ST1 Run-through
Academic Clinical Fellowship (ACF) Interview Guide 2026
The NIHR interview format, the published scoresheet, the pre-released dataset, key dates for 2026 and how to prepare.
By the TheatrePass editorial team · updated 1 September 2026 · 8 min read
An Academic Clinical Fellowship interview asks you to be two candidates at once: a safe, appointable surgical trainee and a credible early-stage researcher. Most applicants over-prepare one half and improvise the other, usually because the academic component has no national mark scheme they can find and the local variation is real. This guide explains how ACFs are structured, what the academic station rewards, why the clinical questioning still decides outcomes, and how to prepare for a format that genuinely differs by region.
Interview format
ACF interviews are run by the local NHS England office hosting the post, but the scoring is national: recruitment offices use the NIHR's published scoresheets, and the interview lasts about 30 minutes, digitally on Teams or Zoom. There are no stations. One panel of clinical academics works through your dataset appraisal, your record, your plans and your understanding of the clinical-academic balance, scoring individually without conferring. An ACF is 25 per cent academic time to 75 per cent clinical, usually over three years (four for GP trainees), and competition varies widely by specialty and region, reaching around 13 applicants per post at the sharp end.
How ACF interviews are scored
| Heading | Max marks |
|---|---|
| Explaining the dataset concisely to a scientific audience | 16 |
| Explaining the same result to a lay audience | 8 |
| Your academic achievements and your personal contribution | 8 |
| Knowledge of the science linked to the advertised ACF post | 16 |
| Your practical experience of research, in any form | 8 |
| Broad reading: something outside your own area that excited you | 8 |
| Balancing clinical and academic responsibilities | 5 |
Two readings of that table sharpen preparation. A third of the marks (24 of 69) sit on the pre-released dataset, split between a scientific explanation and a lay one, so rehearse both registers on the same paper. And a whole heading rewards reading OUTSIDE your field: have one recent paper from another area that genuinely interested you, and be ready to say why in a minute. The score bands are non-linear (the 16-mark headings run 0, 2, 4, 6, 10, 16), which means the step from good to very good is worth more than the step from average to good. You are rated Appointable or Not appointable as well as ranked, and appointable-but-unsuccessful candidates become reserves, offered posts in rank order.
Clinical benchmarking and key dates
Your rank comes from the academic interview alone. The specialty's own national interview is a gate, not a weighted component: unless you already hold a training number at the level advertised, the academic offer stands only if that interview finds you appointable, and you get one attempt per ACF post. Shortlisting runs on a 9-question, 28-point application form, and every applicant must score at least 2 on both the academic experience and academic potential questions to be shortlisted.
| Stage | Date (2026 round 1) |
|---|---|
| Applications open | 2 October 2025 |
| Applications close | 30 October 2025 |
| Interview window | 10 November 2025 to 16 January 2026 |
| Initial offers | 20 January 2026 |
| Hold deadline | 27 January 2026 |
| Upgrades | none in ACF recruitment |
What an ACF is
An Academic Clinical Fellowship is a training post with protected research time, typically around a quarter of the programme, running alongside standard clinical training in your specialty. In England these posts usually sit within the national academic training pathway and are designed to lead towards a competitive doctoral fellowship application; the devolved nations run equivalent academic tracks with their own structures. Understand the post as an audition for a research career as much as a job: the panel is asking whether you can plausibly win funding and produce work within the protected time, while keeping pace clinically.
How selection differs
ACF recruitment is typically run locally or regionally, with the university and the deanery jointly involved, and it often sits earlier in the cycle than standard national recruitment. Panels usually combine academic and clinical assessment, and most schemes require you to reach an appointable clinical standard as well as score academically. The practical consequence cuts both ways: you cannot rescue a weak clinical performance with a strong research story, and a polished clinical performance with nothing behind the research claims fails the other half.
The academic station
Your research story
Expect to walk through your research experience: what you did, why it mattered, what you contributed personally, and what you would do next. The scoring pattern rewards ownership and decisions, not volume: why this question, why that method, what went wrong, what you changed. Prepare a three-minute spoken version and a thirty-second version, and be ready to defend the weakest item on your CV without becoming defensive. A small project you can argue for beats a long author list you cannot.
Critical appraisal
Many schemes include appraisal of a paper or abstract, sometimes with preparation time. Use a visible structure: the research question, the design and whether it fits the question, the population and setting, bias and confounding, the size and precision of the result, and whether it should change practice. Then practise delivering that appraisal aloud in under five minutes. Written fluency does not transfer to spoken fluency on its own, and the appraisal station is a spoken examination.
The clinical half still counts
ACF panels regularly meet candidates who can discuss methodology and falter at a deteriorating patient. The clinical questioning typically matches the standard recruitment level for the grade: structured assessment, prioritisation, explicit escalation and professionalism scenarios. Prepare it with the same seriousness as a standard application, because an unappointable clinical score usually ends the application regardless of academic strength.
