A new report by the Royal College of Physicians (RCP) notes that the greatest barrier doctors face in engaging in research is a lack of time. Research for all: Building a research-active medical workforce notes that doctors often lack the time and support to actively engage in research within their hospitals even though they are eager to do so.
Drawn from the findings of a survey of almost 2,000 doctors, respondents cited the lack of time as having a ‘significant impact’ on their ability to engage in research. Comments include:
- ‘The enthusiasm that used to be present is stultified in clinical medicine by too little time’
- ‘Clinical work frequently overwhelms my home life and I therefore do not wish to devote any further time outside of my usual working day to work on further projects, inevitably in the evening and at weekends’
- ‘Clinical work is very demanding and there is little time left for research during working hours’
The report points out that doctors’ clinical contact with patients makes them uniquely well placed to identify which research questions will make a difference in the lives of patients, and what kinds of new treatments or processes would readily be translated into clinical practice – meaning that if we want research to have an impact, we need to ensure that doctors have the time to contribute.
The report also highlights the discrepancies between the ease with which men and women fit research into a clinical career, and some of the issues with the way the culture of research is perceived.
However, enthusiasm for research is high – with just under two thirds (64%) stating they were interested in becoming more involved.
The report also focuses on the variable level of service and support doctors can receive from Research and Development (R&D) departments. It notes:
‘Responses suggest that the performance of R&D departments is variable. For some respondents, R&D departments are perceived as opaque, inaccessible and, in some instances, a barrier to research. Perceived barriers referenced by respondents included: excessive bureaucracy; lack of transparency; a focus on compliance, rather than enabling research; and a focus on well-established or ‘big name’ researchers around the hospital, rather than proactive encouragement of research participation across the workforce.’
However, the report goes on to say that there are significant opportunities for R&D departments to improve how they involve doctors and in addition how they promote and raise awareness among doctors, researchers and aspiring researchers.
As a result of the findings the report include a range of recommendations:
- Trusts should take steps to ensure that doctors have protected time for research and can make efficient use of that time
- R&D departments need to ensure they are active enablers of research as well as maintaining their governance and oversight roles. This means taking a proportionate approach to the risk of research studies.
- Trusts and universities need to adopt employment policies that facilitate employees to move between NHS and university employment without losing employment benefits that are contingent on the length of service. This is a particular issue in respect to parental and maternity leave.
- Research funders should consider collaborating to make the grant application process more straightforward. As many respondents noted the time and effort required to apply for funding felt excessive.
In addition the report also calls on doctors and others to play their part:
- Doctors need to be proactive in talking to their medical director or R&D department about what research opportunities are available. They should consider making contact with local research networks so they are aware of trials in their specialty, and engage with the host of online information about the support that is available.
- Royal colleges and specialty societies should include sessions on research skills and engagement in regular conferences.
Professor Margaret Johnson, RCP academic vice president and the report’s author said:
‘It is a real shame that the main barrier to more doctors engaging in research is having the time to do so. We know patients in research-active institutions have better outcomes than those in other institutions, and are more likely to benefit from earlier access to new treatments, technologies and approaches. We need to move more research to the bedside, so that more NHS patients can enjoy these improved outcomes. We also want more physicians to engage in research, so that future patients can benefit from discoveries that have not yet been made. We want these discoveries to lead the rest of the world.’