Reviving academic psychiatry in Australia and New Zealand

Abstract

Australian & New Zealand Journal of Psychiatry, 56(5) Fostering the next generation of academic psychiatrists is crucial to maintaining our leading role in providing evidence-based care for the patients we serve. Embedding academic psychiatry into clinical services ensures the development of cutting edge clinical evidence and rapid translation into clinical practice, thus improving clinical outcomes (Burke et al., 2018). There is much to be loved about a career in academic psychiatry: self-determinism in terms of time and following interests; opportunities to teach and mentor; being able to influence policy and practice; connecting and collaborating with colleagues; asking difficult questions and sometimes finding answers; and long-term job satisfaction. It is often said that clinicians burn out but academics never retire – this may in turn improve recruitment and retention, especially in the public mental health sector. Despite these benefits, fewer psychiatrists are taking this career pathway, and those that do face significant challenges. Husain (2021) has argued that there is a genuine existential threat to clinical scientists who are ‘under pressure either to voluntarily seek extinction or to evolve into a set of desktop scientists who don’t run experimental studies but rather analyse big data’. Husain worried that such a shift away from experimental studies would have significant deleterious consequences for discovery science (Husain, 2021). In the United States, while the current COVID-19 pandemic has highlighted the critical importance of clinical scientists, it has also brought the decline of this workforce due to constraints on reimbursement, time and funding into stark relief – the percentage of physicians engaged in research has declined from 4.75% in the 1980s to 1.5% today (Utz et al., 2022). In New Zealand and Australia, we do not have far to look for inspiration in academic psychiatry. John Cade was a psychiatrist who discovered lithium in a kitchen at Bundoora Repatriation Mental Hospital in Melbourne. Mason Durie is a leader of Māori health and research world-renowned for the promotion of Indigenous knowledge. Beverley Raphael’s mentorship inspired a generation of academic psychiatrists, demonstrating the importance of creating a stimulating and supportive environment to help grow a culture of lifelong learning. So how can we build and grow the next generation of clinical academics? Utz et al. (2022) proposed the multipronged strategy of: (1) providing an immersive research experience for medical trainees (e.g. funding for a gap year in research laboratory), (2) lowering financial barriers to academic careers, (3) restoring the educators and mentors in clinical science and (4) building a leak-free physician-scientist network. These approaches are in keeping with the call by Scott Henderson et al. (2015) from Australia and Richard Porter from New Zealand, along with 19 other senior academic psychiatrists across Australasia, for urgent actions to be taken. They suggested (1) the creation of adequately remunerated academic psychiatry pathways, (2) improved recruitment into psychiatry and increased opportunities to engage Reviving academic psychiatry in Australia and New Zealand