Changes to training in academic medicine might cause problems for trainees who are interested in pursuing a career in academic psychiatry. The new system comprises academic clinical fellowships and clinical lectureships. During an academic clinical fellowship trainees will be expected to secure an externally funded training fellowship in research or medical education. After the attainment of a higher degree, trainees might enter the clinical lecturer grade, which will offer opportunities for postdoctoral level research or career progression in medical education.

My concerns are related to the stages at which recruitment will take place. The Modernising Medical Careers website states that the next allocation of academic clinical fellowships will be for appointment to posts at the ST1 level, to commence in August 2007 (http://www.mmc.nhs.uk). A recent article stated that until these cohorts emerge from training there will be interim arrangements to fill ‘new’ clinical lectureships (Reference Dimitri and StephensonDimitri & Stephenson, 2006). However recent advertisements for new clinical lecturer posts have stated that candidates should already have national training numbers and an MD/PhD. This does not appear to be an interim arrangement but rather the introduction of the new model.

Where does this leave a current trainee who (under the old system) hoped to pursue a higher research degree in a clinical lecturer position, who is now definitely not eligible for a new clinical lecturer post and is at too high a training stage to apply for an academic clinical fellowship at ST1 level?

A Department of Health publication (2006) is helpful although vague, stating that applications for academic clinical fellowships will be invited from senior house officers or specialist registrars, depending on the grade of trainee the programme can accommodate. Will old style clinical lectureships continue to exist and be advertised as such until the new system is underway? Will all academic clinical fellowships in August be at the ST1 level? It would be useful to have clarity on the availability of such fellowships in psychiatry at the ST4 level.