What is a clinical fellow?

Clinical fellowships are fixed-term locally contracted posts (usually 12 or 24 months) outside the national training pathway, combining clinical work with time set aside for non-clinical activities such as education, research, quality improvement or professional development. However, it's primarily a service provision role, rather than a training post, and distinct from the Academic Clinical Fellowship programme.

It's a career option if you're a qualified doctor who has completed the foundation training programme in the UK, or an international medical graduate (IMG) with full GMC registration and the right to work in the UK (a Skilled Worker visa).

What are the types of clinical fellow?

There's a wide range of clinical fellowship roles at different levels and within different specialties and types of organisations (NHS, universities, government and the private sector). The employer will usually determine the job title, responsibilities and pay scale.

Fellowships generally fall into one of the following categories.

Specialty and sub-specialty - Junior or senior clinical fellowships give you experience in a particular department of the trust, doing clinical duties under the supervision of a consultant, alongside protected time for research, teaching and more.

Clinical research - Alongside clinical duties, you can develop research skills and contribute to medical advances as part of teams working on projects or trials.

International schemes - If you're an IMG, there are trust programmes that provide training and supervised hands-on experience as part of the on-call rota. Each has its own selection criteria and schedule and there may be one or more intakes per year.

Clinical leadership schemes - Fixed term secondments within a host organisation such as the NHS , the GMC or NICE that enable emerging leaders to develop essential skills like strategic thinking, project management or understanding heath policy.

Where can I find fellowship vacancies?

You'll find clinical follow posts advertised on job sites like nhsjobs.com and Indeed, NHS trust websites, email circulars and department notice boards.

Clinical supervisors and colleagues may also tell you about upcoming vacancies and new fellowship schemes, so it pays to keep your ears and eyes open and ask around, especially if you're enjoying a rotation or if a hospital is a hub for your preferred specialty.

What are the upsides and potential downsides of being a clinical fellow?

Taking a fellowship post is a personal career choice, but here are some points that might help you decide if it's right for you. First, the positives.

Gain specialty experience - A specialty fellowship is a great opportunity to work in a specialty that might be harder to access through core training. Find out whether plastic surgery or paediatrics is right for you, before committing to the training path.

Enhance clinical and non-clinical skills - As part of the departmental rota, you'll be able to practise procedures and enhance your diagnostic and treatment planning skills, which should help build your confidence. And you have protected time to pursue non-clinical interests such as research, teaching, public health, med tech or leadership.

Strengthen your portfolio - You can improve your prospects for a specialty training post or another job application with evidence that you've assisted with procedures, completed projects and taken part in further training.

Widen your professional network - Working under consultants and collaborating with other experts and attending conferences are all opportunities to make connections, whether you need professional advice, a career mentor or a job reference.

Get a better work-life balance - Wellbeing and burnout is a growing concern among doctors in training but a fellowship should offer some breathing space. You might be able to negotiate on the ratio of clinical to non-clinical work in your contract, or limit on-call time so you can study, travel or pursue other interests.

On the other hand, a fellowship might not be suitable if you're concerned about the following.

Not as well-paid as other roles - The pay grade is set by your employer. You can usually expect to be paid at the rate that matches your experience but you're likely to earn less than you would as a locum or in a training post, especially if you're reducing your clinical hours.

No guarantee of professional development - This isn't a structured training post and you might find you're expected to plug gaps in the rota and there isn't much time and support from your consultant. If you reduce the amount of clinical work you do, there's also a risk of deskilling. Many fellows still report good training opportunities and experience.

Increasingly competitive - As awareness of fellowships grows and more doctors take time out of the national training pathway, there's growing competition for some posts in popular specialties. You may also want to think about trust grade posts or locum work.

How can I make the most of a clinical fellowship?

What you get from a fellowship will depend on your employer but also on your own determination and enthusiasm. These tips should help you make it a positive experience.

Do your research - If possible, talk to doctors currently or previously in the post about their experience - ask about the role, working conditions and support and get a feel for what's involved.

Negotiate and make the job your own - Unlike national training, there's often scope to expand or refine a fellowship post, so use the interview or offer stage to talk about your interests and the kind of clinical experience you're looking for and make your case for different hours or additional benefits like study leave.

Ensure you get a proper induction - Fellowship roles typically start in August, but you should get an induction covering essentials like the computer system, hospital policies and protocols and the chance to familiarise yourself with the hospital. This is especially important if you're an IMG and new to the UK and the NHS.

Be a self-starter - You'll still need to improve your portfolio and the onus is more on you to manage your professional development, such as keeping a log of procedures, getting the necessary experience with audits, presentations, courses and conferences. Be prepared to make the most of all the networking opportunities available too.

Ensure you have the right indemnity - You should be able to call on expert medico-legal advice and representation if something goes wrong during your fellowship. NHS indemnity won't cover things like trust disciplinary proceedings or GMC investigations, but your medical defence organisation can help.

Get MDU support

If you're an MDU member, contact us to make sure you have the right level of support as a clinical fellow. If you're taking a post outside training, log in to My membership to update your working circumstances or call our membership team on 0800 716 376.

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