The NSW cancer clinical research workforce in 2010
For NSW to continue to build on strengths in clinical and translational research, it will be important to continue to encourage new researchers to commence careers in these areas and for clinicians to be supported to engage in research.
In Australia the risk of being diagnosed with cancer before the
age of 85 is one in two for men and one in three for women.1 Cancer is the leading cause of burden
of disease in Australia accounting for 19 per cent of total disease
burden in 2003.2 Research has been,
and will continue to be, crucial to better preventing, detecting
and treating cancer and has been recognised as one of the strategic
cancer control programs of the Cancer Institute NSW since its
inception.
The objectives of the research support strategy of the first
NSW Cancer Plan 2004-20063
were to encourage and develop cancer research and research outcomes
via a number of mechanisms:
- Developing, attracting and retaining outstanding cancer
researchers in NSW.
- Developing and supporting outstanding research teams.
- Encouraging collaboration or co-locations to attain critical
scientific mass and enable significant research findings to be
immediately translated into cancer control policy and
practice.
The second NSW Cancer Plan 2007-20104 aimed to build upon and consolidate these
achievements. It included initiatives aimed at further expanding
and supporting translational and clinical trials research in
NSW.
For NSW to continue to build on strengths
in clinical and translational research, it will be important to
continue to encourage new researchers to commence careers in these
areas and for clinicians to be supported to engage in research.
While the Cancer Institute NSW research support program spans
many disciplines of research, encouraging a strong culture of
clinical research has been recognised as an essential component of
driving the translation of research.
Clinician researchers play a critical role in medical research
by bridging the gap between research and the clinic and are
essential to the generation and transfer of knowledge within
translational research settings. Given their vital contribution to
a high performing health system there is concern regarding the
declining numbers of clinicians conducting research.5
The Cancer Institute NSW research support program aims to
increase NSW's cancer research capacity in general and targeted
schemes have supported and trained clinician scientists. From 2004
to 2009 $156 million was invested in Cancer Research in NSW
including:
- $28 million specifically towards translational research.
- $20 million for the NSW Cancer Trials Network.
- 18 clinical research fellowships worth $11 million.
The impact of these schemes on the cancer research workforce has
been monitored through state wide surveys of cancer research
activity, most recently in 2007 and 2010.
Methods
A cancer research activity survey conducted in Dec 2009-April
2010 captured information at a research group level for the period
2007-09 replicating a survey conducted in 2007 covering the period
2004-06.
Research groups in NSW were identified based on previous
response to the survey conducted in 2007 and direct contact with
organisations that could reasonably be expected to be conducting
such research. For the individual researcher survey, invitations to
participate were distributed by group leaders, research networks
and using the Cancer Institute NSW grant-related distribution
list. A custom-built website was used to implement the two
online surveys.
One hundred and forty-four research groups responded to the
2007-09 survey compared to 116 groups in the 2004-06 survey. There
were some slight differences between the two surveys in terms of
the definition of a 'group' response with some combined responses
received in 2004-06 that were unable to be split by group. However,
in both surveys the proportion of groups who responded was
approximately 68-72 per cent of all groups identified who were
conducting some form of cancer-related research.
All groups were asked to nominate their broad areas of research
and allocate the per cent of effort allocated to each. They were
also asked to report on external funding received and the size of
their workforce (in terms of full-time equivalent (FTE) staff
numbers). In 2010 this information was collected across a range of
position categories and against whether the staff had a clinical
background indicated by a medical and/or other allied health
degree.
Results
Research in the area of clinical medicine and
science
The NSW cancer workforce in the area of clinical medicine and
science has increased from 420FTE identified in 2007 to 518FTE in
2010, now representing 34 per cent of the cancer research workforce
Figure 1 & Table
1. The clinical medicine/science research area
demonstrated the highest growth of all broad research areas in
external funding with a 155 per cent increase for the period
2007-09 compared to 2004-06.Figure
2
The 2010 survey shows that within the traditional career
researcher categories (senior, mid and early career researchers
plus PhD students) the distribution of FTE for clinical science and
medicine follows the pattern seen across the entire NSW cancer
research workforce. However, the clinical medicine and science area
appears slightly more 'top-heavy' with comparatively more senior
researchers and comparatively fewer PhD students Figure 3.
