Strengthening the clinical academic pathway: a systematic review of interventions to support clinical academic careers for doctors and dentists

Abstract

ObjectiveEvaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities.DesignSystematic review.Data sourcesMedline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019.Study selectionEligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career.Data extraction and synthesisAbstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed.Results148 studies examined interventions; of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists.Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups.ConclusionsExisting research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers.Systematic review registrationOpen Science Framework: https://osf.io/mfy7a

Experiences of the clinical academic pathway: a qualitative study in Greater Manchester to improve the opportunities of minoritised clinical academics

“… 10 11 A recent systematic review of the existing interventions to support CA careers for doctors and dentists found that protected research time could enhance CA retention and career progression. 11 In addition, to bolster the feeling of belonging for minoritised CAs, representation and inclusion is crucial.…”

“…7 8 Various challenges have already been recognised for CAs, such as limited funding, financial insecurity, limited CA positions and the demanding workload of a clinical role. [9][10][11][12][13] For CAs from minoritised backgrounds, those challenges could be compounded. For example, for female CAs, social expectations around family commitment and parenting responsibilities could result in their being unable to pursue CA careers.…”

“…Previous work has highlighted the value of intercalation for healthcare students to the diversity of the CA pipeline. 11 16 Interrupting professional training to develop research skills at the early career stage of future healthcare professionals is critical to widen access and participation for under-represented groups in clinical academia. The removal of educational achievement scores from the allocation process for foundation posts is a cause for alarm, as it will have far-reaching consequences for student uptake of intercalation and amplify the inequities in the CA pipeline.…”

Clinical academics in the NHS: a cross-section study of research engagement during the monkeypox pandemic

“…As highlighted by previous studies, these multifaceted future interventions including those intended to address inequities, require careful evaluation to determine their usefulness. [25][26][27] Additionally the involvement of junior academic staff and staff with protected characteristics in co-developing the evaluation of these future interventions is vital.…”

Experience of an NIHR Clinical Lectureship (medical/dental) and the determining factors for a clinical academic career post lectureship: a mixed-method evaluation

“…An international body of literature has developed highlighting concerns around the future supply of clinical academics in the healthcare system,1–9 and issues around clinical academic progression to early stage postdoctoral level,10 11 including studies addressing gender difference in career progression 7 12–15. Thus, a need to undertake an evaluation of the CL and its role in addressing the gap around clinical academic progression from early to late postdoctoral level was identified.…”