- Email: [email protected]
UK's Research Assessment Exercise
UK’s Research Assessment Exercise The Council of Heads of Medical Schools (CHMS) is responding to the Comment by Jangu Banatvala and colleagues on the UK’s Research Assessment Exercise (RAE, Feb 5, p 458).1 The Council supports the principles of the RAE and believes that it has served to sharpen the focus of research. The 2008 RAE has embraced the need to assess and value work of an applied nature, and the Council will be providing input to the RAE team on the criteria for assessment. UK medical research is internationally viewed as second only to that of the USA in terms of quality, and it is important that the next RAE reflects this. The previous Exercise put medicine in 35th place in the discipline rankings. We believe that it is primarily the underfunding of teaching and research across the university sector that has compromised clinical academic medicine. Medical schools pride themselves on the innovations made in teaching and learning over the past decade, and value the quality of their undergraduate programmes as well as their RAE ratings. CHMS strongly believes that medical students should be exposed to both high quality academics and clinicians throughout their training. The allegations by Banatvala and colleagues that tuition in medical schools is inadequate and that schools are recruiting research stars at the expense of teaching quality are unfair and untrue. The role of clinical academics in teaching, research, and patient care is rightly valued by the UK’s medical schools, which recognise that the nation needs top quality academic clinicians in all disciplines. Contrary to the allegations made by Banatvala and colleagues, professors in all branches of medicine are important to medical schools. Schools are confident that quality research is undertaken in the craft specialties and www.thelancet.com Vol 365 March 19, 2005
are concerned that craft specialists seem to underperform in the RAE, relative to the generality of clinical academics. Recent initiatives focusing on clinical research, for example through the UK Clinical Research Collaboration, will help to address this. Additionally, grouping research purely by clinical specialty is no longer entirely appropriate. Individual disciplines benefit from taking a multidisciplinary research perspective as is becoming the norm. It should be recognised that without strong academic leadership in all specialties, teaching and research will suffer in the medium and long term. Medical schools value their role within the wider universities, and CHMS argues strongly that this is where medical education should remain. It would be extremely destabilising to see medical education moved to “universities of the health sciences” and such a move would damage the UK’s reputation for high quality medical education and research. I declare that I have no conflict of interest.
David Gordon [email protected] Council of Heads of Medical Schools, Woburn House, 20 Tavistock Square, London WC1H 9HD, UK 1
Banatvala J, Bell P, Symonds M. The Research Assessment Exercise is bad for UK medicine. Lancet 2005; 365: 458–60.
Jangu Banatvala and colleagues1 seem to imply that the decline in academic medicine is a direct result of the Research Assessment Exercise (RAE). This is an over-simplification of a complex problem, as outlined in the report on academic medicine from the Academy of Medical Sciences in June, 2002.2 This report recommended a number of initiatives, some of which have been implemented and have begun to take effect. It is true that the RAE has not been ideal for medical schools, particularly those with large multidisciplinary and applied research programmes, but RAE 2008 should address some of
these shortcomings. What cannot be denied is that the RAE has forced medical schools to develop long-term sustainable research strategies, which build on their relative strengths. In Leeds, this has resulted in the development of three new multidisciplinary research institutes, each having critical mass and supported by significant investment in buildings, equipment, and people. These institutes bring together clinicians and scientists in productive and equal partnerships to answer challenging scientific questions. They also provide a conduit for translational research, which has been recognised by successful bids for the National Cancer Research Network and the UK Clinical Research Network (in collaboration with University College London). Of course we seek to recruit research stars, but only within agreed corporate priorities and not at the expense of highquality teaching, which we view as a high academic pursuit. Banatvala and colleagues imply that obstetrics and paediatric research is not supported in Leeds. This is not true, since paediatric research, particularly genetics, is extremely strong in Leeds and is incorporated into one of these research institutes, along with obstetrics research. In fact, our recent experience demonstrates that clinical academics thrive successfully when located and supported in a researchintensive environment. Banatvala and colleagues also pay scant acknowledgment to the major changes that medical schools have made to their curricula in response to the challenge of Tomorrow’s Doctors.3 These include initiatives for widening access, graduate entry, and innovative approaches in educational research. The major solution to dealing with the threat to academic medicine is to forge stronger partnerships with our partner institutions and there are many successful examples of this throughout the UK. Leeds is pushing forward new models of clinical academic collabora-
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
e-mail submissions to [email protected]
1025
Photolibrary.com/Kindra Clineff
Correspondence
Correspondence
tion with the concept of Clinical Academic Centres, in which the tripartite mission of teaching, research, and high-class clinical practice is carried out by specialty teams, each of which may provide different proportions of activity. This is supported by the consultant contract, which sits across one of the most complex groups of organisations in our society, where the commitment is clearly defined for each individual. In this way, the research and teaching time of individuals is protected both for clinical academics and National Health Service consultants.
