Developing pathways for clinical academic careers for practitioners: The paternoster model supported by ‘learning by doing’.

Our mapping exercise of support that the CLAHRC community provide for nurses, midwives and applied health professionals  (NMAHP)  http://clahrc-yh.nihr.ac.uk/capacity-building/national-and-international) found that ‘learning by doing’ opportunities are widely offered by the CLAHRC community. They include short-term CLAHRC fellowships, internships, secondment opportunities and grant/ fellowship preparation awards. Such activities offer protected time away from the clinical environment, but do not contribute to formal training or qualifications. 

Nevertheless they provide important ‘next step’ capacity opportunities at recognised ‘pinch points’ in the formal training pathway. They include openings at pre-masters, post masters and post PhD levels of experience. As such the provide an important element of the clinical-academic pathways for NMAHPs, and recognise that rather than an escalator pathway for career progression, the model works more like a paternoster.


A paternoster is a continuously moving lift consisting of a series of linked compartments without doors. One has to prepare to get into the compartment when it arrives at the level that you are on. Such ‘learning by doing’ opportunities offer such preparation, application of previous learning, and confidence building to step back onto the upwards pathway.