Clinical Fellow

A Clinical Fellow is an NIH employee who possesses an M.D., D.D.S., or D.O. (or equivalent clinical degree) and is on a time-limited, renewable appointment. The purpose of the Clinical Fellowship is to provide junior-level physicians, surgeons or dentists experience in biomedical research relevant to the Institute or Center’s (IC) program needs. To be eligible for the Clinical Fellowship, a candidate must: 1) be a graduate of an accredited medical, dental, or osteopathic school, and 2) have satisfactorily completed a prescribed period of post-graduate training approved by the Council on Medical Education and Hospitals, the American Medical Association, the American Osteopathic Association, or the American Dental Association, or have completed at least one year of residency in a program approved by the Accreditation Council for Graduate Medical Education (ACGME) or another nationally recognized accreditation organization; or 3) be accepted into an ACGME- accredited NIH-sponsored graduate medical education training program. The candidate must have demonstrated outstanding scholastic achievement and the ability to conduct successfully, with minimal supervision, pre-established programs in both clinical and laboratory research.

This position has both clinical and laboratory components, with some time spent in direct patient contact supporting the performance of clinical protocols, and the rest in laboratory research related to these protocols. In some cases, Clinical Fellows may receive approved credit towards residency training, advanced subspecialty training, or Board certification. Clinical Fellows participate in protocol-based clinical research as well as laboratory research. Scientists with considerable experience beyond postdoctoral training (PGY-9 equivalent or beyond) may be designated Senior Clinical Fellows provided they fulfill the competitive selection requirements.

Because Clinical Fellows perform services for NIH in addition to the training experience, these positions apply against the IC's Full-Time Equivalent Employment (FTE) ceiling.

A Clinical Fellow (Visiting Program [VP]) is a foreign national, who has U.S. clinical credentials to allow them direct patient contact at NIH facilities. Clinical Fellow (VP) appointments are normally made for two years, but may be made for a shorter period, depending on their NIH-provided visa restrictions. Appointments may be renewed; however, the total length of an appointment may not exceed the visa maximum length restrictions. All renewals are subject to applicable visa restrictions.

Both Clinical Fellows and Clinical Fellows (VP) are Full-Time Equivalent Employment (FTE) positions.

Approvals (Process)

Clinical Fellows are appointed using Title 42(g) and approved by the delegated authority in each IC. Clinical Fellowships are traditionally approved by the Scientific Director (SD) for an initial 2-3 year period. Depending on salary level and other pay components proposed, review and approval is required from both the IC Title 42 Standing Committee and the NIH Compensation Committee (NCC). Please consult the Title 42 Pay Model for additional information.

All Clinical Fellows 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.

Additional approvals and requirements for Visiting Program fellows can be found at the Division of International Services (DIS).

Check Sheets / Checklists

There is currently no Deputy Director for Intramural Research (DDIR) -approved check sheet or checklist for the Clinical Fellow designation. 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 Title 42(g) appointed Clinical Fellows is based on the Title 42 Pay Model. Clinical Fellow salary ranges are in Band I. Depending on salary level and other pay components proposed, review and approval is required from both the IC Title 42 Standing Committee and the NIH Compensation Committee (NCC).

In most situations, a Clinical Fellow will be paid at the entry-level rate; for additional clinical training experience, higher salaries within the band may apply for specially qualified fellows who are also Board-Eligible or Board-Certified.

Recruitment Process / Appointment Mechanisms

Recruitment of a Clinical Fellow is made via Title 42 or Commissioned Corps. Please be aware that Title 38 provisions may be applicable. Appointment of a Clinical Fellow position applies against the IC’s FTE ceiling.

Clinical Fellowships are traditionally approved by the Scientific Director (SD) for an initial 2-3 year period. The maximum length of the appointment may not exceed eight years – the duration is determined by the length of time spent at NIH ns all fellowship capacities – unless the scientist is approved for a tenure-track or another permanent NIH appointment. Please refer to the 5/8 Year Duration Policy for additional information.

Official position descriptions are not required. However, the supervisor must prepare a narrative statement fully describing the duties and responsibilities required. The narrative statement should be reviewed periodically and updated as necessary to ensure that the duties are commensurate with the level of compensation. The review should also ensure the narrative statement accurately reflects the work being performed.

Non-citizens may be appointed as permitted by 42 U.S.C. § 209(h). The non-citizen must have an appropriate work visa. Appointments and/or extensions of non-citizens may not exceed the duration of their visas.

Qualifications for a Clinical Fellow appointment include the following:

1. A Clinical Fellow is a doctoral-level health professional with interest in biomedical research relevant to NIH program needs, who is employed on a time-limited appointment renewable subject to the 5-year/8-year rule. Clinical Fellows participate in protocol-based clinical research as well as laboratory research. Scientists with considerable experience beyond postdoctoral training (PGY-9 equivalent or beyond) may be designated Senior Clinical Fellows provided they fulfill the competitive selection requirements.
2. To be eligible for the Clinical Fellowship, a candidate must be a graduate of an accredited medical or osteopathic school and have satisfactorily completed an internship approved by the Council on Medical Education and Hospitals, the American Medical Association, or the American Osteopathic Association. The candidate must have demonstrated outstanding scholastic achievement and the ability to conduct successfully, with minimal supervision, pre-established programs in both clinical and laboratory research.
3. Foreign Education:
   1. Candidates who have completed part or all of their education outside of the United States must, in order to meet qualification requirements, have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in the United States. It is the responsibility of the candidate to provide written proof of his/her foreign education accreditation prior to appointment. In addition, the servicing human resources office is responsible for verification.
   2. Foreign educated scientists from certain countries (e.g., China) may be unable to provide official transcripts. In those rare cases, a copy of the diploma, with official English translation, if necessary, may be accepted. However, if the diploma does not indicate the field in which the doctorate is awarded (e.g., indicates only Doctor of Philosophy), then copies of transcripts or listings of courses, with official translation, are required. 
   3. Foreign education must be evaluated by an accredited organization to ensure that it is comparable to education received in the United States. ICs may wish to consult with the Division of International Services, ORS, and with OIR for preliminary advice on the equivalency of foreign degrees with U.S. doctorates. Simply because a degree is identified as a doctorate does not mean it is equivalent.
   4. Foreign educated scientists must have U.S. clinical credentials to allow them direct patient contact at NIH facilities.
4. References:
   1. A minimum of two references is required from professionals in the field, attesting to the candidate’s scientific qualifications, credentials and accomplishments. Additional references may be required depending upon OIR or OER policies and the IPD or EPD proposed.

Renewals

Clinical Fellow appointments are made via Title 42(g) and renewed in 1-year increments, according to the 5/8 Year Duration Policy. The maximum length of the appointment may not exceed eight years – the duration is determined by the length of time spent at NIH ns all fellowship capacities – unless the scientist is approved for a tenure-track or another staff NIH appointment.

Resources

A Clinical Fellow is not granted independent resources by their Institute.

Termination

Clinical Fellow appointments may be terminated before their expiration date for cause (e.g., personal or scientific misconduct), unsatisfactory performance, or administrative reasons, including but not limited to, programmatic changes and/or budgetary considerations. Terminations of a Clinical Fellow must follow the policies and processes appropriate to the Title 42(g) appointment mechanism.