*E W Hillhouse, P N Noble [email protected] Faculty of Medicine and Health, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK 1
2
Science Photo Library
3
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
1026
Banatvala J, Bell P, Symonds M. The Research Assessment Exercise is bad for UK medicine. Lancet 2005; 365: 458–60. Academy of Medical Sciences. Clinical academic medicine in jeopardy: recommendations for change. London: Academy of Medical Sciences, 2002. http://www.acmedsci.ac.uk/p_clinacad.pdf (accessed Mar 8, 2005). General Medical Council. Tomorrow’s doctors: recommendations on undergraduate medical education. London: General Medical Council, 2003. http://www.gmc-uk.org/med_ed/tom doc.htm (accessed Mar 8, 2005).
p53 tumour suppressor gene and the tobacco industry As the current Editor-in-Chief of the journal Mutagenesis, and as the Honorary Secretary of the United Kingdom Environmental Mutagen Society (UKEMS), co-owner with Oxford University Press (OUP) of the journal, we would like to respond to the Public Health article by Asaf Bitton and colleagues (Feb 5, p 531)1 and to place the described events of 2001 in proper context, which we feel the article failed to do. The article gives the erroneous impression that manuscripts deemed supportive of the tobacco industry have been favoured by Mutagenesis
over those that are critical. Mutagenesis has always adopted an objective peer-review process based on scientific merit. That the journal published the response by Hainaut, Olivier, and Pfiefer2 to Paschke’s article3 is clear evidence for this. Other Mutagenesis papers and commentaries have also supported the hypothesis that p53 mutations in smokers’ lungs are the result of tobacco-carcinogen-induced DNA damage.4,5 Publication of papers supporting or contradicting this or other hypotheses is entirely consistent with the Mutagenesis policy of encouraging open scientific debate. We would also like to make clear that James Parry had announced his intention to retire as Executive Editor in 2001 some 3 years earlier. There is thus no connection between the events described in The Lancet and his stepping down as Editor in that year. He completed a 3-year term on the Editorial Board in 2004. Pierre Hainaut has been a member of the Editorial Board since 2003. When the manuscripts referred to by Bitton and colleagues were published, there were no requirements for registering conflicts of interest. Mutagenesis, together with most other journals, relied on individuals’ integrity to ensure that manuscripts received fair and unbiased treatment. We wish to emphasise that Mutagenesis now makes all possible attempts to ensure transparency at all stages of peer review and publication of scientific articles. Authors are required to declare conflicts of interest at time of submission, and to sign declarations when papers have been accepted. The Editors have signed declarations that they will not handle papers where they may have a conflict of interest. Reviewers (including members of the Editorial Board) are required to declare any interest that might be perceived as causing bias before undertaking the review of a manuscript; if necessary the Editors will then assign another
reviewer. These procedures are more stringent than those currently operated by many other scientific journals. It is to be regretted that neither The Lancet nor Bitton and colleagues contacted UKEMS or the past or present editorship of Mutagenesis to give us the opportunity to correct these misimpressions before publication of the article. We declare that we have no conflict of interest.
*David H Phillips, Peter Jenkinson [email protected] Mutagenesis, Institute of Cancer Research, Brookes Lawley Building, Cotswold Road, Sutton SM2 5NG, UK (DHP); United Kingdom Environmental Mutagen Society (UKEMS), SafePharm Laboratories Ltd, Derby, UK (PJ) 1
2
3
4
5
Bitton A, Neuman MD, Barnoya J, Glanz SA. The p53 tumour suppressor gene and the tobacco industry: research, debate, and conflict of interest. Lancet 2005; 365: 531–40. Hainaut P, Olivier M, Pfiefer GP. TP53 mutation spectrum in lung cancers and mutagenic signature of components of tobacco smoke: lessons from the IARC TP53 mutation database. Mutagenesis 2001; 16: 551–53. Paschke T. Analysis of different versions of the IARC p53 database with respect to G-T transversion mutation frequencies and mutation hotspots in lung cancer of smokers and non-smokers. Mutagenesis 2000; 15: 457–58. Biggs PJ, Warren W, Venitt S, Stratton MR. Does a genotoxic carcinogen contribute to human breast cancer? The value of mutational spectra in unravelling the aetiology of cancer. Mutagenesis 1993; 8: 275–83. Pfiefer GP, Denissenko MF, Tang M. p53 mutations, benzo[a]pyrene and lung cancer: a reply. Mutagenesis 1998; 13: 537–38.
