Clinical Scientists fill a very special niche in the National Health Service. There are opportunities for laboratory work, basic and applied research, management, and teaching. Clinical Scientists working in the National Health Service enjoy the added advantage of contributing directly to patient treatment and care. This unique satisfaction makes that work especially relevant and rewarding.
The basic vocational training of a Clinical Scientist prepares him/her for a variety of roles, for example, advising clinicians on appropriate diagnostic tests and on the scientific approaches to treatment likely to be most fruitful; devising scientific or engineering solutions to clinicians' problems; and developing solutions for a wide range of different types of patient, thereby pushing back the frontiers of clinical science.
The term Clinical Scientist embraces a wide range of career opportunities within a variety of different disciplines. The main groups are:
The first degree may be a science degree, preferably with some knowledge of physics or behavioural science. She/he deals with the detection and management of hearing impairment (including the psychological reactions to it) from the mild to the profound - in children, the elderly and occupationally induced. Grade A training begins with a full-time MSc course at Southampton or Manchester University and proceeds to a one year supervised in-service placement culminating in a written, practical and oral examination.
The training programme is for a period of two years. The first year will involve the completion of an Audiological Science MSc for which bursary and course fees are paid. The second year will be based at the above mentioned hospitals with secondments to other centres, both regional and UK wide. During this second year, the trainee will receive a salary. This practical training will lead to the completion of the British Association of Audiological Scientists Certificate in Audiological Competence.
A good degree in a physical science (or engineering) is required for entry to the two year training programme, which involves intensive training in each of three major areas of medical physics or clinical engineering (perhaps with rotation to different specialty centres) plus acquaintanceship training in at least three additional areas. The areas are, for example; computer science; diagnostic radiology; electronics and instrument design, non-ionising radiation; nuclear medicine; radiotherapy; physiological measurement; radiotherapy physics; radiation protection; rehabilitation engineering and ultrasound. Note these approved areas for training do change and new areas added. Training includes an accredited MSc. Some Training Centres accept candidates who hold (or expect to hold) an accredited MSc in Medical Physics or Bio-engineering or other postgraduate qualification; the training period may be reduced to fifteen months under these circumstances.
All formal training programmes referred to above lead, via an examination coupled with assessments by the in-service training supervisor, to a formal qualification; otherwise, a Certificate from the British Association of Audiological Scientists or the Diploma of the Institution of Physics and Engineering in Medicine (IPEM), (medical physicists, clinical engineers) as appropriate. This constitutes the qualification which assists the trainee to secure a post in the specialty at Grade B.
Most Grade A trainees are employed as 'Regionally Funded Trainees'. This means that they are employees of the NHS Trusts and maybe seconded to suitable training bases at local hospitals. The secondments will vary in number and duration depending on the scientific discipline, but the aim of the secondment is to provide quality training, a wide variety of experience and insight into specialised services. The programme of training and secondments will be individually arranged for each trainee, but following national guidelines where applicable. In addition to the Regionally Funded schemes, each hospital with a relevant scientific service may employ trainees using its own funds. Training places of this nature may need to be checked for accreditation and that the opportunity will be given to acquire the relevant exit qualification, as failure to do so may prejudice later career prospects.
Most trainees will be based in a department accredited to provide training. This accreditation, or 'seal of approval' is given by the relevant professional body and to become accredited, departments and training programmes have to meet nationally-set standards. The accreditation process ensures a consistently high standard of training for Clinical Scientists throughout the NHS.
An ambitious Clinical Scientist should expect to be mobile during training and indeed during his/her career. Although Grade B constitutes the 'career grade', progression to the top has to be merited. The most rapid career progression may be achieved by applying for a higher-scaled vacant post elsewhere. Assessors appointed by the Department of Health, representing the leading edge of the profession, advise employing authorities on all new appointments and will judge candidates on their track record, on the basis of evidence such as publication in peer-reviewed journals, active participation in local, national and international meetings, and candidates' awareness of current developments in the NHS.
It should be emphasised that Clinical Scientists training does not end when they leave the Grade A Training Scheme. As with doctors, training is expected to continue - in less strictly supervised form - until at least one further vocational qualification is obtained, while the scientist discharges functions specified in his/her job description. These qualifications include a Diploma, Chartered status (CEng, Corporate membership of the Institute of Physics for medical physicists), often with a PhD en-route.
Grade C is the highest grade for Clinical Scientists and carries medical consultant equivalent status. Posts graded thus usually involve the management of a large department or a major departmental section. It is also possible to achieve this status while occupying a post which is actually graded B; this is earned by a consistent and continuing output of distinguished scientific work judged by peers to advance the clinical science as a whole, either in a theoretical sense or in the practice of that science.
State registration has one purpose - the protection of the public. One element is to ensure that clinical scientists are competent to practise. A standard is set which is recognised throughout the United Kingdom and is thus a significant form of public protection from unprofessional or unethical behaviour. Clinical scientists working in or indirectly for the National Health Service or local authorities must be registered with the Clinical Scientists Board. Also private health insurance companies will only recompense patients who are treated by state registered clinical scientists. Removal from the register means that an individual would no longer be able to work as a clinical scientist in the public sector.
The United Kingdom Parliament formally acknowledged the professional status of clinical scientists by setting up the Clinical Scientists Board through the Professions Supplementary to Medicine Act 1960. This gives a considerable degree of professional autonomy to Clinical Scientists. It means they have the right to maintain their own professional discipline and standards of conduct, to set standards of education and training for entry to the profession and to maintain their own scope of practice.
It is illegal, under the Professions Supplementary to Medicine Act, for someone to use the titles "state registered clinical scientist", "registered clinical scientist" and "state clinical scientist" unless they are registered with the Clinical Scientists Board.