What Is an NHS Clinical Fellow? Pay, Training and Career Impact

In the NHS, a clinical fellow is usually a doctor working in a non-training post, employed directly by a hospital trust rather than as part of a recognised specialty training programme. Clinical fellows do clinical work under consultant supervision, and many posts also include time for education, research, leadership or quality improvement. Pay and terms are set locally, so it is important to check the contract carefully.

What the role involves

Clinical fellow jobs vary a lot between trusts and specialties. A typical post includes:

• clinical work on wards, in clinics or in emergency departments, on a rota
• supervision by consultant staff
• in many posts, a set amount of protected non-clinical time, for example for teaching, research, simulation or leadership projects

Some posts are mainly service roles, others are designed as development opportunities, such as education or leadership fellowships.

Who takes clinical fellow jobs

Doctors take these posts for many reasons, for example:

• after foundation training, before applying for specialty training (sometimes called an "F3" year)
• to gain experience in a specialty before applying
• to build a portfolio with teaching, research or audit
• doctors new to the UK, to gain NHS experience
• to work more flexibly or take time out of training

Non-training posts and your training

Clinical fellow posts are not recognised training posts. The BMA groups them with other locally employed doctor roles, such as trust grade and FY3 posts. This matters because:

• time in the post cannot be assumed to count towards specialty or GP training
• you may not automatically get the educational opportunities and oversight given to doctors in training programmes

If you want the experience to count later, check with the relevant royal college or training programme before you start, and keep a good portfolio of what you do.

Pay and contracts

Because clinical fellows are employed locally, the trust decides the contract terms. Many trusts pay clinical fellows on a scale matching the equivalent resident doctor grade, but this is not guaranteed.

The BMA has a checklist for doctors considering trust grade, FY3, clinical fellow or locally employed doctor contracts. Points worth checking include:

• which pay scale you are on, and whether you get pay progression
• whether your rota, hours and rest follow national safe working limits
• how out-of-hours work and extra shifts are paid
• your annual leave and study leave, including any study budget
• how much protected non-clinical time you get, and whether it is protected in practice
• how long the contract lasts, and notice periods
• who your educational or clinical supervisor will be

Our resident doctor pay guide shows the national pay points, which can help you compare an offer, and the resident doctor pay calculator estimates take-home pay.

Finding clinical fellow jobs

Clinical fellow posts are advertised on NHS Jobs and trust websites. Look at the job description for:

• the grade the post is equivalent to, such as foundation, core or specialty level
• the split between clinical and non-clinical time
• the rota pattern
• whether the post includes a qualification, such as a postgraduate certificate

Pros and cons

Possible advantages

• flexibility and a break from rotations
• protected time to build your portfolio
• experience in a specialty before applying
• often a fixed base for a year or more

Possible drawbacks

• does not usually count as recognised training
• terms can be less favourable than national contracts
• some posts are mainly service work, with little real protected time

Concerns have been raised about doctors spending many years on local contracts, so think about how the post fits your longer-term plans.

Questions to ask before accepting a post

The interview is also your chance to find out whether the post suits you. Useful questions include:

• What does a typical week look like, and how many hours are clinical?
• How is the non-clinical time protected when the rota is short-staffed?
• Who will be my clinical and educational supervisor, and how often will we meet?
• Have previous fellows gone on to the training programmes they wanted?
• What teaching, courses or study budget are available?
• Is the post equivalent to a particular resident doctor grade for pay?

Ask to speak to a current or previous fellow if possible. They can tell you how the job works day to day.

Using a fellowship to build your application

If you plan to apply for specialty training later, use the year to build evidence:

• keep a log of procedures, cases and courses
• complete audits or quality improvement projects, and present them
• get involved in teaching, and collect feedback
• ask supervisors for written feedback and references in good time
• check the person specification for the programme you want, and fill any gaps

Store everything in one place, such as an e-portfolio, so it is easy to use in applications.

Clinical fellow questions

Is a clinical fellow the same as an academic clinical fellow?

No. An academic clinical fellowship is a national training post that combines specialty training with research. A trust clinical fellow is usually a non-training post.

Can I be a clinical fellow straight after foundation training?

Yes. Many posts are designed for doctors who have completed foundation training.

Sources

Checked on 14 October 2026:

• BMA: Checklist for locally employed doctors