Section 3: Type of Training/ Route to Training

There are several entry routes into academic medicine. By and large, if you want to become an academic consultant it is advisable to do a PhD or in rare cases an MD (the latter really only for those who plan on doing clinical trials type of research only).

In general, a PhD or MD are done outside of training. If you are already on a training rotation then you need to secure approval for OOP-R ( time Out Of Programme-Research)- more on this below.  If you are not in a training post then although you are not under the same time pressure-bear in mind that it may be more difficult to secure funding such as prestigious fellowships from Wellcome Trust or MRC which generally require you to be in training.

 

Academic Clinical Fellows (ACF) posts

 

These are training programmes recently developed to help trainees who want careers in academia to develop their research skills.  Some have entry levels at foundation, core training and others at ST3 level.  The general principle is that these trainees have specially allocated time to develop their research portfolio and plan their projects with a view to applying for funding for PhD etc.  They vary and each speciality and deanery has their own programme- e.g. some give blocks of 4 months per year dedicated to research and others give 1 day per week (the latter in my opinion being less useful). My advice is research how the ACF you want to apply for is actually structured and make time to go and see the person running it.  Some have specific PhD projects they want you to do and others suggest you can choose and develop your project during the training programme. In general, if you fail to get your PhD- due to funding or other reasons then you just go back to a normal clinical training number.

quick-tip-e1366327676423In my opinion, ACF jobs at foundation and core training level are not that helpful because you also have to attain your usual clinical competencies but you may have 4 months less per year of “proper” clinical work to do it so it can add pressure. At that stage of your career, unless you were an outstanding undergraduate, it would be difficult to obtain the required number of publications etc to get funding for your PhD or MD at the end of it.  I would advise that if you want to do an ACF, ST3 level entry is much better as you’ve already decided your speciality/sub-speciality and will already have a developing CV.

 

Pros:

  1. Time, Time, Time! To successfully get funding for your PhD you need time to find a supervisor, plan the project, do some preliminary work to justify it to the grants body, write papers to improve your CV, prepare for interviews, maybe get some lab experience.  Anyone who is in full time training in the UK knows that is incredibly difficult to balance with rota commitments, clinics, preparing for Royal College exams etc. This is really the strong selling point for ACFs. You have structured time to do all of this.
  2. Some ACF posts (not many) come with a pre-designed project so essentially a lot of the preliminary work about finding a supervisor and designing a project is done for you- although initially this may sound as a bad thing remember if you’re coming from a purely clinical background you basically know very little (nothing!) about research and it’s very difficult to learn about designing a T-cell experimental protocol for example so a project which has already been planned by the experts is much more likely to be successful.
  3. Rarely- and if you’re really lucky, the ACF project already comes with funding and this is basically the best possible outcome. But, this is very, very unlikely, the supervisor usually has someone lined up for the job who’s done some work on the project already and who they’ve been grooming for it.

Cons:

  1. You still have to get funding but the stakes may be higher for ACFs who will be given a “failure to progress” for academic ARCP outcome. Currently just under 40% of ACF trainees go back to normal training.
  2. There is a rigidity in terms of when you have to apply for funding (different for each ACF) but usually after 2 years of taking up the number-so there is a time pressure to get your CV and project together by then. In normal clinical training, you can apply at any time and leave the programme upto and including ST6 usually so you can fine tune applications and CV etc.
  3. Some people don’t like the idea of the project that they have to do and there may be limited choice as to the location or subject of the project.
  4. Less time to obtain clinical competencies and may get inadequate training due to less patient exposure.
  5. Require 2 ARCP outcomes and need to achieve separate “academic” competencies.
Non-ACF routes

 

If you are in full time clinical training and want to do a PhD or research you need to find a supervisor.  This is usually a consultant/professor (or clinical supervisor) you’ve worked with during a rotation in tertiary centre. Start the conversation early- at your induction meeting if possible and ask what opportunities they have in their lab or department.  They may have projects already lined up that they need someone to do or they may develop one with you in mind.  Generally, the projects already in the pipeline are better- usually there is some preliminary data and maybe even some funding for it (for a year or 2)  as a clinical research fellow. You may be expected to carry out some clinical work but this may not be counted towards your training.  You will still be required to officially leave the training programme on an OOP-R to do this and if you fail to get funding you will go back to clinical training with research experience but not a higher degree.

If there is no “soft money” for the project then this makes things very difficult.  Essentially you have to plan and apply for the project whilst still in full time training, unless you can afford to take time out and do unpaid work preparing for grants and interviews-(your deanery may not allow this so make sure to check with them first).  This means using your free time to do this- collect data on annual leave, write papers during the weekend and background reading on the subject whenever you can.  It requires 100% commitment.

When choosing a supervisor, I suggest you look at previous record with other trainees- how many succeeded, got their PhD and went on to good academic careers. Also speak to them and see what their experience was like.

Section 4: Subspecialties

What are they within the specialities, how to do them and prospective.

Section 5: Application Process

ACF application process

 

ACF application form is similar to the usual training number application forms but includes extra questions on research experience, evidence of commitment to academia and project proposal if you have one. Although some ACFs say you don’t have to have a specific project in mind before going for an ACF, it is usually a good idea to have one and a potential supervisor lined up. Without that, though you may still have a chance, you risk looking as though you just applied for it and have a vague plan you want to be an academic. A candidate with a project and a supervisor instantly looks more attractive.

The scoring, compared to normal applications, puts more emphasis on your academic achievements such as prizes, publication and presentations.  You still have to show the relevant level of competencies, however, and the form includes the usual questions about clinical experience and audits etc.

Applications and interviews for ACFs are usually earlier than the normal application round (generally open around October with interviews Dec/Jan) to allow those who fail to get an ACF to apply for normal NTN rounds in April-June.  Be aware of the deadlines and start planning early.

Grant & Fellowship Applications

 

These have various deadlines across the year and multiple rounds. Options include applying for funding from big research bodies such as Wellcome Trust, Medical Research Council or NIHR ot going for project specific funding bodies eg. British Heart Foundation, Diabetes UK & Arthritis Research UK.  Go on the websites, find out the deadlines and application process and start early. It takes several weeks to fill in a grant application form and you will go through several versions to be checked by the supervisor and co supervisor to ensure project proposal is acceptable.