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

BackgroundRecruitment and retention of clinical academics in the UK is under threat. Acute clinical crises can increase opportunities for clinical research. We aimed to examine research involvement amongst clinicians working in sexual health and HIV medicine during the monkeypox (mpox) pandemic and identify factors associated with differential research engagement. MethodsWe carried out a cross-sectional study between August and October 2022 using anonymised, self-reported data collected via an online survey disseminated worldwide across multiple specialities. We assessed demographic characteristics, research involvement and outputs, workplace setting, involvement with policy work and public health agencies and media. We examined differences by geographical location comparing the UK, the EU and the US. ResultsOf a total 139 respondents from the UK, none identified themselves as clinical researchers, compared to 23/210 (11.0%) from the EU and 5/58 (8.6%) from the US. Overall research engagement was lowest in the UK (15.1% vs. EU 36.7% and US 37.9%). In the UK, research activity was greater amongst consultants (19.5% vs. 18.8% doctors-in-training and 4.9% nurses), those aged 35-50 years (19.7% vs. 15.4% <35 and 8.5% >50 years), males (34.3% vs. 7.1% females and 33.3% non-binary), and those who self-identified as White (15.6% vs.13.3% all other). In research-active individuals, measurable research achievements by journal publications or submissions and obtainment of grant funding were significantly higher in older, male, White, consultants. Less disparity across demographic characteristic groups were seen in both the EU and the US compared to the UK reflecting more diversity amongst research-active clinicians in overall research activity. Markers of research achievement were closer to parity in representation across gender and ethnicity, particularly for the EU. ConclusionsAdherence to and evaluation of existing UK-based recommendations to improve the clinical academic pipeline are needed to increase research engagement and diversity to safeguard UK clinical research in future. Key messagesO_ST_ABSWhat is already known on this topic - summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be doneC_ST_ABSThe future of clinical academia in the UK is under threat due to a fragile NHS workforce, infrastructure, and environment. Reasons for poor recruitment and retention include lack of mentorship, insufficient job security, delayed career progression, and pay. What this study adds - summarise what we now know as a result of this study that we did not know beforeDuring the mpox pandemic which was an opportunity to produce research, both rates of overall self-reported research engagement and diversity amongst research-active clinicians were significantly lower in the UK compared to both the EU and the US. Reduced engagement with clinical research was especially noticeable in at earlier stages of training, in women, and those from ethnic minority backgrounds. How this study might affect research, practice or policy - summarise the implications of this studyEvaluation of the existing UK-based recommendations to improve the clinical academic pipeline is needed to determine their usefulness. This evaluation should be co-designed by a diverse range of people with protected characteristics with potential to form the future clinical academic pipeline such as junior and senior clinical academics and research-active clinicians.