General Practice & Primary Care
Being an Academic Clinical Fellow (ACF) or an Academic Clinical Lecturer (ACL) in General Practice offers a unique opportunity for academic and clinical training in a world-leading Academic Health Sciences Centre integrating primary and secondary care. The Division of Health and Social Care Research provides the focus for this integration. Community-based and public health researchers and teachers enjoy strong collaborative links across the Faculty of Life Sciences and the local community. The Division comprises over 120 staff and researchers with seven professors in Epidemiology, Health Economics, Medical Sociology, Physiotherapy, Public Health, Social Sciences and Health, and Statistics. We are highly multidisciplinary, with clinicians, social scientists, psychologists, statisticians, informaticians, educationalists and epidemiologists. In the national Research Excellence Framework 2014 (REF 2014) 86% of our performance was rated 4* and 3*, sixth in the UK. We are funded by NIHR, MRC, EU, and charities, and focus on translational research from ‘bench to community’.
In Primary Care the Division has world leading expertise in the integration of data from clinical and research domains, leading an important EU project ‘Translational Medicine and Patient Safety in Europe (FP7-TRANSFoRm) www.transformproject.eu, and collaborating in ‘Electronic Health records for research’ (IMI-EHR4CR). These projects are developing standards and methods for integrating clinical trial workflow and data capture into electronic health records. TRANSFoRM is also developing a decision support system for diagnosis. All local general practices are on a single electronic patient record system (EMIS Web).We run a unique database (Lambeth DataNet) of routinely collected data in 49 local practices. This database provides the basis for much research using the whole community of Lambeth. In this research we are drawing together the Department of Informatics and the Department of Primary Care and Public Health Sciences (GSTT BRC).
In our emphasis on translational research from ‘bench to community’, research within the Division is integrated with major National Institute for Health Research (NIHR) infrastructures: the NIHR Biomedical Research Centres (BRC) at Guy’s & St Thomas’ NHS Foundation Trust, where the Division leads the Populations Sciences cluster; the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, where the Division leads the Stroke and Public Health themes; the Division hosts the NIHR Research Design Service London (RDS London), that complements a growing Research Consultancy Service; and the NIHR Clinical Research Network National Speciality Hub, that provides oversight of the need for and capacity for clinical research in nine specialty groups. Our research informs clinical guidelines and national policy in stroke, health inequalities, medical diagnosis and clinical research informatics. We have strong links with local communities that are urban and multi-ethnic. The research undertaken by ACFs and ACLs will link their primary care interests with the research themes of the Division.
The Division has a very strong undergraduate educational unit called KUMEC, Kings Undergraduate Medical Education in the Community. KUMEC is responsible for delivering 13% of the face to face teaching of undergraduates in the medical school. General practice ACFs and ACLs will have the opportunity to contribute to teaching and examining of medical students across the five years of the medical curriculum.
For ACFs links with the Division will be forged in ST1/2 years seeking to develop their research interests and engagement with a senior academic who will oversee a research project in each year of ACF ST3/4 posts. In ST4 emphasis will be on project completion, publications, and a doctoral research or in-practice fellowship application. Opportunity will be given to work in Genomic Medicine and Informatics in Primary Care through the GSTT BRC, in projects linking large primary care clinical databases, and in practice-based projects focussing on biomarkers in early disease.
The ACF will undertake clinical training within the programme run by the London School of General Practice and based at Guy’s and St Thomas’ NHS Foundation Trust or King’s College Hospital NHS Foundation Trust. These programmes have developed outstanding innovative training posts between primary and secondary care and always attract a large number of clinical applicants. The ACF will concentrate on clinical training in years one and two. They will increase their academic involvement as the programme progresses. In year three the post will be divided 60:40 clinical:academic and in year four 40:60 clinical:academic. We expect our general practice academic trainees to publish their research every year. Many have successfully obtained NIHR and charity-funded doctoral research training fellowships, NIHR in-practice fellowships, and post-doctoral NIHR and MRC research fellowships.
Academic clinical Lecturers (ACLs) will also be supervised by a senior academic in developing a personal research portfolio. This should lead to the acquisition of research funding, strengthening of their publication record, and ultimately developing an application for a post-doctoral research fellowship. ACLs in general practice will already have completed their clinical training and a PhD. These ACL posts will be split 50:50 between clinical and academic work. They will integrate further academic and clinical development at a point where the post-holders should be aiming to embark on a career as independent researchers.