Every pathway to an academic career is unique. The diverse nature of plastic surgery provides the opportunity to pursue a wide range of clinical, laboratory, educational and applied research.
Blending clinical and academic activities can be hard work, but very
rewarding. An understanding of research principles is valuable for all surgical
trainees, and some may be inspired to spend additional amounts of
dedicated time to research activities. Academic plastic surgery offers the
opportunity to participate in the broader scientific community, and develop a
field of expertise in turn contributing to the leading edge of patient care.
Five main routes of entry exist:
1. National Institute for Health Research Integrated Academic Training
Programme (NIHR IAT)
2. The Welsh Clinical Academic Track (WCAT) Programme
3. The Scottish Clinical Research Excellence Development Scheme
4. Individual charity or institutional awards
5. Funded research positions
The NIHR Academic Clinical Fellowship scheme (ACFs) allow trainees to
undertake 25% research and 75% clinical training over 3 years at the predoctoral
level. The NIHR Clinical Lectureships (CLs) allow trainees to
undertake 50% research and 50% clinical training over 4 years at a postdoctoral
Awards made through the NIHR are either via Universities who have had
posts allocated, or personal awards through a national recruitment.
Details for both streams are available at the NIHR website.
The WCAT scheme is a fully integrated clinical academic training pathway
funded by the Welsh Assembly Government combining the ACF and CL
schemes described above to provide seamless training from PhD level, to
post doctoral to independent investigator. The first 3 years encorporate a
fully funded PhD (80% research and 20% clinical training) and the following 5
years allow 20% research and 80% clinical time. In a craft specialty such as
plastic surgery, this gives the optimum opportunity to both meet the
requirements for FRCS Plast and independent practice as a consultant,
whilst keeping up to date with research activity. 10% of all WCATs in Wales
are trainee plastic surgeons so there is a critical mass to foster research
excellence (www.reconregen.com). Details for applications can be found at
the Wales Deanery website.
The Scottish Clinical Research Excellence Development Scheme (SCREDS)
provides an integrated research training and career development pathway
enabling clinicians to pursue concurrently or sequentially academic and
clinical training within the NHS. It facilitates both the attainment of a senior
clinical academic appointment and the award of a Certificate of Completion
of Training (CCT). Awards typically allow for 20% research training time, and
80% clinical time up to the point of CCT. Appointees also benefit from having
an academic mentor throughout training.
Individual awards are highly competitive and through a variety of funding
3-4 year funding can be obtained through the Medical Research Council
(MRC), Wellcome Trust (WT), Cancer Research UK (CRUK), and Academy of
Medical Sciences (AMS) amongst others.
A large number of shorter 1-2 year funding schemes include those from the
Royal College of Surgeons of England (RCSEng), and the Royal College of
Surgeons of Edinburgh (RCSEd).
These awards have individual conditions, but usually involve a national
recruitment with a research plan in place, and open competition often with a
wide range of medical and surgical specialties. Some allow for integration of
some clinical training, but this varies between awards.
Funded research positions
Occasionally, research opportunities will be available in the form of a
research project that already funded as part of a larger project grant. These
positions usually involve an application to the Principal Investigator of the
project, and may be advertised through local or national routes. As the
project is pre-determined in this funding stream, this can work well if the
research area matches your interest.
Accommodating research during training
Research undertaken within the NIHR scheme is automatically integrated
with clinical training, with the national training number (NTN) being converted
to an academic NTN (NTN-A). WCATs have a fully integrated run through
NTN-A, and entry can be anywhere from FY2 onwards depending on
Research undertaken with individual awards or through pre-funded positions
will need to be discussed with individual training programme directors for a
period of Out of Program Research (OOP-R). Individual deaneries have
mechanisms in place to facilitate this.
Establishing an independent Research Group
Substantive academic surgery posts remain few and far between in plastic
surgery in the UK. In fact the majority of academic plastic surgeons hold
honorary or single session academic positions and future appointments at
professional level are likely to be based on personal achievements rather
than continuation of established posts.
The transition from pre-doctoral research training to establishing an
independent research group remains both challenging and exciting.