It’s not just academic: the academic foundation programme
Authors: Rachel Brettell
Publication date: 27 Sep 2012
Rachel Brettell offers some advice to people considering the academic foundation programme
Many medical students and junior doctors have heard of the academic foundation programme: some know they want to apply, and a few know exactly what it entails. For everyone else, it’s well worth giving this career path some serious thought. With medical academics recently agreeing that the number of places on the academic foundation programme should be increased to widen access, it is a good time to think about whether the programme might be for you.
What is the academic foundation programme?
The academic foundation programme is open to final year medical students who are considering an academic career in clinical research. During the two year programme trainees can expect to gain research, teaching, leadership, and management skills as well as their basic foundation programme clinical competencies. This year 501 academic foundation programme places were available across the United Kingdom (that is, roughly 5% of foundation trainees are academic trainees), and these are generally highly competitive. A wide range of programmes is available across the country, from primary care to academic surgery, medical education to clinical leadership. Full details are available on the UK Foundation Programme Office website, with interview dates and web links for more information about individual programmes (www.foundationprogramme.nhs.uk).
What each academic foundation programme job entails varies considerably, depending on location, specialty, and individual preferences. All academic foundation programme posts have dedicated time for research, education, or clinical leadership in foundation year 2, either as a four month block or as one day a week for academic work during your clinical rotations. During your academic release you will spend varying proportions of your time working on a research project, teaching undergraduates, and attending departmental activities and training courses, possibly with some ongoing clinical commitments. You may be given a particular research project or be able to design your own. Often trainees work within an existing team. I was interested in primary care conditions so spent my time working with a group already publishing in this area and undertook a national observational study looking at how primary care factors influence admission rates for heart failure. Other trainees completed a wide range of projects, including laboratory and basic science work, education research, epidemiological studies, case reports, and literature reviews. Although it is helpful to know what general area of research you are interested in, you will not usually be expected to finalise your project until just before you start in the department. The rest of your time in the foundation programme will be spent in regular clinical rotations to gain your basic foundation programme competencies.
The academic foundation programme is also the first step on the National Institute for Health Research’s integrated academic training programme. This pathway aims to combine academic training with each stage of a clinical career and to provide a clear and coherent training path for academics. It is not an easy route, with competitive selection at each stage. The aim is to become not only a respected clinician but a respected academic as well. After foundation training, candidates can apply for an academic clinical fellowship, which prepares trainees for application to a higher degree, or a clinical lectureship for doctors who already have specialty training experience and hold a PhD or MD or equivalent. Academic clinical fellows spend around 75% of their time on specialist clinical training and 25% undertaking research or educationalist training, whereas for clinical lecturers this split is roughly 50:50. About 250 academic clinical fellowships and 100 clinical lectureships are available each year. 
It is important to remember that if you apply to an academic foundation programme you are not committing yourself to an academic career. Many doctors who undertake an academic foundation programme subsequently return to regular clinical training, and others join the academic career pathway later. Even if you are not on an academic foundation programme you can still do research and teaching during your foundation years and beyond.
What is it like?
Perhaps you want a taste of research, or maybe you want to be a professor. Everyone has different reasons for applying to an academic foundation programme and different opinions to share. Talk to as many people as you can to get different advice about the programmes available.
The academic foundation programme is exciting. It provides an insight into the world of academic medicine that allows you to make more informed choices about your future career. You get dedicated time to investigate something you’re passionate about. Who knows: if it all works out, your research could change lives.
Many cite autonomy as the best thing about academia. Instead of being a tiny cog in a large hospital machine, you are your own boss, coming up with your own ideas. It is sometimes scary and daunting, but the flexibility is ultimately liberating.
You’ll work with world class experts and non-medical colleagues who have knowledge and experience you can benefit from. Hopefully, you will learn a lot about yourself, including personal strengths and weaknesses as well as your particular research interests and career plans.
People worry about forgetting clinical competencies, but you will develop many transferable skills in academia that will stand you in good stead when you return to hospital. These include teaching, time management, and asking for help. You will also develop key skills for an academic career, such as experimental techniques, literature review, critical appraisal, or statistics.
Academic foundation posts are unbanded, which frees up time for other things such as job applications, professional exams, or life outside work.
