NIHR fellowships are the National Institute for Health and Care Research’s structured programme of personal career-development awards, run through the NIHR Academy, for individuals rather than for a single research project. Where most NIHR funding pays for a piece of applied health or social care research, a fellowship pays for a person’s development as an independent researcher — funding protected research time, training, and (for clinically qualified applicants) a bridge between clinical practice and an academic career. This guide sets out the fellowship ladder itself: what each award funds, who is typically eligible, and how the awards connect to one another, distinct from NIHR’s project and programme funding covered in CASRAI’s broader NIHR Funding Opportunities guide.
The NIHR Academy and the shape of the ladder
The NIHR Academy is NIHR’s collective term for its research career-development infrastructure: the fellowship and training programmes themselves, plus the schools, mentoring, and professional-development support that surrounds them. Its awards are organised as a ladder running from pre-doctoral through doctoral, postdoctoral, and senior/advanced levels, deliberately mirroring an academic career trajectory rather than funding isolated one-off awards. A researcher is generally expected to progress through the ladder over successive applications rather than enter at a senior level, and NIHR explicitly frames the scheme this way in its own fellowships summary material.
Two things distinguish the NIHR ladder from a single generic fellowship scheme. First, it runs two parallel tracks: a clinical academic pathway (the Integrated Academic Training, or IAT, programme) specifically for medically and dentally qualified applicants who are also progressing through NHS specialty training, and a broader personal-award route open to a wide range of health and social care professions — nurses, midwives, allied health professionals, pharmacists, healthcare scientists, and non-clinical researchers working in NIHR’s remit — who are not tied to the medical/dental specialty-training timeline. Second, awards are funded at Whole Time Equivalent (WTE), meaning a fellowship can typically be taken up part-time (commonly between 50% and 100% WTE) with the funded duration adjusted accordingly, which matters for clinicians balancing an award against continuing clinical duties.
Pre-doctoral level: Academic Clinical Fellowship (ACF)
The Academic Clinical Fellowship (ACF) is the entry point to the clinical academic pathway. It is a clinical specialty training post — held by a doctor or dentist already in, or entering, NHS specialty training — that incorporates protected academic time (typically around 25% of the post) alongside normal clinical training, so the trainee builds a research track record and prepares a doctoral fellowship application without leaving clinical training. ACF posts run for a standard duration of three years (up to four years for GP trainees) and are allocated through the Integrated Academic Training programme; NIHR allocated 278 ACF posts for the 2026/27 recruitment round. A parallel, non-medical Pre-doctoral Clinical Academic Fellowship route exists for other clinical professions to undertake a Master’s and prepare a doctoral application while maintaining clinical practice.
Doctoral level: NIHR Doctoral Fellowship
The NIHR Doctoral Fellowship funds a PhD (or equivalent doctoral qualification) in a subject area falling within NIHR’s Remit for Personal Awards — applied health and social care research relevant to patients, the NHS, or the social care system. It is the core doctoral-level award for the broader, non-medicine-specific personal-award route, and is also the natural next step for an ACF holder moving off the clinical specialty-training pathway into a research doctorate. The award is three years Whole Time Equivalent, and can be taken up part-time (between 50% and 100% WTE, with duration adjusted proportionally), funding the fellow’s salary, research costs, and training and development activity for the duration of the doctorate. NIHR runs the Doctoral Fellowship in numbered competition rounds (Round 13 was open as of this guide’s research), each with its own application guidance and timeline published on nihr.ac.uk.
Postdoctoral level: Clinical Lectureship, Advanced Fellowship, and the Development and Skills Enhancement Award
Postdoctoral funding branches into several distinct instruments depending on career track and specific need, rather than a single next-step award:
- Clinical Lectureship (CL) — the postdoctoral award on the clinical academic (IAT) pathway, for doctors and dentists who have completed a doctorate and are continuing specialty training while establishing themselves as independent researchers. It provides a combined clinical and academic training environment, with a standard duration of four years Whole Time Equivalent or until the completion of clinical training (CCT/CCST), whichever comes first — explicitly designed to run alongside, not instead of, continuing clinical specialty training.
- Advanced Fellowship — the postdoctoral award on the broader personal-award route, for researchers building toward research independence and, eventually, leadership of their own research programme. An individual can hold up to two Advanced Fellowships in sequence, with total funding across both normally capped at around eight years Whole Time Equivalent, reflecting that this stage of a research career can genuinely span several years and more than one funded period before a researcher is ready for a senior award or professorship.
