Transitioning between clinical and academic practice from the perspectives of clinical academic trainees, academic training programme directors and academic supervisors: a mixed methods study

BackgroundThe career pathway of clinical academics in the UK is challenging. To pursue academic endeavors, trainees often undertake approved time 'Out of Programme for Research' (OOPR), a standalone research fellow post or join an 'Integrated Academic Training' pathway. Time out of training may impact their clinical skills, confidence and competency. The aim of this qualitative study was to explore the challenges associated with returning to clinical training after prolonged leave for academic trainees.MethodsStakeholders were clinical academic trainees and supervisors within the Yorkshire and Humber region of England, and training programme academic leads from universities across England. Qualitative data-analyses of verbatim recorded data from three focus groups and 12 individual telephone interviews were conducted within an a priori framework.ResultsReturning to a high-stress environment with a perceived lack of specialty-level advocacy and support, feeling isolated from peers, struggling to balance competing demands, meet clinical and academic expectations and managing clinical deskilling in a trainee's return to clinical training were common experiences described by stakeholders. There was a lack of recognition from academic leads, however, on the impact of such challenges on the trainees' subsequent ability to successfully integrate their clinical and academic careers. Various solutions were identified by stakeholders to overcome such barriers, including a normalised, phased, individualised supported return to work and capacity building for supervisors.ConclusionsThere is an apparent disconnect between the clinical and academic world, with clinical academic trainees stuck between the two, being pulled by each, feeling like they are not quite meeting the expectations of either. Time away from training for trainees on OOPR is often longer than for other reasons for time out of programme (typically 3-4 years if completing a doctoral degree). Given the importance of clinical academics in bridging clinical research and practice, and the concerns recently raised about the rate of attrition of clinician scientists within the NHS, it is of the utmost importance that clinical academic trainees are supported throughout all stages of their careers.