Research for Respiratory Trainees

Dedicated time to conduct research offers trainees the chance to delve deep into a subject, acquiring a set of skills and knowledge few people in the world possess.

Research is central to training and core to the curriculum, fostering skills that every Consultant needs: critical thinking, appraisal of the literature, and communicating clearly and persuasively. In addition, the process of planning and completing a research project provides trainees with opportunities to develop a range of other abilities, including leadership attributes, organisational skills, time management and presentation skills.

All trainees must achieve basic research competencies, but these can be achieved via several paths, dependent on the interests and opportunities unique to the individual. Not everyone needs to undertake a higher degree! The curriculum and ARCP decision aid outline these routes, with the essential competencies summarised in the academic checklist:

• Applying for appropriate ethical research approval and demonstrating the ability to write a full scientific paper.
• The attainment of a higher research degree.
• Giving a national/international presentation and undertaking an assessed research course.
• Pursuing research/ a research degree (eg. MA/MSc) in medical education.

There is also no right or wrong time to pursue a research interest. Many choose to take time out of programme midway through specialty training (ST5/6); others perform their research earlier, pre- or even post-specialty training. The only time you cannot do this is during your final 12 months of training.

Routes into research

There are a number of routes into research; the one you should pursue will depend on your long term career aims, your previous experience, and the opportunities that currently exist. Talk to possible research supervisors early to identify types of research opportunities. When it comes down to it, in order to do research you need money – both for your research costs and to pay your salary. Finding funding is a hurdle you encounter early on your path, some ways to get funding for your research are below.

NIHR Academic Clinical Fellowships. Funded by NIHR. Posts are allocated to institutional partnerships of a University, NHS Organisations/Trusts, and Local Education Training Boards (LETBs). Academic trainees are recruited by the LETBs through open competition via a national process for academic recruitment. They are only an option for a small number of trainees as they are ST3 entry only, and are restricted to specific groups/supervisors/projects.

‘Soft funding’. This is funding that a Primary Investigator can obtain, which is not attached to a specific person or project. It can be used to fund entire projects or, often, to fund someone for a short amount of time whilst they get pilot data that they can then use to apply for larger grants from a major funding body. The only way to know about the existence of such funding is to speak to research leads/PIs.

‘Pump-prime funding’. Similar to the above, they allow time for planning and acquiring pilot data in preparation for a larger project which will require longer-term funding. Grants often come from charities such as the British Lung Foundation (BLF). This may be a good option if you have an idea and a supervisor, but are not yet ready to apply for a fellowship.

Pre-existing fellowships. Posts that are already set up in an institution/group and already funded. Trainees then apply competitively to the post and, if successful, can register for an MD/PhD. This route has the advantage of avoiding the pain of completing funding applications, but has the disadvantage of having to join a project which you have not designed/written and is not ‘yours.’ They may be funded by a legacy grant and regularly call for applicants, or be from a specific initiative and come up sporadically. Ask around and look out for job adverts. Fellowships similar to these are common in sub-specialty training often comprising a mix of clinical work with research.

Personal Research Training Fellowships. Provided by major funding bodies such as MRC, Wellcome and NIHR. They are competitive and require a lot of planning. They are probably the best route into a long term career in academia. In order to gain a personal research fellowship you need to persuade the funding panel that:

• You are personally worth their investment.
• Your supervisor and group has the expertise and experience to support you in developing research skills.
• Your project is important and worthwhile.

MRC Fellowships. Designed to support and develop individuals in the field of research. They recognise the different routes to transition to independence and leadership.

NHIR Integrated Academic Training. Supports individuals to obtain research experience through Academic Clinical Fellowships, Clinical Lectureships, and In-Practice Fellowships.

Wellcome grants and funding schemes. Provides an overview of available schemes that support research careers and funding. 

Although writing a grant/fellowship proposal is long and painful, it is a good experience. It forces you to really delve into your research question, immerse yourself in the literature and justify your methods and costs. By the time you get to interview you really feel you own the project. You will need to find a supervisor who will support you in the entire process so plan ahead and talk to lots of people.

Applying for OOPR

Applying for time out of programme for research is a multi-step process so plan as far ahead as possible. You should informally alert your TPD as soon as possible that you are considering OOPR. Once you have a supervisor and project confirmed you should formally request OOPR. If you are awaiting a funding decision then include the date you expect to hear the result, and whether this is essential for you going out of training.

For most training programmes, it is only possible to leave the programme in October or April and 6 months notice must be given. Steps in applying for OOPR include:

• Applications to research bodies for fellowships/funding (e.g. MRC, Wellcome, NIHR).
• Applications to the JRCPTB, via a Research Application Form, accompanied by a job description and an up to date CV.

Much of the paperwork is to ensure that you can ‘count’ part of your research time towards your CCT date. Once you have submitted all the forms the JRCPTB will submit applications to the Respiratory SAC for review of the research content including an indicative assessment of the amount of clinical credit (competence acquisition) which might be achieved.

This is likely to be influenced by the nature of the research (eg entirely laboratory-based or with strong clinical commitment), as well as duration (eg 12 month Masters, 2-year MD, 3-Year PhD). On approval by the SAC, the JRCPTB will advise the trainee and the deanery of the decision. The deanery/LETB will then make an application to the GMC for approval of the out of programme research. All applications for out of programme research must be prospectively approved.

Additional resources:

Author: Dr Akhilesh Jha