The heads of Scotland’s five medical schools have come together to co-author a piece, which can also be found in The Herald, published on Saturday 26 July, highlighting the quiet crisis facing clinical research in Scotland. Professor David Argyle, Vice Principal and Head of College of Medicine and Veterinary, University of Edinburgh, Professor David Blackbourn, Head of the School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Professor Rory McCrimmon, Dean of the School of Medicine, University of Dundee, Professor Iain McInnes CBE, Vice Principal and Head of College, College of Medical, Veterinary & Life Sciences, University of Glasgow and Professor Deborah Williamson, Dean of Medicine and Head of School, University of St Andrews discuss the challenges below.
Scotland is facing a quiet crisis. While our NHS strains under growing pressure, the lifeblood of future healthcare innovation—our clinical academic workforce—is quietly being drained away. If we do not act, we risk weakening the very system that has delivered some of the most transformative advances in modern medicine.
Clinical academics are the engine translating biomedical progress into human healthcare. These are the doctors and healthcare professionals who not only treat patients, but also design clinical trials, test new therapies, and bring the latest scientific discoveries to the bedside. Their impact is measurable: hospitals active in research have lower mortality rates and deliver better patient outcomes. In economic terms, investment in medical research pays dividends—every £1 spent returns around £1.25 annually to the wider economy.
Scotland has long punched above its weight in this field. From pioneering bowel cancer screening programmes using the faecal immunochemical test (FIT), now central to early detection efforts worldwide, to the EAVE-II platform, which was instrumental in understanding vaccine effectiveness during COVID-19, our clinical academics have delivered innovations with national and global impact. Our universities have also played a foundational role in training generations of clinical researchers, including those who went on to become global leaders and Nobel laureates, illustrating the far-reaching potential of sustained investment in this workforce.
And yet, the number of clinically trained researchers in Scotland is declining at an alarming rate. This is especially evident at the crucial mid-career level—senior lecturers and research-active consultants—where we’ve seen a 30% drop over the last decade. These are the future leaders of our health system: those who secure major grants, mentor junior doctors, and help bridge the gap between lab bench and hospital ward. While the NHS workforce as a whole has expanded, its research arm is shrinking—and fast.
The reasons are well known. Scotland currently lacks a dedicated, additional, ring-fenced funding stream to support the training and development of clinical academics. Without structural backing, research becomes optional—an extra task squeezed between clinics and night shifts. And yet, despite these pressures, many young doctors remain determined to pursue research careers—not because the system supports them, but in spite of it.
It is time we did better for them—and for the future of Scottish healthcare.
There is now a clear opportunity to reverse this trend. The Office for Strategic Coordination of Health Research (OSCHR), through a taskforce led by Professor Patrick Chinnery and endorsed by leading national research bodies, has laid out a detailed and practical roadmap. Among its recommendations: the creation of a national clinical academic career framework, expansion of joint NHS–university research posts, and the integration of research pathways into routine NHS workforce planning.
These are achievable goals. What’s needed now is political will and national leadership.
Scotland must adapt and implement these reforms without delay. That means coordinated action from NHS Education Scotland, the Chief Scientist Office, universities, health boards, and government. We also need visible champions—those willing to mentor, invest in, and inspire the next generation of research-active clinicians.
We now face a choice. Do we allow this research capacity to wither, or do we build on it to create a health system that is smarter, faster, and fairer? The answer should be clear.
If Scotland wants to remain a global leader in healthcare innovation, we must support the people who make it possible. At the heart of these discussions must be the public and patients we serve—because their future depends on it.