What is a clinical fellow and is it the role for me?
Are you a doctor exploring your next job opportunity? We often get questions about clinical fellow roles as a locum agency. It’s important to understand what a clinical fellow does and if it’s the right fit for you in this competitive field. That’s why we’ve had a chat with Dr. Valeed Ghafoor to create the ultimate guide to clinical fellowships, including the pros and cons.
- What is a clinical fellow?
- What are the benefits?
- What are the disadvantages?
- Summary
- Valeed Ghafoor’s opinion
Dr Valeed Ghafoor has an impressive background, working as a GP partner, OSCE examiner, lead tutor, private GP, and company director for a new remote GP admin service. We’ve known Valeed since his time as an FY2, navigating the world of locum jobs. He’s been in your shoes, making career decisions, and is the best person to explain what the clinical fellow role is all about.
We’ll hand it over to Valeed.
What is a clinical fellow?
A clinical fellow is a clinician, usually a doctor, who has at the very least completed their medical degree and foundation year one and two training (or the equivalent qualifications abroad).
Being a clinical fellow is a defined training opportunity for you to gain more specialised experience within a chosen area of medicine. The role usually involves a supervised clinical workload alongside non-clinical opportunities such as education, research, and leadership.
Common examples of clinical fellowship roles include:
- Emergency medicine
- Obstetrics & Gynaecology
- Medicine
- Surgery
They can also include medical education, public health and more niche areas of medicine that are not otherwise so accessible.
The fellowships are usually fixed contracts for 12 or 24 months but can vary depending on the specific programme and agreement in place. The application requirements, availability and structure of clinical fellow roles can also vary from area to area and specialty to specialty. The application process for these fellowships can be highly competitive and require you to demonstrate commitment and interest.
Clinical fellowship programmes can often be described as either junior or senior clinical fellow roles. Junior clinical fellow roles may require a doctor from ST1 to Specialist Registrar and a senior clinical fellow is typically an experienced Specialist Registrar who is almost at consultant level. Depending on the role and fellowship you will need to meet the criteria and experience that the role requires.
What are the benefits of being a clinical fellow?
Specialty experience
Clinical fellowship posts are often used as interim opportunities. They allow you to gain exposure, experience and skills within a specific area or department. This significantly enhances your CV and provides valuable networking opportunities. These things together are highly valuable for future opportunities and career progression.
Specialty preparation
Clinical fellowships give you exposure to certain specialties, allowing you to transition into them. The roles also provide you with the opportunity to confirm the specialty you want to pursue without committing to a specialty training programme.
Supervision
Clinical fellows are allocated a supervisor who is an expert in the field, usually a consultant. The supervisor and the senior team will provide mentorship, guidance, and feedback during the post. This supervision is not available to trust doctors or locums.
Research and education opportunities
Many clinical fellowship roles include hands-on opportunities to be involved in research, audits, and quality improvement projects. This can lead to publications and presentations that further propel you within your specialty of choice.
Non-clinical and education time is often protected as it is agreed within the contract. For example, a role may be 80% clinical and 20% educational, guaranteeing you the time to participate in nonclinical activities.
Location
On application for a clinical fellowship role, you will be aware of where the fellowship you are applying for is based. This means you can apply to fellowships taking into consideration the location.
If you choose to apply for a training programme like ST1 Obstetrics and Gynaecology, it will be a national application. This means that after the initial application and interview process, the choice of location depends on – and can be restricted by your application ranking. This often means you are unsure of the location you will be allocated.
Work-life balance
Clinical fellowship rotas must adhere to working time regulations. This allows for rotas that have adequate rest periods and breaks, and ensures working hours are safe. As a result, work-life balance can be well maintained in these roles.
Other benefits
Study budgets: the programme provides a budget for educational opportunities, including courses, conferences, and examinations to gain extra qualifications. These can often be very expensive. The study budget allows you to focus on progression without worrying about the costs involved.
