The healthcare landscape is undergoing a major transformation. As a result, it’s an exhilarating time to be involved in clinical research. Indeed, there is a strong academic culture in diabetes and endocrinology, with numerous opportunities for clinical academic careers. Here, we provide an overview of these potential opportunities for trainees.
So, why do research during your clinical training? Clinical research is vital for evidence-based medicine and for developing new therapies. The third defining principle in the NHS Constitution states its ‘commitment to the promotion, conduct and use of research to improve the current and future health of the population’.1 In fact, an emerging body of evidence demonstrates that research-active hospitals have better patient outcomes.2
At a personal level, doing research makes you a better clinician (by developing the skills necessary to appraise evidence) and is good for your future career (remember, the best jobs are competitive). Importantly, clinical research is fun and interesting!
A plethora of clinical academic training opportunities is available, from Foundation Training to the Certificate of Completion of Training (CCT). Options are summarised in the Figure. Several of these allow trainees to gain experience in clinical research while continuing to acquire their clinical training competencies, whereas others require time out of programme.
SPECIALISED FOUNDATION PROGRAMME
Formerly called the Academic Foundation Programme, this programme gives foundation doctors an early opportunity to gain experience in research, leadership, management or medical education, in addition to the competencies included in the Foundation Programme Curriculum.3
NIHR POSTGRADUATE CERTIFICATE AND MASTER OF RESEARCH PROGRAMMES
‘Doing research makes you a better clinician and is good for your future career. Importantly, clinical research is fun and interesting!’
A new initiative, this partnership between the National Institute for Health and Care Research (NIHR) and the Academy of Medical Royal Colleges aims to provide a range of researcher development programmes for healthcare professionals starting their clinical research careers.4 The courses give clinicians the essential knowledge and skills required to work in clinical research delivery.
NIHR ASSOCIATE PRINCIPAL INVESTIGATOR SCHEME
This six-month in-work training opportunity offers practical experience for healthcare professionals who are new to clinical research under the mentorship of a local principal investigator.5 On completion, healthcare professionals are issued with a certificate confirming Associate Principal Investigator status, which is endorsed by the NIHR and Royal Colleges.
These can be undertaken at several training stages (e.g. before or during specialist training) to carry out full-time clinical research. Funding can be obtained from a range of sources, including local and national charities. Trainees may also choose to undertake a one-year Master’s in clinical research alongside the fellowship, to provide formal recognition of training.
Possible opportunities for trainees to gain experience in clinical academic training. Associate PI, associate principal investigator; FY 1/2, foundation years 1/2; iBSc/iPhD, intercalated BSc/PhD; IMT 1–3, internal medicine training years 1–3; MRes, Master of Research; NIHR PGCert, NIHR Postgraduate Certificate; ST4–7, specialty training years 4–7.
NIHR ACADEMIC CLINICAL FELLOWSHIPS
An Academic Clinical Fellowship provides up to nine months of protected research time over three years during clinical training (starting in internal medicine training years 1–3).6 It is designed to allow specialist trainees dedicated lab time to generate pilot data, forge a relationship with a supervisor and prepare an application to an external funding body for a PhD fellowship.
DOCTORAL RESEARCH TRAINING FELLOWSHIPS
Specialist trainees can apply to the deanery for permission to take time out of programme to complete a PhD. The PhD years (typically three years) provide a strong and dedicated platform for developing research skills, receiving bespoke mentoring and learning to become a clinician scientist. You will also be afforded the opportunity to disseminate data to the wider scientific community through publications and presenting at scientific conferences. At present, there are various external funding bodies, which (depending on the specific award) can cover your basic clinical salary and PhD fees, as well as allowances for consumables, equipment and travel:
• Wellcome Clinical PhD Programmes: potential applicants apply directly to funded universities, with the project decided after award.
• MRC Clinical Research Training Fellowships: research proposals are assessed considering the track record of the candidate, the importance of the research question, the candidate’s choice of sponsor and what the institution has to offer.7
• NIHR Fellowship Programmes: these are designed to support trainees looking for a career in health and social care research methodology.8 Like MRC Clinical Research Training Fellowships, these are personal awards, with applications assessed considering the person, project and place.
• Alternative funding sources: these include charities and local department research funds.
NIHR ACADEMIC CLINICAL LECTURESHIPS
These are post-doctoral awards which provide a clinical and academic training environment for specialist trainees to establish themselves as independent researchers.9 The standard duration is four years (or until CCT) and allows clinicians to spend 50% of time in specialist clinical training (supernumerary) and 50% of time in research or educational training.
Across the clinical spectrum, there are many opportunities for trainees to gain experience in clinical academic training. Importantly, these opportunities continue beyond CCT, providing NHS Consultants and healthcare professionals with dedicated research time.
Being a clinical academic is like being a child in a sweetshop – you can do clinical work, research and teaching all in one job and be paid for it – who could ask for more!
Edouard G Mills
MRC Clinical Research Fellow, Imperial College London
Specialist Trainee in Endocrinology
Waljit S Dhillo
Professor of Endocrinology & Metabolism, Imperial College London
Dean of the NIHR Academy
1. NHS 2021 The NHS Constitution for England www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england.
2. Downing et al. 2017 Gut 66 89–96.
3. UK Foundation Programme 2022 Specialised Foundation Programme www.foundationprogramme.nhs.uk/programmes/2-year-foundation-programme/specialised-foundation-programme.
4. NIHR 2021 Clinician Researcher Development Programmes Competition www.nihr.ac.uk/documents/clinician-researcher-development-programmes-competition/28789.
5. NIHR 2022 Associated Principal Investigator Scheme www.nihr.ac.uk/health-and-care-professionals/career-development/associate-principal-investigator-scheme.htm.
6. NIHR 2021 NIHR Academic Clinical Fellowships (Medical) Guidance for Recruitment and Appointment 2022 www.nihr.ac.uk/documents/nihr-academic-clinical-fellowships-medical-guidance-for-recruitment-and-appointment-2022/28793.
7. UK Research & Innovation 2022 Clinical Research Training Fellowship www.ukri.org/opportunity/clinical-research-training-fellowship.
8. NIHR 2022 NIHR Fellowship Programmes www.nihr.ac.uk/explore-nihr/academy-programmes/fellowship-programme.htm.
9. NIHR 2022 NIHR Clinical Lectureships (Medical) Guidance for Recruitment and Appointment 2022 www.nihr.ac.uk/documents/nihr-clinical- lectureships-medical-guidance-for-recruitment-and-appointment-2022/30062.