Academic Training in ICM

Over the entire training period, up to one year of research can count in full towards accreditation in ICM. Subsequent periods of research time may not be counted towards accreditation. However local trainers should be flexible about counting clinical time for individuals who spend time in posts that have a mix of research and clinical training. In such instances, requirements for clinical training should take account of the performance of the doctor in training and achievement of key capabilities and experience, rather than be solely based on time spent in clinical training.

However, where academic doctors in training need additional clinical training time, this must be provided to ensure that these individuals are fully trained both as academics and specialists in ICM. The purpose of ACL posts is to provide 50% time for research training. Achievement of key capabilities and experience may permit completion of research training within the remaining 50% of the post, but where this is not possible, local HEE offices have a responsibility to ensure that individuals are fully trained clinically.

Trainees who achieve Dual Accreditation in ICM and a second clinical specialty should recognise that maintenance of clinical skills in two parent clinical specialties, while continuing a credible research career, represents a substantial burden. While this is not impossible, careful thought should be given by trainers and doctors in training as to whether they feel that a continued career as a clinical academic is compatible with satisfying the needs of re-validation in two clinical specialties.

The purpose ACF or ACL posts is to ensure that individuals have protected research time, and doctors in training who are appointed to these posts must have their research time protected so that an ACF gets 25% of time for research and an ACL 50% time for research, averaged over the duration of the post. Indeed, where these posts are funded by the NIHR, this is the absolute minimum that will be accepted. It is important to recognise that this may result in some increase in overall training time to ensure that clinical training capabilities are achieved.

However, where the trainer and trainee agree that clinical capabilities are being achieved, and clinical training is not suffering, there should be flexibility about how much training if any needs to be prolonged, and in many instances, a 50% research post may not result in a doubling of the clinical training time in the post. Thus, for example, in a four year CL post, a trainee will undertake the equivalent of two years of research training and two years of clinical training. If the time based requirement for clinical training was applied inflexibly, if such an individual came into the post with 2.5 years of clinical training remaining, and if clinical training needs were judged inflexibly just on the basis of time spent, they would need to undertake a further six month period of clinical training at the end of the four years. It is reasonable to view the individual’s training as an integrated whole, and where all the required capabilities and outcomes have been reached, it should be possible to award CCT at the end of the four year period, if the local trainers, the doctor in training and FICM TAQ are in agreement. It is essential that these individuals are not burdened by a strictly time-based assessment of their training at this stage. Where clinical capabilities are met their training time should not be discounted because of an ongoing commitment to research. The recognition that this does not represent “double counting” training time has been accepted by HEE and the GMC.

Clearly there will be some doctors in training (and not just academic trainees) where capabilities  are not met satisfactorily, and training time may need to be extended further, rather than rigidly calculated pro rata, based on time spent in training. Again, this is a decision for local trainers which may need clarification from FICMTAQ. Where the allocation of time for clinical training in an ACL post does not satisfy the clinical training needs of an individual academic doctor in training, it is essential that local HEE offices make provision for additional clinical training, either through extension of ACL appointments or through re-entry to the conventional clinical training scheme for a period.