic Other
blocks in F1 are medicine and surgery Other
blocks in F2 mirror academic interests
12
Academic Foundation Programme Appointment Process
Academic domain in addition to normal foundation
form Academic domain concentrates on why not
what Presentation and interview (c30
minutes) Interview concentrates on foundation
and academic issues equally Appoint people to
the scheme not to individual subject areas
13
Academic Clinical Fellowship
  • Combination of 25 academic / 75 clinical
    training.
  • Central funding
  • Speciality specific
  • Central application system
  • Now out with MMC system
  • Competency based
  • Leads to application for externally funded
    fellowship and Phd/MD

14
Academic Clinical Fellowship
15
ACF-Newcastle
13 programmes awarded in round 1 2, in round 3,
3 more.
16
ACFs in Newcastle /Northern
  • Neurology
  • Hepatology
  • Dermatology
  • Reproductive Medicine
  • Urology
  • Paediatric Oncology
  • Geriatric Medicine
  • Clinical Dentistry
  • Psychiatry (child adult old age)
  • Ophthalmology
  • Otolaryngology
  • Trauma and Orthopaedics
  • Pathology of Ageing
  • (Respiratory)
  • (Rheumatology)
  • (Clinical Pharmacology)

17
ACF in Geriatric Medicine
  • Oxford total 2 (2008-1 post) (James Kennedy)
  • St Georges total 4 (2008-1 post) (Emma Baker)
    combined with CP.
  • Southampton total 2 (2008-1 post) (Avan Sayer)
  • Newcastle total 7 (2008-1 post) (Julia Newton)

18
ACF in Geriatric Medicine - Newcastle
  • 7 posts over 5 years
  • 1ST SpR
  • 2nd ST1
  • As of now will recruit from ST1

19
Academic Clinical Lecturer
20
ACL
  • 50 research / 50 clinical training.
  • Post doc
  • Developing own research grouping
  • Leads to application for Senior fellowship

21
ACL - Newcastle
13 matching CLs awarded Probable additional 5
22
ACL- Newcastle
  • 3 programmes
  • Ageing Specialities
  • Dental
  • Psychiatry

23
ACL in Geriatric Medicine
  • Oxford total 1 (2007)
  • Newcastle total 5 (? 5 more) Age related
    medical specialties

24
Academic Senior Lecturers
25
Academic Senior Lecturers
New blood ASL posts 4 awarded in 2006/7
26
Clinical Academic Career Path Committee
27
Academy of Medical Sciences guidance
  • Training needs to be flexible and
    trainee-centred, with mentoring to ensure the
    attainment of both academic and clinical goals. 
  • The academic component of the training period
    must include preparation of an application for a
    competitive peer-reviewed research training
    fellowship or educational training programme
    leading to the award of a higher degree, the
    completion of which is considered as the
    end-point of the ACF period.
  • It is essential that ACFs have the opportunity
    to develop competencies that enable them, in Year
    1, to define a research question, and in Year 2,
    to develop a research proposal. The Academic RITA
    should record the ACFs progress specifically in
    relation to these training goals.

28
Criteria for the Assessment of Academic Progress
  • Academic educational supervisor
  • separate individual from the clinical educational
    supervisor
  • usually be an established clinical academic
  • formal mentoring role
  • responsible for drawing up an Academic Training
    Programme with the trainee, and a
    realistic/achievable timetable for delivery.
  • required to identify training goals relating to
    generic academic competencies and specific
    academic goals for each individual as
    appropriate. These targets will be summarised
    within the Personal Development Plan (PDP) for
    the trainee, which should be agreed within a
    month of commencing work and annually thereafter.

29
RITA
  • The academic component will be an integral part
    of the RITA process for the Academic Clinical
    Fellows (ACFs) and Clinical Lecturers (CLs)
  • MMC UKCRC.

30
Generic academic competencies
  • Three domains
  • 1) Research Experience,
  • 2) Research Governance,
  • 3) Communication/Education.
  • Academic progress is to be assessed in relation
    to each of these domains.

