Training Pathway.

The NIHR Integrated Academic Training pathway was created following the Walport Report, chaired by the Director of the Wellcome Trust, Dr Mark Walport.  It was published by the United Kingdom Clinical Research Collaboration (UKCRC) in 2005.  This created a new career pathway designed to safeguard the workforce planning and continued development of world-leading academic clinicians.


Clinical academics on the Integrated Academic Training pathway undertake ongoing clinical specialty training in the same way as Specialty Training Registrars (STRs) under the Gold Guide pathway, but receive funded, protected time to undertake academic training and research project hosted by their University Medical School.  

Resources / Links / Contacts

The Integrated Academic Training Pathway is funded and regulated by the National Institute of Health Research Trainees Coordinating Centre.  Further information regarding the management of the scheme is available.

Academic Foundation

Foundation training forms the first stage of postgraduate medical training. It spans two years and for logistical purposes is divided into Foundation 1 and 2 (F1 and F2).

HEE works in close collaboration with the Foundation School to ensure foundation training is of the highest quality. There are three areas within Yorkshire and the Humber, covering distinct geographical regions: West Yorkshire, South Yorkshire and North Yorkshire and the East Coast. The Yorkshire and the Humber Foundation School, directed by Mr Craig Irvine, covers all three of these areas.

Academic Foundation offers trainees a four-month academic placement in the second year of their contract. During this period they will either complete a short supervised Research Project, or undertake a period of Medical Education Training. 


Academic Foundation Recruitment takes place in the autumn and candidates apply for a clinical Foundation Programme placement.  Candidates should register with the National Foundation Programme Applications System nationally, then use their unique RA-number to apply to their Units of Application.  

Note that for Academic Foundation, candidates must indicate their interest in an Academic Foundation post at the point of application to ordinary clinical-only foundation. This will trigger additional questions relating to the area of Academic Foundation applied for.

Each Local area offers slightly different Academic Foundation programmes.  Please see the Foundation pages for more information.


Academic Clinical Fellowships

Academic Clinical Fellowships (ACFs) are prestigious and highly competitive Clinical Academic Training Posts. They offer trainees the opportunity to progress in clinical specialty training while developing research skills and working alongside world-renowned academics to conduct, present and publish research. 

ACF posts are 3-year fixed-term contracts which attract an NTN(A) and guarantee protected research time for the duration of the post. They may be offered at any level up to ST3 (ST4 entry is permitted in Paediatric Medicine and Psychiatry). Trainees will join the specialty or core training programme appropriate for their level of entry, but will undertake 75% clinical training, and 25% academic research in their chosen specialty.  ACFs hold a training contract with Health Education England working across Yorkshire and the Humber, an employment contract with the NHS Trust at which they are working clinically, and an honorary contract (without remuneration) with the University at which they complete their research.  

Clinically, they are supervised by their local Clinical and Educational Supervisors, responsible to the Training Programme Director and the regional Head of School.  Their research is supervised by their Academic Supervisor, who reports to the Specialty Academic Lead (the senior academic responsible for the University programme).  The Academic Training Programme Director has overall responsibility for the Academic programme and reports to the Deputy Postgraduate Dean with responsibility for Academic training.  This comprehensive support network acts to ensure that Academic Clinical Fellows progress both clinically and academically throughout their demanding role.


ACF trainees also undertake a Research Training Programme provided by the University for which funding is provided by NIHR, which can lead to a postgraduate qualification such as a MSc or a PGDip.  They also are eligible for a £1,000 bursary per year to attend or present at academic conferences.


All Academic Clinical Fellowship posts are run-through training posts, regardless of specialty.  A trainee entering ACF at ST1 in a specialty with a Core Training period would therefore be guaranteed continued training to CCT in the eventual specialty, as long as they progress satisfactorily through their training.   This applies whether a trainee wishes to continue with combined Clinical Academic training or not.  However, they are committed to the original GMC-approved specialty. If a trainee wished to change their original specialty he or she would have to apply in open competition in the same way as any other trainee.  Further information regarding ACF run-through is available.

Trainees who wish to pursue a continued Clinical Academic career after the end of the ACF fixed-term contact would normally make an application for an externally-funded fellowship to enable them to undertake a PhD.  If successful in that application, they would take Out-Of-Programme Research (OOPR), and return to the training programme after the PhD was completed.

If a trainee no longer wishes to continue as an academic clinician, he or she could take up the run-through promise above, and return to normal 100% clinical training in their originally appointed specialty. Please note that ACF trainees in Core Training Programmes will have a run-through to higher specialty training subject to attainment of the required clinical competences set by the curriculum and academic objectives set by their academic supervisor. Trainees who do not make satisfactory academic progress may have their academic status withdrawn at ARCP and this could result in the loss of run-through entitlement.

Resources / Links / Contacts

The National Institute of Health Research Trainees Coordinating Centre (NIHRTCC) provides a wealth of information on Academic Clinical Fellowship posts.

This can be found on the NIHRTCC website.

Out of Programme Research (OOPR)

Under the Gold Guide, Medical Trainees can apply for a period of dedicated research to undertake a higher degree such as a PhD or MD. During this time they move "Out-of-Programme" and their clinical training is paused until an agreed-upon date for return to the specialty training programme.

We would expect the majority of our Academic Clinical Fellows to use the pilot research conducted during their ACF post to apply for an externally-funded fellowship, but any specialty trainee is eligible to apply for OOPR.


The process for application for OOPR is the same as for any Out-of-Programme experience, and is outlined in the policies section.  Trainees must submit an OOP form to the Deanery, countersigned by their clinical Training Programme Director. The Postgraduate Dean or a deputy will make a decision on whether the period of OOP is to be approved.

