Frequently asked questions

Recruitment for all ACF and CL opportunities on the Integrated Academic Training programme (medical) is conducted via Health Education England regions and managed through Oriel, the national NHS online recruitment system. For Imperial College London, recruitment to ACF and CL posts is coordinated by the London Recruitment team, based in the Operations Department of Health Education South London and overseen by the NIHR. Details are available on the NIHR website and the London LETBs Recruitment site.

As soon as they have been appointed, ACFs and CLs (medical) should make contact with the Clinical Lead/Training Programme Director and Academic Training Lead for their specialty to discuss and agree how the research block will be organised. For ACFs, research blocks are usually organised in 3 month or 3+3 month back to back concurrent periods, but this will depend on the specialty. For CLs, the structure of research blocks can be variable but many are organised in 6-month or one-year blocks. Each specialty/division will have a slightly different model and approach, depending upon local circumstances, and the research time must be planned in full agreement between Clinical and Academic Leads. Planning for this should start as soon as the ACF/CL appointment has been confirmed.

Study leave funding allows clinical academic medical trainees to enhance their clinical education and training in areas not easily acquired in the clinical setting or locally  - and is used to support the development of clinical knowledge and understanding. This funding is available to clinical academic trainees (ACFs and CLs) over and above the bursaries and funding provided specifically to support academic training, in the same way for non-academic clinical trainees. Please note: trainees in OOPRs and OOPEs are not entitled to the NHSE study leave funding. Trainees in an OOPT are entitled to full NHSE study leave funding. Any application submitted by the trainee entitled to NHSE funding requires a pre-approved NHSE course code which can be obtained from the  NHSE PGME support portal.

ACFs and CLs must be in a recognised NHSE / IAT training post to be eligible for study leave. Study leave applications are managed by the Imperial College Healthcare NHS Trust (ICHT) Medical Education Centre. To undertake study leave, you first need to obtain permission locally within your department following their outlined processes and then submit an MS Form. Further details about the process can be found on the ICHT / Trust Intranet (accessible after you join the trust), or by contacting the relevant ICHT Postgraduate Education Centre Team by email, see below:

• imperial.postgradeducation.cxh@nhs.net
• imperial.postgradeducation.hh@nhs.net
• imperial.postgradeducation.smh@nhs.net

Once study leave applications have been approved, trainees will be reimbursed for the study leave costs via payroll.

• ACFs  will be reimbursed directly via the Trust payroll
• For CLs employed by Imperial College London, obtaining study leave involves two steps. Initially, they must apply via the Trust's process. Once approved by the ICHT / Trust Medical Education Centres, CLs must follow the College process for expense reimbursement through “My Expenses”. To claim reimbursement, CLs should upload a screenshot or copy of the approval confirmation in the My Expenses system, demonstrating Trust-level approval. Activity code H34001 (Health Education England/NHSE) along with their relevant College departmental cost centre should be used when submitting the claim. Initially, study leave costs are charged to a College departmental cost centre and approved by a departmental approver. Subsequently, these costs are recharged back to NHSE by the Central Faculty of Medicine Finance Team.

For more details on study leave, please go to NHSE PGME support portal here.

^{Updated 1st April 2024}

For medical trainees undertaking the Integrated Clinical Academic Training Pathway, the following applies: ACFs will have a contract with Imperial College Healthcare NHS Trust and an honorary contract with Imperial College London, CLs will have a contract with Imperial College London and an honorary contract with Imperial College Healthcare NHS Trust. Honorary contracts normally run concurrently with the substantive contract and are issued to allow trainees to work at the organisation where they do not have a substantive contract. For queries about contracts please contact the following:

• Imperial College Healthcare Trust

Human Resources Department, Medical Personnel (veronica.williams6@nhs.net and jasmine.haron1@nhs.net)

• Imperial College London

Honorary and Visiting Researcher Associations / Human Resources Division (honvisit@ic.ac.uk)

For medical trainees undertaking the Integrated Clinical Academic Training Pathway, academic blocks will not usually include on-call commitments, so trainees will only be paid at the basic salary rate for the duration of their academic time. This may, however, vary by clinical specialty and trainees should talk to their Clinical Training Programme Director or department training lead. ACFs/CLs may wish to supplement their salaries during academic training by arranging to undertake ad hoc shifts that fit easily around their academic blocks. This should not detract from their academic work and should be limited.

