Reform of academic medicine requires a focus on integrated academic training

I hope The BMJ1 and others2 continue to highlight the current state of academic medical training. Attention is understandably focused on recruitment to the specialised foundation programme becoming a lottery,34 but one neglected element is the messy shape of academic training after these posts.The integrated academic training pathway is a minefield,5 and I often have difficulty explaining this to senior colleagues who followed simpler paths. The pathway consists of a two year specialised foundation programme, followed by a three year academic clinical fellowship (with nine months of research time, starting from core training year 1 to specialty training year 4) designed to secure funding for a higher degree. Academic clinical lectureships continue the path to academic and clinical independence. This pathway is complicated by recent changes in clinical training—for example, training in medical specialties is now more generalist. Of course, this pathway is a blueprint that is rarely strictly followed.At…
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