1. NIHR Trainees’ Meeting
Leeds 20th September 2011
Peter Dukes
Head, Research Career Awards, MRC

2. Clinical Research Fellows
Fellowships
The person
The project
The ‘place’
Grants
The project / programme
The people
The ‘place (s)’
“The thing I enjoy so much is that my work has direct application to people…”
MRC/Academy of Medical Sciences Clinician Scientist

3. MRC Clinical Research Fellows
Potential research leaders of the future
Vision
Synergy between clinical & research training
Development through excellent research
Intellectually demanding project
Using advanced methods, skills & technologies
Development in an excellent environment
Committed, professional supervision
Depth & breadth of research excellence
Access to essential research facilities & resources
Engagement in research translation
Inspirational leadership & mentorship
MRC postdoc Clinical Fellows report
More collaborations per award than other MRC Fellows and grant holders
More instances of further funding…
More impact on policy…
Senior Clinical Fellows:
Progression: Of 24 Senior Clinical Fellows whose fellowships terminated in
46% (11) had applied for major MRC grants.
50% of the 20 applications made by the 11 fellows were awarded
Comparator: Award rates for standard 5-yr grants = ~33%
Citations of MRC postdoc Clinical Fellows’ papers
7% of their papers are cited 8x more than ‘expected’
5% of their papers are uncited, compared to >15% of all UK medical/health/clinical papers
Patrick Maxwell’s RTF class of ’91
Of the 61 individuals who could be tracked, 29 (44%) are Professors, including 11 (17%) Fellows of the Academy of Medical Sciences (FmedSci), and 4 (6%) have become senior leaders in industry. (Percentages are calculated from the total cohort number of 65).

4. Applying for Your Fellowship
Plan your options
Supervisor / Institution / Project focus / Fellowship
Identify competition scope, criteria, process & dates
Check your eligibility
Develop your proposal well ahead
Take advice!!!
Understand the application forms & guidance= web-based
Institutional sign off= critical
Submit through web, on CD…
Admin check by funder
Peer review…

5. Overview: Applying for Your Fellowship
10. Peer review
~3 expert referees assigned. Report & score.
Shortlisting by referees’ scores
Interviews min
Timed 2 or 3 minute presentation
Two designated Panel members ask questions
Other members then follow
They focus on the project & your potential
Synergy between clinical & research training
Outcome within 1-2 wks
Reserve list ?
Time out: sort with Deanery

6. Senior Clinical Fellowship
Overview of schemes 1 MRC Research Fellowships for Clinicians 3
Senior Clinical Fellowship
Clinical Training / SCL 10
Clinician Scientist Fellowship
52 awards (+2x10 Clin Pharm/Path)
Clinical Training / CL
These are the CURRENT CLINICAL FELLOWSHIP schemes
Targeted to key points in the “career life-cycle”
Clinicians will move in and out of the pathway, so as to balance clinical and research training
MRC not cradle to grave
MRC has INCREASED provision for clinical training:
Also: Population Health Scientist Fellowships, Biostatistics, Bioinformatics and Methodology (not shown)
Issues highlighted by Training & Careers Group
Pull in, pull through, pull across…
Need better MRC support for MRC trainees, especially at vulnerable CRTF  CSF break during clinical training [Wellcome has £5m initiative targeted at the “break” population] supporting the CRTF-CSF gap]
Clinical Research Training Fellowships
Clinical Training / ACF
Approx Years post PhD -3 -2 -1 1 2 3 4 5 6 7 8 9

7. University-based MRC post doctoral fellowships – Non-Clinical, Clinical and several Capacity Development fellowships
Senior Non-Clinical
Career Development Award
PhD
Research Yrs Post PhD -1 1 2 3 4 5 6 7 8 9 10 11 12
Clinical Training
Clinical RTF
Clinical Training
Clinician Scientist
NON-CLINICAL – above the boxed line (note, no immediate postdoc non-clinical fellowships)
CLINICAL -
Senior Clinical
Population Health Scientist
Bioinformatics, Biostats, EoH 3yr yr yr
Methodology Research 4yr

9. Clinical Research Fellowships
Support for clinicians at each stage of their careers
Research Training Fellowships
Postdoc Training Fellowship for MB/PhD Graduates
Intermediate Clinical Fellowships
Senior Research Fellowships in Clinical Science
Research training integrated with clinical training
Clinical Research Training Fellowships (3-yr  PhD)
Clinician Scientist Fellowships (4 or 5-yr, postdoc)
Senior Clinical Fellowships (5-yr)

10. Great outcomes Great outcomes MRC postdoc Clinical Fellows report
More collaborations per award…
More instances of further funding…
More impact on policy
Citation analyses
MRC Fellows’ papers more cited than ‘expected’
Careers
2x as competitive as “norm” in gaining grants
~50% progress to academic chairs…

11. Patrick Maxwell’s RTF class of ‘91
Of the 61 individuals who could be tracked, 29 (44%) are Professors, including 11 (17%) Fellows of the Academy of Medical Sciences (FmedSci), and 4 (6%) have become senior leaders in industry.
Percentages are calculated from the total cohort number of 65.
Note that in 1991 in contrast to today the Clinical Training Fellowship competition was also open to non-clinicians and that 16 out of the 55 awards were non-clinical (see Appendix 1 for details).
This data, although on a relatively small scale and qualitative, demonstrates that an impressive proportion of early clinical fellowship awardees developed into established (clinical) research leaders.

12. Post-CRTFs: Active as clinicians & researchers
Academics (clinical activity)
NHS Consultants (research activity)
88% of post-CRTFs in academic posts are clinically active; 65% spending >25% of time on clinical activities. Most direct or lead research
~80% of post-CRTFs in fully clinical posts are research active, spending <25% of time on research. Most contribute to research led by others

13. MRC CRTFs help you build your research competence & career
Effect on research competence & achievements? 85% responded significantly or very significantly
Effect on Career? 94% said significantly or very significantly

14. Clinical Research Fellowships
Outstanding scientists
Extraordinary opportunities
Great outcomes
Competitive!
“The thing I enjoy so much is that my work has direct application to people…”
MRC/Academy of Medical Sciences Clinician Scientist

15. Great outcomes Great outcomes MRC postdoc Clinical Fellows report
More collaborations per award…
More instances of further funding…
More impact on policy
Citation analyses
MRC Fellows’ papers more cited than ‘expected’
Careers
2x as competitive as “norm” in gaining grants
>50% step into chairs…

17. Research-intensive Clinical Fellowships in the context of the Integrated Academic Training Path (England) (Data: OSCHR fellowship Survey, March 2009)
This slide shows data collected from 12 funders as part of the OSCHR partners survey of clinical fellowships (March 2009).
Full report available on the MRC website.
MRC (plum colour) funds about one-third of CRTFs in England (and UK, although this slide = England).
NIHR has created both a pool of pre-doctoral ACFs, across with the intention of (i) broadening the participation in research training of a medical specialties and locations that have not had a strong history of research engagement; and (ii) enhancing the competitiveness of talented individuals for an MRC, WT, BHF or other CRTF.
NIHR has also invested with HEFC in additional Clinical Lectureships (50% research time, but without research expenses) to help sustain post-doctoral research interest.
The funders are developing a project to track over time a cohort of trainees, including ACFs, to identify what works in promoting research careers, the impact of the funders’ investments in clinical research training and what determines peoples’ career choices as the move along the IATP.