Intended for healthcare professionals


Applying for academic clinical fellowship posts

BMJ 2014; 349 doi: (Published 08 July 2014) Cite this as: BMJ 2014;349:g4415
  1. Roxanne Keynejad, academic foundation year 2
  1. 1St George’s Healthcare NHS Trust, London, UK
  1. roxanne.keynejad{at}


Roxanne Keynejad outlines the process for applying for an academic clinical fellowship, discusses the advantages and disadvantages of these positions, and offers some words of advice from a successful applicant

Academic clinical fellowships (ACFs) enable trainees to obtain formal exposure to research during clinical training and are valuable for those considering higher research degrees. Competition for posts is fierce, so be organised, focused, and well prepared. There are other paths available into academic practice, but as long as you have realistic expectations and good reasons for pursuing clinical academic training, it is worth applying for an ACF.

The National Institute for Health Research integrated academic training pathway creates opportunities for trainees to combine research with clinical training, often incorporating a PhD training fellowship (see figure). Around 250 ACFs are available in England each year. They are specialty training posts offered from core training year 1 (CT1) up to specialty training year 4 (ST4). They divide training into 75% clinical work and 25% research, often split into two blocks of academic work over the ACF, which lasts up to three years (or four years for general practice trainees). ACFs offer time to gain experience and prepare applications for training fellowships from bodies that fund PhD research, such as the National Institute for Health Research, the Medical Research Council, or the Wellcome Trust. Trainees are not required to pursue this route, however, and 38% of 2013 leavers return to full time clinical training.1


The integrated academic training pathway

ACFs offer a number of advantages to trainees wishing to pursue research. They afford protected time to explore research interests and to undertake projects through which pilot data can be collected for use in a future PhD. In addition, trainees doing ACFs are given a national training number, allowing them to pursue run-through training in uncoupled specialties.

The disadvantages of doing an ACF include losing up to nine months from core training, reducing exposure to subspecialties and clinical experience during which all competencies must be acquired and examinations passed. Academic posts may also be unbanded, with an associated reduction in income. In addition, although competition ratios are not published by Health Education England,2 there is a great deal of competition for ACF posts. The application process is demanding and you should start preparing as early as possible, including undertaking activities showing commitment to academia, such as taster weeks, teaching, completed audit cycles, quality improvement projects, presentations, and publications. Although competition for posts can be fierce, shortlisting takes candidates’ career stages into account (box 1).


Applications open in mid-October and close four weeks later. Interviews take place from November to January, with offers issued in mid-January. So you must also apply to standard training in December to maximise your chances of obtaining a training post. General practice ACFs are applied for alongside standard general practice through an additional form and extend training from three years to four. Candidates must meet selection criteria for the clinical specialty and ACF to be eligible. Round 2 recruitment for unfilled or newly created ACFs opens in February. Applications are made directly through local education training boards, apart from general practice (which is made through the National GP Recruitment Office) and cardiothoracic surgery (which is made through Health Education Wessex). Offers are coordinated through the UK offers system.

The number of ACFs offered in each specialty varies according to hosting centres’ expertise and National Institute for Health Research priorities (dementia was a priority in 2014, for instance). ACFs in some specialties may be offered in round 2 but not round 1. The basic specification is identical, irrespective of specialty, and available from the National Institute for Health Research,3 supplemented by more detailed clinical and academic person specifications provided by local education training boards once posts are advertised.

After requesting information about identity, qualifications, and employment, ACF applications incorporate “white space” questions with 100-250 word limits. In 2013, these encompassed: experience and commitment (three questions); teaching and audit (two questions); management; leadership; team working and communication (one question); academic achievements (eight questions); and personal skills (four questions).

Generic shortlisting criteria3 assess essential criteria (clinical experience, academic experience, commitment to a clinical academic career, language skills, and reasoned/analytical approach) and these criteria are marked out of a maximum of 14. Desirable criteria (higher degrees, prizes, honours/distinctions, teaching experience, extracurricular activities, scientific publications, scientific presentations at national/international level, key academic achievements) are assessed out of a maximum of 22. You should assess your CV against these criteria well before applying and take steps to improve weak areas.

Proactively seeking out information to assist your application is often helpful. You can contact the department hosting the ACF as the department may welcome visitors or assistance with data collection, analysis, or teaching. You may gain insights into attributes they value, and current ACFs may offer advice.


