title: More students, less capacity? An assessment of the competing demands on academic medical staff.
abstract: BACKGROUND
  Medical student numbers in England have increased by more than 60% over the last decade. The capacity of universities and the National Health Service (NHS) to deliver education and training to these expanded cohorts is not clear.
  
  
  METHODS
  We carried out an interview study in three English medical schools, involving 60 academic, administrative, clinical and managerial staff, sampled across disciplines.
  
  
  RESULTS
  Given the expansion in medical student numbers, capacity in medical schools must increase. This requirement has become even more immediate in light of the shift towards more resource-intensive curricula. However, the aims of the Research Assessment Exercise and NHS policies are at odds with attempts to build teaching capacity. Although monies have been made available to recruit new staff and to backfill clinical time spent teaching, the success of these strategies is questioned by interviewees. Other initiatives, such as the new consultant contract and educational quality assurance processes, have the potential to promote the importance of teaching but are presently perceived as being inadequate so to do. As was consistently expressed by interviewees, within the competing triad of research, service delivery and teaching, the latter is perceived as taking a poor third place.
  
  
  CONCLUSIONS
  That research, service delivery and education are in competition will come as no surprise to UK academic staff. However, our results show a striking uniformity of opinion. We would question whether existing NHS and higher education policies enable medical schools and health care organisations to deliver education of the highest quality to the enlarged student population.
authors.affiliation: Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK. j.m.parry.1@bham.ac.uk
authors.forename: Jayne
authors.initials: J
authors.lastname: Parry
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mathers
authors.forename: Hywel
authors.initials: H
authors.lastname: Thomas
authors.forename: Richard
authors.initials: R
authors.lastname: Lilford
authors.forename: Andrew
authors.initials: A
authors.lastname: Stevens
authors.forename: Peter
authors.initials: P
authors.lastname: Spurgeon
mesh_terms: D001291:Attitude of Health Personnel; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004739:England; D006291:Health Policy; D006801:Humans; D008503:Medical Staff / Q000523:psychology*; D011785:Quality Assurance, Health Care; D012106:Research; D012577:Schools, Medical / Q000706:statistics & numerical data*; D013337:Students, Medical / Q000706:statistics & numerical data*; D016526:Workload