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The Complete Guide To Becoming A Clinical Scientist

Published on: 5 Oct 2021

clinical scientist

 

The Role Of A Clinical Scientist:

Clinical scientists aid the prevention, diagnosis and treatment of illness. The job title is applicable to an extensive range of roles that are grouped into four domains – clinical bioinformatics, life sciences, physical sciences and clinical engineering, and physiological sciences – and subdivided into specialisms.1 Clinical scientists may work exclusively in laboratories or in direct patient contact in clinics and wards.

Clinical bioinformaticians integrate biosciences, mathematics, statistics and computer sciences to support the delivery of patient care by developing and using systems for the acquisition, storage, organisation and analysis of biological data. The three specialisms in clinical bioinformatics are genomics, health informatics and physical sciences.  Genomics is a rapidly developing field in which databases and computing tools are applied to genomics data to determine the best diagnosis and treatment for individual patients.

Clinical bioinformaticians working in genomics may also support the 100,000 Genomes Project which aims to combine genomic data and medical records to study the causes, diagnosis and treatment of disease. Additionally, service development is a component of the job, for example, creating databases, sequencing pipelines and programs for automatic analysis. 

Clinical bioinformaticians working in health informatics use innovative technology to ensure that the use of bioinformatics data in diagnostics and treatment is efficient and conforms to information governance standards.

They also advise on mining, processing and interpreting big data and explain its significance to patients and other healthcare professionals. This role combines expertise in information analysis and computing, and clinical, biomedical or physical sciences. 

Lastly, physical sciences is concerned with designing the appliances, programs and algorithms that are used in bioinformatics. The work may include authorising computer systems for clinical use and creating computer systems for controlling medical equipment, modelling biological processes, investigations or treatment and processing data produced by medical appliances.

There are numerous specialisms in life sciences. Cancer genomics is the study of genetic mutations that result in cancer. Clinical scientists working in cancer genomics analyse DNA to identify the type of cancer to assist in deciding treatment. They also monitor treatment outcomes. Clinical biochemists analyse body fluids, for example, blood and urine, to assist in the diagnosis and management of illness. They also advise doctors on the selection of tests, interpretation of results and additional investigations. 

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Developing diagnostic tools and conducting research in cooperation with clinicians are standard activities. Clinical biochemists work in hospital laboratories and, increasingly, in direct patient contact. Clinical scientists working in clinical immunology use complex molecular techniques to study patients’ immune systems to identify the cause of disease. This enables clinical immunologists to assist in the management of allergies, cancers and infectious diseases. This is a growing specialism with potential for career development. 

Clinical microbiologists are engaged in the prevention, diagnosis and management of infectious diseases. They use culturing, sequencing and molecular techniques to identify microorganisms to guide treatment. They are also involved in the development of new tests. Most commonly, the work is performed in hospital laboratories.

However, public health organisations employ clinical microbiologists for infectious disease surveillance roles. Next, cytopathology centres on the examination of cell specimens by light microscope to diagnose disease. This specialism is divided into cervical cytopathology and diagnostic cytopathology. 

Clinical scientists working in cervical cytopathology examine cells from cervical samples to detect changes that could advance to cancer, as part of screening programmes. Diagnostic cytopathology relates to other cancer diagnoses, for example, respiratory tract, lymph nodes and thyroid gland and this role may extend to sample collection. 

Clinical scientists working in genomics examine DNA to identify differences that cause hereditary and acquired genetic conditions. This comprises prenatal diagnosis, carrier testing, predicting the likelihood of genetic conditions being passed onto children and confirmation of diagnosis. 

A related specialism is genomic counselling. Genomic counsellors aid the prediction, screening, diagnosis and management of genetic conditions by analysing family history and organising and interpreting genetic and genomic investigations to provide patients and families with information regarding the impact of their condition on daily life, health and family. They also predict the likelihood of inheriting or passing on genetic conditions and counsel patients regarding adjusting to their condition and making decisions relating to it, with consideration of ethical, cultural and linguistic diversity. This expertise is now central to multidisciplinary teams working in, for example, oncology, neurology and reproductive medicine

Clinical scientists working in haematology and transfusion science aid the diagnosis and management of disorders of the blood and bone marrow, for example, anaemia, leukaemia and haemophilia. They are also involved in organising blood transfusions, including determining blood group status. Histocompatibility and immunogenetics is concerned with supporting stem cell and organ transplantation by tissue typing donors and recipients to assess compatibility, which minimises the risk of immune damage and rejection. Histocompatibility and immunogenetics laboratories keep records of potential donors and recipients and are responsible for the collection, processing, storage and distribution of cells and tissues. 

