@ajlees 2/2 It is hard though when many are expected to deliver same grant income and research outputs as non-clinical researchers in half the time and for those in lab-based research even more challenging. Where are next generation of clinical academics coming from?

@Jcalcolado It has come about here through an ever growing schism between the NHS and the university. It used to be almost seamless with many physicians having part NHS part university funding

@ajlees You know those times much better than I do but from what I get from colleagues ist that these professors 25 years ago developed their academic track before stroke thrombolysis, having full weekend shifts with barely any acute cases and lots of time to think. Is that true?

@neumann_wj Clinical research was encouraged and part of the job There was much less red tape, The lawyers the bean counters and the research and development quangos had not arrived. We were on call too worked long hours pre thrombolysis

@ajlees 2/2 I am the former, first a doctor which motivates me to resolve uncertainties with research. I love clinical work, including stroke at weekends! But time is divided. The “dislike” you refer to concerns people who are the latter, perhaps, fundamentally academics but with MB ChB

@BleedingStroke I suspect Edinburgh has far fewer 'dislikers' thanks to the residual Warlow influence, especially in stroke My view is the 'dislikers' should not see patients at all, and stay in the office or the lab- they are taking up clinic space to no advantage

@ajlees Then these “new academic physicians “ are not academic !

@ajlees What do you think is the reason for this?

@ajlees So true! The reason I “went into” academic medicine is because as a student and trainee I came across people who were great clinicians, teachers and researchers. With a few notable exceptions there are few of those polymaths around 1/2

@ajlees @pash22 This is a major problem in Oxford. Possibly due to insufficient funding for clinical research?

@ajlees Any data on this? In 20 years, my list of best clinicians in my head is mostly of brilliant full time clinicians (and I’m an ivory tower academic). Most academic have by definition a split focus. Doesn’t mean they still don’t add value.

@ajlees Medicine is more complex than ever. Changes all the time. The trusty senior registrar is gone. Part time clinicians with narrow research fields can lose their confidence and retreat from front line clinical medicine. Some were never suited for it.

@ajlees The reason behind this being the doctor patient relationship ..it is going bad to worse over time

@ajlees 1/2 Other than the increasing demands of academia and there being only 24h in the day, the issue is, is one an academic clinician, or a clinical academic? Which is the noun and which the verb?