Clinical research pathways project

The Working Group was jointly nominated by all partner academies. 

Evidence-gathering activities for this project will include a series of high-level, in-person workshops in Africa, Asia, and Latin America to identify region specific challenges and opportunities around clinical research pathways. Findings could then inform future action in each region and globally. The workshops aim to: 

• Bring together evidence across regions on the current ‘state of play’ for clinical research career pathways in institutions. 

• Identify case studies across the globe of tools that have successfully built institutional capacity to strengthen locally embedded and sustainable career pathways.  

• Generate new evidence and analysis to fill the gaps in policy and research. 

In 2017, the Academy of Medical Sciences and the InterAcademy Partnership for Health hosted an international workshop exploring clinical research capacity in low- and middle-countries (LMICs).  

The workshop identified improving career pathways for clinical researchers in LMICs as a key opportunity to strengthen clinical research capacity. Participants also outlined the following key opportunities and strategies to complement the strengthening of career pathways: 

• Improved clinical research mentoring opportunities, both institutionally and individually. 

• Academy networks that can offer learning and support opportunities. 

• Support for LMICs to define their own clinical research agendas. 

• Strengthened national and regional networks.  

• Increased health research funding from national governments as well as from international donors. 

• Advocacy and research diplomacy to demonstrate the impact of clinical research. 

Within the UK, the Academy has published several reports as part of its work on UK biomedical and health career pathways. This includes its Transforming health through innovation: Integrating the NHS and Academia report, and its Future-proofing UK Health Research: a people-centred, coordinated approach report, which identified several solutions to address challenges faced by the clinical academic workforce. 

The project, which will take the form of a working group project, will aim to: 

1.1 Understand the career pipeline for clinical researchers across low- and middle-income countries, including the barriers and facilitators to develop clinical research in LMIC and how this affects the career pipeline for clinical researchers. 

2.1 Promote global and regional knowledge sharing of best practices in building and strengthening locally embedded and sustainable clinical research career pathways. 

3.1 Synthesise existing evidence to identify mechanisms at the institutional and environmental level of the research ecosystem to build, support, and strengthen locally embedded career pathways.  

4.1 Generate new evidence and analysis to target barriers, unmet needs and gaps in policy and research to build the evidence base. 

5.1 Develop specific and targeted recommendations about effective policy interventions that will strengthen the clinical research career pathway within LMICs. This will include identifying key entry points in the career pathway to support the implementation of targeted interventions/programmes to promote the retention of talented researchers. 

Within Scope 

The project will: 

2.1 Take a global approach, working across world regions to identify international case studies and generate evidence to foster knowledge sharing and learnings. This will generate recommendations for an international audience.  

3.1 Explore clinical research in its broadest sense, acknowledging that in many contexts clinical research includes public health and wider health research. The project should also acknowledge the importance of One Health in relation to clinical research.  

4.1 Consider varied stages of the career pathway for researchers with a PhD or equivalent, who play an active and leading role in the research process (e.g. PI, sub-investigator) including early, mid, and late career researchers with high research literacy. This includes a wide range of health professionals such as doctors, nurses, midwives, and pharmacists. 

5.1 Consider institutions beyond academic universities, including healthcare settings and research centres.  

6.1 Ensure an equity lens is applied to evidence generation, evidence synthesis, and any recommendations, taking into consideration underrepresented and minority groups.  

7.1 Explore the challenges and opportunities impacting clinical research pathways at the institutional and environmental levels of the clinical research ecosystem. This includes exploring regulatory processes, policies and advocacy for local funding for research within the projects evidence gathering activities.  

8.1 Focus on the clinical research career pathway for broader healthcare professionals, rather than primarily medical doctors. Although the exact scope of this is to be decided.  

Out of Scope 

1.1 To limit the scope, the project will not explore the clinical research career pathway for the broader scientific workforce (e.g. laboratory technicians, data analysts etc.). 

2.1 The project will not explore the individual level of the research ecosystem (including fellowships etc) as this is covered extensively already in wider literature.  

3.1 The project will not explore the school and undergraduate level of the pathway to narrow the scope.  

4.1 The project will not be designing or delivering any research capacity strengthening programmes or interventions, due to its nature as a policy project. 