An additional role is assistance in disease diagnosis and management by testing for genes involved in immune function. Clinical scientists working in histocompatibility and immunogenetics are based in hospitals or organisations, for example, NHS Blood and Transplant and Anthony Nolan Trust.

Histopathologists dissect and prepare – using staining, molecular and immunological techniques – tissue samples for microscopic examination by clinicians. Finally, reproductive science and andrology focuses on the management of infertility. Clinical scientists working in this specialism are involved in fertility treatments, for example, in vitro fertilisation and intracytoplasmic sperm injection and subsequent embryo transfer.

They also perform cryopreservation techniques. Specifically, andrology relates to male reproduction.  

The third domain of clinical science is physical sciences and clinical engineering. Firstly, clinical scientists working in clinical measurement design, build and maintain medical appliances – for example, laser devices, joint replacements, electronic aids and tools for laparoscopic surgery – for diagnosis, management and rehabilitation.

They also perform quality assurance checks on hospital equipment. Some clinical scientists working in clinical measurement conduct research into, for example, body mechanics. 

Clinical pharmaceutical science is concerned with the manufacture and provision of radioactive materials used in medical imaging and treatment, for example, cancer therapies. Clinical pharmaceutical scientists also ensure that medicines are safe to use and are prepared and dispensed in an aseptic environment. Additionally, they design protocols for the manufacture of new medicines.

Clinical scientists working in device risk management and governance check that medical equipment is working safely and effectively. They are engaged in all aspects of equipment maintenance including testing prior to introduction to practice, advising on safe use and disposing safely. Some professionals in device risk management and governance may also contribute to designing equipment. 

Clinical scientists work in imaging with ionising radiation aid and advise clinical staff on generating quality images while complying with guidelines for minimising radiation exposure for patients and healthcare professionals and safely disposing of radioactive substances.

They also conduct quality assurance and safety checks on imaging equipment and develop image analysis programs. Modalities utilised in this specialism include x-ray, computed tomography and positron emission tomography. 

Clinical scientists working in imaging with ionising radiation may also perform procedures other than imaging, for example, measuring glomerular filtration rate – an evaluation of kidney function – and administering radioiodine – a treatment for hyperthyroidism. Imaging systems that do not involve ionising radiation, for example, magnetic resonance imaging, ultrasound and optical imaging are the remit of clinical scientists working in imaging with non-ionising radiation. They advise on safety, perform quality assurance checks and develop image analysis software.

They may also be involved in therapeutic procedures, for example, laser surgery and ultraviolet treatments. A similar discipline is radiation safety physics that is engaged in ensuring that diagnostic and therapeutic equipment that uses radiation is safe for patient and staff use. 

Additionally, they calculate radiation doses received by patients and staff during procedures, check that equipment is functioning in accordance with guidelines and design and implement policy relating to the use of radiation and radioactive substances. 

Clinical scientists working in radiotherapy physics ensure the safety and precision of radiotherapy treatment. This is achieved by calibrating equipment and performing complex calculations to design treatment regimens that are therapeutic, in that tumours are treated, but limit damage to surrounding tissues. Clinical scientists working in reconstructive science provide corrective treatment in the form of prosthetic reconstruction and therapeutic management, particularly of the face, jaw and skull, that is required as a consequence of congenital malformation, diseases such as cancer, or trauma.

They meet patients to understand their requirements, explain treatment plans and take impressions. Subsequently, they design and build devices, for example, prostheses, therapeutic splints and titanium skull plates and monitor performance at follow-up appointments. Additionally, they may be consulted in emergency settings, for example, to construct splints required for operations for trauma patients.

Lastly, rehabilitation engineering specialises in assessing the needs of people with disabilities and designing, building, testing and prescribing assistive devices corresponding to those needs. The assistive devices may be standard, or custom made. Examples comprise wheelchairs, artificial limbs, electronic communicators and devices for surgical correction of deformities. 

The final domain is physiological sciences. Clinical scientists working in this domain use innovative modalities to investigate the functioning of body systems, detect abnormalities and guide management.  Physiological sciences encompass diverse specialisms. Audiology is an evolving discipline that is engaged in the assessment of hearing and balance and subsequent provision of therapeutic services. 

