Internationally, the increasing emphasis in universities on the quality of teaching, on student employability and on a corporate approach to entrepreneurial income generation has created a tension around the primacy afforded to published research outputs as a focus for academic work and status. In this study, a framework for academic socialisation is developed and used to understand how lecturers in health professional fields attempt to "juggle" four areas of work--teaching, leadership, knowledge exchange and research activity. Studying academics in professional fields, with a well-developed focus on employability and strong partnerships with employers, provides useful insight into contemporary academic work and identity. A significant proportion of lecturers in health professional fields, even of those working in research-intensive universities, appear to "subvert" the paradigmatic primacy afforded across the higher education sector to research outputs and identity as a researcher.