This paper deals with a detailed survey of medical and dental schools in th
e UK and a poll of the views and experiences of specialist registrars. Betw
een 1991-1992 and 1995-1996 the total number of academic staff in the medic
al schools increased roughly in line with the increase in the number of med
ical students. In 1995-1996 there were 19 professorships and 27 other acade
mic posts vacant through lack of suitable candidates. The major incentive t
o young doctors to follow an academic career is the challenge of research,
but research is the first to suffer when they are under pressure from deman
d for more patient care. The balance of activity between patient care, teac
hing and training, and research has been disturbed by pressures for more se
rvice and revisions of the medical curriculum. Suggestions are made for the
protection of research time. Aspects of training are discussed at length a
nd recommendations made for improvements. It is suggested that efforts shou
ld be made to align more closely the management of medical schools and of t
he trusts with which they are associated.