Researchers with a clinical background
Of the whole cancer research workforce in NSW in 2010, 23 per
cent had a clinical background Table
1. This proportion is highest amongst senior researchers
at 47 per cent but less than half this proportion was observed
among early and mid-career researchers. Researchers with a clinical
background were most frequently working in the area of clinical
medicine and science (50% of all with a clinical background worked
in this area) but also commonly in basic science (21%),
psychosocial/behavioural research (16%) and health services
research (10%) Figure 4.
Within each broad research area, psychosocial/behavioural and
health services had the highest proportion of researchers from a
clinical background followed by clinical medicine and science.
Within these three broad research areas over two-thirds of all
senior researchers came from a clinical background contrasting with
slightly less than one-third of senior researchers working in
public health or basic science Figure
4b.
Figure 1: Number of full time equivalent staff allocated
to each broad research area; 2004-06 and 2007-09
 |
NOTE: The area of "Health Services" was not included in the
2004-06 survey
Figure 2: External funding received for research: 2004-06
compared to 2007-09
 |
Figure 3: FTE within traditional career researcher
position categories: clinical medicine and science compared to all
cancer research
 |
*excluding administrative, technical and other support
categories
Table 1: NSW Cancer research staff (estimated by FTE
workload) by position type
| Position Level |
All FTE |
Clinical Medicine &
Science |
| Total FTE |
Clinical FTE |
% of position level |
Total FTE |
Clinical FTE |
% of position level |
| Senior Researcher |
180.1 |
84.6 |
47% |
65.1 |
42.9 |
66% |
| Mid-career Researcher |
163.5 |
35.4 |
22% |
43.8 |
14.8 |
34% |
| Early-career Researcher |
190.4 |
45.3 |
24% |
46.7 |
14.5 |
31% |
| PhD Student |
317.9 |
59.6 |
19% |
64.7 |
19.4 |
30% |
| Research Assistant / Technical Assistant |
319.3 |
24.2 |
8% |
70.1 |
2.6 |
4% |
| Other Administrative Staff |
135.4 |
9.9 |
7% |
56.4 |
5.5 |
10% |
| Clinical Research Staff (coordinator and/or
administrative) |
222.6 |
97.7 |
44% |
170.8 |
77.2 |
45% |
| Total |
1,529.1 |
356.7 |
23% |
517.6 |
176.9 |
34% |
Figure 4a:
FTE staff with clinical background by position category and broad
area of research.
 |
Figure 4b:
Proportion of staff with clinical background within position
category and broad area of research
 |
Discussion
The substantial increases observed in clinical research funding
and the size of the workforce in NSW are encouraging signs that NSW
has considerable strength and potential in this field. While basic
research still predominates as the largest broad area of cancer
research in NSW, there has been a proportional shift in the last
three years towards areas of research such as clinical medicine and
science and psychosocial/ behavioural research. This may reflect
strategic funding directions of the Cancer Institute NSW as well as
other major supporters of cancer research such as the NHMRC.
Additionally it signals that these areas are particularly strong in
NSW.
The recent survey also reveals the significant contribution of
researchers from a clinical background. This includes those with
medical and oncology training as well as trained allied health
professionals. It is estimated that almost a quarter of the
workforce has come from a clinical background, with much higher
proportions in the areas of clinical medicine and science,
psychosocial/behavioural and health services research.
Within traditional career research positions, the comparatively
lower proportion of clinically trained researchers at early/mid
career stages compared to senior researchers suggests that there
has perhaps been a change in clinical career paths over time with
less clinicians entering into a research career. In most research
areas there are also a substantial proportion of researchers at a
senior level compared to early and mid-career levels. This pattern
is particularly pronounced in the area of clinical medicine and
science. This is likely reflective of the aging of the general
population in NSW and underlines the importance of succession
planning over the next decades.
These factors pose a challenge for future leadership in clinical
and translational cancer research. For NSW to continue to build on
strengths in clinical and translational research, it will be
important to continue to encourage new researchers to commence
careers in these areas and for clinicians to be supported to engage
in research.