For medical trainees undertaking the Integrated Clinical Academic Training Pathway, formal requests to go 'Out of Programme' must be made to Health Education England (HEE) and the NIHR, via the Operations Department of Health Education South London and overseen by the NIHR. Details and advice on OOP are available on the London Postgraduate Medical and Dental Education website.

• Trainees are advised to discuss their OOP requests with their supervisors and clinical academic leads before submitting a formal application
• Trainees need to consider and submit OOP requests to HEE well in advance of requiring time out
• Please note that when an OOP request is granted by HEE, this does not mean that the NIHR will automatically grant trainees the ability to return to their academic post
• OOP can be granted for up to four years to academic trainees
• OOP requests are subject to the approval of the Postgraduate Dean and NIHR and will, therefore, be handled centrally by HEE and not the Imperial AHSC CATO office.

Only medical trainees undertaking the Integrated clinical academic training pathway are eligible to apply for the NIHR bursary, BRC funding and the Research training award. 

If trainees are Out of Programme, studying a PhD, and were formerly an ACF at Imperial College London, they are not permitted to make a funding application.

CATO encourages academic trainees to develop genomics knowledge, but this is not mandated. HEE are currently offering scholarship funding for Genomics courses for Health/NHS professionals and they also offer a number of free online resources. We suggest you first check the HEE Genomics Education Pages to decide what learning might suit you. If you decide it’s the modules from the Imperial MSc in Genomic Medicine you should contact the course organisers at the College to see if /when they have space, and then if need be, go back to HEE to apply for their free funding. If / when this route has been exhausted ACFs can also apply to CATO for funding via the Research Training Programme Award bursary.

• Health Education England (HEE): Genomics Education–resources & taught courses: https://www.genomicseducation.hee.nhs.uk/education/
• Imperial College London: Genomic Medicine. MSc/PG Cert/PG Dip:  https://www.imperial.ac.uk/study/pg/medicine/genomic-medicine/
• Imperial CATO/ bursary funding: https://www.imperial.ac.uk/medicine/study/clinical-academic-training-office/support-for-doctors/funding/ 

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What is the purpose of the CCT extension process?

NIHR Clinical Lecturer (CL) posts can now be extended beyond the Certificate of Completion of Training (CCT)/Specialist Training (CCST) to support academic development and the transition to research independence.

Upon reaching CCT, NIHR-funded CLs will have completed clinical training. Extensions beyond CCT allow CLs to gain additional academic skills and competencies necessary for research independence. These extensions are not consultant posts and will not be funded by NIHR as such. Obtaining a consultant post or a post-doctoral fellowship will end the NIHR CL role. Salary during the extension will be covered by NIHR at an enhanced rate compared to pre-CCT levels.

Locally-funded NIHR-recognised posts follow the same process but do not require submission to NIHR.

Note: Extensions are not automatic and are considered on a case-by-case basis.

Extension duration

• A CL extension is for a maximum of 24 months beyond CCT, or until the 4 year funding maximum is reached. For example, a CL who uses 3.5 years of the funding to reach CCT can request up to a 6 month extension.
• Except in exceptional circumstances, post-CCT/CCST CLs must reduce their clinical commitments to 2 clinical sessions per week, which should be sufficient to maintain clinical skills and remain appointable as a NHS consultant. Those employed in the craft specialties may undertake up to 4 clinical sessions per week, with the extension request accompanied by an explanation for this requirement.

Eligibility

• The option to apply for an extension post-CCT is open to CLs in specialty training provided they are within the 4 year’s funding for the award.
• If the trainee does not reach CCT by the end of the 4 year CL post period, then no extensions will be considered by the NIHR.
• Applications for extension must be made to NIHR at least 6 months prior to CCT.
• A trainee that wishes to apply for an extension must have more than 12 months remaining of their training at the time of appointment to the NIHR CL post.
• Trainees with less than 12 months to CCT will be considered ineligible.
• GP CLs are ineligible for a post-CCT extension, as they have already gained CCT and are fully qualified.

What documents are required for the CCT extension application?