31
Academic Competencies and Outputs
  • 1) Generic and applied research skills
  • Examples include
  • Identifying a research supervisor
  • Identifying a research topic
  • Defining a research question
  • Observational and experimental research design
  • Developing a research proposal
  • Writing a grant application
  • Critical appraisal of a paper or topic
  • Carrying out an experiment
  • Data interpretation and statistical analysis
  • Writing a research paper or thesis
  • Commercialisation of research outputs

32
Academic Competencies and Outputs
  • 2) Research Governance
  • Examples include
  • Information storage and retrieval
  • Patent and Intellectual Property issues
  • Laboratory safety
  • Clinical trials / clinical trials legislation
  • Research ethics and how it is monitored
    (including COREC processes)
  • Home Office and Animal Licences
  • Animal husbandry
  • Storage of human tissue
  • NHS structure and regulations
  • Fraud/Scientific misconduct
  • Research and Integrity (awareness of complex
    dilemmas in scientific research).

33
Academic Competencies and Outputs
  • 3) Communication/Education
  • Examples include
  • Writing skills
  • Verbal presentation skills
  • Electronic media / audio-visual presentation
    skills
  • Poster presentations
  • Teaching skills/experience
  • Supervision skills/experience
  • Science and the Media
  • Effective networking and collaboration
  • Collegiality/ability to work co-operatively and
    creatively with colleagues
  • Assertiveness skills

34
Outputs
  • Significant outputs should be recorded on the
    Assessment of Academic Progress form, and
    supporting evidence should be provided.
  • Presentation at national / international research
    meetings
  • Submitting an application for a grant or
    fellowship
  • Publishing a peer-reviewed article
  • Delivering an educational lecture or seminar

35
Assessment of Academic Progress documentation
  • Training record
  • Records of 6-monthly (or more frequent) progress
    review meetings
  • Educational Supervisors report (to have been
    shared with and signed by trainee at least 2
    weeks before meeting). This should include a
    listing of the academic competences achieved in
    the period under review, listed under the 3
    headings
  • generic and applied research skills
  • research governance
  • communication / teaching skills
  • Record of academic outputs (provided by trainee)
  • Research proposals
  • Academic placements / modules
  • Publications/ Courses
  • Personal Development plan
  • Miscellaneous

36
Assessment of Academic Progress - process
  • The trainee should be asked to comment on
    progress through the year, competences gained,
    significant milestones and future aspirations.
  • The panel will discuss the achievements, comment
    on any deficiencies and make recommendations
    about the training goals for the next 6 months.
  • They will complete the Assessment of Academic
    Progress Form, which should be agreed and signed
    by the trainee.

37
Overview of the programme
  • Newcastle
  • Academic Clinical Career Pathway committee
  • Chaired by Dean of Clinical Medicine
  • Brings together the University, Trust and
    Postgraduate Deanery
  • Academic Interviews in addition to the same
    clinical interview
  • Academic RITA / Progress assessment in addition
    to the same clinical interview
  • Academic Lead for Programme Lead on RITA panel
  • Active and effective mentorship programme

38
National Institute for Health Research
39
NIHR Academic Links
  • Virtual National Research
  • Facility
  • Position, manage and
  • maintain the research, the
  • research staff and the
  • infrastructure of the NHS.
  • Enable the NHS to become
  • an organisation that supports outstanding
    individuals (both leaders and collaborators),
    working in world-class
  • facilities (both NHS and university),
    conducting
  • leading-edge research
  • focused on the needs of
  • patients and the public.

40
NIHR Infrastructure
  • The UK is at the international forefront of
    developments in basic biomedical research that
    have the potential to transform patient care. It
    is vital that we turn that potential into
    reality.
  • Biomedical Research Centres
  • We will create Research Centres within our
    leading NHS / university partnerships to drive
    progress on innovation and translational research
    in biomedicine and NHS service quality and
    safety.
  • Experimental Medicine Facilities
  • We will support purpose-built, cutting-edge
    clinical research facilities and specialist
    clinical, research and support staff in locations
    where universities and NHS Trusts can work
    together on dedicated programmes of
    patient-orientated research.
  • Technology Platforms
  • Access to technology platforms is increasingly
    essential for the conduct of leading edge health
    research. Current access to these platforms is
    inadequate across the NHS in England. The initial
    focus will be on diagnostic imaging, the area
    identified as most critical in scoping work
    conducted by the Academy of Medical Sciences and
    our recent survey of NHS providers.

