The NIHR Academic Clinical Fellowship (ACF) programme offers a great opportunity for (potential) infection trainees to further their goals in research and academia whilst undertaking clinical training, providing dedicated research time.
Background Information
Typically, universities apply to NIHR for several posts in specialties aligned with the institution’s strengths/priorities in the 1-2 years prior. Once awarded to the institution by NIHR, the process can differ somewhat regionally. In some institutions there is internal competition to allocate the ACF to a specific Principal Investigator (PI)/ group before it is advertised (if this is the case, the PI will usually be on the panel interviewing applicants). In other institutions, successful candidates later select from several pre-defined projects under different PIs. In some cases, projects are well defined and decided ahead of starting, whereas in others the project may be linked to grant applications in preparation or be less well-defined. There is usually a degree of flexibility – it is not uncommon for successful applicants to explore alternative projects/supervisors over the course of their ACF.
Application Logistics
There are often a different number of ACFs available in a given specialty year by year. Generally, these are offered at a grade from ST1-ST4. Some deaneries seem to preferentially offer earlier (i.e. ST1, entering at IMT), while others offer later (ST3 ID/MM or ST4 ID/GIM). The application for each post is separate although the contents of the application form are the same – this means if the application is progressed, interviews will be separate. Previously, there was no limit to the number of applications allowed each cycle, however in recent years this has been capped at three applications. Posts offered in in infectious diseases are relatively common compared to other specialties. Whether the post is being offered in combination with medical microbiology/virology or with general internal medicine may not be specified at the outset, especially for posts with entry in ST1/ST2. Applicants who do not already hold an infection NTN (or DRN if applying at IMT stage) will also need to ‘clinically benchmark’ – this does not mean candidates need to rank high enough to be offered a post in the relevant deanery, but rather that they need to be deemed appointable at interview.
Application Process
ACF applications generally open 4-6 weeks before purely clinical applications and are advertised on institution websites and the NIHR website, with applications through Oriel. Person specifications can be found on the NIHR website. There is usually a long-listing and short-listing stage. Interviews tend to occur between November to January, with offers made in January (prior to clinical offers) with clinical benchmarking pending if required. The NIHR website has details for each application cycle.
Starting Out
In some cases, successful applicants will already be known to the PI/group they start out with, particularly if they have already been working in the region. However, this is not always the case. In the early days it is important to understand how both the academic and clinical pathways will work locally – this varies by region.
Academic time may be allocated as three-month blocks per year, one day per week, nine months at the end of year ACF ST3, or some other variation. Within the same deanery, this can be allocated differently dependent on specialty. ACFs may have a lot of choice in the structure (e.g., blocks vs throughout) or only limited choice (e.g., when to take a three-month block each year). Where there is choice, it is worth considering the type of project you have/want and what would work best. If undertaking a laboratory project, a longer time in one block might work best. Alternatively, if the ACF project is linked to a bigger programme/grant, it may be more beneficial to have continuous involvement (e.g., one day a week). The timing of blocks is also important relative to ARCP, clinical exams etc. Often the academic time is more useful later in the first year, particularly if starting out IMT or CIT in that year.
Clinical placements for ACFs will generally work differently compared to non-academic trainees. Usually, ACF contacts are linked to one trust within the deanery – consequently for the duration of the ACF there may only be a very limited number of sites candidates will rotate through. This can be both advantageous (not needing to move/commute) and disadvantageous (if certain clinical training opportunities are more limited at specific centres). For those starting at IMT, there may be more choice in the clinical rotations done as an ACF. It is useful to choose specialties that will aid in meeting portfolio requirements (especially given more limited clinical time) – for example choosing specialities with more clinic or procedure opportunities.
It is useful to meet early on with an academic supervisor after taking up the post. This helps to establish your supervisors’ expectations and plan your time – is there a project you are expected to work on? If not, what suggestions do they have for how you might use your academic time? You may also wish to explore other supervisors/groups in this early period, especially if there is no defined project for you. Some institutions expect ACFs to undertake specific modules of an MSc over the course of the three years. ACFs generally enroll on these modules without a fee, though in some cases some of the ACF budget may go towards this. Otherwise, the ACF budget (£1000 each year for duration) can be used to learn new skills (including online courses/learning platforms), buy software licenses, buy a laptop, attend conferences etc.
Overall, the ACF is a perfect time to (1) explore different research areas within the broad specialty of infection, (2) develop new research skills, and (3) explore new collaborations and working under different supervisors before ultimately using time later in the ACF to put together a proposal for a PhD fellowship.