Maximum Length

Health Education England – Yorkshire and the Humber allows academic trainees* a usual maximum of three years of OOPR, with a possible further year extension dependent on individual circumstances. 

*Academic Trainees are defined as those who have undertaken an Academic Clinical Fellowship or similar post in the previous twelve months and trainees who have been awarded an externally-funded fellowship from a major research funder e.g. Wellcome Trust, MRC, NIHR. Trainees who are in clinical-only training posts wishing to undertake higher degrees may also be considered for academic status to allow them to take a longer OOPR period on a case-by-case basis.

Return to Programme

It is essential that the clinical training programme are given as much notice of intended return to programme as possible. Failure to do this may mean that a training post is not immediately available at the end of OOPR.

Clinical Lectureships

NIHR Clinical Lectureships

NIHR Clinical Lectureships (CLs) are higher-level post-doctoral specialty training posts that offer the opportunity to continue clinical training while conducting, producing and publishing research.  Trainees are also expected to take on academic teaching responsibilities and supervise the research of trainees within the University Medical School.

CL's are four-year fixed-term national posts and attract an NTN(A). An NIHR Clinical Lecturer will have a training contract with Yorkshire and the Humber Deanery and will be employed by the host University, with an honorary contract with the NHS Trust at which their clinical training takes place.  They will undertake 50% clinical training and 50% academic research over the term of the post.


Like ACF trainees, CLs are clinically supervised by their local Clinical and Educational Supervisors, responsible to the Training Programme Director and the regional Head of School.  Their research is supervised by their Academic Supervisor, who reports to the Specialty Academic Lead (the senior academic responsible for the University programme).  The Academic Training Programme Director has overall responsibility for the Academic programme and reports to the Deputy Postgraduate Dean with responsibility for Academic training.  This comprehensive support network acts to ensure that Clinical Lecturers progress both clinically and academically throughout their demanding role.

Clinical Lecturers must have a higher degree (PhD or research MD) in order to be eligible for the post.  NIHR permit candidates to submit the final manuscript for the PhD/MD no later than the date of the Clinical Lectureship interview.  The PhD/MD must be awarded by the start date of the post.  They are (like ACF trainees) eligible for a £1,000 bursary per year to attend academic conferences.

All CL posts are run-through as with ACF posts above, but are also limited by CCT, as they are training posts. A Clinical Lecturer who reaches CCT within the fixed-term of the post will be eligible to apply for the normal 6-month grace period.  After this time, the post will expire unless CCT is revised through ARCP or application to the Specialty Advisory Committee (SAC). A trainee who finishes the fixed term of a Clinical Lectureship without reaching CCT is entitled to return to 100% clinical training in-specialty as a normal STR/SpR within Health Edication England - Yorkshire and the Humber to complete their training in the normal way.

After the Clinical Lectureship ends, trainees (or consultants, if CCT is reached by this point), can apply for a number of other awards to continue with their Clinical Academic career. These are covered in the 'Other Awards' section of the website.

Resources / Links / Contacts

The National Institute of Health Research Trainees Coordinating Centre (NIHRTCC) provides a wealth of information on Clinical Lectureship posts.

Further information is available in the 7th edition of the Gold Guide -

Dental Integrated Academic Training (IAT)

Dentists in Training are also eligible for combined Clinical Academic training on the Integrated Academic Training Pathway. After the completion of Dental Foundation (DF) Training, Dentists in Training can apply for an ACF in a Dental Specialty such as Paediatric Dentistry, or Oral and Maxillofacial Surgery.

ACF trainees will spend 75% of their time training clinically, and 25% of their time conducting academic research.  They will also be eligible to join the funded Research Training Programme offered by the host university.

CL trainees will split their time 50/50 between clinical and academic duties. They are required to hold a higher degree in the same way as for Medical CL applicants, but must be higher specialty trainees or possess significant clinical experience in the case of General Dental Practitioners (GDP's).

Dental Academic Recruitment runs from 1st March to 31st March of the following year.


Further Guidance on the Dental Integrated Academic Training Pathway is available.

Other Awards

The Integrated Academic Pathway forms a coherent career path for Clinical Academic Medical and Dental trainees. However, it is not prescriptive and the route in the graphic under the pathway introduction page is not the only way that Clinical Academic training can take place.

NIHR offer a number of other awards available to all Health Professionals, such as the Doctoral Research Fellowship (providing funding for PhD/MD study), the Post-Doctoral Fellowship, the Career Development Fellowship and the Senior Research Fellowship.  Further details of all these awards, including how to apply and recruitment rounds are available from the NIHR website.

The Medical Research Council (MRC), the Wellcome Trust and the Academic of Medical Research Charities all offer a number of fellowships to clinical academic trainees. Links to the websites of the organisations mentioned are provided in the Links box on the right.

Other specialty-specific organisations that provide research funding to clinical academics include:


Cancer Research UK (CRUK), the Leukaemia Research Foundation (LRF), Leukaemia & Lymphoma Research (LLR)

Diabetes & Endocrinology

Diabetes UK, European Foundation for the Study of Diabetes (EFSD), Diabetes Research & Wellness Foundation (DRWF)


The Stroke Association, The Brain Research Trust (BRT)


Arthritis Research UK/Arthritis Research Campaign (arc)

Respiratory Medicine

European Respiratory Society (ERS), Asthma UK


National Institute of Dental and Cranio-Facial Reserch (NIDCR), British Society for Oral and Dental Research (BSDR)

Links to the websites of all the above organisations are provided in the Links box on the right.

If you or your organisation funds Medical or Dental Fellowships or Research, or you are aware of a funder, please email and we will be happy to publish your link here.