Academic training opportunities

Jeremy LevyHead of London School of Medicine

Director of Postgraduate Medical Education

Imperial College Healthcare NHS Trust

KIDNEY AND TRANSPLANT INSTITUTEImperial College

What is academic medicine?

• Combining clinical medicine with research or teaching in one form or another

• Lab based, clinical trials, community or public health, translational, pure science, teaching, training …

• Shouldn’t all doctors being doing this?

• Lots of routes into academic medicine

• Aiming to do dedicated period of research leading to MD/PhD during training

Can everyone/anyone do research ?

• No, and funding not available for all

• If an NTN holder need permission from STC/Deanery, and 3 months+ notice to start

• Need approval for time out from FP or ST grades

• Don't need approval in gaps between training segments

• Cant “defer” start to ST1/ST3 unless already registered for higher degree and only one year left .. apply when you want to start

Can it be combined with clinical training contemporaneously?

• Full time research - No.

• It is possible to set it up, and conduct clinical research to a degree, but not full time research (eg ACF programmes).

• Can be if MSc (eg part time).

• Of course can/should be combined in a training scheme with time off for research

London School of Medicine academic output 2009-2010

• Achieved 217 higher degrees including 117 PhDs or MDs

• wrote >1500 papers, 29 books, 452 case reports

• presented >2260 papers at international or national meetings

• 215 trainees were awarded fellowships of which 30 were international and 135 national, and of which 49 were worth more than £250,000.

• 237 trainees were awarded grants competitively of which 29 were international and 137 national, and 98 were worth more than £50,000.

When to do it

• The big question ! Contentious. No correct answer.

• If before ST3 post - younger, more energetic, more likely to become a greater scientist ? More opportunity to study/work overseas eg US

• BUT poorly differentiated as a doctor, may not fit with future career, older when doing nights etc as SpR/ST3+, long gap between research and finishing training.

• Run through specialties eg pathology/paeds/public health easier at early stages (ie ST1/2)

When to do it

• Ideally after one or two years of SpR training? Ie just after ST4 ..Makes combining training easier if want to continue in clinical medicine, but older when starting research career so may not become the best!

• CANNOT start it in the last year of SpR training.

Clinical academic training pathway

F2F1 ST4ST3 ST6ST5

Medical School

SSMBSc

MB/PhD

4/12 academicplacement

AcademicFoundationProgramme

NTN(A)

Academic Clinical

Fellow (75:25)

Training Fellow

ClinicianScientist

Clinical Lecturer(50:50)

CCT

NB 1 Easy transfer with clinical training programme2. Includes training pathway in medical education

PhD/MD

CT1 CT2 ST7

Integrated academic training pathway

• Academic Clinical Fellows

• 25% of time in research/education

• 75% of time in specialist training

• ~250 each year in UK

• Aiming to get people to then apply for Research Training Fellowship (RTF) for PhD/MD

• Ends after 2-3 years on obtaining RTF, or return to clinical training

ACFs

• Most start at ST3 level, but at least 30 London in CMT

• Some at ST1 (eg neuro, paeds, public health, radiology)

• See NIHRTCCweb site (www.nihrtcc.nhs.uk)

• Generally advertised in Oct/November BUT vacancies may come up at any time ...

• London deanery web site also advertises all for London

Integrated academic training pathway

• Clinical Lecturers (CLs)

• 50% of time in post-doc research/education

• 50% of time in specialist training

• ~ 100 each year

• Encouraged to apply for Clinician Scientist Fellowship (CSF)

• Ends after up to 4 years on obtaining CSF, or apply for Sen Lect, or return to clinical training/full time NHS post

ACF not only route

• No reason cant be applying for research fellowship from routine clinical post ..

Need to approach lab / research principal investigator, plan in advance, submit proposal to funding body for salary... Based on YOU, the project and the lab

• Your preparation will be at weekends/evenings

• Dont forget MRC/Wellcome centres, and pure science labs ..

Funding for research fellowships

• MRC/Wellcome/BHF/Action research/ARC NKRF/industry/soft money …. Imperial has dedicated PhD fellowship funding from MRC and Wellcome

• Usually for you but potentially for the project/department

Academic careers

• ASK consultants NOW, plan early, apply early

What next – listen today

• Plan early. Look at NIHRTCC. Decide on geography. Grant funding competitive – depends on project AND person usually.

• ACF and CL scheme not always very competitive

• Get a case report or clinical project published NOW!

• Make contacts .. ICHNT fantastic place to do so. Use the time even if not for 2 or 3 years, including MRC/Wellcome centres