Do I need to publish 200+ papers? Do I need to spend all my time in a lab/looking under microscopes? What does a professor (in the medical field) ACTUALLY do!?
I had so many questions about an academic medical career before starting my Master’s and still have a lot… but I’ve had the privilege of being able to ask lots of clinical academics that I work with what the ‘hype’ is all about! So I thought I'd write a blog post about what a career as a clinical academic doctor looks like.
What is a clinical academic doctor?
Clinical academic doctors combine their clinical practice with teaching and research. An academic clinical career may be for you if you are interested in practising as a doctor but also want to make a difference to the future of medical science and education. The combination of treating patients, conducting research to enhance these treatments, and teaching the next generation of doctors means that clinical academics stay at the forefront of clinical knowledge.
Most clinical academics will work for the NHS and a university and split their time between the 2. Most will conduct research as part of their role. This can be for the university or for private companies, like those in the pharmaceutical industry. They will then teach students at the university and (in medicine) on placements / internships. Many find that this dual role gives them greater career flexibility and an exciting and varied workload. There is a huge variety of clinical academic careers across a diverse range of specialties which makes each clinical academic post unique! CATCH UK is a fantastic website to read more about academic clinical careers.
Clinical academics have a passion for advancing the understanding of healthcare and driving new innovations in cutting-edge clinical practice. The research you carry out will primarily aim to achieve safer and more effective evidence-based treatments for patients, and your teaching will improve the quality of care that future healthcare professionals provide to patients.
Routes into clinical academia
You do not need to know you want to do an academic clinical career during medical school but the earliest opportunities are getting involved in research projects and intercalated degrees. This will demonstrate an interest beyond the standard MBBS and carries points for the Specialised Foundation Programme application (can read more about the SFP here)
There are also a few formal structured pathways that can lead you to a clinical academic career once you become a doctor, In England, for example, there is the HEE/NIHR Integrated Academic Training (IAT) programme for dentists and medics, and the HEE/NIHR Integrated Clinical Academic Programme for nurses, midwives, allied health professionals, pharmacists, and healthcare scientists. Similar structured schemes exist in Scotland, Wales, and Northern Ireland.
Instead, you may opt to follow a more ad hoc route into clinical academia. This could include entering the standard foundation programme, then doing your training for a while, and completing research and educational activities that you've sought out yourself on the side. Pursuing independent research jobs, teaching posts, or various fellowship schemes, at all career stages alongside your clinical role will count, and still give you insight and show your interest in academia. However, you may require time out of your chosen training programme (known as "out of programme experience" or ‘OOPE’) if wanting to take weeks-months off to do bigger projects - some of which may even require you to go abroad.
The NIHR (National Institute for Health Research) funds approximately 250 Academic Clinical Fellowships (ACFs) and 100 Clinical Lectureships (CLs) in medicine each year. Funding is also available for a smaller amount of fellowships and lectureships in dentistry each year.
The NIHR also offers another award, the In-Practice Fellowship (IPF), which funds Master's degrees (or equivalent) for GPs and dentists.
The NIHR Academic Clinical Fellowship (ACF)
This is a clinical specialty training post in medicine or dentistry that incorporates academic training. This post is 3 years (up to 4 years for GPs). Alternatively, it can be taken part-time and extended up to a maximum of 5 years (6 years for GPs), as long as 25% of your time as a doctor is spent completing the academic component.
The funding will support the university / institution that is hosting and managing your post, cover your basic salary, give you access to an academic research training programme that teaches you general research skills, and a yearly £1000 bursary for you to attend scientific meetings and conferences.
As an ACF you will spend:
75% of your time in your specialist clinical training
25% of your time in research or educational training.
To be eligible for an ACF you must be:
Medically or dentally qualified
At the early stages of specialty training (between ST1 and ST3, up to ST4 only in the case of Emergency Medicine, Psychiatry, and Paediatrics.)
Able to demonstrate outstanding potential for a career as a clinical academic (any extra degrees you already hold and publications will look great here).
Able to meet the clinical specification for the advertised post.
You apply through Oriel. I have met some doctors doing the ACF with my research team at Cambridge and they've been amazing to work with!
