Although most surgical trainees aspire to become NHS consultant surgeons, some surgical trainees will aim instead to become clinical academics, or at least wish to know more about this as a possible career option. For these individuals, and for others who may wish to undertake a period of full-time research prior to becoming an NHS surgeon, it is hoped that the following will provide some guidance.
What are the attractions of academic surgery?
A career as an academic surgeon is undoubtedly very challenging and requires hard work, determination and commitment to succeed. Continued success is dependent on securing research grant income and publishing high quality papers. At the same time there are all of the demands of practicing clinical surgery in the modern NHS with the need to maintain and develop operative skills, and demonstrate excellence of service provision in an environment that is becoming more regulated and onerous. Administrative duties can also be time-consuming. Moreover the rewards are not usually of a financial nature. What then are the attractions? For most academics it is the opportunity to combine the stimulation and excitement of undertaking research in a supportive environment, with the contrasting satisfaction of practicing clinical surgery, often of a highly specialised nature. Clinical academics work in a stimulating environment with enthusiastic colleagues and some of the brightest trainees. Many become key opinion leaders in their area of clinical practice and their expertise is often sought out in their own hospital and region as well as more widely by the Department of Health. The opportunities for travel to other centres nationally and internationally, both short term and longer term in the form of sabbatical leave, may also appeal.
What does a consultant academic surgeon do?
Most academic consultant surgeons are expected to spend around half of their contracted time undertaking clinical surgery on behalf of their hospital and the other half of their contracted time undertaking academic work in the form of research and usually to a lesser extent teaching. This can lead to tension between clinical and non-clinical work. Like all doctors, the first responsibility of an academic surgeon is to the care of their patients. However, with careful time management, a flexible approach, and a supportive clinical environment there is not usually too much difficulty in finding adequate protected time for research. A typical week might comprise a day spent going over research findings with colleagues, planning the next step in what might turn out to be an important clinical advance, followed by a day teaching undergraduates in the morning and doing out patient work in the afternoon. The next day may be spent in the operating theatre, followed by another day of research and perhaps a trip to another centre to give a research presentation or to examine a thesis. Because academic surgeons are nearly always based in large teaching hospitals, often in departments providing complex regional surgical services, there is usually an opportunity to focus surgical clinical practice in a relatively narrow or specialised area so that provision of high quality clinical care can be combined effectively with associated research. Indeed such focus of activities is really essential for a successful University Department of Surgery. The type of research undertaken by academic surgeons is very variable and may range from running a basic laboratory research programme to directing health service research in surgery. Currently there is an increasing emphasis on the importance of translational and clinical research and this favours the surgical academic. Irrespective of the type of research, success usually depends on establishing strong collaborative links with colleagues who have complimentary expertise.
What are the employment arrangements for academic consultant surgeons?
Most established academic consultant surgeons are primarily employed by a university and hold a designated academic position as University Lecturer (Cambridge and Oxford only), Senior Lecturer, Reader or Professor. As such their salary is paid through the University (on the same scale as for NHS Consultants), irrespective of whether the university post they hold is funded directly by the Higher Education Funding Council, or indirectly from the relevant NHS hospital or Trust. Academic surgeons hold an honorary position as a Consultant with one (or sometimes more than one) hospital or NHS Trust and, as such, have all of the privileges (and all of the responsibilities) of NHS consultant surgeons. Consultant level academic appointments are usually, like their NHS counterparts, permanent posts, subject in some cases to satisfactory academic performance during a probationary period. Like NHS consultants, university surgeons are eligible to apply for Clinical Excellence Awards which can significantly increase total salary. They are also encouraged and expected to apply for academic promotion in line with their academic achievements and for the most able academic surgeons this might mean promotion to chair level after about five years from appointment to University Lecturer/Senior Lecturer, although it often takes much longer. Academic promotion is not usually associated with an increase in basic salary.