Abstract
BACKGROUND: Research-active healthcare institutions are associated with improved patient outcomes and staff satisfaction. However, research funding in the United Kingdom remains disproportionately concentrated in established academic centres, limiting opportunities for newer institutions - often located in regions with greater health need - to develop research capacity. This entrenches health inequalities and restricts the pipeline of clinical researchers in underserved areas. METHODS: We used a case study methodology to explore how one new United Kingdom medical school, situated within a teaching-focused university and region of relative socioeconomic disadvantage, built research capacity and supervisory infrastructure from the ground up. Drawing on internal expertise and infrastructure, strategic partnerships and national funding schemes, we examined the structural enablers and barriers encountered in establishing a locally relevant research ecosystem. RESULTS: A phased approach to capacity building was employed, starting with internal resources and strategic collaborations. Supervisory infrastructure was developed through networked partnerships, enabling undergraduate and postgraduate research opportunities. The creation of thematic research groups evolved into recognized research centres. This foundation enabled successful bids for competitive external funding, including undergraduate and postgraduate research schemes, which in turn developed research capacity. We highlight how equitable access to research opportunities - particularly for students from widening participation backgrounds - was embedded within the curriculum and supported by funded placements. Our experience demonstrates that early, targeted investment in research infrastructure, even in settings with low baseline research activity, can generate sustainable capacity, increase participation and reduce regional disparities in research engagement. CONCLUSIONS: To promote equity in research funding and reduce health inequalities, national funding bodies should adopt more inclusive investment strategies that actively support emerging centres. Structural reform is needed to ensure that funding mechanisms do not solely reward existing capacity but also foster its development in underserved regions. Our findings offer a scalable model for building sustainable research ecosystems in new or underfunded centres, aligned with local health needs and population outcomes.