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Academic medicine

Hello, I'm a third year at Cardiff and I'm considering an academic career.

In particular I am interested in becoming a neurologist with a research component. As such I was wondering what the best way to go about this would be. I am intercalating next year (Pharmacology) and would most likely consider a MSc after my house-jobs. Then I wonder if a D.Phil / PhD / MD is the best approach during speciality training, or as a gap between core and speciality.

Additionally how does pay work? In terms of does one have their NHS pay and then additional pay from the Uni one is attached to? If so, what could one reasonably expect to make as a consultant and senior lecturer / reader / Prof.? Obviously I am not in this for the money (otherwise The City or Orthopod with all the private practice would be on the cards).

Thanks for any responses.

Muppet Science
Original post by Muppet Science
Hello, I'm a third year at Cardiff and I'm considering an academic career.

In particular I am interested in becoming a neurologist with a research component. As such I was wondering what the best way to go about this would be. I am intercalating next year (Pharmacology) and would most likely consider a MSc after my house-jobs. Then I wonder if a D.Phil / PhD / MD is the best approach during speciality training, or as a gap between core and speciality.

Additionally how does pay work? In terms of does one have their NHS pay and then additional pay from the Uni one is attached to? If so, what could one reasonably expect to make as a consultant and senior lecturer / reader / Prof.? Obviously I am not in this for the money (otherwise The City or Orthopod with all the private practice would be on the cards).

Thanks for any responses.

Muppet Science


There is an "academic pathway" that exists as the sort of "ideal route" to follow for an academic career, although I think it's normal for people not to follow it exactly.

Academic Foundation Programme > Academic Clinical Fellowship > PhD > Clinical Lectureship > CCT

So you'd do 2 years of Foundation Programme with one research block as part of the AFP. Then you'd start an ACF programme, which lasts for 3 years, with a 75:25 split between clinical:research. This would let you get preliminary data to apply for funding for a PhD. You'd then do your PhD. After completing the PhD, you'd apply for a 3 year Clinical Lectureship, which has a 50:50 split between clinical:research. Then you'd get your CCT, and could apply for Lectureship positions etc, although I'm not entirely sure how things work after you've got the CCT. There's a fair bit about the career pathway if you google it! :smile:

If you were employed by the university, I think they would pay your salary. I think they'd match the standard NHS salary for a clinician of the same grade, but I'm not 100% sure of that.
Reply 2
Original post by Muppet Science
Hello, I'm a third year at Cardiff and I'm considering an academic career.

In particular I am interested in becoming a neurologist with a research component. As such I was wondering what the best way to go about this would be. I am intercalating next year (Pharmacology) and would most likely consider a MSc after my house-jobs. Then I wonder if a D.Phil / PhD / MD is the best approach during speciality training, or as a gap between core and speciality.

Additionally how does pay work? In terms of does one have their NHS pay and then additional pay from the Uni one is attached to? If so, what could one reasonably expect to make as a consultant and senior lecturer / reader / Prof.? Obviously I am not in this for the money (otherwise The City or Orthopod with all the private practice would be on the cards).

Thanks for any responses.

Muppet Science


Do your higher degree as part of your specialty training - 1) more likely to be decided on your specific career path, it's always best for your own development I suppose to spend 3 years becoming the world's expert in a very very very very specific thing if you're then able to vaguely apply that thing to your research life after it. For example, no point doing a PhD with a massive lab component if you actually want to go on and do epidemiological research. 2) the new contract provides extra money if you do your PhD within your specialty training.

You get 1 pay packet (not one from the NHS and one from the university), this is covered by the university (but is actually covered by you, technically, through the grants you get for the university). Contracts are 4 year rolling, at least at the beginning, so if you're getting no grant money in you can be cut. For academic clinicians, the work you do for the NHS is free to the NHS (the university is paying your wages), so you're "honorary" (you've probably seen consultants called this) and have much more control over your working life. For example, if you only want to work 9-5 on a Monday and do no clinics, you can do that.

As for amount - my understanding is that it matches the NHS payscale, but people don't often discuss their pay so I'm not really sure. Presumably if you're bringing in loads of money and are really good you get paid more. Who knows though.
(edited 7 years ago)
As the others have said, there is now a formal academic pathway and I think you would need a pretty good reason to deviate from that. It works well and has the right amount of flexibility built in at the right times. You can move in and out of the pathway but, realistically, it's probably harder to get back in once you've been out for any length of time. *

-Academic foundation programme (FY1/FY2): usually five clinical rotations and one four-month academic rotation.
-Academic Clinical Fellowship (ST1-ST3): largely clinical but 25% of time is dedicated to research. This is a run-through post and so you do not need to compete for an ST3 job in neurology - it is guaranteed as long as progress is satisfactory. You should spend the 25% academic time applying for doctoral research fellowships, i.e. money to support your PhD study.
-PhD: 3-4 years "out of programme" but guaranteed to return to training as an ST4 after your PhD.
-Clinical Lectureship: 50% research and 50% continued clinical training at ST4+.
-Senior Clinical Lectureship: equivalent of an NHS consultant but employed by a university. It will usually come with an honorary NHS consultant appointment at the same time.
-Professor: combined clinical/research role (proportions spent in each domain are negotiated individually - it's largely up to you) and bringing in lots of research grants.

