Pre-doctoral medical academic training

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Pre-doctoral training is the stage before completing a PhD or MD. It is when you begin to build the skills, experience and professional connections needed to prepare for independent research.

Clinical academia is flexible. There is no single route into it and you do not need to complete every programme listed here to build a successful academic career. Some people start early, while others move into research after several years of clinical experience. What matters is choosing opportunities that fit your interests, specialty and circumstances.

Training opportunities across the UK

The structure of training varies across the four UK nations, but all aim to support clinicians in developing the knowledge and skills needed to contribute to high-quality research, innovation and education.

England

After completing the Specialised Foundation Programme (SFP) or standard foundation training, you can continue clinical training without an academic component or apply for an Academic Clinical Fellowship (ACF) early in specialty training. You can usually enter an ACF at any point from post FY2 to ST2 level.

ACFs provide protected time for research alongside your clinical work. They are designed for trainees in the early stages of training who want to develop a career in academic medicine or dentistry.

Typically, ACFs consist of 25% academic time and 75% clinical training over three years (or four years in primary care). This allows you to build research skills while progressing clinically. The fellowship offers structured support to help you apply for a competitive PhD or MD fellowship.

ACFs are delivered in partnership between universities and NHS organisations.

NIHR Academic Clinical Fellowships Medical Training Recruitment – Medical Hub

“ An ACF gives fellows access to Masters-level training for those wanting to develop a career in research alongside clinical training. This helps you develop academic competencies and decide whether a research career is for you. ”

Dr Damian Roland, former NIHR Academic Clinical Fellowship (ACF) awardee

Scotland

In Scotland, clinical academic training follows an integrated model, though there are no direct equivalents to ACF posts. Most doctors enter academic training after gaining a National Training Number (NTN) through a Clinical Lectureship.

These posts allow you to combine academic and clinical work while working towards both your Certificate of Completion of Training (CCT) and an academic appointment.

There are two main pathways:

Scottish Clinical Research Excellence Development Scheme (SCREDS) – funded by universities and NHS Scotland, available at both pre-doctoral and post-doctoral levels.
Clinical Academic Track (CAT) – funded by the Wellcome Trust, beginning with a pre-doctoral PhD phase followed by a post-doctoral lectureship. Wellcome’s funding for clinical academic training is currently provided through various PhD Programmes run by different university alliances across the UK, rather than a single, centrally administered “CAT” scheme by Wellcome itself.
The TRACC (to Train and Retain Academic Cancer Clinicians) programme – Cancer Research UK Edinburgh and Glasgow Centres’ clinical academic training programme in cancer enables clinicians who have already completed their medical degree to develop an academic career and undertake a clinical research training fellowship, leading to the award of a PhD.

Clinical Lecturers usually spend around 20% of their time on research and 80% on clinical work, although this ratio can be adjusted to suit the needs of the trainee and their research.

SCREDS Scheme

Both SCREDS and CAT trainees can take Out of Programme (OOP) time to complete a PhD or MD. Clinicians not on these schemes can also undertake OOP research as Clinical Fellows. These are generally funded by organisations such as the Medical Research Council (MRC), Wellcome Trust or British Heart Foundation.

Wales

The Welsh Clinical Academic Training (WCAT) programme provides an integrated pathway for doctors and dentists to combine clinical and academic development from ST1 to CCT. It is delivered by Health Education and Improvement Wales (HEIW) in partnership with Bangor, Cardiff and Swansea Universities, with funding from the Welsh Government.

WCAT trainees have 20% protected academic time throughout clinical training, increasing to 50% in post-doctoral stages and complete a three-year research project leading to a PhD. Entry is possible at most stages of training except the final year.

Trainees are encouraged to apply for external fellowships such as those from the MRC or NIHR. If unsuccessful, WCAT can provide salary support during the research period.

About the WCAT

All WCAT trainees take three years out of programme (OOP) for a funded PhD. They can also apply for further OOP time later in training.

Through membership of the Office for Strategic Coordination of Health Research (OSCHR), WCAT trainees also have access to UK-wide opportunities through UKRI, Wellcome Trust, Cancer Research UK, British Heart Foundation, and NIHR schemes, provided they meet the specific eligibility criteria of the individual funding body and scheme.

Northern Ireland

Northern Ireland does not have a single formalised national pathway but offers a range of Academic Foundation, Academic Clinical Fellowship and Clinical Lectureship posts similar to those in other UK nations.

Clinical academic training is coordinated through the Clinical Academic Training Programme Board (CATP), a collaboration between Queen’s University Belfast and the Northern Ireland Medical and Dental Training Agency (NIMDTA).

ACF posts in Northern Ireland usually run for two years, with 25% research time and the rest in clinical training. They are open to trainees at ST3 or above, or ST1 or above for GP. During this time, trainees are supported to apply for an externally funded PhD fellowship.

Queen’s University Belfast website NIMDTA

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Last updated on 2 February 2026.