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Competition ratios

Clinical radiology is a very rewarding career but getting a training post is competitive.

Key statistics from 2023:

  • There were 3068 applications for 350 ST1 training posts in England, Scotland & Wales.
  • There were on average 8.77 applications to every 1 post.

Click here for more information including statistics from previous years

What is a radiologist?

Overview on what a radiologist is and what they do

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Academic radiology training

As well as standard ST1 Clinical Radiology training, there is also the option to undertake a National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF).  An academic clinical fellowship is a specialty training post that incorporates academic training.  It’s aim is to give a platform to simultaneously develop academic and clinical skills for aspiring clinical academics.


NIHR Academic Clinical Fellows (ACFs) spend 75% of their time undertaking clinical radiology training and 25% undertaking research or educationalist training.  Doctors undertaking an ACF also receive a National Training Number (NTN) for Clinical Radiology.  It is important to note that usually you do not extend your ‘normal’ radiology training, even though you are only spending 75% of your time doing this.  This is what makes it so hard, and why deaneries rigorously interview you – you essentially have to do all clinical competencies whilst also doing academic work.

ACFs typically last 3 years and are usually during ST1-3.  During this time, alongside clinical radiology training, ACFs will be able to develop their academic skills and be supported in preparing an application for a Research Training Fellowship (to undertake a higher research degree such as a PhD) or an application for a place on an educational programme (also leading to a higher degree).  Success in these applications is defined as the end point of an ACF.

Therefore at the end of the 3 years of ACF you will either take time out-of-programme to complete the higher degree or you go back into training to complete ST4-5.  You still get your CCT after 5 years of training, however this does not include the extra time out-of-programme to undertake the higher degree, which is typically 3 years.

Radiology research looking at the quantitative analysis of fractional anisotropy on colour-coded principle eigenvector maps at the level of the decussation of the superior cerebellar peduncles (Nottingham)
Radiology research looking at the quantitative analysis of fractional anisotropy on colour-coded principle eigenvector maps at the level of the decussation of the superior cerebellar peduncles (Nottingham)

Application process

Applications for ACFs start earlier than normal speciality training.  The programmes on offer vary and change year-on-year depending on what funding is available to the deaneries and research networks.  For example, applications normally open in early October each year and close in November.

You must apply for the ACF post and also apply for standard ST1 clinical radiology training

The ACF application process includes several steps in addition to the normal ST1 recruitment process.  It is best to think of it as an additional process to go through.

ACF recruitment

ACF applications are all done through Oriel, exactly the same as normal clinical radiology ST1 applications.  They are advertised separately for each deanery so you will need to fill in each ACF application independently.  For example, a candidate may make 5 applications on Oriel – 4 ACFs to 4 deaneries and 1 generic clinical radiology ST1 application.

The selection process for ACF varies widely depending on each deanery and post, however there are some common elements.  At time of submitting the application, you need to answer white-space questions.  The length and type of questions may vary between deaneries, but common questions include:

  • Why do you want to pursue a career in academic medicine?
  • What is your research experience to date?
  • Why you do want to come to this deanery?

This differentiates the ACF application form the standard ST1 Clinical Radiology application form.  It is worth preparing answers to these before the applications open.

After shortlisting, most deaneries then invite their top 5-10 candidates for interview.  Interviews vary widely, and can be single or multiple station.  They are often chaired by the Academic Radiology lead and Training Programme Director.  Questions cover both academic and clinical topics.

National ST1 Recruitment

All ACF offers are conditional on ‘clinical benchmarking’ in the national recruitment.  Therefore, in order to be successfully appointed as an ACF, you need to also pass national ST1 clinical radiology recruitment as well.  This includes the MSRA and interviews.  The rank itself doesn’t matter, but needs to be high enough to get a training number.  Look at our resources on the ST1 National Recruitment for further information.

Some ACF jobs are advertised as ST2 or ST3 posts, which you can apply for after you have started training in radiology, therefore if you already hold a Radiology national training number (NTN) you do not go through the national application process again, only the application and interview process for the ACF job.  This can be a good way of getting into academic training if you were unsucessful at getting an ACF post when applying to ST1 radiology, or if you decide to turn to academic radiology after starting radiology training.

Top tips for ACF applications

  1. Thoroughly research the ACF programme you are applying to

    • Know what sub-speciality research they do, and does that suit you? Are there links with a University to do an additional degree?
  2. Consider the impact on clinical training

    • Radiology training alone is an incredibly short and intense training programme, unlike FY1/2 or CMT. Make sure you understand the challenges and demands of doing an ACF alongside clinical radiology training. Remember you spend most of your time as a clinical trainee. Do you have a preference for large, medium sized or small training programme? Do you want to be in University hospital or get some DGH experience? Another thing to consider is the impact of the FRCR examinations on your academic time. The FRCR 2A exam is a huge undertaking, and many ACF trainees should consider putting their research work to the side for maybe the 6 months running up to the exam to give time to revise and pass the 2A on the first attempt.
  3. Prepare early

    • ACF posts are competitive and there is a lot to do in a small space of time. ACF posts open earlier than standard radiology applications. Write draft answers to common white space questions. Tie up any loose ends in your research and push to publish any existing work. Likewise, close any incomplete audit loops.
  4. Find a mentor

    • Seek out an academic mentor who can help support you whilst going through this process.
  5. Mock interviews

    • Academic ones in particular are particularly helpful, as this is a new experience.
  6. Do not disregard the national training application

Find out more

We have written a guide: Starting research during radiology training, which may be useful to read if you are interested in a career in radiology research.

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