We appreciate that Goel and Goel highlighted one of the main points of our article [1]: academic clinicians who take time or interest in medical education research and teaching are not receiving enough reward and recognition. Institutions usually place higher merit on research and publications in other areas.

To answer the question about any existing reward systems in the field of medicine: in the UK, clinicians who take the highly competitive academic career path are rewarded with protected time for teaching and research, but no extra monetary incentive [2]. Some centres will offer academic posts with specific focus on medical education. However, in most cases, the protected time is mostly shared between clinical activities, teaching and research activities. These academic posts are also very competitive (roughly 5% of newly qualified UK doctors will occupy these posts) [3]. Therefore, the incentive to teach (apart from personal interest) is usually to further support a portfolio to progress into an academic career.

In the UK, there are dedicated ‘teaching hospitals’ – a hospital that provides medical education and training to future and existing healthcare professionals, alongside patient care. These hospitals receive extra funding from their affiliated medical school (through taxpayer contribution), but individual academics of the teaching hospitals do not receive any extra financial reward. Some teaching hospitals and medical schools have student nominated teacher award schemes, where exceptional teaching activity is recognised [4]. However, this is not universally applied.

Our recommendations for objective and universally recognised reward systems for teaching excellence:

  • Protected time: 
    although academic clinicians receive protected time, this is usually not specifically allocated to teaching activity. It may be helpful to evenly distribute time for both teaching and research with equal recognition for both.
  • Monetary incentive: 
    For teaching hospitals that receive extra funding (from either the public or private sector), some of this financial contribution for teaching should reach the individual academics who actually provide the teaching and research.
  • Incentive for career progression: 
    Teaching excellence should receive equal weighting to research with regards to career progression (both academic and non-academic). An ideal system would be to outline a separate and objective points-based criteria specifically for teaching in job applications, but this may be difficult and resource consuming.
  • Funding for teaching fellowships or teacher training courses: 
    Institutions should fund attendance to training courses or run their own courses by academics who have gained background to educational theory. Academics should be encouraged to take teaching fellowships.
  • More teaching based academic posts: 
    Academic posts with increased or sole focus on medical education should be created.


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