Future of academic respiratory medicine: near crisis point

Abstract

A crisis is a time of intense difficulty, a turning point when an important change needs to take place. Here, we argue that the UK is approaching a critical point in clinical research capacity, following years of decline in medically trained research staff.1 The British Thoracic Society (BTS) respiratory consultant and trainee surveys (2024) highlighted the problems facing respiratory research. The surveys identified a strong interest in research, but also a lack of opportunities. This editorial outlines the results of these surveys and several initiatives the BTS, National Institute for Health and Care Research (NIHR) and Asthma+Lung UK are taking to revitalise respiratory research. Rates of chronic lung diseases are increasing, with respiratory diseases now responsible for 5 of the top 10 causes of death.2 Despite these challenges, the medical research workforce has diminished. 24% fewer medically trained research staff have been appointed over the last decade. As an overall proportion of the consultant workforce, the number of clinical academic consultants has almost halved to 3%.1 The problem is particularly pronounced in respiratory medicine. Compared with other Western European countries, the UK is an outlier, spending the least on respiratory research. Respiratory medicine accounted for only 4% of the NIHR fellowships (PhD and mid-career) and 3% of NIHR grant awarded in 2023. No respiratory doctors were recipients of the 58 NIHR Senior Investigator awards in 2024.3 The future feels bleak, with more clinical academics over 65 than under 36. This decline is anticipated to accelerate, exacerbated by the challenging financial position that most UK universities are …