The NIHR Clinical Lectureship (CL)
This is a post-doctoral award (must have a PhD to apply) that provides a clinical and academic training environment for doctors and dentists to establish themselves as independent researchers and leaders.
This award is 4 years long or until completion of clinical training (CCT/CCST) is reached, whichever is sooner. Alternatively, you can undertake the award part-time and for a maximum of 6 years, as long as the academic component does not fall below 33% of your time working as a doctor.
As a CL you will spend:
50% of your time in the later stages of your specialist clinical training
50% in research or educational training.
To be eligible for a CL you must:
Be in higher specialty training (Beyond ST4)
Have completed a research doctorate (PhD) or equivalent
Show outstanding potential for continuing a career in academic medicine or dentistry.
So, for example, let's imagine I was in an ideal world where all my academic medicine dreams came true:
Finish medical school
Apply for the Specialised Foundation programme (2 years)
Apply for a specialty training post in Paediatrics (ST1).
Between ST1-ST4, I can apply to the NIHR ACF
I'd apply for the Paediatrics / General Surgery combination (An example of the ACFs offered in 2022 can be found here)
Once completed, I can put the NIHR Fellowship as an award on my CV
I would then do a PhD at some point (the dream ends here)
I'd then apply for the NIHR Clinical Lectureship (CL) during my ST6-ST8 years
I complete the Clinical Lectureship and my Paediatrics training. I am now a Paediatrician (eligible to apply for consultant posts) and an independent researcher (eligible to apply for senior lecturer roles)
Let's say I bag a consultant paediatrician post AND become a senior lecturer at a university.
I'd do this for a few years, splitting my time between working as a consultant, lecturing / teaching, and research, then apply to be a Professor at the university in my field when a post opens up.
WOW! As you can see, AN ACADEMIC CAREER IS A LOT OF TIME AND EFFORT.
A helpful overview of this process can be found below (source: MSC - Academic medicine)
If someone is a Professor, it means that they are the most senior faculty member in a department, at a University or other academic institution (i.e. you cannot be a random Professor not attached to a university as the institution needs to employ you and give you this title). Becoming a Professor depends on your level of expertise, knowledge, and educational qualifications on a subject. The role will require you to teach students (e.g., in the medical field, this would be medical students) and conduct robust research. Therefore, it is highly unlikely that a person will become a Professor until they have completed education at least to Ph.D level. To become a Professor, you usually have to go through the following stages: become a Lecturer, Assistant Professor, Associate Professor, and finally, a Professor to be at the top of the teaching profession (see diagram below).
* Not many UK universities include this 'Reader' step!
It is important to note the difference between medical doctors and having a Doctorate.
‘Dr’ (in the non-medical sense) denotes someone who has been awarded a PhD. Since most professors will be PhD-holders, this means that in the medical field, professors hold a medical degree AND a PhD (= doctor squared). 'Professor' doesn’t denote any qualification but rather, an academic staff grade - the highest grade on the university pay scale (more about how much they make below).
Clinical professorship can be either full- or part-time and, in the medical field, professors are expected to have considerable practical experience in their respective fields as opposed to thousands of published papers and educational credentials (so yes, expect to have been working as a doctor for many years before you get the role of a professor)! Being a professor requires dedication and commitment - most professors reduce their clinical practice to around 1-2 days a week (if that) and spend the rest of their time teaching and leading high-profile research for the university they are employed by. Their workload actually increases (even though it may not be in the form of patient cases).
Do academic doctors get paid more?
In regard to professorship, discussed above, the national average salary for a Clinical Professor is £115,413 per year in the UK (not including the separate salary you will receive from the NHS / your own private practice if still practising as a doctor a few times a week). This means that you get more money than a standard consultant but will involve different work (i.e., you will have to sacrifice a lot of your clinical practice to do teaching/research).
For academic doctors in training, you will be making around the same as other doctors who are NOT pursuing academia. However, you will just be doing less clinical work than them as you have to dedicate time to your research / academic activities.
However, doctors who return to clinical training after successfully undertaking a pre-agreed period of approved academic research can receive an academic pay premium of £4,288 per year. These payments are taxable, non-pensionable, and made annually until you complete your clinical training.