1. Academic Surgery – Future Tense? Norman S Williams Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

4. Mission of an Academic Surgical Department Provide a clinical service Conduct relevant research Ensure organisation and delivery of undergraduate curriculum Provide academic leadership to organisation Contribute to postgraduate training Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

5. Pressures Clinical - same as NHS - Targets, EWTD, DTC’s, need for consultant led service, new contract, higher patient expectations etc, etc, Research - RAE, downgrading of applied clinical research, obsession with basic science Teaching - Increase in student numbers, more intensive tuition - PBL’s, OSCE’s Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

6. RAE Discriminates against clinical research Applied physiological research - “not sexy” Overemphasis on molecular biology Consequences Universities disinterested in supporting clinical academic posts HEFCE monies used to recruit scientists to boost grading Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

7. Situation at Barts and The London 2001 RAE Hospital based subjects Graded 4 (1997 3a) £5 million deficit ”Restructuring” 70 of 308 (28%) HEFCE posts axed 35 Clinical academics: 35 support staff Student numbers increased in 2003 by 40 per year Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

8. Data from UK Council of Heads of Medical Schools 1998-2005 40% increase in medical student entry Since 2000 12% decrease in clinical academic staff 33% Reduction in Lecturers Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

9. Aspirations of Barts and The London Aims to be a 5 star Medical School Principal Investigators - Research income of £150,000 per annum : 2 hours teaching/week Teaching Research Post - Research income £50,000 per annum : 8 hours teaching/week Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

10. Possible Outcome (?Doomsday Scenario) No Academic Surgical Departments in UK Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

11. Likely Scenario (?Preferable ) Primarily teaching only academic units -Funded entirely by NHS -Minimal research – clinical trials Selected Research Active Units Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

12. Selected Research Active Units Funded by “mixed economy” - NHS, HEFCE contribution dependant on external grant income Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry Core Academic Unit Basic Research Group Translational Research Group

13. To secure a future we need to: Raise profile of clinical research Emphasise the need to translate basic science discoveries into the clinical arena Fund infrastructure of clinical research via NHS - divert SIFT Inculcate ethos that everyone has an onus to pass on skills and knowledge to younger genertation i.e. teach Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

14. The students of today are the doctors of tomorrow and the consultants of today are the patients of tomorrow!! Centre for Academic Surgery - Barts and The London School of Medicine & Dentistry

16. In the UK we need action now particularly for Academic Surgery !!