Interviews vary, but all assess both clinical and academic commitment and aptitude. You may have separate clinical and academic panel interviews, one asking standard specialty recruitment questions and the other focusing on teaching, research, reasons for wanting the post, and long term plans. The preparation necessary for the interview is similar to that for any professional interview, and it should be treated as seriously as an examination. Practise interview skills as much as possible to ensure you are prepared but do not come across as over-rehearsed. Interview books may help you to reflect on experiences when asked, “Tell me about a time when you . . . ” (box 2). Candidates concerned about interview performance can undertake interview courses. These can be expensive, however, and since many candidates obtain posts without such courses, they may be most useful in reducing anxiety and obtaining frank feedback on performance.


You will require a comprehensive portfolio—a folder of evidence of achievements stated in your CV and application form.4 Its preparation generally takes longer than anticipated and is therefore best done at least one month before the interview. Then you can free up the days before your interview for practice, including on talking interviewers through your portfolio and highlighting features showing your suitability for the post.


Offers are made in mid-January. The process is competitive, so you may be made an offer if the first placed candidate declines the post. If you are unsuccessful, consider reapplying in round 2; new posts are often created by February. If no posts interest you, consider reapplying in November to start at CT2, CT3, or ST4, after gaining experience enhancing your application and interview performance. You will be informed of your interview score and maximum score, with your interview rank, after recruitment has concluded. For a nominal fee, you are entitled to request shortlist and interview score sheets, and these may help you to evaluate your performance. Other options exist (box 3), and formal academic posts are not a prerequisite for trainees to pursue research.

Box 1: Experience of ACF applications—Cían Hughes, academic foundation year 2, St George’s Healthcare NHS Trust, London

Why did you apply for ACFs?

I enjoyed my academic foundation job, was keen to further my research skills, am interested in PhD study, and ultimately want to become a senior lecturer or professor.

For which ACFs did you apply?

Ear, nose, and throat (ENT) at University College London. I liked the department and its research projects.

What advice would you give a candidate?

Research the position carefully and have an idea of what sort of research you might be interested in before applying, even if you change your mind afterwards.

What were the interviewers looking for?

A well rounded individual with clinical, research, and management/leadership skills. I feel I demonstrated my abilities in these areas while showing commitment to specialty.

What is different about ENT?

Like other surgical specialties, ENT is uncoupled for non-academic trainees and highly competitive at ST3, especially in London. Since the ACF includes a national training number, you are competing against less academically inclined, but nonetheless impressive, trainees looking for a secure training number.

What do you wish you had known before applying?

I wish I had spoken to more ENT trainees, both academic and non-academic; I could have been better prepared for the clinical interview. Being an ACF can often feel disorganised, since you don’t fall into the standard training pathway—it’s easy to be forgotten by the local education training board.

Box 2: Resources

  • Picard O. Medical interviews: a comprehensive guide to CT, ST & registrar interview skills. 2nd ed. Wood D, Yuen S, eds. London: ISC Medical, 2013

  • Ramachandran M. Secrets of success: getting into specialty training. 1st ed. Ramachandran M, Smith PJ, Gladman MA, eds. London: CRC Press, 2009

  • BMA Careers E-Learning modules via BMJ Learning, including “Maximise your portfolio,” “Make a successful application for specialty training (ST1),” and “Adding value to your CV”

  • BMJ Careers for articles about specific specialties, including academic surgery,5 academic general practice,6 and academic forensic psychiatry,7 ACF experiences,8 and alternative research options9

Box 3: Other options

The Welsh Clinical Academic Track provides run-through training from CT1/ST1, incorporating a salary funded three year full time PhD in academic medicine or dentistry.10 The MRC Centre for Neuropsychiatric Genetics and Genomics clinical academic mentorship scheme is one programme supporting trainees applying for the Welsh Clinical Academic Track.11

Edinburgh Clinical Academic Training offers a range of routes into research, including three Scottish PhD portfolio schemes, focused on translational medicine and therapeutics, clinical pharmacology and pathology, and psychiatry.12

You can also pursue self directed PhD studies, advertised salaried PhD posts, or independent research outside the PhD framework alongside your clinical activities.9


  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.


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