In terms of pay, clinical academics are usually paid the same as their purely clinical counterparts. You do however have more control over your working week (fewer fixed commitments) and can negotiate odd extra payments depending on how much you are in demand. There are also clinical excellence awards, which can boost salaries considerably. The platinum CEA (rarely awarded) currently adds Β£80,000pa to the standard consultant salary. Clinical excellence awards are under review at the moment and it's not sure how/whether they will feature in the new consultant contract.

As you noted, the financial downside is that it can be difficult to balance NHS work, research, and private practice. Most academics lose out on private practice for this reason but I don't know whether that's necessarily a major consideration for neurologists (outside of London) anyway. That said, some clinical academics make a good private practice living as patients like to see the professor...*
Thanks all, very helpful information.

Original post by MonteCristo
As the others have said, there is now a formal academic pathway and I think you would need a pretty good reason to deviate from that. It works well and has the right amount of flexibility built in at the right times. You can move in and out of the pathway but, realistically, it's probably harder to get back in once you've been out for any length of time. *

-Academic foundation programme (FY1/FY2): usually five clinical rotations and one four-month academic rotation.
-Academic Clinical Fellowship (ST1-ST3): largely clinical but 25% of time is dedicated to research. This is a run-through post and so you do not need to compete for an ST3 job in neurology - it is guaranteed as long as progress is satisfactory. You should spend the 25% academic time applying for doctoral research fellowships, i.e. money to support your PhD study.
-PhD: 3-4 years "out of programme" but guaranteed to return to training as an ST4 after your PhD.
-Clinical Lectureship: 50% research and 50% continued clinical training at ST4+.
-Senior Clinical Lectureship: equivalent of an NHS consultant but employed by a university. It will usually come with an honorary NHS consultant appointment at the same time.
-Professor: combined clinical/research role (proportions spent in each domain are negotiated individually - it's largely up to you) and bringing in lots of research grants.

In terms of pay, clinical academics are usually paid the same as their purely clinical counterparts. You do however have more control over your working week (fewer fixed commitments) and can negotiate odd extra payments depending on how much you are in demand. There are also clinical excellence awards, which can boost salaries considerably. The platinum CEA (rarely awarded) currently adds Β£80,000pa to the standard consultant salary. Clinical excellence awards are under review at the moment and it's not sure how/whether they will feature in the new consultant contract.

As you noted, the financial downside is that it can be difficult to balance NHS work, research, and private practice. Most academics lose out on private practice for this reason but I don't know whether that's necessarily a major consideration for neurologists (outside of London) anyway. That said, some clinical academics make a good private practice living as patients like to see the professor...*


I'm just speculating here but would a MSc after the academic house jobs be a good idea, or is it fine for one to jump straight to a PhD during ST years, as you mentioned?
Reply 5
Original post by Muppet Science
Thanks all, very helpful information.

I'm just speculating here but would a MSc after the academic house jobs be a good idea, or is it fine for one to jump straight to a PhD during ST years, as you mentioned?



Are you not allowed to intercalate straight into a masters at Cardiff? Might be a bit late though since you're intercalating imminently. The F3 year is a fairly common year to take out to do something out of programme and I know people that have done masters degrees, either here or abroad, so it isn't going to be completely left field for you to do something like that.

You could do something part-time. Masters are split into 3 elements (certificate, diploma, masters) which are cumulative, and you can generally do 1 part per year part-time. The benefit is that you're not having to take a year out (and the whole cut in pay, etc., as you wouldn't be funded for a masters like you would for a PhD). There are programmes like this that are specifically designed for people that want to do research clinically and for them to do it part time whilst working, there is probably similar degrees in Cardiff/wherever you want to work as a doctor.
There's no real need for an MSc and a lot of people will counsel against them if you're intending to complete a PhD anyway. That said, you could use an MSc to learn a little more about your specialty and the dissertation element to start working out the direction in which you are going to take your PhD. There are lots of part-time +/- distance learning MScs around. If you were looking at taking a year out (e.g. after FY2 or CT2), I'd think carefully about a Masters degree overseas just to justify the additional time out of your career - most US Ivy League schools (Harvard, Yale, etc) will run MPHs. Look out for Fulbright/Knox/Kennedy Scholarships for funding.
If you do not go down the fixed academic pathways the trend nowadays is to get into specialty training before a higher degree. In neurology this has classically been the opposite however now if you do a PhD after CMT you will need to recertify your cmt competencies somehow which is a bit of a ballache. Might change by the time you get to that stage though. I use the word 'trend' deliberately though... It's not fixed in stone and the St3 interviews for neurology are still brimming with people who already have a PhD under their belt, at the moment.

Cambridge also run a registrar programme where a PhD is integrated and compulsory, it's not an ACF.

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