Leave: As a contracted employee, you are entitled to paid annual leave days. You are also entitled and have sick leave and for some fellowships, maternity leave.
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What are the disadvantages of being a clinical fellow?
Competitive
The roles in themselves are competitive and require strong applications and interviews. Unfortunately, unsuccessful candidates may find themselves without a fellowship and in turn without a job.
Temporary position
As mentioned, clinical fellowships are usually fixed contracts that are often 12 -24 months long. This means you will need to go through an application process again for other roles/training programmes following your fellowship, which can naturally create an element of uncertainty.
Lack of exposure
You may find you don’t gain the experience or exposure you had anticipated or expected in your specialist area. This can be for many reasons such as a lack of time, a lack of opportunities or because opportunities within the department didn’t align with your personal expectations or goals. This can be disappointing and hinder your anticipated personal development.
Balancing clinical and non-clinical roles
You are expected to take on a clinical workload and participate in non-clinical activities such as education and research. Non-clinical tasks can be time-consuming and take longer than the allocated non-clinical time. Time management is an essential skill to balance both areas.
Pressure
Often fellows work with experts in their desired fields. This can add an element of pressure for you to always perform your best. You may also pressure yourself to continuously perform at your best to try and secure a permanent role or be accepted into the highly competitive desired training programme.
Pay
There have been some concerns that fellowship roles are not as competitively paid as other roles within trusts, despite similar levels of training being required and similar workloads. This can be off-putting given the demanding nature of the role.
Furthermore, fellowships are often 9-5 roles which may mean many fellows see their pay reduced, especially if they are coming from jobs with night shifts and long days that are paid at a higher rate. This reduction in pay may cause financial stress or worries.
Location
Although you can apply for chosen roles and locations, specific or specialist fellowships may only be offered at specific trusts or sites. If this is the case, you may have to relocate. This can be challenging and disruptive to your personal life.
Summary
In summary, clinical fellowships provide excellent training and development opportunities for clinicians. Many fellows find benefit in these roles, especially for career progression and personal development. However, they also have several disadvantages that need to be considered.
If you are exploring clinical fellowship opportunities, carefully think about the advantages and disadvantages along with your personal circumstances, expectations and other opportunities to make sure it is the right direction for you.
Dr Valeed Ghafoor’s opinion
I have seen many people take fellow posts because they wanted to experience a field that they were uncertain of. For example, if you think you might enjoy obstetrics & gynaecology (O&G) and respiratory medicine too, these are separate fields, and you may not have experienced either in any detail. You might decide on a year out of training to try each specialty for 6 months. Rather than locuming to fill a staffing gap specifically, a clinical fellow would be a more protected developmental opportunity.
Usually, people would do this role for less pay than being a locum doctor and as such they are typically rewarded with more developmental and educational experiences. As an example, a locum in respiratory or O&G will spend most of a shift seeing patients and being on-call or doing ward jobs. As a clinical fellow there would typically be a greater focus on learning and development and enhancing your CV with teaching, clinical skills, or research. In respiratory you might get dedicated ultrasound and chest drain experience whereas in O&G you would likely get more hands-on surgical experience or more specialised outpatient clinic experience.
In fields such as cardiothoracic surgery and neurosurgery, where gaining experience during foundation training is nearly non-existent, you might not know if a specialty is for you. Even those who go into core surgical training typically have very generalised rotations so they can develop transferable skills. You could quite easily spend two years doing foundation training and another two years doing core surgical training and never see a neurosurgical or cardiothoracic case.
You might then decide to apply for a clinical fellow job and experience the role to see if it is indeed correct for you. Clinical fellows in neurosurgery, as you would expect, are more likely to have a realistic insight into the specialty, often having hands-on experience and sometimes relevant research and audit opportunities. As a result, they would likely be better suited for consideration to be appointed to a neurosurgical training scheme compared to somebody without as much relevant experience.
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