Why am I writing this article and who am I writing it for?

At the end of 2026, I will have been a clinical academic in gastroenterology for 25 years. I have enjoyed my time, so far, thoroughly, but it has been hard work, and I have had to make some sacrifices to be ‘successful’. I entered academia in an era where there was less of a fixed career structure. This meant there was little in the way of formal training or career guidance but, at the same time, allowed for more autonomy and freedom. Nowadays, people need to demonstrate commitment to an academic career increasingly early on. It would be hard to imagine someone drifting through for the first 4–5 years after medical school, as I did, and ending up as a professor in a university teaching hospital. I struggled to navigate through the academic system for much of my first 10–15 years, even when appointed as a consultant and associate professor. I repeatedly found myself at a crossroads in life, wondering whether to continue to pursue academia or whether to switch tracks back to full-time clinical medicine. As the first person in my family to complete a university degree, let alone to study medicine, these were always difficult decisions, and I lacked a local mentor with influence and knowledge. I, therefore, always had to make them myself without much in the way of advice.

Reflecting on this, it is crucial to understand that academic success is not determined by intellect (just ask anyone who knew me at medical school in the 1990s). Rather, it is achieved by a mixture of serendipity (often being in the right place at the right time or having the right idea at the right time) and hard work. However, selecting the right people to work with, as well as developing and honing academic-specific skills and behaviours, such as time management and priority setting, is also critical. So, one reason for writing this article is to provide advice and guidance to aspiring academics as to how to navigate the system so that their experience is better than mine and another is, perhaps, for my own catharsis. In addition, a decline in clinical academics has been identified in the National Health Service.1 The decline is disproportionate to other groups within the workforce and needs to be reversed, but only 50% of research-active medics felt they would continue in an academic career.1 This highlights the national importance of strategies to train and retain successful clinical academics. For those interested in reading more about the specific issues I discuss, several of the references I quote are a valuable resource,2–11 provide much more detail and are far more entertaining than this relatively short article. Clearly, there is no uniform recipe for academic success, and others may have different opinions. Hopefully, however, at least some of what is written here will not only be useful for those considering, or embarking on, an academic career but will also resonate with those who have been involved in academia long-term.