Integrating research into clinical training through academic pathways.

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Medical students

Newcastle University offer intercalation opportunities during undergraduate training, allowing students to take a year out of the main programme to study an additional degree.

Both undergraduate and postgraduate degrees are available, including BSc, MSc, MRes, MClinEd and MA programmes. Postgraduate programmes are undertaken following completion of either stage 3 or stage 4 of the MBBS degree, with the following available programmes.

MRes Medical Sciences
The course is flexible and practice-based. It will suit health professionals and those involved or interested in medical education. Through advancing your skills and knowledge you will enhance your contribution to educational practice. You will also extend your ability to contribute to medical education as a discipline.
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Masters in Medical Education MMedEd, PGDip, PGCert
The course is flexible and practice-based. It will suit health professionals and those involved or interested in medical education. Through advancing your skills and knowledge you will enhance your contribution to educational practice. You will also extend your ability to contribute to medical education as a discipline.
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Bioinformatics MSc
The Bioinformatics MSc combines foundational skills in bioinformatics with specialist skills in computing programming, molecular biology and research methods.
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Computational Systems Biology MSc
The Bioinformatics MSc combines foundational skills in bioinformatics with specialist skills in computing programming, molecular biology and research methods.
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Neuroinformatics MSc
This course provides specialist expertise in core neuroinformatics (such as computing and biology) focusing on the development of research skills.
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Synthetic Biology MSc
This course provides you with a balance of molecular biology, engineering, computing and modelling skills necessary for a career in synthetic biology.
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All programmes aim to allow students to develop an inquisitive research mind within a supportive yet challenging environment.

Whilst all opportunities offer excellent research training, the MRes programme is particularly attractive, offering students the opportunity to choose advertised research projects in a topic of interest; these may be hospital-based clinical or laboratory-based basic science projects.

There is an extensive range of faculty-wide programmes, with the chance to work with internationally renowned surgeons and/or scientists within the North East.

Furthermore students may undertake learning modules in various fields, ranging from cancer to behavioural science, prior to performing their formal research project and writing up a dissertation.

NESTAC will be aiming to assist regional supervisors to advertise their projects via this website, as well as being involved in the annual MRes project event, where students may attend and discuss potential projects with supervisors.

Academic training pathways

At the turn of the millennium it was becoming clear that academic surgery was becoming a dwindling career path for budding surgeons.

Whilst carrying out a period of formal research (MD/PhD) was typically seen as a right of passage prior to being awarded a registrar training number, with the advent of streamlined training an increasing number of trainees have not pursued an academic interest, and as such less trainees have been inspired to take on a substantial research role as part of their consultant commitments.

Surgical Academics 20%
Clinical Lectures 50%
The stats support this, with the Walport report in 2005 quoting a 20% reduction in surgical academics and 50% reduction in clinical lecturers in surgery.

With this in mind an academic training programme was introduced, which allows trainees to have protected time for research. The programmes are fully NIHR funded, and hope to facilitate students or trainees to approach research the ultimate aim of developing their own specialist interest as a consultant, running their own research unit or laboratory as principal investigators (PIs), thereby advancing knowledge and development in their specialist field and improving patient care.

The schematic above demonstrates how the structured academic pathway runs in line with mainstream training. AFP/ACF/ACL posts will now be discussed in more detail, as well as how to partake in more formal research within the mainstream pathway via OOPR opportunities.

Academic Foundation Pathway

Medical students may apply for the Academic Foundation Programme (AFP), as opposed to the mainstream foundation programme.

This is a competitive application, requiring students to already have some experience of research on their CV. As such an intercalated degree is near enough expected, with the additional benefit that this provides opportunities for further CV boosting with presentations, publications and prizes.

The AFP allows trainees to gain research, leadership, management and teaching experience, with 4-month dedicated academic placements in both F1 and F2, in combination with specific academic teaching opportunities and an allocated academic supervisor.

With the assistance of the AFP director, students are encouraged to seek out a supervisor in an subject of interest, with the aim of carrying out either a clinical, translational or basic science project

The Academic Compedium provides useful information on what is expected of foundation doctors pursuing research within the foundation programme, and therefore what they may be expected to achieve during an AFP post.

Further details on how to apply for the AFP are available on the FP website whilst specific details of the AFP in the North East are available on the Madeinheene website.


Following completion of either the academic of standard foundation programmes, trainees may apply for an Academic clinical fellowship (ACF) post consisting of 25% research time and 75% clinical training over 3 years (equating to sufficient clinical competency comparable to the 2 year core training programme).

