Clinical academics in the NHS: a cross-section study of research engagement during the monkeypox pandemic

Background Recruitment and retention of clinical academics in the UK is under threat. Acute clinical crises can increase opportunities for clinical research. We aimed to examine research involvement amongst clinicians working in sexual health and HIV medicine during the monkeypox (mpox) pandemic and identify factors associated with differential research engagement. Methods We carried out a cross-sectional study between August and October 2022 using anonymised, self-reported data collected via an online survey disseminated worldwide across multiple specialities. We assessed demographic characteristics, research involvement and outputs, workplace setting, involvement with policy work and public health agencies and media. We examined differences by geographical location comparing the UK, the EU and the US. Results Of a total 139 respondents from the UK, none identified themselves as clinical researchers, compared to 23/210 (11.0%) from the EU and 5/58 (8.6%) from the US. Overall research engagement was lowest in the UK (15.1% vs. EU 36.7% and US 37.9%). In the UK, research activity was greater amongst consultants (19.5% vs. 18.8% doctors-in-training and 4.9% nurses), those aged 35-50 years (19.7% vs. 15.4% <35 and 8.5% >50 years), males (34.3% vs. 7.1% females and 33.3% non-binary), and those who self-identified as White (15.6% vs.13.3% all other). In research-active individuals, measurable research achievements by journal publications or submissions and obtainment of grant funding were significantly higher in older, male, White, consultants. Less disparity across demographic characteristic groups were seen in both the EU and the US compared to the UK reflecting more diversity amongst research-active clinicians in overall research activity. Markers of research achievement were closer to parity in representation across gender and ethnicity, particularly for the EU. Conclusions Adherence to and evaluation of existing UK-based recommendations to improve the clinical academic pipeline are needed to increase research engagement and diversity to safeguard UK clinical research in future. ### Competing Interest Statement YW, MS, RP, and SP declare no conflict of interest. CO has no COI related to mpox. She is a recipient of honoraria and research grants from GILEAD, ViiV, GSK, MSD, Janssen, AstraZeneca; National roles include BHIVA Chair (2016-2019), MWF President (2021-2023), Co-Chair of HIV Glasgow International AIDS conference (2022-); International role(s) include member of International AIDS Society governing council (2019-). VA has received speaker fees from ViiV, MSD, and GILEAD. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from the Queen Mary University of London Ethics of Research Committee (QMERC22.297, 27/09/2022). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript.