Pathways to Research Careers in Medicine

Research can allow you to develop many skills that can also be applicable to clinical work done, such as learning to think critically and how to assess medical literature properly. In the constantly evolving world, being a participant in research studies can not only allow you to remain up to date with advances in the medical field, but also can allow you to be part of the improvement of knowledge. As a clinical professional and researcher you can learn how to analyse, evaluate and expose data and apply it to patient centred care.

Furthermore, it offers oppurtunities to collaborate with universities and organisations not only in the UK but further afield, stimulating international improvements and collaborations worldwide in healthcare. Research has a great impact on health policy and global working relationships, giving you the oppurtunity of interacting with influential individuals, therefore highlighting the importance of seeking out and maintaining contact with mentors who can guide you through different research projects.

It can be very difficult to balance out clinical work with research as it demanding on time and comes with its difficulties. Taking on both clinical work with patients and research requires both a passion and organisation. It is always important to maintain a healthy work-life balance and being involved in both aspects can be rewarding, but is very demanding and it can be stressful due to the different work-loads.

Nowadays there is more pressure to specialise in either one field or the other and it can feel like you are are not dedicating your time and energies to either places properly. Additionally, advancements clinically and academically may be limited compared to professionals involved in only one field. In research, there is always a certain amount of uncertainty in the outcome of projects and it can lead to potential ‘dead time’, therefore individuals involved need to demonstrate patience and be able to use a variable skill set in their careers. Clinical work is seen as being more tangible, whereas in research the goal maybe further away and more intangible in the moment.

At the holistic level of patient care research is just as important as clinical work, but on a day to day basis with demands of working in a clinical department with critical patients it can be hard to immerse yourself in projects when there is nobody that can take on the clinical work when you are not there. It is crucial to focus on teamwork and creating an adequate working environment where clinical work can be delegated in order to provide research time to clinicians interested. 

The specialised foundation programme is exciting. It provides an insight into the world of academic medicine that allows you to make more informed choices about your future career. You get dedicated time to investigate something you’re passionate about and you have more independence in your work. 

You get to work alongside medical and non-medical colleagues who have knowledge and experience you can benefit from. You will develop many transferable skills in academia that will stand you in good stead when you return to hospital. These include skills such as teaching and time management. You will also develop key skills for an academic career, such as experimental techniques, literature review, critical appraisal, or statistics.

During academic training you will have extra opportunities to produce posters, attend courses and conferences, give presentations, and submit publications. You will also have had the opportunity to develop your research interests and foster links with a department where you may want to work in the future.

You cannot choose whether you want to pursue research or education in the programme and are allocated a position in either.

The academic foundation programme is hard work: you must obtain all of your clinical competences, but many times you have less time in hospital than your peers. Alongside clinical work you must complete the academic requirements which underlines how important it is to be motivated and organise your time well, in order to manage the competing demands. Additionally, being involved in research and education can feel more slow paced than hospital work and it can require more time to complete projects and publish papers. 

In Scotland during training, it is possible to follow an integrated training and career development pathway that enables clinicians to pursue academic and clincal training within the NHS. The program is called Scottish Clinical Research Excellence Development Scheme (SCREDS) and this can be done concurrently or sequentially to clinical specialisation. It is created to allow clinicians to become lecturers, do out-of programme research and allows for advanced academic career development such as becoming senior clinical fellows.

SCREDS programme 

On the other hand, in England it is possible to follow an integrated training and career development pathway that enables clinicians to pursue academic and clinical training with the National Institute for Health and Research (NIHR) and Health Education England (HEE). The programme is called the Integrated Clinical Academic Pathway (ICA). It provides a opportunities to undertake fully funded research, research and academic training and professional development whilst maintaining a clinical job.

Integrated Academic Training

HEE-NIHR Integrated Clinical and Practitioner Academic Programme

In medical school at the University of Alberta, there are two combined MD and graduate degree options, including an MD/MBA and MD/PhD.  They also have MD-STIR (Special Training in Research) which assures students of sponsored supervision in the first two years and recognition on their parchment upon graduation.  These can be viewed on the website

Beyond that, at the residency training level, departments have their own strategies to prepare selected trainees as clinician scientists.  While there is no assurance of an academic post upon completion of residency training and certification in a specialty, these candidates are carefully groomed with a strong chance of being successfully hired into these roles.  In Canada, many of residents with backgrounds in research, including the combined degrees mentioned above, are unfortunately enticed away from the long and winding road that leads to the top tiered clinician investigator.

That said, during residency training, trainees may be involved in simple after hours projects, or they may have protected rotations.  They may complete a graduate degree by taking time off from their residency program, or unusually, there are sometimes ways to do it concurrently.   The more secure and traditional route, however, very popular in surgical residency training is the Clinician Investigator program. This program is an approved residency training program by our Royal College of Physicians and Surgeons of Canada, with a program director, and resident salary, and it creates the protected time for residents to complete a graduate degree (Masters or PhD).  There are three pathways within CIP including a continuous training (24 months of continuous intensive research training), the fractionated training pathway (12 months in period of 3 months blocks interspersed with other residency training, followed by 12 months of continuous), or the distributive curriculum training (27 months completed concurrently with a RC special training in 3 sequential years (ie. each year would include 3 months of clinical training and 9 months of research training).

Each department may have different practices as it relates to promised academic posts at the end of residency training.  While there is no “program” or assurance of this as such, the practice of making promises is alive and well.

Completing a PhD is a wonderful way to integrate yourself in the world of research and academia and can be done at various stages of a career which allows for some flexibility.  It is an additional research that adds to the body of knowledge and is the highlest level qulification. There are many options when deciding how and when to undertake a PhD, for example during a specialisation or after it. A full-time PhD will require time out of training (3-4 years) while part-time PhD will take longer to complete but can be done alongside clinical work. Additionally, there is the option to complete a PhD by portfolio, intended as an accelerated part-time PhD for those who have already part-taken in extensive research over a significant amount of time and have a number of publications arising from this that can be grouped together.

Alternatively an MD can be undertaken, which is a form of PhD awarded to those exlusively with expertise in medicine, and lasts around 2 years full time/4 years part-time. Both can allow you to enter research but an MD is more suited to clinical aspects while a PhD is solely focused on research.