1. CL Personal Statement
   • A 1–2-page plan detailing:
     • NTN, CL Post Dates, and CCT Date: Clearly mention your NTN (National Training Number), the date you commenced your CL post, and your expected CCT date.
     • Academic/Research Plans: Outline your plans for the next 1–2 years, emphasising academic goals.
     • Achievements: Highlight achievements during your CL post.
     • Time Allocation: Explicitly state that your CL time has been split 50% clinically and 50% academically. Indicate that the post-CCT extension will involve 80%+ research and 20% clinical work, detailing clinical responsibilities (e.g., one clinic per week, on-call rota).
     • Fellowship Applications: Mention the fellowships or clinician scientist awards you plan to apply for and approximate timelines.
2. Academic Supervisor Statement
   • Request a brief supportive letter from your academic supervisor or Head of Department addressed to NIHR and the Imperial IAT Lead/CATO Director (Prof Jeremy Levy).
   • The letter should:
     • Endorse your progress and plans.
     • Explain how the extension will further your academic career.
     • Confirm that the extension positions you well for future fellowships or senior academic roles.
3. Clinical TPD Support
   • Request a formal email from your Clinical Training Programme Director (TPD) to Prof Levy. The email should:
     • Confirm your CCT date.
     • State that there are no concerns about your training and that you are on track for CCT.

Document Submission 

Send all the required documents to the CATO Director Prof Levy, email: cato@imperial.ac.uk. He will write a covering letter expressing full support from Imperial College and CATO, confirm ongoing financial bursary support, obtain approval from the NHSE Head of Schools and Associate Academic Dean, and then forward the documentation to NIHR and NHSE.

 Who can I contact for further information or clarification?

For queries, contact Prof Levy at cato@imperial.ac.uk or reach out to your Clinical TPD or Academic Supervisor for guidance.

Further information NIHR Website: https://www.nihr.ac.uk/extension-process-clinical-lectureship-posts

I am currently an IAT CL on an Imperial College London substantive contract with an honorary contract at ICHT (‘License to attend’) and will soon be going on maternity leave – how does this impact on my NHS terms and conditions?

This should not make a difference to your maternity pay entitlements as Imperial College Healthcare NHS Trust considers ICL employment as continuous service for maternity leave. Also, maternity pay payments should be calculated based on total salary (including any banding payments you may currently be receiving).

Please check the following useful information:

• NHS Employers website: General maternity guidance for rotational doctors and dentists in training
• Imperial College London HR website: Family Leave
• BMA website: Maternity, paternity and adoption

Since everyone’s circumstances will be slightly different, specific questions about parental/family leave should be directed to the

• ICHT Medical Personnel Team: imperial.medicalhradmin@nhs.net and Jasmine Haron email: jasmine.haron1@nhs.net
• ICL HR Team: hrstaffhub@imperial.ac.uk 

What is Academic Flexible Pay Premium (AFPP)?

• AFPP pays a ~£4000 annual supplement to any doctor acquiring a PhD beyond foundation years, from time of completing PhD until they reach CCT, while in formal training (NTN) posts.
• This is paid by the employer (NHS Trust or University)
• As stated, only if you are in a training post, and only until CCT, and only if PhD acquired after foundation years.
• People who undertook an MB-PhD are not eligible
• Note: the BMA medical academic staff committee is always very helpful in this regard (if you are a BMA member, get in touch: https://www.bma.org.uk/)

Some caveats:

• Only payable if on new junior doctors contract
• The point of the APP is to replace the automatic pay increments that the old contract gave and get rid of the disincentive to take time OOP for research.
• Lecturers (or others) still on the old junior doctors contract will have received those increments and therefore will NOT be eligible for the AFPP. (They will undoubtedly be better off to stay where they are). 

ACFs remain employed by NHS Trusts throughout the ACF programme. Trainees remain employees of NHS Trust whilst working in an academic block but also receive honorary contracts with relevant academic institution. The most recent Trust that they are at will fund their salary, i.e. ACFs salaries are funded though ongoing contracts with the Trust they left before their academic block. Trust employers will receive funding for the ACF salary through the quarterly Learning and Development Agreement (LDA) process.

Q: Who funds the NIHR (Integrated Academic Training) IAT ACF posts?

A: NIHR funded ACF posts are 100% funded (not including on-calls or banding) for 3 years. The rotating trust for clinical training is the employing body and an honorary contract is set up with the medical school.  Details of all ACF appointments, recruited on our behalf by HEE, are sent to the relevant trust HR Teams via the HEE trust portal once they have been finalised. 

All ACF trainees in post will have their salaries funded at 100% for the duration of the academic award - whether working in the clinical or academic component of their academic programme. 

Trust employers will receive funding through the quarterly Learning and Development Agreement (LDA) process. If you have any queries about the funding process, please contact england.ETCFinance.London@nhs.net.