Academic Radiology with Academic Clinical Fellow, Dr Mat Elameer

Hi guys and welcome back for another episode of Radcast. This month we're going to be covering a topic that if we're being honest with ourselves, most of us don't really give much consideration to in radiology, and that's academia and research. Yes, I certainly wouldn't say we're experts in this area, but I'm glad to say we're joined by someone far more qualified than either of us to talk about it, in the form of Dr. Matt Elamir. So hi Matt. Hi guys, hi.

Matt yw anacademic clinical fellow in radiology in Newcastle. He also did academic foundation training as well, so he's truly committed to the academic path and he can tell us all about his experience. Well, no pressure. Ha ha ha. So yeah, thanks a lot for uh inviting me on. I I appreciate that. Um so uh just you know, as as you guys have said, my name's Matt. I I'm at the minute I'm a diagnostic neuroradiology fellow in Newcastle, so I've just started my S T four year.

Uh I've actually just finished my three-year academic clinical fellowship. Um I have continued my academic status as an honorary clinical researcher. There are various ways maintain kind of university status as a clinical researcher and this is where it was the easiest route for me while I'm biding time before I can get onto a PhD fellowship. But we can talk about that in due course. Right, so I'm learning things already. So you don't the academic clinical fellowship isn't for the duration.

short period. Yeah, that's right. So it's anything between one and three years. So standard academic clinical fellowships starts S T one and run through to the end of S T three.

Can you tell us a bit about your background, where your love of research started? Yeah, absolutely. So I I had a bit of a rocky course. By no means was I one of these people who in first year med school ended up with loads of publications and always knew that I wanted to go into clinical academia.

Um, to be honest, I I struggled quite a bit in my first and second year and I think there's a preconception that if you want to go into research you you have to have always been, you know, top decile. Um that certainly wasn't the case for me. Um and I I I think one thing I've learned over the course of the last few years is that it what matters much more is kind of your interest and and commitment to doing research rather than your uh academic background.

Um I I intercalated a BSC in my third year at med school and to be honest I probably wouldn't have made that decision if it was left up to me. Um I I went to UCL and it's compulsory for us to actually integrate BSCs in our third year. So I found myself in the position of kind of having to do it rather than you know have have actually sought out that opportunity.

Um but as it turns out that was probably one of the best things that ever happened to me was uh was doing that VSC, which I did, as you said, in medical physics and bioengineering. That that does seem somewhat related to radiology then. So are you one of one of the rare breed that knew that they wanted to pursue a radiology career whilst you were still in medicine?

Yeah, so it it was kind of the other way around. I mean, I I really enjoyed physics and maths at school. I did A level physics and A level maths. Um and medicine was kind of a last minute decision almost that I'd been teeing myself up to go into electrical engineering. Um and then I I did some work experience and no offense to electrical engineers, but it was incredibly dry. Um I don't think we have any electrical cells. But you know, if there are, I'm I'm sorry.

But um so I I did some uh last minute work experience in medicine and I feel that this is definitely the way to go. Um So the decision to do medical physics and bioengineering wasn't because I particularly wanted to do radiology. If uh I didn't really know much about radiology at all as a second year med student.

But it was more just because I I wanted to do a little bit of physics and something a bit mathsy, uh just because that was stuff that I'd enjoyed at school. Um and then throughout the course of the BSC, that's when I fell in love with medical physics and especially the medical imaging side of things.

And yeah, I did a dissertation project which was investigating a novel kind of x-ray technique. And I just that was the moment for me where I thought this is this is what I wanna do. I wanna be an academic really.

It was brilliant. The the AFP is a fantastic programme and I would absolutely encourage anybody who's uh in medical school at the stage of applying to foundation to at least consider uh the AFP. Uh it can be a little bit variable depending on where you go. The nature of the program changes from deanery to deanery. One of the things that brought me to the northeast where I am now was the flexibility of that AFP. So a lot of AFPs down south have a predetermined project.

And you basically apply for a specific project. Um very few of them, to be honest, would be anything to do with radiology. Um so I came up to Newcastle thinking that, you know, if I if I came up here with some flexibility, I'd be able to forge my own path that would hopefully lead on to uh academic radiology down. Right, so you're not from Newcastle or

No, no, I'm actually I'm a Welsh Iraqi. Um and I I I went to London for med school and I didn't really enjoy the big city. It was great for a few years but six years was was a bit too much. So yeah I I was I was quite happy to get out to be honest of the South. And now you're adopted too. Yeah, exactly. I'm a I'm a Geordie. Y I you enjoyed it there. Yeah, absolutely. Yeah, for for a whole host of reasons.

