Future opportunities and challenges in academic anesthesia in the United Kingdom: a model for maintaining the scientific edge.
PURPOSE OF REVIEW: This review outlines the methodology of a major report into academic strategy recently undertaken by the Royal College of Anaesthetists in the United Kingdom. Analyzing the factors that made the report's conclusions robust and workable provides lessons for other countries or healthcare systems faced with similar problems in academic anesthesia. RECENT FINDINGS: The main themes covered by this review include: organization of healthcare and university systems, medical postgraduate training, and funding of research. In the UK, there exists a dual process: clinical service delivery and postgraduate clinical training [which are both the province of the National Health Service (NHS)], and research and undergraduate education (which are both the province of universities). Both NHS and universities are sponsored by the UK government. 'Professors' or 'heads of academic department' in the UK have no automatic responsibility over the activities of the majority of anesthetic consultants in their own hospitals. Anesthesia in the UK has never been a specific unit of assessment in the research granting process, such that anesthetic departments have received little external grant support compared with many other departments such as medicine or cardiology. As a result, anesthetic departments across the UK have either become entrenched as small departments or they have vanished through mergers. SUMMARY: The review's main conclusions are: the creation of a central National Institute for Academic Anaesthesia to coordinate and implement academic strategy and funding; engaging with national pathways for the training of future academics; and suggestions for the future role for anesthetic specialist societies in academic strategy. These initiatives can radically transform the research environment in a positive way.