The whys and hows of a clinical academic career in Child and Adolescent Psychiatry
Clinical academia in the United Kingdom (UK) is facing a paradox; while training the next generation of clinical academic doctors in the UK is becoming more competitive and restrictive, with many candidates disputing one position, on the other hand, the overall number of clinical academics is diminishing (Politis et al., 2024). This blog was supposed to encourage people to follow clinical academic careers in child and adolescent psychiatry, but I didn’t want to be tone-deaf to the crisis our field is currently facing. Be warned, this is an optimistic blog with doses of realism. So, amid increasing competition, why and how to pursue a clinical academic career in child and adolescent psychiatry?
An overview of clinical academic training in the UK
One of the many fantastic things about pursuing a clinical academic career in the UK is the possibility of joining the Integrated Academic Training Pathway. According to NIHR guidance, the programme supports the training of doctors and dentists in England to develop their clinical academic careers. It is delivered through several schemes that rely on close partnerships between the NIHR, Health Education England (HEE), medical schools and NHS organisations. In practice, this means you can apply for positions either at foundation entry, specialty training level entry or at higher training entry for positions which embed research within clinical training (an Academic Foundation Place, an Academic Clinical Fellowship (ACF) or a Clinical Lectureship). These positions are advertised in partnership with universities and often it is a competition between more than one specialty. When I applied for my ACF, it was a competition between Child and Adolescent Psychiatry, Public Health and GP. Each university will have its own Clinical Academic Training Office – I recommend reading carefully through their websites as each programme will have its own characteristics. Some offer more generous bursaries; others offer the opportunity to complete a master’s degree alongside the ACF; it depends. The most important consideration, in my view, is the type of research you want to do and if this aligns with the department’s current lines of research and future priorities. Identify a supervisor early if you don’t already have one and reach out via email before applying.
A personal perspective
To write a blog about my trajectory always seemed a bit preposterous to me, but it made me reflect on my journey until the Academic Clinical Fellowship offer and how often I wished to have found a blog like this when going through my application journey. During this path, which was certainly not linear, I obtained inspiration from many sources, including Malaika, a brilliant colleague (you can check more on her fabulous work here: Trailblazers in Child and Adolescent Mental Health: Celebrating Women Pioneers – ACAMH) who said during an Early Career Researcher panel we organised for our first ACAMH ECR Branch: “you have to take that leap of faith”. I hope some of what I write will resonate with you and encourage you to take your own leap.
After completing the foundation training equivalent in my home country, I moved to England to complete a research masters looking at eating disorders epidemiology in children and young people at the University of Cambridge. Quite early in my master’s, I knew I wanted to pursue an academic career and so did my supervisor – who encouraged me to apply for an MRC Doctoral Training Fellowship to continue developing my research into a Doctorate. I also applied for a NIHR Doctoral Fellowship – both applications were developed alongside the research master’s. I still remember the first time I opened the MRC website and looked at all those empty fields late at night in the office. It seemed an enormous task for a newcomer but I put one foot in front of the other and said let’s do it. The MRC application became less daunting as months passed and the percentage in the completion bar went up.
Ultimately, both bids failed but the MRC application in particular had a huge effect on my self-esteem as an early career researcher (ECR). We received some really encouraging feedback which I will certainly use in future grant applications – and as I was advised by a very senior supervisor; her own rate of success around grants is 50%. I learnt that you will fail many times in an academic career, but it is okay, as long as you are prepared to keep going. As I heard from a clinical lecturer in a recent event: “persistence is the only way through”. Here, I want to add a caveat: it is totally fine if you need to take some time off to recompose and bounce back after a rejection. Certainly, repeated rejections can take a toll on a researcher’s mental health and everyone’s circumstances are different. At the end of the day, it is up to us to know our own limits and try not to push beyond them too much. Especially in medicine, it is a common trap to conflate our self-worth with our academic achievements (a trap I have been the victim of too), however this can be a dangerous route, particularly in a field where rejection is almost a constant.
Five pieces of advice for aspiring ACF applicants
Reach out to people in the university you want to apply to – not only potential supervisors but academic trainees
Your research project is one of the criteria that you will be scored on in your interview. Considering an ACF is only nine months long, you need to demonstrate that your project is feasible within the timeframe. In my humble opinion, the best way to do that is by discussing your project idea before with academics in the department you are applying for. So, reach out early!
Find sources of inspiration
Inspiration is essential to help keep you going when failure arrives and can come from many sources: your mentors, friends, colleagues and more.
Prepare for the interview consistently
The interview questions are published beforehand on the NIHR website so take advantage of that and prepare early! Also, be prepared to answer questions like “What is your motivation to be a clinical academic?” because they might come up too.
Remember you can still thrive at an academic career without an ACF
The IAT programme was initially designed as a multiple-entry point system, not a continuum. Competition ratios have skyrocketed since, and whilst an ACF certainly helps, it is absolutely not a requirement to apply for a PhD or for a Clinical Lectureship. So if the ACF does not work out, know that many thriving academics did not do one.
Persistence is the only way through – prepare to fail
My supervisor, a very senior academic, told me her own rate of success around grants is 50%. Failure is inherently part of academia, and persistence really is the only way through. Remember, LinkedIn, Twitter and social media show snippets of reality but not the full picture. Any academic career you look at will include a share of rejected articles, job applications, grants and so on. So, don’t be deterred if it does not work out initially!
NB This blog has been peer reviewed
References
- Politis et al, 2024; BMJ 2024;384:q485 http://dx.doi.org/10.1136/bmj.q485
- Academy of Medical Sciences. Transforming health through innovation: Integrating the NHS and academia. Jan 2020. https://acmedsci.ac.uk/file-download/23932583
- IAT Guide | NIHR
- Trailblazers in Child and Adolescent Mental Health: Celebrating Women Pioneers – ACAMH
About the author
Clara is from Brazil and is a junior doctor and aspiring child and adolescent psychiatrist. She currently serves as a Young Person Ambassador for ACAMH and is interested in eating disorders and in the epidemiology of mental health disorders in young people. Clara is a MPhil candidate in the Department of Psychiatry at the University of Cambridge.