Senior Clinician

A Senior Clinician is a NIH employee on either a permanent (Title 5 or Commissioned Corps) or indefinite appointment (Title 42(f) after Title 5 exhaustion has been certified) who has been selected via a Deputy Director for Intramural Research (DDIR) -approved national search. The individual is a manager of a large Institute or Center (IC) program/department with responsibility for substantial resources. A Senior Clinician may be granted independent research resources, which are subject to review by the IC Board of Scientific Counselors (BSC).

A Senior Clinician is a clinical position for which a M.D., D.D.S., or D.O. (or equivalent) degree is required, and at least two or more of the following qualifications, where appropriate:

• Recognized as an international expert in area of scientific mission
• Demonstrated expertise in managing a complex, outstanding program of laboratory and/or clinical research
• Outstanding clinical skills and expertise
• Exemplary skills in and innovative approaches to the latest technologies required
• Evidence of recognition of senior scientific status by peers (i.e., tenure, grant support, awards, other scientific recognition)

A Senior Clinician is a Full-Time Equivalent Employment (FTE) position.

Approvals (Process)

A DDIR-approved search process must first be established when hiring a Senior Clinician. Working with the Office of Intramural Research (OIR) and the Office of Human Resources (OHR), the position must first go through the Title 5 exhaustion process, with participation of the DDIR-approved search committee. If a suitable candidate is selected, then the individual must be reviewed and recommended by the Senior Scientist/Clinician Review Committee (SSCRC) and approved by the DDIR. If a suitable candidate is not selected through the Title 5 exhaustion process, as certified by OHR and approved by the NIH Principal Deputy Director, then the national search for a Title 42(f) candidate can continue. All Title 42(f) Senior Clinician candidates must fulfill the following HHS-required criteria:

• Recognition as a national or international expert in the field, such as: specific experience (e.g., board certification); invited manuscripts, presentations and/or consultations; receipt of honors and awards or other recognition for noteworthy performance of contributions to the field
• Original clinical, scientific, or scholarly contributions of major significance in the field (e.g., grand rounds presentations)
• Leadership in the field (e.g., attending physician or chief resident, member of institutional committee such as IRB)
• Special knowledge and skills of benefit to the IC or NIH (e.g., high programmatic demand at NIH for the medical specialty)

Once a candidate is selected, the individual must be reviewed and recommended by the SSCRC and approved by the DDIR. Additional approvals may be required for salary levels under specific appointment mechanisms, including Title 5, Title 5 with Title 38 Pay, Title 42, and Commissioned Corps.

Additionally, a Senior Clinician’s resources must be reviewed on a 4-year cycle that includes both science and, when appropriate, programmatic needs. Each IC can decide what committee to use for the review, either a special subcommittee of the BSC or a specific management team. However, all independent research resources must be reviewed by the BSC.

Senior Clinicians are appointed using one of the following mechanisms:

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

For Senior Clinicians that require clinical credentialing, an additional approval must be received from the Director, CC (or delegate) after recommendation by the Clinical Center (CC) Credentials Committee and the Medical Executive Committee (MEC). For further information, please contact the Office of Credentialing Services, Clinical Center (OCS/CC) at cc_ocs@mail.nih.gov or 301-496-5937.

Check Sheets / Checklists

Below are the check sheets and checklists that have been developed and approved by the DDIR for the Senior Clinician designation.

• Senior Clinician Appointment Check Sheet

Individual ICs may have additional requirements and check sheets. Please contact your Administrative Officer (AO) or HR Specialist for additional guidance. For examples of IC-specific check sheets and checklists, please visit:

• Example IC Check Sheets / Checklists

Ethics

Intramural scientists at the NIH, as is true for all scientists, should be committed to the responsible use of scientific tools and methods to seek new knowledge. While the general principles of scientific methodologies are universal, their detailed application may differ in various scientific disciplines and circumstances. All research staff in the Intramural Research Program should maintain exemplary standards of intellectual honesty in formulating, conducting, presenting, and reviewing research, as befits the leadership role of the NIH.

Within the NIH IRP, the ethical conduct of researchers is governed by the following three disciplines:

• Research Ethics
• Government Ethics
• Bioethics

Ethics information may also be available through your specific IC. Please contact your Ethics Counselor for additional guidance.

Pay / Compensation

Pay and compensation for a Senior Clinician is contingent on the specific appointment mechanism.

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

After initial appointment, any increases/promotions will occur at various intervals, and are again dependent on the appointment mechanism. For pay decreases (i.e., poor reviews, less than satisfactory performance, etc.), the IC should work closely with OIR leadership and the OHR Employee Relations to determine the correct changes.

Recruitment Process / Appointment Mechanisms

A DDIR-approved search process must first be established when hiring a Senior Clinician. Working with OIR and OHR, the position must first go through the Title 5 exhaustion process, with participation of the DDIR-approved search committee. Please consult the Title 5 exhaustion requirements identified in the Approvals (Process) section above for additional information.

Senior Clinicians are traditionally appointed using one of the following mechanisms:

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

For additional information regarding search processes and appointment mechanisms, please visit:

• Search Process for Senior Investigators, Tenure-Track Investigators, Senior Clinicians and Senior Scientists
• Intramural Professional Designations and Appointment Mechanisms Matrix

Below is a sample memo that has been developed and approved by the DDIR for the Senior Clinician designation:

• Model Memo for Senior Clinician

Renewals

A Senior Clinician may either be in a Title 5-term or permanent appointment or a Title 42(f) indefinite appointment, per the process described above. Renewal details are based on the appointment mechanism used.

Resources

A Senior Clinician is a manager of a large IC program/department with responsibility for substantial resources and can be granted independent research resources (salary, operating budget, personnel, and space) by their Institute, at the discretion of the SD. The amount of independent research support, however, must depend on the quality of science as determined by the BSC and other reviews. Based on these and other reviews (assessing the productivity and quality of work), resources may be adjusted up or down by the IC. All Senior Clinician reviews are on a 4-year cycle that includes reviews of both science and, when appropriate, programmatic needs. Each IC can decide what committee to use for the review, either a special subcommittee of the BSC or a specific management team. However, all independent research resources must be reviewed by the BSC.

Termination

Termination of a Senior Clinician appointment must follow the policies and processes appropriate to the specific appointment mechanism.