Annex 7: Principles for the development of Clinical Academic Training
Principles for the development of training of Clinical Academic Careers in Medicine and Dentistry
Purpose of this paper
This paper is submitted for consideration by the UKSTSG as a suggested response by the "academic community" to recommendation 14 of the Shape of Training Review ( SoTR). It describes principles that it is proposed should underpin the future development of academic careers. The UKSTSG are invited to note and support these principles.
Recommendation 14 of the Shape of Training Review ( SoTR) report ( http://www.shapeoftraining.co.uk/reviewsofar/1788.asp) stated that:
"Appropriate organisations, including postgraduate research and funding bodies, must support a flexible approach to clinical academic training"
It is important for patients and service providers that medical training equips doctors with the skills to teach and to undertake clinical and scientific research. It is equally important that doctors are able to participate in research activities throughout their careers on either a full time or part-time basis. The doctors who focus on this aspect of medicine are known as "clinical academics".
The current training pathways are considered not to be flexible enough to permit the acquisition of both clinical and research skills, to prepare for an academic career or to allow trainees to undertake a period of research without jeopardising their clinical training.
In response the following work groups have been convened to consider the issue and to formulate solutions.
1. The UK Shape of Training Steering Group ( UKSTSG) sponsored a workshop that was chaired jointly by Medical Schools Council and Academy of Medical Sciences and was held on September 26th 2014 at the Academy of Medical Sciences. Stakeholders who attended included the 4 Departments of Health, Members of the UKSTSG, Representatives from HEE, NES, Wales and N.Ireland, NIHR, GMC, LETBs, Deaneries, BMA MASC, Employers/ NHS Board, Colleges including AoMRC trainees, Medical students involved in the INSPIRE programme, Trainees, The Wellcome Trust and other AMRC representatives ( BHF, CRUK).
2. A short life task force working group was commissioned in England by CMO Dame Sally Davies under the auspices of UKCRC (Chair Professor Paul Stewart) that focussed on issues such as inconsistencies in training, flexibility of approach, supervision and mentorship, equality and inclusivity.
3. The BMA Medical Academic Staff Committee (Mark Walport) discussed this at their 10th anniversary event held at Goodenough College, Oxford in October 2015
4. COPMeD (Conference of postgraduate Medical Deans) discussed the issue at an event held in Durham in February 2016 that was chaired by Professor William Reid.
5. Contributions have also been obtained from the following research funding bodies; The Wellcome Trust (Jeremy Farrar, Anne-Marie Coriat), MRC (Joanna Robinson, John Savill) and NIHR (David Jones as Dean for Faculty Trainees).
Based on the output from these various forum, principles have been developed that it is proposed should underpin the future training of clinical academics.
The Proposed Principles:
Clinical academic training  must operate within a trainee centred and mentored framework jointly overseen and implemented by the university Medical or Dental Dean, through a designated academic lead, and the Postgraduate Dean  . Clinical academic trainees will normally be employed by an academic institution and will be conducting their academic research within an NHS Trust / Board / local authority. This training tripartite  structure involving the academic institution (where appropriate), the NHS and the trainee is responsible for ensuring high quality clinical academic training and should have the following key features:
- Clinical academic training must be personalised, planned and integrated across both clinical and academic areas. Immersion in academic research for periods of time should be valued and appropriately approved. Although this is time away from clinical training, it is a key aspect of career development. Trainee-centred flexibility in training should be the norm with sufficient protected time for research, to support the research competencies required in all clinical training curricula.
- The University Medical or Dental Dean, Postgraduate Medical or Dental Dean and academic lead should work collaboratively to ensure barriers to integration across academic bodies and deanery functions are addressed.
- Where individuals, on nationally competitive training awards, are required to change employers to pursue their clinical academic career pathway certain accrued employment rights, which are linked to continuous service of employment, must be protected. This includes any changes in employer from a NHS trust/board to an academic institution or vice versa, in principle there should be no detriment to moving in either direction. These include as a minimum all family and care-related leave and pay (not limited to gender or sexual orientation) and sick leave and pay (irrespective of disability status or health history).
- Institutions must have a clear plan for promoting and achieving a diverse clinical academic workforce, along all protected characteristics and in all clinical specialties. Similar plans must exist with respect to the composition of the supervisory and mentoring pool as well as the management structure.
- Trainees must be provided with clear expectations on performance. These expectations should form the basis of assessments of progress. Tools used to manage and assess performance must meet the General Medical Council ( GMC) statutory requirements for the approved clinical training and local academic assurance systems.
- Trainees must have access to high quality mentorship, leadership and support to help the trainee pursue their next career steps.
- Where relevant, trainees must have access to appropriate programmes of research and management skills training including but not limited to informatics, robust research methods, experimental design, statistics, data analytics, ethics and core aspects of management and leadership training relevant to career stage.
- The clinical component of training should remain competency-based rather than time-based and must be managed appropriately by a postgraduate dean and be subject to the usual governance, quality management and quality assurance processes. 
- To participate in and facilitate the collection and sharing of data tracking the careers of academic trainees and those that have passed through academic training.
Obligations of Trainees:
- To take responsibility for their career development and performance academically and clinically through attainment of clinical competencies.
- To fully engage with the clinical academic training programme and, in particular, together with advice from supervisors, manage and direct their research project and training in line with their funder's guidance on good research practice.
- To fully engage with the professional responsibilities laid out in Good Medical Practice. To achieve the professional learning outcomes, to participate in local quality management and statutory quality assurance of clinical training.
- To provide feedback to enable effective monitoring and assurance of the application of these principles on request.
- To assist in the collection of data necessary to track their careers.
- Trainees are expected to provide support and guidance to medical/dental students and more junior trainees on the clinical academic training pathway.
Obligations of the Funder:
- To ensure that their approach to funding clinical academic careers is appropriately tailored to career stage, clear, accessible and easy to engage with.
- To support trainees during this period of training, consistent with the principles outlined in this document.
- To develop a meaningful approach to assurance of clinical academic training and ways to facilitate and share best practice. Detailed guidance will be developed in partnership across funders to enable effective monitoring of progress with the translation of these principles into practice.
- To include these principles and obligations in their terms and conditions of award.
Note: The UKSTSG agreed to support these principles with the important caveat that matters relating to terms and conditions of service were outwith the Group's terms of reference. Consequently, the UKSTSG noted that pay and conditions aspects mentioned within principle three above were matters between employers and employees.
Email: Dave McLeod, Dave.McLeod@gov.scot
Phone: 0300 244 4000 – Central Enquiry Unit
The Scottish Government
St Andrew's House