Sir, I read the call-to-arms of Professors Kay and O'Brien (BDJ 2006; 200: 73) with interest and hope that many fresh faced academic recruits answer it. What with 'time', 'support' and 'secretaries and administrators to help you do your job', life must indeed be rosy in Manchester! I agree there is 'immense value and joy' in an academic career, so why are clinical academics bailing out? Here are some possible reasons:

Service, research and teaching are not just 'competing pressures', they are each potentially full-time occupations in their own right. Yes, there are a few very talented individuals who are able to excel equally at all three, but even the brightest do not achieve it in a 40 hour week. Yet this is all the universities are prepared to pay for. The NHS will offer the same, and often better, for just the service component.

'To pursue and research the things about your profession which most interested you'? Well, let's hope so, but the new recruit will find him/herself allocated to a research group contrived for the purposes of the Research Assessment Exercise (RAE) and may have little freedom in choosing a research topic. The RAE should be an opportunity for the universities to showcase their achievements. However, the financial goalposts are not set until after the returns have been made, and so dental schools are obliged to devote precious manpower and time resources to working out how best to 'play' the system in order to achieve a high rating.

The list of RAE assessors for dentistry is, not surprisingly, comprised of academics pooled almost exclusively from dental schools. Why, then, allow academics from elsewhere within the university, usually the adjacent medical school, to co-ordinate a dental school's RAE return? These individuals know little, if anything, of the demands of dental academia, may have minimal clinical and teaching commitments themselves, and perceive that research not published in mainstream science and medical journals is of poor quality. Actually, in 2004 the impact factors of 14 dental journals were higher than 1.5, and in seven it was 2.0 or above.1

As a clinical academic I am obliged to produce four papers that are deemed to be of adequate quality for the RAE. Not an unduly burdensome load, if protected time for research has been provided. In my NHS post I elect to do research if I wish, am spared the patronising, pre-RAE interview with the co-ordinator with no knowledge of my field, and improve my chances of a Clinical Excellence Award!

Excellence in teaching, as in research, is supposedly recognised as a means to promotion, but is this really the case? While not wishing to encourage these paper chases, the first, and so far the last, assessment of teaching quality was carried out in 1999. The 2008 RAE will be the sixth.

Some suggestions, therefore, none of which will ever happen:

  • With the recent announcements of new undergraduate places, the Government has recognised the nation's dental schools are a valuable resource and, as Kay and O'Brien point out, dental academics have the 'considerable political muscle' of 474 established posts. Therefore, establish dental schools as separate faculties, rather than annexes of medical schools;

  • Refuse to co-operate with the RAE until the funding consequences are known;

  • Failing that, ensure that preparation for the RAE is conducted by someone at least vaguely acquainted with the realities of dental academia;

  • Ensure high productivity (in either teaching, research, service or a combination thereof) is accurately reflected in pay and conditions, not only for clinical academics, but also for non-clinical and preclinical scientific staff.