- Development and Skills Enhancement Award (DSE) — a shorter, more flexible postdoctoral award (up to two years Whole Time Equivalent of salary support, plus training and development costs) intended to fill a specific skills or experience gap between other awards, rather than to fund an entire independent research programme. It is commonly used between a doctoral-level award and an Advanced Fellowship, or to support a specific methodological or leadership skill an applicant needs before their next major fellowship application is competitive.
Senior level: Research Professorships
At the top of the ladder, NIHR Research Professorships are a flagship, longer-duration award (five years) for a small number of established researchers each year, intended to support an outstanding individual in building and leading a substantial applied health or social care research programme. Unlike the earlier rungs of the ladder, Research Professorships are typically filled through a nomination-based process rather than an open competitive call, reflecting the seniority and small annual cohort size of the award.
Who is eligible, and how the two pathways relate
Eligibility is set independently for each award and round rather than by a single fixed rule across the whole ladder, but two structural points hold generally. First, the clinical academic (IAT) pathway — ACF and Clinical Lectureship — is specific to medicine and dentistry and is coordinated with NHS specialty training timelines and National Training Number (NTN)/Deanery Reference Number (DRN) status; applicants outside medicine and dentistry do not use this track. Second, the Doctoral Fellowship, Advanced Fellowship, and DSE sit on the broader personal-award route open to the full range of professions within NIHR’s remit, including non-medical clinicians and non-clinical researchers, and do not require NHS specialty-training status. A clinically qualified researcher can, in principle, move between routes at points where the ladder allows it — for example, a doctor may complete an ACF and then apply for a standard Doctoral Fellowship rather than continuing on the IAT track — but the specific rules for a given transition should always be checked against the current NIHR guidance for that award, since eligibility criteria and remit definitions are reviewed and can change between competition rounds.
Where to find current calls and guidance
NIHR publishes and updates application guidance for each award and competition round directly on nihr.ac.uk rather than through a separate fellowships portal, and round numbers, deadlines, and specific eligibility wording change between competitions. Because of that, this guide deliberately describes the structure of the ladder — what each award is for and how the levels relate — rather than quoting deadlines or numeric eligibility thresholds that are likely to be out of date by the time they’re read; a research administrator supporting an application should always confirm the current round’s guidance on nihr.ac.uk before advising an applicant.
Frequently asked questions
What is the difference between an NIHR Doctoral Fellowship and an Academic Clinical Fellowship?
An Academic Clinical Fellowship (ACF) is a pre-doctoral post held by a doctor or dentist already in NHS specialty training, combining clinical training with protected academic time to prepare a doctoral application. A Doctoral Fellowship is the award that actually funds the PhD itself, and is open both to former ACF holders moving off the clinical training track and to a much broader range of health and social care professions who never held an ACF.
Can I hold more than one NIHR Advanced Fellowship?
Yes. NIHR allows an individual to be awarded up to two Advanced Fellowships in sequence, with combined funding across both normally not exceeding around eight years Whole Time Equivalent — recognising that building toward full research independence often takes more than one funded postdoctoral period.
Do I need to be a doctor to apply for an NIHR fellowship?
No. Only the Integrated Academic Training pathway (Academic Clinical Fellowship and Clinical Lectureship) is specific to medicine and dentistry. The Doctoral Fellowship, Advanced Fellowship, and Development and Skills Enhancement Award sit on a separate, broader route open to nurses, midwives, allied health professionals, pharmacists, healthcare scientists, and non-clinical researchers working within NIHR’s remit.
How is an NIHR fellowship different from an NIHR research grant?
A research grant (for example, through NIHR’s Research for Patient Benefit or Health Technology Assessment programmes) funds a specific research project with a defined question and deliverables. A fellowship funds the individual researcher’s salary, training, and development over a career stage, with the research undertaken during the fellowship being part of that development rather than the primary funded object. See CASRAI’s NIHR Funding Opportunities guide for the full landscape of NIHR’s programme families.
Related CASRAI resources
- NIHR Funding Opportunities: A Guide for Researchers and Administrators — the broader landscape of NIHR programme families, including infrastructure and project funding beyond the fellowship ladder.
- Postdoctoral Fellowships in the UK: A Landscape Overview — how NIHR’s postdoctoral awards compare to UKRI research-council and charity-funded postdoctoral routes.
- MRC Career Development Award: Eligibility, Funding & Fellowship Ladder — the equivalent career-stage ladder run by the Medical Research Council, for comparison with NIHR’s applied-health focus.
- Clinical Research Fellowships: Training Pathways and Certification Tracks — the wider landscape of clinical research fellowship training pathways beyond NIHR specifically.
- Research fellowship (dictionary term)
- Postdoctoral fellowship (dictionary term)