Um, you know, the support for both in academic training and clinical training has really been fantastic. Uh, you know, I I had a great experience in my foundation programme and in my radiology training today. Um not to mention, you know, the quality of life is just quite nice up here. As as you get a little bit older, you realise things like being able to actually afford a house.

start to matter a little bit more. Yeah, yeah no. Um but it's a bit cold isn't it? That's the only thing. Yeah it is yeah it is. Well it's a good thing you guys can't see me'cause I'm actually wearing my dressing gown. Okay. Did um did just did you get many publications out of your Okay, yeah, so I actually I I had no publications when I finished my AFP. So at the end of F two, I hadn't actually published a full paper yet. Um I did have some abstract

got accepted to conferences, um which which is good. But you know, really what the aim of the AFP is at least to, you know, it kind of lead to a publication. And I I did publish the work I did in my AFP, but not until after I'd already started the ACF.

Right. Uh I did a project investigating the centralisation of acute stroke services in the northeast. Um so I I don't know, you know, centralization is something which is encountered in all areas of medicine at the minute. Um basically by concentrating your resources In one area, you're enabled to provide a better standard of care, or at least that's the theory. And it that transformation has happened in strokes in.

First in London and the southeast, kind of in the early twenty tens, and then shortly afterwards um in Manchester, which I believe is your neck of the wood. Nearby, yeah. Yeah. And uh then the Northeast was kind of the third region in the country to uh to centralize our structure. So I did a a retrospective time series analysis looking at what the impact was on various outcomes for stroke, and that included things like, you know, length of time from stroke symptoms to actually having a CT scan.

So there was some imaging involved in that, although it was was not primarily an imaging project. We did we done one episode with an interventional neural from vet to me services. So would that have been related to would your project have been related to that in any way? Yeah, so so centralisation is thrown back to me. That is the current hot topic. Uh so so th the work which we did was m centralization of all

stroke services. So the creation of a hyperacute stroke unit where any anybody with strokes goes straight to the hyperacute stroke unit, which means that if they need thrombolizing, they can start thrombolysis straight away. Um and as it happens, the healthcare trust, which was centralized in the northeast that we were investigating, doesn't actually provide thrombexamy service. So patients who have strokes in Northumbria have to get transferred to Newcastle in order for thrombectomy to take.

So it it's it's complicated. But what we need and I I you know, I think this is probably the outcome of the discussion that you had with the interventional neuroradiologist, is twenty four seven provision of thrombet. You know, so th it doesn't matter, y you know, the it was the whole postcode lottery thing you guys were talking about. Yeah.

Yeah, and it shouldn't you know that shouldn't be the case. Um the UK is quite far behind certainly the rest of Europe and and to be honest, probably a lot of the rest of the world when it comes to thrombectomy provision. Are you doing diagnostic or in Yeah, very good question. So um for somebody who's interested in stroke and you know, interested in uh thrombexomy and stroke services, I I actually am doing diagnostic at neuroradiology.

So you're part of the problem, Matt. Yeah, yeah, no, I know. Um I have a lot of respect for interventional neuroradiologists, but it is a it's a very stressful job and the on call rotors are quite demanding. Um I think it's quite hard as well if you are interested in academia, you know, you want to have a career that enables you to spend a lot of your time not doing clinical work. And I think for for very procedure heavy heavy specialties like IM

Yeah. You know, if you're taking time out of theatre, I think that probably does have some knock on impact to your training, your clinical training. I definitely no, you're you're doing your bit with your research already, I've already taken my Yeah. I I try, I try.

So, what's been your experience of research in radiology? Yeah, so my experience of research in radiology, it kind of started I guess with my intercalated BSC project that was investigating this novel way of performing X rays, kind of a new X ray imaging apparatus. if you like. And and then, you know, I kind of went a few years where even though I knew that I wanted to do radiology for various reasons that I didn't actually do much by way of imaging research.

um until I started the ACF. Um and more recently, since starting my clinical radiology training, I've done some radiology research in the field of stroke um specifically investigating the impact that stroke has on neural tracts in the brain. Um there's a a technique called MRI track docker. which is where you can m map out the directional diffusion of water in the brain.