Following this trainees are encouraged to undertake an MD/PhD, whereby pilot data during their ACF may form part of a fellowship funding application.

Thereafter, assuming a successful project and signed off competencies (clinical and academic) at ACF level, trainees may then take up an academic clinical lectureship (ACL) post which consists of a 50:50 split between clinical and research training over 4 years.

There is a reasonably even distribution between scientific, translational or clinical projects; a recent study demonstrated a split of 22:32:28% respectively in surveyed academic trainees. Therefore when deciding upon projects/supervisors at an early career stage, it is important to carefully consider what you want out of your research experience, and choose an appropriate supervisor/laboratory/research unit/institution as appropriate. It might be difficult to decide upon this with little/no experience of laboratory life; this merely accentuates the importance of carrying out some formal research during medical school, thus indicating whether you may be suited to either a more clinical or scientific orientated project







Formal research within mainstream training pathways

Whilst the structured and integrated academic pathways appeal to many, it is a competitive selection process and not all will be successful. Furthermore some students/trainees wish to maintain a degree of flexibility or are simply not 100% decided upon an academic pathway, with the option to have a research interest within an NHS consultant job more of an attractive option.

Trainees may go through the typical training pathway of foundation, core and specialty training posts, with opportunities for formal research experience along the way.

Research experience is an integral part of training, as highlighted by the CST and ST interview process – part of the CV station at ST3 interviews (which attributes 20% of overall mark) awards bonus points for postgraduate qualifications, peer-reviewed publications, national/international presentations and awards (which can be achieved through conference prize sessions) – the following marking proforma pays evidence to this – here.

The critical appraisal interview station will be much easier to perform well if you are regularly involved in reviewing research studies.

As such all trainees need experience in high quality research, and NESTAC hope to provide these opportunities, especially as this may inspire trainees to pursue further research within their career.

Nonetheless if you wish to excel in a research career, it is generally considered nearly essential to enter a period of formal research to achieve an MD/PhD, as this provides invaluable expertise (running a trial/lab skills) and knowledge (developing a niche specialist interest), development of organizational/team-working skills, experience in grant/fellowship writing, and ultimately the dedicated time to commit to an in depth research project, with the potential for much greater future research prospects as a result.


Pursuing formal research in mainstream training can be done in one of 2 ways:
  1. “Out of training” formal research – Following F2 or CT2, rather than moving on to CT1/ST3 respectively.
  2. Out of programme research (OOPR) – There is the potential to take time out of speciality training (i.e. ST3-8) via “Out of programme for research” (OOPR) arrangements to undertake an MD or PhD, which are usually 2 and 3 year periods respectively. We believe the optimal time for this would be following ST4/ST5; at this stage you will have most likely decided upon the surgical subspecialty you wish to pursue, and as such can tailor the research project towardsa specific area of interest, with the most appropriate supervisors and institutional involvement. At this stage you will have developed a competent level of surgical skills which will allow you to pick up these basics quicker once you return to full time training. Taking OOPR later on (ST7/8) potentially leads to de-skilling immediately prior to taking up a consultant job when ideally you should be on top of your game.


Applying for a project can be done generally in one of two ways:
  1. Advertised projects where the study topic/supervisor is often pre-determined thus limiting any project personalisation, however these opportunities are often fully funded through research fellowships/charity involvement (e.g. MRC/Wellcome/CRUK), and therefore represent an ideal chance to step straight into a set-up project with less concerns regarding money for general costs/consumables/salary and generally the benefit of committing full time (with usually an unbanded salary) to the project. Applications are typically through a competitive interview process, thus re-emphasising the need to optimise your CV during early years training to increase chances of success. Keep an eye out on university websites for such opportunities; alternatively the Newcastle Joint Research Office may be able to guide you.
  2. DIY with the assistance of a consultant supervisor/NESTAC mentor – herein you contact a potential supervisor who might have a project idea and established connections to achieve both a salary (often by taking up a research fellow post and covering an on call rota +/- limited elective duties) and consumables (from a “research pot”/established research fund). Typically the first 6 months is spent generating pilot data, prior to using this data to apply for a fellowship e.g. from RCSEng (salary funded + small amount of consumables for 1yr →MD) or to a charity such as MRC/Wellcome/CRUK (typically 2yrs salary with higher consumable funding →PhD), both of which allow you to commit full time in the second +/- third year to complete your project. Research supervisors will have more detailed information on these and other funding sources, with local charities also possibly providing consumable support.