The Shift into Independence

By the time I started my Academic Clinical Lectureship (ACL), I had already spent several years in research through a PhD and earlier academic training posts, and felt reasonably comfortable with study design, data generation, and grant writing. What I had perhaps underestimated was how different the ACL feels in practice. It is less a continuation of training and very much a transition into independence.

For me, the most striking shift was the realisation that academic work begins to resemble running a small business, within the university. There is an expectation not only to generate ideas, but to sustain them: to secure funding, build a programme of work, and create opportunities for others. I found myself thinking not just about my own trajectory, but about how to support and retain technical staff, how to maintain momentum between grants, and how to ensure that projects remained viable over time. That responsibility can feel heavy, particularly early on.

A piece of advice I received at the start helped reframe this. The ACL is, in many ways, a reward for the work that precedes it: a funded post, a genuine 50/50 split between clinical and academic time, and a defined period, usually four years, to develop your own ideas. I found it helpful to think of it as a protected opportunity to test whether a long-term academic career was right for me. There is reassurance in knowing that, if it does not suit, returning to full time clinical training remains an option.

Making the Split Work

One of the first practical decisions I faced was how to structure the clinical academic split. There is considerable flexibility, and I know colleagues who have opted for block arrangements, with extended periods focused entirely on research followed by clinical work. In my case, I chose a weekly split. This was partly pragmatic, as I wanted to maintain clinical continuity and prepare for FRCPath Part 2, but also intentional. Most clinical academic consultants I had observed were balancing both roles simultaneously, and I wanted to understand whether that was sustainable for me in the long term.

Making a weekly split work required discussion with both the training programme director and the department. Although ACLs are supernumerary, aligning clinical days with service need made integration easier. On call commitments were another area that required early clarity. As these are not funded within the academic component, expectations vary. I opted to maintain a reduced on call commitment, which was valuable for training, but it did highlight practical challenges, particularly where rest days following overnight work overlapped with academic time. In retrospect, this is something I would advise discussing explicitly at the outset.

Returning to clinical training after a period of research also required some adjustment. In my case, I sought out available deanery support, including a short course on time management, which was helpful. Another important consideration was my anticipated CCT date. Time on the ACL counts towards training, and progression remains competency based. Initially, I extended my timeline to allow for the full duration of the ACL, but it is worth emphasising that there is flexibility here, and this should be reviewed periodically. I did, in the end bring my CCT date forward and there is guidance on RCPath website about this.

There were also several administrative aspects that I had not fully appreciated. As an ACL, I became a university employee rather than being employed by the trust, which introduced some complexity. Ensuring that I was not paid twice, and avoiding the associated tax implications, required active coordination. Maintaining access to the NHS pension scheme was another priority, and this needed to be arranged promptly. Differences in annual leave between university and NHS contracts also required discussion specially around AL and carer’s leave entitlements.

Building Momentum and Looking Ahead

Once these practicalities were in place, my focus shifted towards funding. Like many, I targeted early stage schemes, including the Academy of Medical Sciences starter grant. My first application was unsuccessful, but the feedback was really constructive, and a revised submission was subsequently funded. Smaller grants from organisations such as the RCPath, BIA and HIS are also useful in building a funding portfolio.

Mentorship has been particularly important for me during this stage. While local supervisors remain central, I found it helpful to seek perspectives outside my immediate field and institution. Through the NIHR Research mentorship scheme, I was able to connect with a mentor who provided more strategic guidance, particularly around positioning myself for future fellowships and consultant job applications.

Alongside research, I became increasingly aware of the need to develop a broader academic profile. This included taking on more formal teaching responsibilities, contributing to curriculum development, and seeking leadership opportunities within both clinical and academic settings. Quality improvement projects within the clinical service also proved valuable, not only in delivering tangible benefits to patients, but in providing examples that could be clearly articulated in future consultant applications and supervision experience which helps with ARCP.

Throughout all of this, there is an underlying sense, at least in my experience, of stepping slightly outside one’s comfort zone. The transition from trainee to independent academic is not always linear, and there are moments of uncertainty. However, this is a common experience. Engaging with leadership training and peer networks helped to normalise this and provided practical strategies for managing it.

Overall, my experience of starting an ACL has been both challenging and rewarding. It is a period defined by increased responsibility, but also by genuine opportunity. For me, the key has been to approach it with a degree of flexibility, to recognise that not everything needs to be resolved immediately, and that this stage is as much about exploration as it is about progression.