Academic medicine is in crisis (apparently). Recent articles in the BMJ have highlighted this growing problem.

With developments such as the new EU directives and research governance frameworks it is becoming increasingly difficult to begin health services research. Specialties such as geriatric medicine seldom attract funding from large drug companies.

How are we as trainees, and as a specialty, to reverse this tide and build capacity for quality geriatrics researchers? Many of my predecessors on this column have given excellent advice for trainees thinking about taking time out to conduct research. Many geriatrics trainees however, will not take time out. Few trainees would claim to feel confident in research and fewer still would describe themselves as “academics”.

Going fishing
They say that if you are to become hooked on fishing, you should catch a fish the first time you try. I have never caught a fish. I have no enthusiasm for fishing. I did however have a rewarding experience the first time I conducted research and as a consequence, it was easy for me to become hooked. I am engaged in full time research and am currently conducting a Cochrane review.

I began a randomised controlled trial whilst in my second year of training. I developed the idea, sought ethical advice, applied for funding, recruited the patients, analysed the data and eventually wrote the report.

The trial completed on target (although the outcome was not exciting) and enabled me to present the results at national and international conferences. Funding paid for a laptop, as well as staff and laboratory costs. These factors were the reward for what would otherwise have been a thankless task. The sense of having a positive outcome (despite a “negative” study) is what has driven me to seek further opportunities for research.

Props behind the scenes
While I would love to take all the credit for these achievements they were dependent on a series of critical factors. Firstly, I had encouragement from a number of senior staff who provided administrative, clinical and research support and enthusiasm. They were on hand for advice and could find the appropriate person to offer counsel if unable to do so themselves. They also required of me a certain degree of accountability to maintain the project momentum. Secondly, I was able to attend excellent teaching courses on research methodology, which prevented me making mistakes early on in the design and development of the project. Finally, I was encouraged to seek funding where I did not think it achievable for what was a modest project. In retrospect it would have been extremely difficult to succeed without it. For this reason, like getting hooked on fishing, I am convinced that in order to attract more trainees into research, we need to aim to have more trainees succeed first time. How can we achieve this?

A word to trainees
The onus is increasingly on an individual trainee to develop his/her own research portfolio. In general terms, we as trainees need to become better at sharing information about, for example, training courses, and discussing experiences, pitfalls and helpful tips. The learning curve in research is very steep for the naïve, and any help is valuable.

The following suggestions are my (admittedly anecdotal) views on how better to succeed first time:

1. Any trainee needs a good understanding of research methodology. Good courses and books are available on the subject. If you are thinking of starting something, take care to get it right before you go too far.
2. Seek out the right people to help you. It may be that the appropriate person to help with your research lays out-with geriatrics. There is no substitute for good advice, regardless of where it comes from. Choose wisely too. You need to involve people who you think will provide an improved chance of success, whether because of their expertise, enthusiasm or their own successes.
3. Don’t be put off. Setbacks and problems are an inevitable part of the process. Starting out is easy, but you have to be determined if you’re going to get across the finishing line.
4. Set achievable goals. Be pragmatic about your resources.
5. Aim to build reward into your goals; whether it is to present your research at a national or international meeting, or to get it published. There are good reasons that conferences are held in attractive locations!
6. Be prepared to protect your time and resources. Research time is easily lost and never regained.
7. Finally – go for it. Never say “can’t”.

A word to trainers
At the risk of making myself unemployed at a critical time in my career, I would tentatively offer advice to educational supervisors and those responsible for supervising individual trainees.

1. Showing enthusiasm and support is vital – if the ideas you are presented with are patently poor, gentle redirection or focus may be better than cold water!
2. Be supportive in resource terms, whether in protecting research time, or providing study leave.
3. You are not expected to know everything. If you are out of your depth, suggest someone who can help.
4. Have your trainee account for time and energies. Being called to account for their work is not only a helpful motivator, it keeps the trainee focused.

The future of Geriatric Academic Medicine is its current trainees. It is my opinion that we should aim to “build in” first-time success at grass roots level if we are to grow our own researchers and challenge the culture.

Graham Ellis
Glasgow