Clinical scientists working in audiology design and perform diagnostic procedures and interpret the results generated. They devise care plans for patients with hearing or balance disorders. Additionally, counselling and rehabilitation of patients with impaired hearing is a key role. 

Clinical scientists working in cardiac science conduct, and interpret the results of, diagnostic and monitoring procedures – for example, electrocardiography, echocardiography and exercise stress testing – for patients with cardiac pathologies. They also have supporting roles in interventional procedures, for example, pacemaker implantation. Critical care science utilises competencies in physiology and technology relevant to the care of patients with life-threatening illnesses.

Key responsibilities comprise advising other members of the multidisciplinary team caring for critically ill patients on the use of diagnostic, therapeutic, monitoring and life-support equipment, troubleshooting problems with medical devices, for example, ventilators, renal replacement equipment and physiological measurement monitors, running satellite laboratories that perform tests, for example, blood gases and electrolytes at the point of care instead of in centralised laboratories, establishing a renal replacement therapy service and maintaining electronic patient databases. On-call work, including emergency call-outs, is an aspect of this job. 

Clinical scientists working in gastrointestinal physiology measure function of the organs of the digestive system to aid diagnosis and formulation of a treatment plan. This comprises assessment of, for example, pressure, pH and tone. Gastrointestinal physiologists may also perform ultrasound imaging and interventional procedures, for example, percutaneous tibial nerve modulation, which is a treatment for incontinence. Another specialism of physiological sciences is neurophysiology. 

Clinical scientists working in neurophysiology assist in the diagnosis and management of neurological illnesses via assessment of the function of the nervous system. Common modalities utilised are electroencephalography, evoked potentials, electromyography and nerve conduction studies. Work in this discipline is often conducted in intensive care and operating theatre settings.

Ophthalmic and vision sciences relate to the assessment of the structure and function of the optical system to acquire diagnostic and prognostic data that is required by ophthalmologists for the management of disorders of vision and pathologies of the eye and related structures. 

Common activities for clinical scientists working in ophthalmic and vision sciences are measuring visual field and eye pressure, imaging the eye and carrying out electrophysiological investigations of the optical structures. There is scope for research, for example, treatment for genetic diseases and retinal prosthetic implants. 

Clinical scientists working in respiratory and sleep sciences diagnose and treat respiratory illnesses and sleep disorders. In respiratory science, they perform lung function testing and assist in the delivery of care for chronic respiratory disorders, for example, medicines and oxygen. In sleep science, they monitor – via home monitoring or sleep laboratories – and treat patients experiencing poor sleep quality.

Examples of tests performed are cardiopulmonary exercise testing, bronchial challenge testing and blood gas testing. Urodynamics is concerned with the diagnosis and treatment of urinary diseases. Clinical scientists of this specialism utilise an array of appliances to measure parameters, for example, pressure, flow and muscle activity and interpret the results to construct reports.

Lastly, clinical scientists working in vascular science use ultrasound imaging and other non-invasive techniques to evaluate blood flow. Most often, they work with inpatients and outpatients in dedicated hospital departments. Results of the procedures performed are interpreted to write reports.

Typically, clinical scientists work 37.5 hours per week.2 This may comprise a shift pattern. The work is conducted in multidisciplinary teams that are constituted by a variety of healthcare professionals and vary by specialism. In many positions held by clinical scientists, there is vast potential for teaching, management and, particularly, research. 

 

The Route To Clinical Science:

The initial step in the route to becoming a clinical scientist is successful completion of an undergraduate honours degree or integrated master’s degree in a pure or applied science discipline that is relevant to the clinical science specialism that the trainee intends to pursue. A 1.1 or 2.1 degree must be achieved.3 Alternatively, if the trainee possesses a 2.2 honours degree, they are eligible to apply if they also have a higher degree in a relevant discipline. 

Subsequently, trainees apply for the Scientist Training Programme (STP), which has a duration of three years. The competition ratios for the various specialisms are listed in Table 1.4 The STP curriculum is composed of core, rotational and specialty modules, each of which features academic and work-based learning.4 The work-based learning is achieved by employment in an NHS department or, occasionally, by an NHS private partner or private company.  This element of the programme is assessed by eportfolio evidence. The academic component of the programme comprises a part-time master’s degree – MSc in Clinical Science – which is fully funded.  The master’s programme is 180 credit hours, 70 of which are allocated to a research project. 