Take our clinical research pathways evidence survey

Form deadline: 4 October 2024

Strengthening the career pathway for clinical researchers is a crucial building block of broader Research Capacity Strengthening (RCS) efforts in Low- and Middle-Income countries (LMICs). RCS typically targets the three interconnected levels of research systems, all of which play a crucial role in strengthening clinical research career pathways: 

• The Individual level – training of researchers, scholars, and research support staff mostly through PhD studentships, fellowships, and research management training. 

• The Institutional level – the physical environment and organisational capacity available to researchers, including facilities and resources, staff levels and skills, and research culture. 

• The National/International or environment/societal level – the policy and regulatory context as well as the research uptake systems institutions and researchers are a part of. 

Global efforts to target the individual level of the research system to equip LMIC researchers with the skills and training needed to advance their career development is well addressed and documented. This includes many developments and successes emerging from international fellowships, PhD studentships, and the knowledge-sharing built from this. However, there is a need to ensure that strengthening the individual level happens in tandem with strengthening the institutional and (inter)national/environment level to strengthen career pathways, and wider RCS. 

Project scoping activities, including stakeholder discussions and a roundtable, outlined that without strong and supportive institutions, the career pathways available to researchers simply cannot be improved and strengthened. This has important implications for the sustainability of career pathways and the ability for them to remain locally embedded. Currently, in many instances, broader institutional capacity challenges mean that many academics with ‘research’ in their job description have very little protected research time amidst high teaching and administrative loadsvii. This leaves many academic career tracks in LMICs limited to teaching, and many clinicians for example, often lacked a route to allow them to be part-time researchers within a university setting. In addition, in some sub-Saharan African contexts, researchers expressed the institutional environment becomes complex and competitive, making progression and advancement challenging.  

Therefore, the Academy of Medical Sciences, in partnership with a global cohort of national Academies, is undertaking a project to examine these challenges in LMICs across Africa, Asia, and Latin America. We have established a Working Group, which aims to: 

1. Understand the career pipeline for clinical researchers across low- and middle-income countries, including the barriers and facilitators to develop clinical research in LMIC and how this affects the career pipeline for clinical researchers.
2. Promote global and regional knowledge sharing of best practices in building and strengthening locally embedded and sustainable clinical research career pathways.
3. Synthesise existing evidence to identify mechanisms at the institutional and environmental level of the research ecosystem to build, support, and strengthen locally embedded career pathways.
4. Generate new evidence and analysis to target unmet needs and gaps in policy and research to build the evidence base.
5. Develop specific and targeted recommendations about effective policy interventions that  will strengthen the clinical research career pathway within LMICs. This will include identifying key entry points in the career pathway to support the implementation of targeted interventions/programmes to promote the retention of talented researchers. 

The major focus of this project is on institutional capacity, more specifically, how institutions can support and strengthen sustainable and locally embedded career pathways for clinical research. The scope of the project is to explore this in relation to clinical researchers with a PhD or equivalent, and actively involved in the research process (e.g. sub investigator, PI (principal investigator)) including nurses, doctors, midwives, and pharmacists. The scope of this projects also notes that in many contexts’ public health and wider health research is often included within the definition of clinical research.  

In the instance of this project, an ‘institution’ is defined more broadly than a solely an academic institution. This could also include research centres and all medical and care settings (e.g. hospitals, clinics, etc).  

After the conclusion of the project, it is planned that a report will be published, which will make recommendations to important UK and International stakeholders. 

In addition to the responses to this call for evidence, the project will be informed by a series of regional evidence gathering workshops in Africa, Asia, and Latin America as well as commissioned research and expert input from the project's Working Group (co-Chaired by Professor Jimmy Whitworth FMedSci and Dr Patty J. Garcia). Please note that you do not need to address all the questions listed in the form unless you wish to do so – we welcome your input to any of the questions you feel are relevant to your expertise or experience. 

Please also note that selected excerpts from responses to this call may be included in publications arising from the workstream. You can notify us at the time of submission if you do not wish your name or input to be published. We are also happy to receive anonymous submissions.