Authors’ reply We did not state that Mutagenesis favoured papers supportive of tobacco industry positions over papers that implicate tobacco smoke constituents as damaging p53. Rather, our paper showed that the then-editor of Mutagenesis had undisclosed ties with the tobacco industry when he published papers whose authors also had undisclosed ties with the tobacco industry without mention of these potential conflicts, and the fact that the editor www.thelancet.com Vol 365 March 19, 2005
are concerned that craft specialists seem to underperform in the RAE, relative to the generality of clinical academics. Recent initiatives focusing on clinical research, for example through the UK Clinical Research Collaboration, will help to address this. Additionally, grouping research purely by clinical specialty is no longer entirely appropriate. Individual disciplines benefit from taking a multidisciplinary research perspective as is becoming the norm. It should be recognised that without strong academic leadership in all specialties, teaching and research will suffer in the medium and long term. Medical schools value their role within the wider universities, and CHMS argues strongly that this is where medical education should remain. It would be extremely destabilising to see medical education moved to “universities of the health sciences” and such a move would damage the UK’s reputation for high quality medical education and research. I declare that I have no conflict of interest.
David Gordon [email protected] Council of Heads of Medical Schools, Woburn House, 20 Tavistock Square, London WC1H 9HD, UK 1
Banatvala J, Bell P, Symonds M. The Research Assessment Exercise is bad for UK medicine. Lancet 2005; 365: 458–60.
Jangu Banatvala and colleagues1 seem to imply that the decline in academic medicine is a direct result of the Research Assessment Exercise (RAE). This is an over-simplification of a complex problem, as outlined in the report on academic medicine from the Academy of Medical Sciences in June, 2002.2 This report recommended a number of initiatives, some of which have been implemented and have begun to take effect. It is true that the RAE has not been ideal for medical schools, particularly those with large multidisciplinary and applied research programmes, but RAE 2008 should address some of
these shortcomings. What cannot be denied is that the RAE has forced medical schools to develop long-term sustainable research strategies, which build on their relative strengths. In Leeds, this has resulted in the development of three new multidisciplinary research institutes, each having critical mass and supported by significant investment in buildings, equipment, and people. These institutes bring together clinicians and scientists in productive and equal partnerships to answer challenging scientific questions. They also provide a conduit for translational research, which has been recognised by successful bids for the National Cancer Research Network and the UK Clinical Research Network (in collaboration with University College London). Of course we seek to recruit research stars, but only within agreed corporate priorities and not at the expense of highquality teaching, which we view as a high academic pursuit. Banatvala and colleagues imply that obstetrics and paediatric research is not supported in Leeds. This is not true, since paediatric research, particularly genetics, is extremely strong in Leeds and is incorporated into one of these research institutes, along with obstetrics research. In fact, our recent experience demonstrates that clinical academics thrive successfully when located and supported in a researchintensive environment. Banatvala and colleagues also pay scant acknowledgment to the major changes that medical schools have made to their curricula in response to the challenge of Tomorrow’s Doctors.3 These include initiatives for widening access, graduate entry, and innovative approaches in educational research. The major solution to dealing with the threat to academic medicine is to forge stronger partnerships with our partner institutions and there are many successful examples of this throughout the UK. Leeds is pushing forward new models of clinical academic collabora-
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
e-mail submissions to [email protected]
1025
Photolibrary.com/Kindra Clineff
Correspondence
Correspondence
tion with the concept of Clinical Academic Centres, in which the tripartite mission of teaching, research, and high-class clinical practice is carried out by specialty teams, each of which may provide different proportions of activity. This is supported by the consultant contract, which sits across one of the most complex groups of organisations in our society, where the commitment is clearly defined for each individual. In this way, the research and teaching time of individuals is protected both for clinical academics and National Health Service consultants.