And infer from that where the white matter tracts are going and what you know, how big they are, whether they've undergone any degeneration from any process such as stroke or other neurodegenerative disease. Um essentially you can map out these tracks and assess their integrity using MRI tractography. So that I'm involved in a study which we're halfway through at the minute, which is trying to see if we can predict what the outcome is going to be for stroke pain.

by s assessing the damage or how much the stroke overlaps with the corticospinal tract, which is the main descending motor pathway, and seeing if that the degree of damage to the corticospinal tract can help us predict. how well those patients do kind of three months, six months down the line. So th this MR tractography, is that down the line are they um hoping used in clinical practice or is it sort of Yeah, that's an excellent question. And it has neuroscientists.

And researchers have been using this technique for some years now. Um, but it's only recently been filtering into clinical practice. It is actually used when you guys may have seen it being used if you've ever been to a neurosurgical engine. Uh because they use it Yeah, I've seen it in um malignant. Yeah, exactly. Yeah, you're you're exactly right. Uh th because when the neurosurgeons are planning on resecting a tumour, they like to try and avoid the really important nerve tracts.

Um so they can use it to help plan their surgical approach uh to resection. So that's different to functional

Yeah, yeah, exactly. It is it's different to functional MRI. Functional MRI you're looking at you know which Cortices are active in different processes, you know, say which bits of the brain light up when somebody's writing or walking or have Whereas tractography is more structural rather than functional, in that you're looking at where do these nerves actually go, which bits of the brain are you know are they connect?

They're all nice colorful pictures to show the surgeons though. Yes, they're very pretty pictures. Yeah, lots of nice colours. So when you were doing the academic clinical product, Training, how um does that differ to conventional training, like the division of clinical work? Yeah, so that's a nice easy question to answer'cause there's a time split. So essentially the way it works is the ACF the NIH will fund to release

From clinical training for 25% of your time, you know, across years one to three. And how you divide that, you know, you're given some flexibility. So you could either take it all in research blocks, so instead of doing a two month for four month clinical rotation in one year you could do that whole thing as research, or what's a bit more common is to mix and match. So take one day a week. So does that mean then that your your overall training time is going

Yeah, so your training actually isn't extended by doing the ACF. Um the idea is that Hopefully your research projects uh have something to do with clinical radiology and therefore the time that you spend working on them can help you achieve your clinical competencies in theory. Um in in practice it's not always that straightforward and uh a lot of the time that you spend doing research.

you know, is time not spent doing clinical work. And uh over the course of three years, you know, you can find yourself starting to slip behind on the clinical aspect, which is expected if you're spending twenty five percent less time than your colleagues actually do the clinical work. So you'll accept that your clinical expertise, your clinical work has suffered.

I think you can you can do things to try and mitigate that. You know, if you're organized, you know, you can get your portfolio in order earlier on than everybody else to make sure that you've met all of your competencies. You know, uh yeah, clinical supervisors my experience are often very understanding and you know they will go the extra mile to help make sure that I have achieved

all of my clinical competencies, y you know. Say if there's a a an ultrasound list which is normally on one day and that day is my academic day, they may go out of their way to try and house me into a list which is on a different day to where they'd normally have a trainee. So do you have to fulfil all of the workplace based assessments that we have to do or do you

No, you have to achieve the same number of workplace competencies, all the same portfolio targets, the same exams and exam timelines as everybody else. So would you actually recommend? Yeah, I I would absolutely unequivocally recommend the ACF. Um it's it's been a fantastic experience.

And yes, whilst it is hard juggling the clinical with the academic training, um the expectations of the ACF are not set in stone, so you you Whilst from the clinical side of things you you have to every year you have an ARCP and you have to make sure that you've met those targets.

The academic training tends to be a lot more flexible. And if you have, you know, a year where you've not been as productive as the other years, then the academic panels will will tend to be, you know, fairly understandable. So it you're not committing yourself to having to do research and having to spend all your time doing this stuff.

some of the previous ACFs that my trust, you know, haven't been that interested in research. Um, or, you know, maybe the first year of doing the ACF has put them off that academic track. Um and you know, it's not been a problem for them. You know, they've they've just been able to carry on with their clinical training and staying in the ACF and maybe using that their research time to do some audits or something like that, rather than full blown research and that's been fine.

