GP Training - Academic general practice

Academia can provide a rewarding change from clinical practice, says Dr Mareeni Raymond.

There are several routes in academic general practice: research and teaching are both academic specialties and some doctors combine the two (Photograph: SPL)

Last year I finished an academic ST4 post in general practice, one of the many routes that now exist to help GPs to develop a portfolio career. In the past, GPs with an interest in academia often 'fell' into it, or had to forge their own links and interests.

However, in the past decade, specialist academic training has developed such that those interested can find a pathway into academia. Research and teaching are both academic specialties and some doctors combine the two.

It can be difficult to juggle the many hats, a complex timetable and what can seem like a million emails a day. But for those who relish the challenge, who are organised and are always asking 'why?', academia can provide a rewarding change from clinical practice and provide a way to complement clinical practice through development of skills and different ways of approaching problems.

Routes into academia

Academic foundation posts are available to recently qualified doctors and are becoming increasingly competitive. Starting early on in medical school can help in this competition; for example becoming involved in audits, research, teaching and experiencing leadership and problem solving through membership of societies such as Medsin ( can help you stand out from the crowd of applicants.

Academic F2 posts are excellent tasters into academic practice. I did an academic F2 at University College London during which half of my time was clinical, the other half academic. It is important to emphasise that taking on such a post does not mean you are committing to academia.

Such posts offer an insight into the kind of work you may be involved in; if it is not for you, you can leave that career path early on.

To find out which universities have academic F2 posts, go to the Society for Academic Primary Care website ( or the National Institute for Health Research's trainees co-ordinating centre (

Academic ST4 posts are again quite competitive. After finishing the registrar year you extend your training with this post, working five sessions in general practice and five in a research department for one year.

It is a fantastic opportunity to gain experience in teaching and research and you do not need anything impressive on your CV to apply - enthusiasm and evidence that you are interested are all that is needed.

The extra year of clinical experience with a trainer and working in a different practice is a bonus. But for some, continuing with the ePortfolio, ongoing supervision and juggling a sometimes complicated timetable may be off-putting.

Trainees can choose to teach medical students and/or attach themselves to a research community in their department and do some original research supervised by an experienced person who can guide them through the basics of research methodology. These posts very much depend on making the most of contacts and opportunities within the department.

During my year, I wrote chapters for the book A career companion to general practice,1 published papers in peer-reviewed journals and became involved in international research as well as presenting abroad.

Simple measures like a diary, rota and regular meetings to check on how close you are to your goals can make a big difference to how you cope.

Clinical fellowship

A clinical fellowship is an alternative, but there are fewer such posts. The trainee applies early on and has up to three years as a clinical fellow, combining clinical and academic work in all three years. The candidate can complete research by year three or apply for a further training fellowship in the following year (for example, an 'in practice fellowship') to complete the research proposal.

Any GP with an interest in academia can apply, including academic GP ST4s. Often during this training GPs start a master's or doctorate in addition to their research. This again highlights the complexity of the career path and how you will need to be extremely organised to balance it.

Postdoctoral research funding is obtained through organisations such as the DoH, Medical Research Council (, Wellcome Trust ( or other charities.

The 'old' route in

The 'old way' still exists. Many GPs are involved in audit, practice research and teaching medical students in practice. Others write letters, comments and original research for journals or make their own links with academic departments.

For these individuals it is not too late to have a more structured career if it suits, as funding opportunities exist for doctors who can demonstrate an interest. Ask local deaneries, the RCGP or local education centres about ways in which you can fit into the organisation.

Academic general practice is what you make of it. Be aware of the pitfalls and the personality traits that make someone more likely to cope with and flourish in an academic environment, and throughout your career, re-evaluate and take on as much as you can and no more. Often academic work is varied, but at other times there can be almost too many opportunities and it is a learned skill to know when to say 'no'.

Once you decide on academic general practice, self-motivation is key and maintaining work-life balance vital. It is a rewarding and eye-opening career path.

  • Dr Raymond is a GP in London and a teaching associate for University College Medical School

1. Hutt P, Park S. A career companion to becoming a GP: Developing and shaping your career. Radcliffe, 2011.

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