*E W Hillhouse, P N Noble [email protected] Faculty of Medicine and Health, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK 1
2
Science Photo Library
3
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
1026
Banatvala J, Bell P, Symonds M. The Research Assessment Exercise is bad for UK medicine. Lancet 2005; 365: 458–60. Academy of Medical Sciences. Clinical academic medicine in jeopardy: recommendations for change. London: Academy of Medical Sciences, 2002. http://www.acmedsci.ac.uk/p_clinacad.pdf (accessed Mar 8, 2005). General Medical Council. Tomorrow’s doctors: recommendations on undergraduate medical education. London: General Medical Council, 2003. http://www.gmc-uk.org/med_ed/tom doc.htm (accessed Mar 8, 2005).
p53 tumour suppressor gene and the tobacco industry As the current Editor-in-Chief of the journal Mutagenesis, and as the Honorary Secretary of the United Kingdom Environmental Mutagen Society (UKEMS), co-owner with Oxford University Press (OUP) of the journal, we would like to respond to the Public Health article by Asaf Bitton and colleagues (Feb 5, p 531)1 and to place the described events of 2001 in proper context, which we feel the article failed to do. The article gives the erroneous impression that manuscripts deemed supportive of the tobacco industry have been favoured by Mutagenesis
over those that are critical. Mutagenesis has always adopted an objective peer-review process based on scientific merit. That the journal published the response by Hainaut, Olivier, and Pfiefer2 to Paschke’s article3 is clear evidence for this. Other Mutagenesis papers and commentaries have also supported the hypothesis that p53 mutations in smokers’ lungs are the result of tobacco-carcinogen-induced DNA damage.4,5 Publication of papers supporting or contradicting this or other hypotheses is entirely consistent with the Mutagenesis policy of encouraging open scientific debate. We would also like to make clear that James Parry had announced his intention to retire as Executive Editor in 2001 some 3 years earlier. There is thus no connection between the events described in The Lancet and his stepping down as Editor in that year. He completed a 3-year term on the Editorial Board in 2004. Pierre Hainaut has been a member of the Editorial Board since 2003. When the manuscripts referred to by Bitton and colleagues were published, there were no requirements for registering conflicts of interest. Mutagenesis, together with most other journals, relied on individuals’ integrity to ensure that manuscripts received fair and unbiased treatment. We wish to emphasise that Mutagenesis now makes all possible attempts to ensure transparency at all stages of peer review and publication of scientific articles. Authors are required to declare conflicts of interest at time of submission, and to sign declarations when papers have been accepted. The Editors have signed declarations that they will not handle papers where they may have a conflict of interest. Reviewers (including members of the Editorial Board) are required to declare any interest that might be perceived as causing bias before undertaking the review of a manuscript; if necessary the Editors will then assign another
reviewer. These procedures are more stringent than those currently operated by many other scientific journals. It is to be regretted that neither The Lancet nor Bitton and colleagues contacted UKEMS or the past or present editorship of Mutagenesis to give us the opportunity to correct these misimpressions before publication of the article. We declare that we have no conflict of interest.
*David H Phillips, Peter Jenkinson [email protected] Mutagenesis, Institute of Cancer Research, Brookes Lawley Building, Cotswold Road, Sutton SM2 5NG, UK (DHP); United Kingdom Environmental Mutagen Society (UKEMS), SafePharm Laboratories Ltd, Derby, UK (PJ) 1
2
3
4
5
Bitton A, Neuman MD, Barnoya J, Glanz SA. The p53 tumour suppressor gene and the tobacco industry: research, debate, and conflict of interest. Lancet 2005; 365: 531–40. Hainaut P, Olivier M, Pfiefer GP. TP53 mutation spectrum in lung cancers and mutagenic signature of components of tobacco smoke: lessons from the IARC TP53 mutation database. Mutagenesis 2001; 16: 551–53. Paschke T. Analysis of different versions of the IARC p53 database with respect to G-T transversion mutation frequencies and mutation hotspots in lung cancer of smokers and non-smokers. Mutagenesis 2000; 15: 457–58. Biggs PJ, Warren W, Venitt S, Stratton MR. Does a genotoxic carcinogen contribute to human breast cancer? The value of mutational spectra in unravelling the aetiology of cancer. Mutagenesis 1993; 8: 275–83. Pfiefer GP, Denissenko MF, Tang M. p53 mutations, benzo[a]pyrene and lung cancer: a reply. Mutagenesis 1998; 13: 537–38.
Authors’ reply We did not state that Mutagenesis favoured papers supportive of tobacco industry positions over papers that implicate tobacco smoke constituents as damaging p53. Rather, our paper showed that the then-editor of Mutagenesis had undisclosed ties with the tobacco industry when he published papers whose authors also had undisclosed ties with the tobacco industry without mention of these potential conflicts, and the fact that the editor www.thelancet.com Vol 365 March 19, 2005