So there's no sort of minimum requirement of what... in your ace, yeah. Yeah, exactly. Yeah, it's it's not there's no pass fail, you know, you do what you do. Every year you do have a meeting with the academic panel who will ask you what have you done? Um but you know there's no minimum stand

So just kind of looking at at radiology in general as like a whole cohort of people, do you think that across the board typically radiologists are involved in research? I I would say absolutely not. Uh academic radiology is uh very much underrepresented compared to other specialties. You know, surgery, cardiology, medicine. You know, there's huge numbers of academics in in those

Academic radiologists are rare as hens' teeth. Yeah. Um it's a big shame because you know, we we need radiologists to do research. Um what what are your thoughts and why?

It's a tricky one, you know, because I would have thought a lot of the personality types that make somebody interested in radiology would also make them interested in You know not liking people, liking coffee, you know, comfy chairs, that kind of thing, you know, it it should um but but i i in all seriousness I think part of it is that

In other specialties there's the expectation that you do research. Especially in surgeons, you know, if you want to apply for surgery, if you want to be a competitive, you know, applicant for a surgical registrar post, th they will expect you to have publication. Radiology it's it's not it's not quite the same. Obviously the extra points help.

But there's not the expectation, you know, that you have loads of publications and stuff. It is a bit contradictory because radiology is fairly competitive to get into. Um I have my my other four I think there might be a degree of complacency amongst trainees because of the workforce shortage because it's so bad that a lot of the C V building that you have to do in other specialties isn't necessarily required.

to get a job so like stuff like research and even you can include fellowships in that um it's not really standard. Um yeah when you compare to like cardiology. they want to get a job yeah then as a consultant and they have to do a an M D or a Ph thing. Yeah, yeah yeah, you're exactly right. I think there probably is a degree of complacency in that, you know

You you're basically guaranteed to get a consultant job somewhere as long as you can get your outcome six or whatever at the end of the training. Um Uh and even, you know, some uh really competitive trusts for other specialties that, you know, they struggle to recruit radiology consultants to. I was looking there there are drugs advertised in Adam Brooks, you know, for consultant radiology.

that have been a advertised for months. Yeah. And you know, any other specialty they they would have just been eaten up. But there's just not enough radiologists being trained to fill all the all the posts and we do get complaints.

Do you think that perhaps another factor is that a lot of radiology research... too complex or at least perceived as being too complex because we use a lot of very very advanced tech and there's a lot of physical Maybe they didn't even do it beyond G C S. I take your point, um, but I I I would say that there's a lot of different areas in radiology which you can do research. And for me, you know, kind of being a bit of a physics, mathsy gee.

I'm drawn to the new technologies, new techniques side of things. you know, the MR physics and x-ray detectors and and all that stuff. Um but actually the majority of radiology research is is not at all physics dependent. Uh radiology is a is a clinical specialty and things are all about how is this going to make a difference for patients.

Um, and I I I think there is an awful lot of scope to do radiology research, which is quite similar to what your clinical drug is, which is just looking at scans, you know, and writing reports. For someone who isn't that sort of experienced in research, where do you start?'Cause I often feel like, yeah, I I could do more research, I should do it, but I'm not the best at coming up with ideas Sometimes it can be just difficult.

Yeah, so I I think this is where having a strong uh senior support is is really helpful. And I think you probably will find actually most places in the country if you if you email your consultant and say, oh, you know, I'm interested in research, th they will probably know somebody who's who's doing research in your field, you know, either locally or, you know, maybe somebody in a in a different trust or another region.

You know, who's doing research and what you're interested in. So I would say speak to your seniors and and ask for help and uh I'm sure they'll be able to find out.

So you gave us a little teaser earlier on when you said that you were planning on doing a PhD, was it? Can you tell us about those pleasure? Yes. Yeah, so uh I'm very keen to to go down the PhD route. So I something I probably should have said earlier on. I I've basically followed the integrated academic training pathway.

Rates the NIHR um, you know, a decade or two ago had to completely overhaul clinical academic training because they were struggling to find academic clinicians from all specialties, not just race. And as part of making life simpler, they came up with this kind of career pathway progression scheme, um which consists of various different jobs at different levels.

the integrated academic training pathway or IAT starts with the BSC and then goes on to the AFP and then on to the ACF and the next rung of the ladder after the ACF is normally the PhD. Um part of the reason for that is that if you want to do say a a consultant academic job where you're employed by a university and doing maybe fifty percent of your time doing research, all those jobs are postdoctoral jobs.

