Supporting academic training for early-career geriatricians in the UK: the NIHR Integrated Academic
Contributor: Dr Rose Penfold, Academic Clinical Fellow in Geriatric Medicine,
Origin/affiliation: National Institute for Health Research, London, UK
A growing ageing, frail population calls for new approaches to care for older people. Recent years have seen increased funding and opportunities for research in geriatric medicine; however, older adults with frailty remain relatively under-represented in clinical research and a smaller proportion of geriatricians are employed on academic contracts than in other physician specialities. To sustainably grow research opportunities in the specialty, it is desirable to engage and support clinicians from an early career stage.
The UK National Institute for Health Research (NIHR) Integrated Academic Training programme supports doctors to gain research experience alongside clinical training. The NIHR funds approximately 250 Academic Clinical Fellowships (ACFs) and 100 Clinical Lectureships each year in a variety of specialties. These posts offer teaching in research principles and methodology, as well as dedicated academic time and funding. With both dementia and complex health needs in age-related disease now NIHR priority research themes, there has been recent expansion in the number of ACF posts in geriatric medicine.
A study of the first ACF cohort suggests the scheme is successful in developing careers in academic medicine. Posts are highly competitive, attracting a large number of applicants with high fill rates. Nearly half of the initial ACF cohort progressed to a position with an academic component and ACFs were significantly more successful when applying for doctoral research fellowships than their clinical colleagues. From personal experience, the programme has many benefits: protected time to develop a research methodology skillset, experience of writing ethics and grant applications, networking opportunities and time to work up a higher academic proposal. Of course, combining academic with clinical work is not without its challenges: ACFs are required to meet the same training requirements as their purely clinical counterparts in a reduced timeframe. Other challenges highlighted include financial, maintaining work/life balance and poor institutional support.
Overall, I would highly recommend interested UK-based trainees to consider applying for an ACF and for colleagues in other countries to consider the feasibility of similar programmes in their context. Assuming ACFs continue to demonstrate success in developing academic careers, this can generate further impetus to expand early-career opportunities in academic geriatric medicine in the UK.