41
Biomedical Research Centres
  • Eleven Biomedical Research Centres have recently
    been created
  • to drive forward innovation and translational
    research.
  • "Comprehensive" Biomedical Research Centres
  • NHS Organisation Academic Partner
  • Cambridge University of Cambridge
  • Guy's St Thomas King's College London
  • Hammersmith St Mary's Imperial College
    London
  • Oxford Radcliffe University of Oxford
  • University College London University College
    London
  • "Specialist" Biomedical Research Centres
  • NHS Organisation Academic Partner Specialism
  • Great Ormond Street UCL Inst. of Child
    Health Paediatric/Child Health
  • Moorfields Eye Hospital UCL Inst. of
    Ophthalmology Ophthalmology
  • Newcastle Newcastle University Ageing
  • Royal Liverpool Broadgreen University of
    Liverpool Microbial Diseases
  • Royal Marsden Institute of Cancer
    Research Cancer
  • South London and Maudsley KCL Institute of
    Psychiatry Mental Health

42
Clinical Research Facilities for Experimental
Medicine
  • 84 million joint initiative including Wellcome
    Trust, Wolfson Foundation, British Heart
    Foundation, Cancer Research UK and MRC. MRI key
    component of funding.
  • Cambridge nutrition and appetite laboratory to
    study genetic disorders and obesity.
  • Dublin neuropsychiatric disease, cancer, and
    infection and immunity inflammatory bowel
    disease, hepatitis and HIV infection.
  • Edinburgh inflammation in cardiovascular and
    central nervous system conditions and work on
    metabolism in a range of tissues.
  • Oxford patients admitted as emergency cases
    after heart attacks or strokes.
  • Belfast cancer, nutrition and metabolism, and
    vision science.
  • Newcastle new Clinical Ageing Research Unit -
    dementia and cognitive decline, and basic
    mechanisms of cell and tissue damage during
    ageing.
  • Manchester biomarkers for cancer prognosis.
  • Birmingham gene- and cell-based therapy for
    cancer and immune diseases, as well as on heart
    disease, high blood pressure and obesity.
  • Four centres in London
  • Imperial College drug development and early
    clinical trials in Alzheimer's disease,
    Parkinson's disease, arthritis and cancer.
  • King's College neuroimaging and development of
    treatments for mental illness along with the
    study of drug addiction and use of stem cell
    therapy for neurological disease.
  • University College London
  • Institute of Cancer Research

43
Institute for Ageing and Health Campus for
Ageing and Vitality
44
The Campus for Ageing and Vitality
  • Existing and in the pipeline
  • Wolfson Research Centre
  • Henry Wellcome Biogerontology Building
  • Newcastle Magnetic Resonance Centre
  • NHS Centre for the Health of the Elderly
  • IAH Research Laboratories
  • Clinical Ageing Research Unit
  • NHS Falls Unit
  • Regional Medical Physics
  • Planning in progress for
  • Translational Research Building, including new
    laboratories (biomarkers and nutrition), clinical
    and social science facilities, incubator space
    and opportunities for new commercial linkages
  • PET molecular imaging
  • Centre for Assistive Technology
  • Teaching and public engagement space

45
Campus for Ageing and Vitality 2004
46
Newcastle MR Centre
Campus for Ageing and Vitality 2006
47
Edwardson Building (new IAH Labs)
Campus for Ageing and Vitality 2007
48
Clinical Ageing Research Unit - CARU
Campus for Ageing and Vitality 2008
49
Translational Research Facility
Campus for Ageing and Vitality 2010
50
Further development proposed
Campus for Ageing and Vitality 2012
51
There has never been a better and more exciting
time for a career in Academic Geriatric
Medicine julia.newton_at_nuth.nhs.uk
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