Breaking down barriers and helping to progress clinical research careers in the UK

Cancer Research UK

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It can be difficult for clinicians to get a foot in the laboratory door. (Photo: Imperial Science Imagery)

It can be difficult for clinicians to get a foot in the laboratory door. (Photo: Imperial Science Imagery)

Clinician scientists provide a valuable bridge between research and clinical practice. We’re making sure they have the support they need to develop a career in cancer research.

At Cancer Research UK we’ve teamed up with other major funders of medical research to review the career pathways of clinical research academics in the UK. By identifying the barriers, and enablers, to a successful research career, we want to improve the environment for clinical career progression and facilitate the development of clinical trainees.

In the resulting report (PDF) we draw together evidence from over 400 early-career clinicians who applied for clinical research training fellowships or clinician scientist fellowships from the funders involved.

The findings

A compelling 68% of all survey respondents said that it was difficult to pursue a research career, while 57% cited staying active in research as the biggest challenge they faced after finishing their PhD and returning to complete clinical training.

Clinical researchers face a range of barriers and unique challenges in their careers, many stemming from the difficulties of maintaining clinical practice whilst also carrying out research, such as securing funding, finding time to carry out research and lack of support from host institutions or the NHS. These challenges are often most pronounced during the early stages of a career.

The bridge formed between research and clinical practice provides vital insight and helps researchers ask new questions, it is therefore extremely important that appropriate mechanisms and schemes are in place to support the diverse career paths into clinical academia.

The MRC-led review highlighted the positive impact that CSFs can have on successfully launching clinical academic careers. 95% of individuals who were awarded CSFs now hold leadership positions and are directing their own research, compared to 53% of respondents who were not awarded a CSF.

The impact of clinical career support

Dr Ferdia Gallagher is a Clinician Scientist Fellow at the CRUK Cambridge Research Institute who has been supported by CRUK funding at different stages of his career. He has direct experience of the barriers faced in launching a successful clinical research career.

One of the most difficult steps in an academic career is developing an independent group and funding for this is often a bottleneck for many aspiring researchers. CRUK has invested heavily in this area.

CRUK funded my PhD, and this initial funding was crucial in helping me to decide my future research direction. It has also been instrumental in allowing me to attain my current Clinician Scientist Fellowship.

Creating protected time to think about the science can be a big challenge for researchers and finding the right balance can be hard for individuals new to the demands of a clinical research career. The review also identified the benefits of mentorship schemes provided by funders — 57% of respondents taking part in the review said this support was an important factor that enabled them to succeed in their careers.

Ferdia agreed that guidance from others was an important factor in developing his career:

There are many people who have been great role models over my career. I have learnt different aspects of the job from various individuals. Although academia is highly competitive, it is surprising how collaborative most academics are. Science is becoming increasingly multidisciplinary, and we learn more by being open to others’ ideas and working together: we benefit, science benefits and importantly so do our patients.

What are we doing at Cancer Research UK?

The evidence from the review builds on findings from a recent internal CRUK assessment of the complexities that clinical researchers have to overcome to successfully integrate the research and clinical aspects of their roles. We reviewed the funding opportunities that CRUK provided for clinical academics and identified a gap at the critical career transition following a PhD. In response to this, we recently launched a new Postdoctoral Research Bursary to provide funding for research for clinical trainees. We are offering funding of up to £35,000 over two years, enabling trainees to remain active in research after completion of their PhD.

Our ambition is to double the number of fellowships that we fund to build a pipeline of world-leading clinical academics in cancer research. We have increased our funding for Clinician Scientist Fellowships (CSFs) and developed a more flexible framework to allow greater time for awardees to carry out research. We have also introduced a new Advanced Clinician Scientist Fellowship to ensure individuals are fully supported at every career stage. With this award we are offering excellent clinician scientists the opportunity to develop independence and leadership in their field of academic research. The new schemes and changes we have made are intended to leave fellows in a competitive position to secure permanent academic positions and programme funding.

CRUK’s Chief Clinician, Professor Peter Johnson oversaw the changes that were implemented at CRUK:

Cancer Research UK is committed to supporting the next generation of clinical research leaders to help them establish their careers. We recognize the vital role that clinical academics play in bringing discovery research closer to practical application for patients.

The recent cross-funder review highlighted a range of barriers that clinical academics can experience in their careers. Our new schemes aim to tackle some of these barriers by providing funding opportunities for clinicians at every stage of their research career, offering greater flexibility, and increasing the number of fellowships we award.

The review was led by the MRC, in collaboration with the Academy of Medical Sciences, British Heart Foundation, National Institute for Health Research, Wellcome Trust and CRUK. You can download the full review from the MRC website (PDF).

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