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Dr Rachel Stewart
After FY2, Rachel was a junior clinical fellow in plastic surgery and later joined the MDU as a medico-legal fellow before becoming a medico-legal adviser.
It had always been in my mind to do surgery, but I wanted to work in London and knew it would be difficult to get a training post there straight away.
As an FY2, I was aware of people who were doing clinical fellowships before specialty training, so I decided to take that route and use the time to tick things off that would improve my score next time.
I applied for four fellowship posts and had three job offers. The difference from national training is that you're being interviewed by people who work in the hospital and often in the same team, whereas an interviewer for a training post could be anywhere in the UK and you only get one offer to take, or not.
I chose to do a 12-month clinical fellowship in plastic surgery. I knew people who'd worked at the hospital and there was a burns unit that would give me valuable experience. You need a certain number of burns cases in your logbook when applying for plastic surgery ST3 training, and there would be no guarantee of getting this in core surgical training.
I got lots out of my time as a clinical fellow, partly because I was working in a supportive unit that was used to having fellows. I was on the same rota as core surgical trainees and rostered to do the same activities, so I got as much scheduled operating time and on-call duty as a trainee would, as well as regular meetings with my clinical and education supervisors. I also presented at a burns conference, audited a project, and served as joint morbidity/mortality coordinator.
Another good thing was being in the same team throughout, so we got to know each other, and they trusted me to do more. I also understood how the systems worked – like knowing how to add a patient to the emergency theatre list or arrange a scan. With rotational training, you're often only in a post for six months and there are four-month placements in foundation training.
My advice for anyone thinking of doing a fellowship is to plan what you want, tell people this and ask if they'll support you. There are more and more clinical fellowships out there and varying levels of investment in the role by employers, so ask questions and try and get a feel about whether a post is a good fit for you, as much as whether you are right for the role.
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Dr Stefan Hudson
Stefan qualified from Exeter Medical School and completed foundation training before taking a 12-month clinical innovation fellowship at Buckinghamshire Healthcare NHS Trust.
I've applied for other out-of-training jobs but this is my first clinical fellowship. I heard about the post when I attended a conference in Oxford and I've always been interested in med tech, so it was an opportunity to pursue that in a pay-protected way and keep my clinical skills up.
Medical innovation isn't new for the NHS, but this is the first time the trust has run a fellowship. I've been very lucky to be able to mould the job to my requirements. It's a 12-month contract with a 50:50 time split between the innovation role and working as a CT (core training) equivalent grade in plastic surgery.
Because the research and innovation department pay my salary, I'm technically supernumerary, which meant I could choose the specialty I wanted to work in. That was fantastic because I was able to get a job that otherwise wouldn't have been open to me. And I haven't had to do on-calls or nights, which has benefited my work-life balance, even though it's been slightly to the detriment of my clinical experience and pay.
On the innovation side, my job is to identify problems within the trust and see how we can solve them, as well as thinking about how we can better adapt to change. I've done quite a lot, including organising the trust's first Innovation Day event for staff, centralising the resources we use as doctors on a single platform, and initiating a trial of AI voice recognition for notes. I also acquired useful skills for the future, such as attending a digital coding course that provided insight into how software engineers work.
With hindsight, I think an 80:20 split would have been better, but the protected non-clinical time has given me the freedom to attend a lot of conferences and med tech events and build an interesting network outside clinical medicine.
In my clinical practice, I probably don’t have the same comfort with clinical decision-making as my peers who focused purely on plastics. But I have more freedom to be in theatre and observe than I would have on rota.
It was quite challenging to have two incredibly steep learning curves at the same time, but it's definitely been worth doing the fellowship. Choosing a specialty can be quite overwhelming, so it made sense to spend a couple of years making sure I was making the right decision.
Now I know I haven't spent all my time, energy and money on something I didn't want to do. Clinical fellowships can make for a more interesting career, and I've found I really enjoy the managerial side of medicine too.
My advice for anyone doing a clinical fellowship is to plan ahead. When you start in August, the temptation is to enjoy the new job and different lifestyle, but if you want a training post the following year you need to start the application process in October or November. Otherwise, you're effectively committing to two years out of training.
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Dr Aarush Sajjad
After finishing his medical degree in Europe, this doctor returned to the UK and worked on attachments before being accepted onto a two-year junior clinical fellowship scheme for international medical graduates in the North West.
When I was on attachment at the Royal Liverpool Hospital, one of the doctors recommended a junior clinical fellowship programme for international medical graduates (IMGs) and I applied after watching an online presentation by the organiser. When I was accepted, there were about 100 applicants for 12 places, although I think it's become even more competitive.
I'm essentially doing what a UK graduate would do during foundation training with the same benefits. Everyone is really supportive and we're well integrated with the foundation trainees. We have three four-month rotations each year, an assessor and educational clinical supervisor, regular foundation teaching and study time, and I have a portfolio to keep track of my progress and get my CREST form signed off. This says I'm ready for specialty training.
I still have to do my second year and I'm preparing to take the MRCPGP exams. Then I need to decide between GP or internal medicine training.
The work can be stressful, but it's a really good post and it’s been great for my development as a doctor. The only real downside is that the pay is less because we're employed by the trust rather than set by the NHS.
My advice for IMGs is to try and learn as much as you can about how the NHS systems work as that can be the hardest thing to get used to, rather than the clinical side. I was fortunate to have a month-long induction before my start date so all my questions were answered, but a few of my friends who weren't on the two-year fellowship programme were thrown right in after just a few days.
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This page was correct at publication on 23/09/2024. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.