Clinical research in the NHS: a cross-sectional 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 among 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 specialties. 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, European Union (EU) and the USA. Results Of 139 total respondents from the UK, none identified themselves as clinical researchers, compared with 23/210 (11.0%) from the EU and 5/58 (8.6%) from the USA. Overall research engagement was lowest in the UK (15.1% vs EU 36.7% and USA 37.9%). In the UK, research activity was greater among consultant physicians (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, consultant physicians. Less disparity across demographic characteristic groups were seen in both the EU and the USA compared with the UK reflecting more diversity among research-active clinicians in overall research activity. Markers of research achievement were closer to parity in representation across gender and race 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 future UK clinical research.