I meant to write earlier, as a follow on from my part 1 post, but in all sorts of ways events have overtaken me, and the delay in any case helps me make my case. One reason for the delay was that I was on leave, chilling (or not) by the side of a pool stimulating my melanocytes (yes, I know I am a dermatologist…), reading interesting things, and wondering a little more about what is happening in the clinical academic landscape. It is of course worth commenting on the fact that I felt the need to take a holiday to do any serious work. My friend, and former colleague, Bruce Charlton, pointed out to me many years ago that if you walked into a colleagues’ office and they were reading a book or an article, they often seemed to act as though they had been caught reading porn, as though ‘real work’ didn’t involve reading or thinking. One wonders what an academic is meant to do? (My advice: put up an Excel spreadsheet on your monitor; the world will end not in war or pestilence, but in one giant Excel performance management spreadsheet, that will be unread because all those it refers to have left for better pastures, usually as performance managers, or Deans).
One of the things I talked about in Madrid (when I was corrupting the young, or at least trying to advise on medical science careers) was to draw attention to an article by Sydney Brenner published in Science in 1998. Now, in the pantheon of the experimental geniuses of modern biology, Brenner is up there in the first handful. I cannot remember reading anything by him that has not make me see the world differently. He has a depth and clarity of mind (and expression) that puts into shadow all the usual pomp of ‘serious academia’. I did one meet him, but suffered what I can only describe as stage fright, and choked on my first few words. Still, I can still read him.
The Science article was part of a series on the theme of the the impact of science on society . Brenner’s approach, not surprisingly took a different slant: he talked bout the influence of society on science, and the detrimental effects that might follow (I would say, as he has, ‘have followed’). A few quotes will give a flavour of what he was saying.
“What distinguishes science from all other kinds of problem-solving activities is the demand that the answers it discovers work in the real world. It is why rulers gave up slaughtering animals to examine their entrails: Magic does not exist in any world at all. However, in stimulating and supporting science, society, as the paymaster, has taken a much shorter term view of research than most scientists would like. There has been much discussion about the different kinds of science. We call one pure, another applied, and a possible third, strategic—it could also be called “apploid”—that is pure but destined to become applied. Then there is mission-directed as opposed to curiosity-driven research, a distinction that I find particularly obnoxious because one can almost see the word “idle” in front of curiosity.”……
“The increased funding for scientific research in recent years, especially in the health fields, has resulted in a great expansion of the number of scientists and thus in increased competition for academic and research funds. We have established an elaborate system of peer reviews to deal with this competition, and a similar process is in force for the publication of scientific results. All of this has subtle consequences for the scientific enterprise. If you know what sort of research is wanted by a committee you write your grant to satisfy these expectations, and if you know what the oligarchy believes is the correct view of a subject, you give your paper that slant. Ironically, all of this was originally introduced to ensure fairness and to eliminate the older system where powerful people got all the money, appointed who they liked to their laboratories, and published only papers written by their friends. Both the old feudal system and the new bureaucracy have consequences for scientific innovation; the former narrowed its pursuit to only a few, while the latter discourages its pursuit by all. But there are also more insidious effects because in most countries research and education are now linked almost exclusively to universities: Postdocs learn from professors, students learn from postdocs, and the art of surviving is very quickly transmitted. It is only through the use of subterfuge such as applying for money for work already done that innovative research can be freely pursued.”
“We need to take these matters seriously, otherwise science will lose the independence of thought required for innovation that it has cherished for centuries.”
You get the idea, but the article contains many other gems (the most common disease in the world? MDD—money deficiency disease). But if I jump forward to another quote I included in another post entitled FSU: Fred Sanger Units:
“A Fred Sanger would not survive today’s world of science. With continuous reporting and appraisals, some committee would note that he published little of import between insulin in 1952 and his first paper on RNA sequencing in 1967 with another long gap until DNA sequencing in 1977. He would be labeled as unproductive, and his modest personal support would be denied. We no longer have a culture that allows individuals to embark on long-term—and what would be considered today extremely risky—projects.”
Now these changes have been observed by the distinguished physicist and sociologist of science, the late John Ziman many years ago in his book, ‘Real Science: what it is and what it means‘, and elsewhere. Here is a quote from an article in Nature:
“What is more, science is no longer what it was when Merton first wrote about it. The bureaucratic engine of policy is shattering the traditional normative frame. Big science has become a novel way of life, with its own conventions and practices. What price now those noble norms? Tied without tenure into a system of projects and proposals, budgets and assessments, how open, how disinterested, how self-critical, how riskily original can one afford to be? “
Even I have explored these issues in a couple of papers here and here before I realised much formal academic publishing behaves as a black hole for ideas that disturb the status quo (if they are written by me, anyway….)
Anyway, this a longish preamble, covering issues that bug me as what remains of my hair falls out, and which I think are important, especially to the young. If you want to pursue a career as a clinical academic, ponder them and what follows.
I first heard about recent events at Imperial and Warwick via David Colquhoun’s excellent posts on his web site. It is worth reading the post and comments in full, but essentially is appears that an academic employed by Imperial committed suicide, and that he has earlier complained about the pressure he was under from the performance managers (sic) at Imperial. One key aspect is that decisions about performance seem to have been based on how much grant income an individual has brought in, rather than measure of scholarly contribution, or discovery. Since then I have seen similar stories about this method of performance management in the medical school at Warwick (“Show me the money or go”, and here).
Now, I really find it hard to express the stupidity of such approaches, but I am not surprised, as the dominant change over my university career has been the growth of managerialism over honest enquiry and truth. Science — well at least great science— is littered with examples of intellectual giants who have worked with little funds. I have often said in conversations ( with little attention to detailed evidence I should add), that at various (short) periods of my career I had probably received more income than any number of giants who changed modern science— they were just better scientists than me. As David Colquhoun outlines, universities do not want to encourage great science, they want something then can manage, and they certainly discourage people from actually doing science ( as in working at the bench, as compared with being a contractor who touts for contract work). The bankers it seems are not confined to the banking sector, but are alive and well in our universities. So, what of the young, the next generation of clinical academics?
Clinical academics, professionally at least, have both advantages and disadvantages. Advantages, because if they lose their university jobs, there is always the possibility of paying the mortgage by ‘putting up the brass plaque’ as my father would have said in a soft Welsh accent (‘proper job, bach’). But such changes are not always straightforward— but I accept better than the options for many non-clinical academic staff in the current state of the UK.
The disadvantages are in the fact that needs screaming from every hill-top is that the modern clinical academic job is unworkable. Clinical academics are supposed to practice clinically for 20 hours or more a week, teach students and do great research: one or two of these parties will be short changed. It was one of the UKs most distinguished biomedical scientists, who once pointed out to me that he would not like to be a patient of various high profile clinical academics in his own institution because, as he said, he knew how much time they spent on science, and he didn’t want to be treated by mouse doctors when he was ill. These issues are real, and there are obvious solutions, but not I would say, in the current straightjacket of UK clinical academic contracts. It was the Nobel Laureate David Hubel who pointed out that you cannot be a good doctor without seeing a lot of patients— and you have to continue to see lots of patients. As a physician friend, somebody who once worked in one of London’s ‘world class research medical institutions’, once told me, she went to great length to ensure her family were treated elsewhere.
The examples of Imperial and Warwick I think cast a shadow across all of UK clinical academia, especially if you are young and have other alternatives. Other institutions, I hope, may behave better, but you need to go back to Ziman, or read Derek Bok, to realise that many UK universities are no longer ‘communities of scholars’. Perhaps some institutions will buck the trend, and come out and clearly state that they will behave differently — I hope they do, and if they do, that is where, if I was young and starting out, I would want to work. Some of mainland Europe is worth a look at.
So, much as I said in Madrid, I would suggest that any young budding academic clinician needs to think about not just the short term, but the long term. If you are on a grant treadmill judged on what the research councils think is trendy, with a 4 or 5 year cycle, you have to be aware that some institutions are transferring all the risk on to you. This is something else universities have learned from the banks and financial disservice industry. Beware the career equivalent of Wonga schemes, that entice you in but conceal the details of a long term career: beware one sided bets with the bank holding most of the cards.
Finally, a point made by Derek Bok, a former President of Harvard, in his most recent book, Higher Education in America. In it he discusses the relative merits or otherwise of tenure. He states:
“Moreover, it is unlikely that doing away with tenure would be costless. Lifetime job security is presumably worth something to those who hold it.”
Well, that is exactly what you do not have at some UK universities, and increasingly not in the new out-sourced NHS. Future young clinical academics need much more real world savvy than I possessed at that stage of my life. I just hope, it doesn’t eat away at the very real pleasures of chasing real discovery and creating new artefacts.