So you you know, you would struggle to spend fifty percent of your time doing research and you would struggle to find a job that would let you to do that unless you had a PhD. Um so yeah, I'm because I do want to spend fifty percent of my time doing research, uh it's really important for me to have a PhD. Um That's not the only driver for me wanting to do it. You know, also it would be great to develop my research skills.

you know, my analytical skills. Um and so, you know, every uh opportunity that you have to apply for funding and, you know, going through that process I think makes you a better researcher. Um so There are all sorts of reasons why I I would like to do a PhD.

So have you have you applied for funding for y research that you've done so far? So I was a co applicant on a grant which uh we've just found out last week was is successful. Uh and that was my first experience really of actually applying for funding to do the synonyms study that I talked about earlier with the tractography and stroke. That project was already funded before I got involved as a How arduous is the funding application pro

It's it's very arduous. Yeah, it's it's the the whole process is is a bit of a nightmare to be honest. There's a a lot of writing. You have to write pages and pages. You have to have meetings with so many different people. You know, people in the university that from the clinical academic office and people involved in, you know, research costing and funding. research methodologists and statisticians and

You know, I I tried applying for a PhD at the end of last year and that application I worked out I I needed to speak to forty different people to in order to to get my application together. And it was like just pages and pages, tens of pages long, this application. So yeah, very long So you could you could do all that and then still get Yeah, exactly. Uh the research funding is very competitive. Um especially for clinical research funding.

And part of that reason is if you do the clinical PhD rather than the scientific PhD. You will often get funding that salary matches your clinical job. Okay. Um most scientific Ph Yeah, I know it's a bit crass to talk about money, but you know, if you have a house and a mortgage you do actually need to think about these things.

You know, most science PhDs would probably be paying twenty thousand pounds a year, uh which would be I you know, I I think it's fair to say that would be a big drop for for most radiology trainees. Yeah. Um You're not getting out of bed for that much. So Yeah, you'd have to really, really love research. Uh but um so the the the clinical PhDs are always competitive um because there's very few of them because they're so expensive.

Okay. And you said the ultimate aim is for you to get an academic consultant post where you're partly employed by a university. And so how um prevalent are those jobs? Yeah, so there's not loads. Uh there are more in some parts of the country than others.

So it's a lot easier to to get that kind of well, I say a lot easier, what I mean is there are many more people doing those kind of jobs at the biggest academic centres. Yeah. So London, Oxbridge, you know, there'll be quite a lot of consultants who are actually university academics who are honorary consultants. Okay. You know, if if you're out in the out in the sticks, you know, me up in the Northeast, um, there aren't very many consultants who are actually academics.

But obviously you've been... So while presumably you're building a little bit of a little bit of a little relationships with the university? Could you sort of have a post made for you? Yeah, so I mean it's it's quite complicated the you know, the bidding processes for um kind of the creation of clinical academic job.

Um but I I do think it has helped being in the region for a very long time and getting to know the professors, you know, who who do research and imaging research and the people who are, you know, high up in the university. Who can maybe make these things happen? Yeah. Um I I would say that yeah, definitely getting your name out there and you know.

making yourself known to the people who make those decisions will increase the chance of there being a job there when you're when you're applying for jobs. So what what has been the highlight of your academic career so far? The highlight of my academic career so far um has probably been the Stroke Centralisation project that I talked about a little bit earlier on um getting that paper, not you know, not only did it feel great because it was the first

a full length paper that I had published. But it's actually been cited by the Stroke Association. in their kind of impact documents uh uh you know, describing what they think about centralization.

And it's also been cited by NHS England and NHS improvement in in documents relating to the reorganisation of stroke services elsewhere in the country. I think that's that's what you know Clinical academia is all about is about y yes, having a good time doing the project and finding it really interesting, but then actually getting to see what the impact is, you know, and and knowing that maybe you have actually been able to change something and improve care for patients.

It's like it's like you're an influencer. Yeah, but a lot less glamorous. N nobody's sending me freebies for this. Are you doing any research with AI or involved in any AI So at the minute I'm not. Um it is something which I find interesting, but there's a lot of people I think doing research in AI at the moment. I I would say that actually probably the majority of radiology research that's happening or you know

v a very hot topic at the minute. And um I think there's something to be said, you know, for doing research that's not AI centered. Because there are plenty of people who who are doing research that's very AI heavy. Yeah, that was kind of a leading question'cause I was gonna say do you think there's an over

Yeah, I mean I think there is, but I can s I can see why. Uh you know, because the it brings the promise of being able to, you know, deliver good services and improve patient care, you know, in a very exciting way. Um and I can absolutely see why, you know, people who are funding research would give funding to people who are proposing, you know, clinical implementations for AI.