 

Specialism

Competition Ratio (2018)

Andrology

45.0

Audiology

8.0

Cancer Genomics

46.0

Cardiac Science

15.5

Clinical Biochemistry

29.8

Clinical Bioinformatics (Genomics)

15.0

Clinical Bioinformatics (Health Informatics)

15.0

Clinical Bioinformatics (Physical Sciences)

6.5

Clinical Engineering

16.7

Clinical Immunology 

79.0

Clinical Pharmaceutical Science

21.2

Critical Care Science

0.0

Gastrointestinal Physiology

13.3

Genomic Counselling

29.0

Genomics

40.0

Haematology and Transfusion Science

33.1

Histocompatibility and Immunogenetics

17.8

Histopathology

0.0

Medical Physics

7.6

Microbiology

105.7

Neurophysiology

29.6

Reproductive Science – Andrology 

37.3

Reproductive Science - Embryology

37.3

Respiratory and Sleep Sciences

12.0

Urodynamic Science

0.0

Reconstructive Science

6.1

Table 1: Competition ratios for STP specialisms.

 

Work-based learning, during the first year of the programme, features an induction, mandatory training, core modules and several rotational placements.5 At university, introductory modules that cover broad topics from the trainee’s chosen theme – life sciences, physiological sciences, physical sciences and clinical engineering or bioinformatics – are completed.

The first set of MSc examinations are taken at the end of the first year. There is greater emphasis on the trainee’s chosen specialism in the second year. The research project is started and there is another set of degree examinations. In the middle of second year, trainees are required to pass the midterm review of progression.

Finally, during the third year, the final MSc examinations are attempted and there is a work-based elective placement. The programme is concluded by the Objective Structured Final Assessment (OSFA).5 Successful completion of the OSFA, eportfolio and master’s degree result in trainees being awarded a Certificate of Completion for the Scientist Training Programme (CCSTP).6 Trainees then apply to the Academy for Healthcare Science (AHCS) for a Certificate of Equivalence or a Certificate of Attainment. Subsequently, they are eligible to apply to the Health and Care Professions Council (HCPC) for registration as a Clinical Scientist.6

A further programme, termed the Higher Specialist Scientist Training (HSST), has a duration of five years and allows some clinical scientists to progress to consultant level. It results in the attainment of a doctorate degree.

 

Earnings:

Earnings for NHS jobs are classified by pay scales. Trainee clinical scientists are appointed at band 6, at which the starting salary is £31,365.7 The salary increases in accordance with number of years of experience.

Qualified clinical scientists progress to band 7, at which the starting salary is £38,890.7 This also increases over time to a maximum of £44,503 for eight or more years of service. As further experience and qualifications are obtained, it is possible to apply for positions up to band 9 on the pay scale. 

For more information on doctor's salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.

 

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References

  1. NHS Scientist Training Programme - 2020 recruitment [Internet]. Health Careers. [cited 8 November 2020]. Available from:  https://www.healthcareers.nhs.uk/news/nhs-scientist-training-programme-2020-recruitment 

  2. Audiology [Internet]. Health Careers. [cited 8 November 2020]. Available from:  https://www.healthcareers.nhs.uk/explore-roles/physiological-sciences/audiology 

  3. Entry requirements [Internet]. National School of Healthcare Science. [cited 8 November 2020]. Available from: https://nshcs.hee.nhs.uk/programmes/stp/applicants/entry-requirements/ 

  4. Competition ratios for the Scientist Training Programme (STP) Direct Entry [Internet]. National School of Healthcare Science. [cited 8 November 2020]. Available from: https://nshcs.hee.nhs.uk/programmes/stp/applicants/about-the-scientist-training-programme/ 

  5. Setting the scene [Internet]. National School of Healthcare Science. [cited 8 November 2020]. Available from: https://nshcs.hee.nhs.uk/programmes/stp/trainees/setting-the-scene/ 

  6. Completion of the Scientist Training Programme [Internet]. National School of Healthcare Science. [cited 8 November 2020]. Available from: https://nshcs.hee.nhs.uk/programmes/stp/trainees/completion-of-the-programme/ 

  7. NHS Terms and Conditions (AfC) pay scales - Annual [Internet]. NHS Employers. [cited 8 November 2020]. Available from:  https://www.nhsemployers.org/pay-pensions-and-reward/agenda-for-change/pay-scales/annual