An academic foundation programme puts you in a good position for job applications and interviews in comparison with trainees who have done the standard foundation programme, particularly if you are applying for academic posts. During academic training you will have extra opportunities to produce posters, attend courses and conferences, give presentations, and submit publications, which will score you more points on application forms for regular specialty training as well. You will also have had the opportunity to develop your research interests and foster links with a department where you may want to work in the future.
Academic medicine can be frustrating. Unlike in a fast paced hospital, things take time, and projects may fall through at the last minute. Grand plans to undertake a complete clinical trial may be overambitious, and other full time researchers may have unrealistic expectations of you.
Contrary to popular opinion, academia is not all cups of tea and clocking off early. You often work late, and it can be hard to switch off.
The academic foundation programme is hard work: you must obtain all of your clinical competences, but you have less time in hospital than your peers. Academic trainees often have less choice over the other hospital rotations they do. You will also need to gain a range of academic competences.
The varied nature of the academic foundation programme means that it can be difficult to manage the many competing demands on your time, such as clinical work, academic work, family, and friends. And although being unbanded means you have fewer unsocial shifts, it may also have financial implications.
It can be difficult to set realistic goals and get feedback during the academic foundation programme—instead of saving lives on a daily basis, it can take months to publish papers. You may miss day to day contact with patients or feel out of practice when you get back to hospital.
How do I apply?
The application process for the academic foundation programme has changed.  Application for the academic programme opens online at the same time as the regular foundation programme. Candidates can apply to two (of 15) academic units of application and must also rank all the units of application for the regular foundation programme, because unsuccessful academic applicants are automatically included in the standard foundation programme allocation. Each academic unit of application may request supplementary information to be submitted alongside the basic application—for example, your CV, academic experience, or reasons for applying to the academic foundation programme. You will also be required to rank the academic programmes within an academic unit of application before you submit your application, although you do not have to rank all of the available programmes if you would not be prepared to accept an offer for any of them.
Shortlisted candidates are then invited to attend an academic interview; applicants to the regular foundation programme are not interviewed. Shortlisting criteria may vary between deaneries but are based on the foundation programme person specification. Interview scores are allocated on the basis of candidates’ interview performance and the education performance measure from their application form. The new situational judgment test is not used in the scoring of academic foundation programme candidates, although they must sit the exam.
Interview scores are used to allocate places in the first round of offers in January, which must be accepted or declined within 48 hours. After this, a cascade process will run, offering any unfilled posts to the next highest scoring applicants. It will not be possible to hold an academic foundation programme offer while waiting on the reserve list of another academic unit, and linked applications will not be considered if either party accepts an academic foundation programme post.
If successful, you will be offered a specific post that takes into account your academic specialty and other hospital rotations—unlike the process for other foundation programme candidates, who are initially allocated a place within a particular unit of application and are subsequently required to rank the jobs within that unit before allocation.
I thoroughly enjoyed my time on the academic foundation programme, learnt an immense amount, and have now started a general practice academic clinical fellowship to continue my academic training alongside my clinical training. The academic foundation programme isn’t right for everybody, but everyone should be aware of the opportunities, ask lots of questions, and consider what they really want. Whatever happens, those will certainly be important skills as you continue on your medical career.
Competing interests: None declared.
- Jaques H. Medical academics support wider access to academic foundation programme. BMJ Careers 12 May 2012. http://careers.bmj.com/careers/advice/view-article.html?id=20007250.
- UK Foundation Programme Office. About the academic foundation programme. 2012. www.foundationprogramme.nhs.uk.
- Academic Careers Sub-Committee of Modernising Medical Careers and the UK Clinical Collaboration. Medically- and dentally-qualified academic staff: Recommendations for training the researchers and educators of the future. 2005. www.ukcrc.org/index.aspx?o=3146.
- National Institute for Health Research. NIHR integrated academic training programme.www.nihrtcc.nhs.uk/intetacatrain/.
- Kent, Surrey and Sussex Deanery. Medical careers.www.medicalcareers.nhs.uk/career_options/academic_medicine.aspx.
- UK Foundation Programme Office. FP/AFP 2012 applicant’s handbook. 2012:33.
Rachel Brettell GP trainee, specialty training year 1
Marston Medical Centre, Oxford, UK