Now you’ve completed, and possibly even published your first project, you may experience a gamut of emotions — maybe you’ll be relieved, or maybe you’ll be desperate to do it all again. Whether it’s due to a love of knowledge, or a serious coffee habit you couldn’t accommodate in clinical practice, there’s a chance you’ll want to continue in your new found academic vein. If so, you need to think about how you approach this. Your options range from total immersion in full-time academia to research ‘on the side’ whilst remaining in clinical practice — for most, an option combining the two is best. This can be achieved either by a period of full-time research before re-entering clinical practice, or an academic training post whereby a proportion of your time is protected for academic work. In the rest of this chapter, we’ll look through the options, including for those coming from a non-medical background. Until recently there was no clear route for doctors wanting to pursue an academic career in research. However, in 2005, the Walport Report recommended the integration of periods of research into specific medical training programmes through a process called Integrated Academic Training. Under this system, which has developed over the past few years, a number of postgraduate academic programmes have emerged, providing academic training alongside standard medical training. Although these programmes may appear to be a streamlined process whereby doctors pass from one academic programme to another, in reality there is considerable flexibility in the system. Hence, final year medical students who have done an intercalated BSc, PhD, or MB/PhD and know they want to be academic clinicians may reasonably decide not to apply to Academic Foundation programmes, and rather apply for an NIHR Academic Clinical Fellowship (ACF), and will almost certainly not be disadvantaged through not having held an Academic Foundation post. Whilst there is no doubt that Integrated Academic Training represents a considerable advance in the career structure for doctors wishing to become researchers, these academic posts are very competitive and given the number available most posts are only likely to be awarded to ‘high flyers’.