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

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

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 1999-2009 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).

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…

Overview: Applying for Your Fellowship 10. Peer review ~3 expert referees assigned. Report & score. Shortlisting by referees’ scores Interviews 20-30 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

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

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 4yr 2yr Methodology Research 4yr

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)

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…

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.

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

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

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

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…

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.