Navigating the Labyrinth of Integrated Clinical Training in Neurology: a guide for the uninitiated

The National Institute for Health Research (NIHR) Integrated Academic Training (IAT) programme was introduced following recommendations within a 2005 report made by the Academic Careers Sub-Committee of Modernising Medical Careers and the UK Clinical Research Collaboration.1 This report highlighted the need for a more transparent academic career trajectory for trainees, with clear entry and exit points, and need for flexibility to be built into medical training to allow for research time. Now, more than fifteen years later, the NIHR IAT programme is well established, and arguably the best-recognised route for combining clinical and academic training in a given specialty. The protected research time provided by these posts is invaluable for pursuing scientific projects, acquiring any relevant technical or statistical skills, and for planning next steps, including applications for research funding. In this article, our aim is to demystify the application and interview process for NIHR Academic Clinical Fellowships (ACFs) and Clinical Lectureships (CLs); we will also discuss how these positions fit within the clinical academic pathway. This article is an amalgamation of theoretical facts and our practical experience, written in the context of neurology training, but might also be of relevance and interest for other medical specialties. Whilst we have chosen to focus on NIHR posts in this article, as these are most commonly encountered and advertised, some academic centres also offer locally funded ACF and CL posts; details can often be found on the relevant university website.