Trainee Research

Information about clinical academic opportunities

Undertaking surgical research is an important part of surgical training, allowing an understanding and development of research skills for the trainee as well as benefitting patients.

Research undertaken during training equips surgeons with core research skills including critical analysis, dissemination of results through presentation and publication (and therefore development of writing skills), development of leadership and management skills and independent thought as well as encouraging an analytical approach to clinical treatment.

The Mammary Fold, the national breast trainees group, established an Academic & Research Collaborative parallel to the development of the ABS Academic & Research Committee.

Find out more about MFAC

This pathway is for trainees who aspire to follow a clinical academic career path. It is delivered as a partnership between Universities, Deaneries and the NIHR Trainees Coordinating Centre. NIHR Academic Clinical Fellowships (ACFs) allow medical and dental trainees to undertake 25% research and 75% clinical training over 3 years. This period of research is classically used to develop a research portfolio that would allow competitive application for a PhD fellowship from one of the academic funding bodies such as NIHR, Medical Research Council or Cancer Research UK. Clinical Lectureships (CLs) allow trainees to undertake 50% research and 50% clinical training over 4 years, with the aim of developing post-doctoral research, before the award of a Clinician Scientist Fellowship or Senior Lectureship.

A Clinical Academic is a clinician who also wants to include an element of research, teaching or management in their role with the aim of improving clinical practice within their speciality.  Medical clinical academic training pathways have become more structured.  The academic career path can begin at medical school with an intercalated BSc or MSc degree or MB PhD programme, alongside other opportunities to be involved in research.  Nevertheless, the move into an academic programme is possible at various stages in postgraduate medical training.

Recognising the value of supporting clinicians to do research in their area of expertise, the National Institute for Health Research (NIHR) provides a range of schemes to encourage aspiring Clinical Academics.  Academic foundation programme posts funded by Health Education England (HEE), offer protected academic time during Foundation Year (FY2) training, usually in the form of a four-month block spent away from clinical practice.  The NIHR Integrated Academic Training (IAT) Pathway supports Academic Clinical Fellowships (ACFs) for up to three years enabling academic training alongside specialty training with the aim of supporting entry into a PhD programme.  The NIHR also provides Doctoral Research Fellowships (DRFs) supporting a period of out-of-programme leading to a doctoral degree (PhD), and finally, Clinical Lectureships (CLs) of up to four years’ duration enabling post-doctoral clinicians to split their time equally 50:50 between clinical and academic work (Figure 1a).  Universities are required to provide one matched CL post per NIHR-funded CL post through local funding.  DRFs are personal awards following a competitive application process.  Equivalent personal funding to pursue a substantive period of research leading to a higher degree may be obtained from the Medical Research Council (MRC), Wellcome Trust, British Heart Foundation and other charities.

At Consultant level, the NIHR offers Senior Clinical Lectureships or Advanced Fellowships as well as prestigious senior Research Professorship awards.  Equally, there is the opportunity to use NIHR or equivalent funding to pay for research sessions within a Consultant job plan. 

NIHR Integrated Academic Training Programme in England

For overviews of the IAT pathways for doctors, see Integrated Academic Training Pathway (Medicine).

In Scotland, the Academic Foundation Programme (AFP) supports a dedicated four-month academic block for research or medical education activities.  As well as acquiring clinical competencies expected of all trainees, each academic foundation trainee is allocated a personal academic mentor who is actively engaged in promoting and undertaking research at University and/or NHS level.  The AFP provides a great opportunity to become more involved with medical research, education and/ or management.

NHS Scotland | Scottish Medical Training Foundation Programmes

All four Scottish Medical Schools in conjunction with NHS Education for Scotland (NES) are offering additional Clinical Academic Training opportunities (ACAT/DCAT/ECAT/GCAT Programmes). These early academic career programs are focusing on core trainees (CT1/2) or early years of run-through specialty trainees (ST1/2).  Over a two-year programme, the appointed academic trainees will be given an academic mentor, access to the full support of the academic infrastructure, a small budget for research/publications and travel to conferences, help with applying for fellowships and identification of research opportunities.  These trainees will also be encouraged to formulate plans for medium to long-term research opportunities which may include personal fellowship applications, MD/PhD studentships, or entering into training programmes with the view of progressing towards competing for SCREDS Clinical Lecturer positions.

ACAT Aberdeen Clinical Academic Training

DCAT Dundee Clinical Academic Training

ECAT Edinburgh Clinical Academic Training

GCAT Glasgow Clinical Academic Training

The Scottish Clinical Research Excellence Development Scheme (SCREDS) provides an integrated training and career development pathway enabling clinicians to pursue concurrently or sequentially academic and clinical training within the NHS.  It facilitates both the attainment of a senior clinical academic appointment and the award of a Certificate of Completion of Training (CCT).  Normally time within the SCREDS appointment is split into 20% for research training and 80% for clinical training.  These posts are funded either directly by universities or by NES.

NHS Scotland | Scottish Academic Training (SCREDS)

At Consultant level, NHS Research Scotland (NRS) supports NHS clinical staff in developing a research career by funding protected time to contribute to, conduct and lead clinical research, in order to increase capacity in areas that are either aligned to research excellence locally or nationally or areas where the potential exists to develop research excellence.  The Scottish Senior Clinical Fellowship scheme supports clinical scientists in their transition to leadership and provides a research-focussed entry point to a permanent clinical academic career for a period of five years.

NHS Scotland | NHS Research Scotland Fellowships

The other devolved nations also support integrated academic training programmes and details may be found on the following websites:

Trainees can undertake a two year MD programme or three year PhD programme. Occasionally these posts are offered with a limited clinical commitment, which provides the salary. Otherwise fellowships need to be sought through competitive application.

Producing high quality research as a busy surgical trainee, rotating through numerous posts across wide geographical regions is notoriously challenging. Surgical trainee-led research collaboratives offer the opportunity to run large-scale multicentre audits, studies and clinical trials by bringing together interested trainees into one collaborative research group. These collaboratives allow the development of skills in protocol design, statistics, ethics, funding, leadership, management and recruitment.

Over recent years numerous collaboratives have been established, running highly successful research, exemplified by the Rossini Trial.