I think that there's something that um you kind of hear about is that there's a lot of emphasis on research into tech, whether that's hardware. Accurate? Absolutely. That's very accurate. You should be always thinking what is the clinical application of this technology? Right from, you know, the conception of the technology. It was one th one of the things I noticed doing my BSC.

uh was that there are these physicists who have these really amazing ideas and, you know, they're working on these really interesting concepts and th they don't really have any idea what the clinical application might be. You know, they're just investigating it from a technology perspective.

Um I I think that, you know, we'd be able to really speed up integration of tech ne new technologies into clinical practice if people were thinking how is this going to be clinically useful right from the beginning. I suppose that's why you need more radiologists to be involved in the research because they will have their eye on the clinical side of things rather than just research for the sake of it or

Yeah, absolutely, you've hit the nail on the head. We spent half an hour and uh that that sentence is just perfectly exactly my feelings. It's organic. Um Um so I mean we're obviously in the middle of a pandemic. Um Liverpool is right at the heart of it. I think I currently work in the trust with the most COVID patients in the country. So I mean my training's been quite disrupted and we're all Um but how has your research been affected by coming?

Yeah, I mean f first of all I I'm really sorry to hear about everything that's going on. You know, I it it must be really hard. I know the strain that it's put clinical services under all across the country, but uh obviously some parts of the country have been harder hit than others. Liverpool does seem to have been particularly happy.

uh at the minute. Much appreciated. Yeah. Um but yeah, it has been a nightmare from the research perspective. So this the the synonym study with the stroke tractography, we ha had to suspend the study for a number of months this year. Um not only that but we'd recruited papers. Done our index scan.

you kind of between January and March and should have been following up those patients, you know, in March, April, May and um we've had to lose those patients to follow up because um it w you know, there was no way that we could have had the

follow-up meetings to assess how their strength is recovered. And that's really frustrating because you it's hard recruiting patients to studies. It's really hard. And you know every patient you recruit, you know, it's it's a great achievement And then to just have three of them last

Um, it was it was really frustrating. And you know, now things have research has started back up again, but it it seems like with the second wave coming, you know, we're probably looking at having to suspend the study again. So what will you do? Will you just suspend it or are you determined to at some point complete the project completely? Yeah, I think we'd like to complete it, obviously we want to complete it, but there's timelines on the research funding that you have.

And and what's funders uh understanding, you know, if the fact that the pandemic has delayed everything, they can't just keep extending your funding indefinitely. You know, they will reach a point where they'll say you'll just have to close the study with however many patients you've got. Right. Okay, well fingers crossed for you that

you can avoid that happening and and get it done. More collateral damage. Yeah. Yeah. Um so um okay, we've spoken a lot about ACF, but we're just gonna shift the focus onto the application. Um because we know some of our listeners will be in the process of applying for it, so we want to give them a bit of an advantage if we can. Um and so can you tell us a bit about the application process and how it's different from conventional recruitment?

Yeah, so the the ACF application is a bit more like what traditional medical applications used to be before it became such an anonymous point space system. Yeah. In that there are still white space questions, you know, so you put together uh an application with an application form and you have to write paragraphs about things. where people will actually read a paragraph rather than just counting up the number of publications.

degrees and stuff you've had. Um so so it differs uh it from that perspective. There's also an interview uh for the ACF which is done locally. So ACF decide exactly which programs which schools you want to apply for and you only apply to those training programs. So, you know, I applied to Northern, which is where I am now, and I also applied to Sheffield, and I didn't apply to any other ACFs because there was nowhere else I wanted to go.

Um the applications run in tandem with your clinical radiology applications and you you can't just apply to the ACS. you also have to apply to clinical training at the same time. And you have to go to national clinical radiology interviews in London or, you know, Zoom or however they're doing them now and um score highly enough to be appointed somewhere.

But you don't have to score highly enough to get into the deanery that you've applied to the ACF for as long as so all all you need is to be appointable, but you don't need to score highly enough to rank. Right. Provided that you get an offer for the ACF and the local deanery that you've applied in. Yeah. So you could not score highly enough to get a place on the clinical record. Yes, exactly. But is it quite a long

It it's it's not that long, to be honest. You know, it's a few pages. There were probably ten questions or you know, something something along those lines. Um stuff like why do you want to pursue a career in academic medicine? You know, what's your research experience to date? Uh and and and so I'm sure there was a question about just like what are your hobbies, you know, that kind of thing.

