Academic Training in ICM

Published 20/01/2023

Academic Clinical Fellowships (ACF)

A proportion of ACFs are funded by the NIHR in departments where there is a substantial research environment. NIHR Academic Clinical Fellowships are specialty training posts that incorporate academic training. NIHR Academic Clinical Fellows (ACFs) spend 75% of their time undertaking specialist clinical training and 25% undertaking research or educationalist training. ACFs are aimed at those who, at the early stages of their specialty training, show outstanding potential for a career in academic medicine.

The duration of an ACF is for a maximum of 3 years. During this time, alongside clinical training, ACFs will be able to develop their academic skills and be supported in preparing an application for a doctoral fellowship. In addition, many schemes ensure that individuals in ACF posts achieve a Masters or Diploma level qualification during the course of their three year appointment. This varies in content. In some centres this is essentially a taught MSc or Diploma in research methodology, which may not contribute to time spent in obtaining a PhD but provides an excellent foundation for a future academic career. In other centres, this is integrated to produce an MPhil thesis, which serves as a research qualification in its own right, while also being seen as the first year of a 3 year PhD programme.

ACF posts vary in the stage of training at which they recruit candidates. The first of these is at ST1 where the 3 years of ACF can map onto ACCS, IMT or core anaesthetics. The second is at ST3 at the start of the ICM training programme. In each instance, it is recommended that the appropriate professional qualifications (e.g. MRCP, FRCA and/or FFICM) are achieved within these posts before moving onto a PhD training fellowship. This will ensure that trainees would have the best chance of making smooth progress through professional as well as academic training.

Research undertaken in ACF and similar non-NIHR posts is generally supported by project and programme grants in the host department, although some centres have specific funding streams to support such research and the collection of pilot data. However, there are also opportunities to apply for small pump priming grants (such as those provided by the Intensive Care Society and the National Institute of Academic Anaesthesia). Submission of such grant applications, with the ACF named as lead applicant/co-applicant, and involvement in the preparation of the application, should be encouraged, as it provides an important training experience for any future  doctoral fellowship application process.

In Scotland there are no centrally funded NIHR ACF positions in any specialties. Some regions or centres have excellent run through training schemes that include a pre-doctoral training period, a funded period of PhD studies, and a post-doctoral lectureship (for example ECAT). The way in which these local schemes mesh with appointment to national single or dual training schemes in ICM is as yet unclear, especially since the timetables for application for the two are very similar. As these schemes are highly competitive, and often open to trainees from any specialty, careful career planning with regional advisors and the FICM, and potentially some flexibility, are needed to ensure prospective ICM trainees are not disadvantaged. The lack of central funding for ACF positions out with England means individual deaneries and Universities rely on intermittent or short-term funding, or local funding models, to provide pre-doctoral research training.

ACF positions in Northern Ireland are coordinated by Queen’s University Belfast and the Northern Ireland Medical and Dental Training Agency (NIMDTA). ACF appointments are made via a competitive application process with trainees from other specialties, and early planning with the regional adviser in ICM and the programme director for academic training is advised.