Fu Chuen Kon
Balancing between research and keeping up with medicine is daunting for most medical students and it is no easier for clinician-scientists. Doctors have to maintain this juggling act for the majority of their career. In recent years, the number of doctors entering the academic medicine pathway is dwindling [1,2]. A recent survey of UK-trained doctors revealed that the main reasons for this were: lack of job security, poor pay and lack of support from mentors[3]. In response to the drop in recruitment numbers, the Saville Report by the Academy of Medical Sciences (2000) proposed an increase in the number of research posts available, and urged for more clarity on the role of academic training in career progression [4]. In 2006, the National Institute of Health Research (NIHR) was set up and established an Integrated Clinical Academic Training (ICAT) Pathway in order to better standardise academic training in the UK [1]. Despite the alleged doom and gloom, I firmly believe that a career in academia is deeply rewarding as it promises lifelong intellectual stimulation and enables you to be at the forefront of medicine’s latest discoveries. This piece gives advice on how to get into academia in medical school and beyond.
I have reconciled the training pathway outlined in Figure 1 with the University of Sheffield’s medical course and have given a few tips on how Sheffield medical students can use their opportunities to get into academic medicine. However following advice can be used by any medical student.
Medical school
The Phase 2a Research SSC offers a great opportunity to have a taster of what a career in academia entails. If you like your project’s topic or your supervisor, then keep in touch with the research group and ask how you can get involved more.
Be proactive! If you already have a subject matter in mind, a simple Google search will reveal the best supervisors to approach for potential research projects. While this may seem daunting at first, it is probably the most direct way to get involved with a research project. You may be rejected, but it is important not to be disheartened and keep trying. After all, if you keep knocking on the door, it will eventually open!
Intercalating is probably the easiest way to get involved with a research project or publish at medical school. Some Medical Schools like Sheffield offer a research degree (BMedSci) which allows you to work on a research project for the year. There are also taught degrees at Bachelor’s or Master’s level, which also have a research component as part of the course. Intercalating is not the only way to get into academia as there are other opportunities throughout medical school.
Aim to publish. If you are already involved in a project, you should aim to publish your work in a peer-reviewed journal with a PubMed ID. This will not only be beneficial for your CV and job applications in the future, but will give you an idea of the life of an academic. Publishing as a medical student is hard and it would be wise to start as early as possible to take into account manuscript revisions/journal rejections etc. Some types of work are easier to publish than others such as case reports or letters to the editor while others are more difficult, such as basic science research.
In addition to publishing, you should aim to submit your work to national and international conferences for poster or oral presentations. They are relatively easier to achieve compared to publishing and still look good on your CV, as evidence of commitment to academia. In addition, you will develop presentation skills which are essential for any good academic. Some conferences may even publish your abstract on PubMed as part of conference proceedings.
Keep your eyes and ears peeled! More often than not, there are notices on Minerva (Sheffield’s medical online server) and Facebook for supervisors advertising potential research projects. There are also societies like NSAMR and StarSurg which offer collaborative opportunities on regional or national audits. The opportunities are there, it is up to you to seek them out!
Join societies and network. Attend events/talks organised by academic societies, which often advise students on how to get published or get into academia. You could also join the Sheffield Clinical Academic Society and attend their events. This also gives you an opportunity to network with other academics and other like-minded medical students.
After Medical school
The Academic Foundation Programme (AFP) was established in 2005 as a means to educate more doctors on what a career in academia entails [6]. This is usually a four-month placement in FY2, sometimes being a day release during both FY1 and FY2, and can be on Medical Education and Medical Leadership as well. The AFP is part of the ICAT pathway and leads onto the Academic Clinical Fellowship (ACF) programme. The AFP is by no means the only way to get into academia but provides a good starting point. To successfully obtain a position, you would most likely need an extensive portfolio i.e. presentations, teaching experience, publications, which you can achieve whilst at medical school.
Academic Clinical Fellowship (ACF) is normally a 3-year programme and follows on from the AFP, allowing trainees to have 75% clinical work and 25% protected research time. ACF holders are normally at ST1 level or higher and by the end of the programme should have enough data and experience to apply for funding for a PhD from external bodies such as the British Heart Foundation, Wellcome Trust etc. Many pursue a PhD after the ACF and subsequently apply for Academic Clinical Lectureships and Clinician Scientist Fellowships. While highly competitive, the ACF is probably the most clear-cut way to enter academic medicine.
Clinical Research Fellowships are short term positions which are offered in some hospitals. This is where you do research most of the time on top of occasional clinical duties. These fellowships lie outside the Integrated Clinical Academic Pathway and you would have to take time out of your clinical career. This is an alternative to the ACF, especially if you have decided on academia later on in your career and still prepares you for a PhD and higher academic positions. These positions are usually advertised in the BMJ.
To summarise, a career in academic medicine is a long but worthwhile journey. There is not one path into academic medicine. I personally would relish the role of an academic clinician, as I am innately curious and want to unravel the mysteries of medicine, translating new discoveries to the bedside in order to improve patient care. If you feel the same way, I strongly recommend you pursue a career in academic medicine!
Bibliography
[1] Lopes J, Ranieri V, Lambert T, Pugh C, Barratt H, Fulop NJ, et al. The clinical academic workforce of the future: A cross-sectional study of factors influencing career decision-making among clinical PhD students at two research-intensive UK universities. BMJ Open 2017;7:1–11. doi:10.1136/bmjopen-2017-016823.
[2] Darbyshire D, Baker P, Agius S, McAleer S. Trainee and supervisor experience of the academic foundation programme. J R Coll Physicians Edinb 2019;49:43–51. doi:10.4997/JRCPE.2019.111.
[3] Lambert TW, Smith F, Goldacre MJ. Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors. JRSM Open 2015;6:205427041560264. doi:10.1177/2054270415602644.
[4] Sciences A of M. the Tenure-Track Clinician Scientist : a New Career Pathway To Promote Recruitment Into. 2000.
[5] England HE. Clinical Academic Careers Framework: A framework for optimising clinical academic careers across healthcare professions. n.d. doi:10.1136/bmj.320.7237.768.
[6] Bodagh N, Meechan C, Woodland P. The academic foundation programme: A new foundation for academic medicine. Br J Hosp Med 2017;78:C110–2. doi:10.12968/hmed.2017.78.7.C110.