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Priorities for research in accident and emergency medicine.

The Royal Army Medical College was founded in 1860. The staff included a Professor of Military Medicine, a Professor of Military Surgery, a Professor of Military Hygiene and a Professor of Pathology. The main role of the Professor of Surgery is to participate in the teaching ofyoung medical officers in those aspects of surgery particularly relevant to the military community and also to participate in the education and training of army surgeons. My illustrious predecessor Surgeon General, Sir Thomas Longmore initiated the research activities of the Department of Military Surgery which, with various fallow periods have continued to the present day. 'Research' is a term which can cover a multitude of activities from information gathering at one end of the scale to quite specific scientific laboratory research on the other. In the medical profession it is generally admitted that much of the research carried out in our hospitals is a higher professional training activity. I believe that retrospective and prospective surveys of the management of patients in a department are not only interesting but necesssary if we are to deploy our resources in the most efficient way for the patient's benefit. Clinical research is more commonly thought of in terms of clinical investigation and the clinical trial has come to dominate the research activities of our major hospitals. To be effective, clinical research needs appropriate facilities and equipment and in my experience the people involved must have sufficient time to set aside from the clinical commitment. Even for individual research projects some sort of organization is required, particularly in these days when most research projects must be vetted by an ethical committee. I believe that clinical research should be relevant to some practical problem and that it should be productive in that it leads to some change in practice which is ultimately to the benefit of our patients.