Wellcome News 57 editorial

Clinical researchers - medically trained scientists working in health research - operate at the critical interface between research and clinical practice. They help to connect basic research with the pathways that take us from the diagnosis and understanding of disease to the design and trial of new interventions and preventative strategies.

Yet in spite of the huge opportunities for clinical research, there has been a long-standing decline in clinicians opting for a career in academia. This was due to a lack of clarity about career pathways for young clinicians with academic interests, and a lack of suitable training posts.

Now, with the reestablishment of clear and flexible academic career pathways and the funding of new training posts, there is evidence that the decline is being reversed. At the Wellcome Trust, we are ‘doing our bit’ to enhance training opportunities for clinical scientists by expanding and refining our investment in training schemes at every level of support.

Recognising the need to get more clinicians through basic research training, we have established integrated PhD programmes targeted at clinicians. These fellowships provide structured research training at the PhD level, borrowing from our experience of training basic research scientists. In 2008 we awarded 13 PhD programmes, seven of which are dedicated solely to those with medical qualifications, and two of which are available for those with or without medical qualifications. We also awarded four programmes in translational medicine and therapeutics that aim to reverse the decline in clinical pharmacology, a key area for the development and optimal use of drugs.

But this is only the start. One of the major problems faced by clinical researchers post-PhD is to maintain research momentum while undergoing speciality professional training. Clinicians do not have the flexibility to undertake multiple postdoctoral posts and must juggle research time with the demands of ongoing medical training. For these individuals, the Department of Health in England and the devolved administrations, working with the universities, have established new clinical lectureship posts. These are structured so that half of the individual’s time can be spent in academic activity and half in clinical training. But these lectureships are highly competitive, and success is less likely if clinicians do not have the financial support to gather the data required for a successful application.

That is where we come in. Starter Grants for Clinical Lecturers, funded by the Trust and offered in partnership with the Academy of Medical Sciences, support clinicians post-PhD for up to two years, allowing them to develop their own research programmes and obtain the crucial pilot data needed to apply for longer-term funding.

We have also developed a new postdoctoral fellowship programme for clinical scientists, aimed specifically at talented clinicians who have completed their PhD at a very early stage, either before or as an integrated part of their medical degree. Our Postdoctoral Training Fellowships for MB/PhD graduates provide flexible opportunities for postdoctoral research, providing salary and research costs, and support to allow reintegration back into postgraduate medical training afterwards.

Through these and our other training schemes, we aim to develop a cadre of the best clinical researchers who will go on to make outstanding contributions. We hope that many will ultimately compete for our Senior Research Fellowships and similar schemes from other research funders. Indeed, the current generation of clinical academic leaders includes several former Wellcome Trust Senior Research Fellows. It is a hugely exciting time for medical research and we aim to be able to support the best scientists who will advance our knowledge of both health and disease and will translate that knowledge into health benefit.

Mark Walport
Director of the Wellcome Trust