Skills, interests and aptitudes

Diplomacy is one of the most important skill needed for running multi-centre clinical trials and epidemiological studies, as they necessitate obtaining and maintaining the collaboration of many individuals, all of whom needs to feel some ownership of a project.

Other key skills are the abilities to design, organise and manage complex projects. A broad background in clinical medicine is invaluable with specialisation in one, or at most, a small number of clinical areas. An in-depth knowledge of the disease is important to define the research questions, design the studies, determine the appropriate outcomes and analyse and interpret the results. An understanding of statistical concepts and methodology is crucial - the best partnerships are between doctors who understand statistics, but know their limitations, and statisticians who are interested in medicine!

Career pathways

The career pathway in clinical epidemiology has not been well defined and there have been a limited number of opportunities. Clinical epidemiology is not recognised as a separate discipline. However the academic careers initiative as part of the UK Clinical
Research Collaboration (UKCRC) hopefully will offer the prospect of more flexible training, an increased number of individuals trained in clinical epidemiology and more opportunities for them.

There are two main routes to accreditation. The first is via a clinical career, ideally including some research training related to epidemiology, leading to an MSc and/or PhD, and then a move into epidemiology. However, many working in this field have taken an MSc at a later stage. The second is to train in public health medicine and become accredited as a consultant in public health. Several individuals who have not followed either of these routes have become accredited in specific areas related to clinical trials or epidemiology
through the academic and research route.

Career opportunities at present are largely within clinical trials units, in academic departments of epidemiology or in public health. The pharmaceutical industry and the regulatory agencies involved in licensing new medicines are other possible
avenues.

How to get started

The challenges to date have been the lack of a career structure and most people have come to clinical trials after obtaining clinical accreditation in a specific disease area. A good approach is to seek clinical training fellowships from the MRC or Wellcome Trust to
obtain training leading to an MSc and/or PhD in epidemiology or medical statistics. In 2006 an MSc in Clinical Trials at the London School of Hygiene and Tropical Medicine (LSHTM) was established, which can be taken part time as a distance learning course. For those who do not want to finish a clinical training, accreditation in Public Health is an option but this is often a much less attractive to those who really want to focus on clinical trials and other epidemiological research in a specific clinical area.