Balancing questions
Expect at least one question about balance: how you will deliver research output without falling behind clinically, and what happens when the two collide in the same week. Answer operationally rather than aspirationally: named supervision arrangements, a planned use of the protected time, early conversations when commitments clash, and evidence from any period in which you have already run both. Panels are not looking for superhuman capacity; they are looking for someone who has thought about the collision before it happens.
Choosing where to apply
ACFs are advertised by region and specialty, and the academic fit matters more than the postcode. A unit whose research themes match your interests can supervise you into a credible fellowship application; a prestigious name with no active group in your field cannot. Read the department's recent output before you rank your choices, and be ready to say in the interview why that environment specifically, because the panel will usually include someone from it.
A preparation plan
- 1Weeks 8 to 5: assemble the storiesWrite your research narrative as a series of decisions. Map your clinical preparation to the standard recruitment format for your grade. Read each post's recruitment pages line by line.
- 2Weeks 5 to 2: practise both voices aloudAlternate days: clinical scenarios one day, research story and critical appraisal the next, all spoken and timed.
- 3Final week: simulate the actual formatMock the specific station pattern your region describes, with follow-up questioning on your weakest publication and your most practised clinical structure.
Interview Library › Academic panel › Appraising a Surgical RCT Abstract
Academic panel
Appraising a Surgical RCT Abstract
Take a look at this abstract. It is teaching material we have written, not a real study, so there is nothing to recall and nothing to look up. Read it, then talk the panel through how you would appraise it.
CONSTRUCTED TEACHING MATERIAL, NOT A REAL STUDY.
Study exhibit
Constructed teaching material, not a real study
Randomised controlled trial
DRAINVIEW: a randomised controlled trial of routine versus no abdominal drain after elective open colorectal resection
Background
Prophylactic abdominal drains are placed after colorectal resection to detect and drain collections, but they may cause pain and delay recovery. We tested whether omitting a drain reduces time to recovery without increasing reintervention.
Methods
Single-centre, open-label randomised controlled trial. Adults undergoing elective open colorectal resection were randomised 1 to 1 to a routine pelvic drain or no drain. Randomisation used a computer-generated sequence held centrally with concealed allocation. Surgeons and patients were not blinded; the outcome assessor recording the primary outcome was blinded. The primary outcome was time to functional recovery in days. Secondary outcomes included reintervention within 30 days and anastomotic leak. The trial was powered to detect a one-day difference in recovery (90% power, alpha 0.05), requiring 400 patients. Analysis was by modified per-protocol, excluding patients who did not receive their allocated management.
Results
420 patients were randomised (210 per arm); 198 drain and 201 no-drain patients were analysed. Mean time to functional recovery was 6.1 days (no drain) versus 6.8 days (drain), a difference of 0.7 days (95% CI 0.1 to 1.3, p = 0.04). Reintervention within 30 days occurred in 6.0% (no drain) versus 4.5% (drain), p = 0.51. Anastomotic leak was 4.5% versus 4.0%, p = 0.79. The trial was registered after recruitment began.
Conclusion
Omitting the abdominal drain shortened recovery after open colorectal resection and should become routine practice.
420
Randomised
210
Drain arm
198
Analysed (modified per-protocol)
210
No-drain arm
201
Analysed (modified per-protocol)
“"This is a constructed abstract of a single-centre randomised trial asking whether omitting an abdominal drain after open colorectal resection speeds recovery. I will appraise it in four passes: the question, the internal validity, the results, and applicability.”
“First, the question. It is a clear treatment-effect question with a defined population, intervention, comparator and a primary outcome, which for a treatment effect makes a randomised design the right choice. My first worry is already visible: the trial was registered after recruitment began, so I cannot confirm the primary outcome was pre-specified, and I would want to check the registry against the paper for…”
Why this scores
“I will appraise it in four passes: the question, the internal validity, the results, and applicability.”
declares the scaffold before touching detail so the panel can follow every point.
“registered after recruitment began, so I cannot confirm the primary outcome was pre-specified”
catches a specific reporting flaw from the abstract and names its consequence rather than reciting registration as a ritual.
References
CASP Randomised Controlled Trial Checklist Critical Appraisal Skills Programme
Academic panel · 71 scenarios
3 more…
How TheatrePass helps
TheatrePass rehearses the spoken delivery both halves of an ACF interview depend on. The mock interviews run clinical scenarios with follow-up pressure, and the question bank's motivation and professionalism material transfers directly to academic probing about your research story, your choices and your plans.
Interview formats and selection criteria change between recruitment cycles. Content is reviewed each cycle and dated; always confirm details against the current national recruitment guidance.
