New figures highlight alarming trends in the UK’s clinical academic workforce, underscoring the need for immediate action to reverse these declines and safeguard the future of medical research and education.
Data released by the Medical Schools Council (MSC) reveal a steady decline in the number of clinical academics and an ageing population with 35% over the age of 55. While the government’s 10-Year Health Plan shows positive recognition of the importance of embedding research into all areas of healthcare to drive reform, there must be an emphasis on early-career engagement and career development for clinical academics to increase numbers. The UK’s ability to contribute to scientific research, educate future doctors and drive the government’s prevention and innovation agenda is at risk without urgent investment.
Medical clinical academics are doctors who combine clinical work with teaching and research, and play a critical role in advancing medical science and educating future NHS clinicians. Data from MSC’s clinical academic survey however highlights concerning trends in their representation across the profession.
In 2024, there were 3,090 full-time equivalent (FTE) clinical academics in medicine. Only 3.4% of consultants hold clinical academic posts, down from 4.7% in 2009. Additionally, the proportion of the workforce below consultant level holding clinical academic posts peaked in 2015 at 1.5% but has now fallen to 0.9%.
Age distribution remains a critical concern for the sustainability of the workforce with 35% FTE clinical academics being aged over 55. At the Professor level, the picture is starker with 63.7% being aged over 55, more than double the 31% reported in 2004. Meanwhile, the number of early-career clinical academics is falling. In 2024, there were only 140 FTEs under the age of 36, a 7.5% decline since 2020 and a 28.8% fall from 2015. Without targeted investment in career entry points, this trend will further jeopardise future capacity.
Gender diversity in the field has seen gradual improvement with more women entering clinical academia. Although men still make up two-thirds (64.5%) of the workforce, this represents progress compared to historical data. In senior positions, men comprise 74.4% of Professors and 60.8% of Readers/Senior Lecturers, a marked improvement from 2004 when these figures were 89% and 76% respectively. Over the last five years, the number of female Professors has risen by 19.1% and female Senior Lecturers by 19.8%, while the number of male Professors declined by 5.4%. These gains suggest a positive trajectory which could undoubtedly enable further growth through role modelling and mentorship, though continued efforts are needed to support women into leadership roles.
For the first time, data on nationality indicate changing patterns in workforce composition. In the last five years there has been a 14% decrease in clinical academics from the European Economic Area (EEA), while representation from the rest of the world has grown by 12%. Posts filled by UK nationals have also increased by 6.6%, reflecting shifts in international mobility and recruitment following Brexit.
Flexible working has also become significantly more common. Since 2015, the number of female clinical academics working less than full time has risen by 112.5%, and among males, by 76.7%. These arrangements vary across career stages, with 25.3% of Professors, 40.9% of Senior Lecturers, and 47.9% of Lecturers working LTFT.
To support the growth of clinical academia it is important that their work is recognised through national award schemes. In 2024, only 28.7% of clinical academics held a Clinical Excellence Award (CEA) – a substantial decline from 55.3% in 2009. Changes to the scheme in 2022, replacing CEAs with National Clinical Impact Awards has meant awards are now less financially valuable and no longer pensionable.
Since 2015, there has been encouraging growth in clinical academic FTEs in the devolved nations: Northern Ireland (+16.7%), Wales (+3.2%), and Scotland (+18.6%). Within England, several regions have seen strong gains, particularly Kent, Surrey and Sussex (+133.3%), the North East (+34.6%), and the East Midlands (+27.5%). This is likely to be linked to the establishment of new medical schools. However, Yorkshire and the Humber has seen a 13.6% decrease in FTE over the same period, underscoring the need for targeted support in areas facing decline.
Immediate action is needed to reverse declines in the number of clinical academics with early-career engagement being crucial. Greater understanding of clinical academic career pathways is needed as suggested in the OSCHR report. The Clinical Academic Training and Careers Hub (CATCH) was launched in October 2021 to promote the role of clinical academics and support health professionals beginning their clinical academic journeys. Investment in protected time for research and education is critical to preserving the UK’s world-leading position in academic medicine.
“With the government’s goals for implementing a prevention and innovation agenda over the next ten years, the role of clinical academics in driving medical research is more vital than ever. This year’s data highlight concerning trends in the clinical academic workforce, particularly the decline in early-career entrants and the growing proportion of senior academics nearing retirement. The government’s failure to reimburse the universities for the additional cost of the new contractual arrangements for NHS consultants only adds to the risks and undermines our ability to train the next generation of doctors and contribute to the UK’s global leadership in medical research.
“The impact of clinical academic work is disproportionately large, yet the workforce remains small and increasingly stretched. If the NHS is to be saved, funding must be found and bottlenecks in the training pipeline must be prevented. This includes improving the sustainability of academic careers, ensuring access to protected research time, and addressing the challenges in reward structures.
While it is encouraging to see increases in female representation and greater regional diversity in some parts of the UK, longstanding disparities persist – particularly in senior roles and by ethnicity. A representative clinical academic workforce is essential to producing inclusive research. We must continue to work with government, the NHS, and universities to ensure clinical academia is a rewarding, supported, and accessible career path for all.”
Professor Patrick Maxwell, Chair, Medical Schools Council