Director's update: Refreshing our offer to clinicians

As many people are aware, clinical research is an area of Wellcome Trust activity which is particularly close to my heart. In my own career I have had first-hand experience of juggling a job as a hospital doctor with a clinical research interest, and specialist training.

Dr Jeremy Farrar

Credit: Wellcome

Wellcome Director Jeremy Farrar

Some might say I made life even harder for myself by changing specialism from neurology to infectious diseases in my early thirties. Since then, the majority of my career has been spent in Vietnam, where until very recently I was still doing twice-daily ward rounds, while also conducting and publishing research on avian flu, dengue fever, typhoid, TB and a range of other infectious diseases.

My impression on returning to the UK a year and a half ago is that the challenges facing a clinician wanting to pursue research are still there – particularly in establishing yourself early in your career. However, the UK is a unique place to be a clinical researcher, and there are really exciting opportunities thanks to what we, the NIHR, MRC, CRUK and other charities offer, and also because the NHS provides healthcare for the vast majority of people in the country. Clinician scientists are a hugely valuable asset to the NHS and, more widely, they are the interface between clinical medicine, public health and basic research.

The Wellcome Trust has long recognised this key role for clinically qualified researchers. One example of a clinician researcher we have supported for a long time is Sadaf Farooqi at the University of Cambridge, who has been funded by Wellcome Trust clinical schemes since the late 1990s. Her team's research into the genetics, physiology and neuroscience of severely obese patients has directly led to improved diagnostics for a range of obesity syndromes and a mechanism-based treatment for a specific obesity disorder, congenital leptin deficiency. This transformational treatment has been used successfully around the world, improving the lives of patients with this deficiency.

At the Wellcome Trust we have been listening to the clinical research community, both through individual meetings and through workshops with the directors of the Wellcome Clinical PhD Programmes, clinical trainees, funders, medical school deans and others. What we have heard from you is that there is scope to update how we support clinical researchers, so that our funding and approach is more flexible, and better at supporting diversity among clinical trainees.

We also want to make sure that our funding is suited to the pressures facing early-career researchers who take on the challenge of gaining a clinical specialism, whilst also conducting research, and maintaining a home life.

The first change we are introducing is to deliver all our PhD training to clinicians exclusively through tailored PhD programmes from autumn 2016 onwards, meaning the end to the Research Training Fellowship. We believe that training small groups of PhD students in programmes gives the best opportunity to embed clinical academic training within universities and university hospitals, to build a community of researchers, and enhance mentoring.

We will be launching a competition in autumn 2015 for new clinical PhD programmes, and we envisage that this expansion to our existing portfolio will ensure that clinicians from across the range of specialities, in all corners of the UK, the Republic of Ireland, and in our Major Overseas Programmes, will be supported. We encourage innovation in the creation of new PhD programmes. For example, programmes could include elements of industrial collaboration, be hosted across multiple institutions, be open to allied health professionals or those working in medical humanities.

The second change we are introducing is the establishment of a Postdoctoral Clinical Scientist Fellowship, consolidating two of our existing schemes into a single, flexible offer.

We are also providing additional funding which means that our capacity for supporting clinicians at a postdoctoral level will increase by 50%. This enhanced support at the postdoctoral level is in line with changes we have introduced for our basic science fellowships. The new approach also allows the possibility of longer term support and greater accommodation for balancing research and clinical training. It will be open to those who are re-entering academia after career breaks or extended periods of clinical training, and will adapt to the changing clinical training model.

We believe that these changes, supported by significant additional Wellcome Trust funding, will help improve diversity among the clinical trainees and clinicians we fund, and particularly help early career researchers to establish themselves in their chosen fields.

As ever, we welcome feedback on these changes. 

More details about our new clinical career pathway, and details of how to apply will be available in due course.