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Editor,—The message of your contributor(s) concerning prospects for clinical research in paediatrics was disturbing.1 Two aspects cause me concern.
First, that the author(s) requested anonymity. Was this through reticence or self effacement? There seemed little in the article to cause offence. If the author(s) thought that they or their departments might be censured by their universities or grant giving bodies, this would be a serious enough matter to be taken up by national academic and representative bodies. Academic paediatricians need visible, resolute leadership and the unequivocal support of non-university paediatricians.
Second, your contributors offered no proposals to deal with the threat. It will not recede spontaneously and neither academic medicine nor clinical practice is immune from the laws of natural selection—adapt or perish. Those who lead our specialty and promote its academic underpinnings should be making plans individually and collectively (including other specialties) to meet and overcome the threat. These include your contributors, presumably, and our newly elected college Vice President who has declared his commitment to promoting paediatric research.
One tactic would be to expect that all trainees in paediatrics should undertake a period of research—not a series of audit projects. Some European countries specify that a number of papers in peer reviewed journals is required for the final certification process. The arguments for promoting research in the training of NHS consultants were set out by the President of the Royal College of Physicians a few years ago.2 Practising evidence-based medicine without knowing how the evidence is assembled is as absurd as managing asthma without knowledge of respiratory physiology.
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