Did you get any sort of help or tips on how to complete it or how did you go about it? So I'd say the best thing that helped me with the ACF application was having applied for an AFP and having done the AFP application. Es especially within the same deanery, because um there were a lot of similarities between the AFP and the ACF application. Very similar questions. Okay. So you apply in tandem to the the clinical radiology. Um is the timeline sort of the same? So you you know, do you apply

Yeah the the type the timeline's similar. I think it was probably slightly earlier, by maybe a month or two, but uh um the dates do change from year to year and uh you know anybody who's looking into this should As soon as they think they might want to apply for an ACF, they should start looking at the national dates for recruitment. Uh how competitive is A?

Uh again, it depends where you are and and things have changed a little bit as well. So when I applied to the ACF, they were actually offering them only uh in a specialty specific manner. So I there are only radiologists who are applying for the same ACF post as I Um whereas the way it's gone now, certainly in northern and I think probably in a lot of other deaneries, is they mix specialties. So you might be competing against

academic psychiatrists or academic GPs or academic ophthalmologists for one ACF post. So they've become, I think, a lot more competitive than they were when I applied. So it's just ACF is kind of considered its own thing and then th it becomes whatever specialty the Well it's it's more the funding and commissioning process for ACFs are are are quite complicated.

It it's more that, you know, maybe a deanery will have X number of ACF posts to allocate and then decisions are made about what specialties they want to allocate them to. Okay. And when I applied we had some ring fenced specifically for radiology. And that ring fencing has been lost, I expect, because the overall number of ACF posts probably isn't as as high as it was when I applied. yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw.

Or do you actually have other opportunities down the line to get onto Yeah, so there's two answers to that. Uh the first answer is yes, you you can absolutely apply. Some schools will advertise ACF ST two posts. Or ACF ST three posts that you can apply for after you've already started your clinical radiology training. And you could apply, you know, to another deanery to do those.

You know, if there's an ACF in a given deanery, that is normally an extra numerary position. Um so they will normally be able to accommodate somebody coming in from another school or or what have you. Um, the second point to that question is that even if you don't get onto an ACF at all, you can still do research and get involved in research and you could even still apply for a PhD fellowship, even if you hadn't done the ACF.

Uh and uh um I think you answered this one a little bit earlier, partially, but if you start ACF and then you decide feeling it um it's the all these p values and area under the curve it's not really doing it for you anymore. Um can you can can you can you switch to conventional clinical radiology training or you have to see out Your ACF but you can do non research stuff during

Yeah, you can swap to just clinical at any time if you wanted. Um but I personally I I don't think that that would be a sensible thing to do because as I said there's no the ACF doesn't really have expectations. Obviously people funding them hope that you'll go on to publish papers. get PhD fellowships and stuff, but if you decide it's not for you and that's not what you want to do, then you're not really going to get penalised for that. Um so you could do, but I don't think it

be beneficial to swap from doing academic to pure clinical training. Right. So so what advice would you give to junior doctors or medical students to help them prepare for the ACF or AFP? Start early is the number one piece of advice I would give you. It takes months to prepare applications for these things.

Uh and you really need to be, you know, as soon as you have the thought in your head, oh, I might want to apply for an AFP, I might want to apply for an ACF, then you need to be starting researching into how you can go about doing So yeah, number one, start early. Number two, speak to people.

speak to people who are already doing those jobs, people who have done the AFP, people who have done the ACF. You know, hopefully you guys will be able to put my contact details out and I'm very happy to answer emails from anybody who who thinks that this might be something which they're Have a great- Yeah. Okay, um that's great, Matt. Thank you for sharing your experiences with us and the listeners. Hopefully this episode will help to bring academia and research a bit more into the forefront.

people's minds because joking aside, I think we do all need to be a bit more involved in it, as we said, so that we can influence changes and new developments in a way that works for us rather than having non radiologists and big companies drive Yeah, I absolutely I hope that we've been able to post academic radiology in a positive light. And uh thanks again for the opportunity.

No, thank you for joining us. So thanks for listening, guys. We'll be back next month with another episode. In the meantime, you can catch all of our previous episodes on all the major podcast platforms and also at anchor.fm. Rydyn ni'n gwneud yn ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud. Thank you and watch by