When is a PhD The Right Next Step and How to Get Started
12 January 2024 | Professor Candy McCabe
I am a Registered Nurse and have worked as a Clinical Academic for nearly thirty years. I am a Professor of Clinical Research and Practice at the University of the West of England, Bristol, and Head of Education and Research at Dorothy House Hospice, near Bath. My specialist areas are chronic pain, life-limiting conditions and end-of-life care.
Undertaking a higher degree is always a large personal and professional commitment. It can often feel that there is never a right time in life to do this. Even when you have decided this is what you want to do, it can be difficult to know how to get started. I have worked as a Clinical Academic nurse for nearly thirty years and in this time, I have undertaken higher degrees myself and also supported others along this journey. What I have learnt along the way is that there is no ‘one size fits all’, and there are many different ways to achieve this goal at any stage in life. What is most important is that the route you decide to take works for you.
The Nursing and Midwifery Council requires all registered nurses to have an understanding of research methods, ethics and governance in order to safely apply and share published research findings within an evidence-based practice. Standards of proficiency for registered nurses – The Nursing and Midwifery Council (nmc.org.uk). This level of research knowledge and skill can be sufficient for many and is an excellent foundation. However, for others, as they start to progress through their career, and develop specialist practice, such as Community Nursing, they may find that clinical puzzlements start to emerge; ones they personally wish to explore further. Undertaking a higher degree can be an opportunity to advance research skills and start to conduct your own research.
Why a doctorate and is it right for me?
A Master’s degree can support the development of advanced practice and increase research skills and knowledge, but a PhD can move that practice to consultant level and be the first step into an academic career. A doctorate qualification can help to take your career in a new direction, such as a full time educator or researcher in academia, or a split role between academia and clinical practice as a clinical academic.
In order to undertake a doctorate you usually require a Master’s degree, though for some Higher Education Institutions (HEIs) this is not essential, if there is evidence of a first degree at a 2:1 or above. However, it is always helpful to have undertaken some research methods training prior to applying for a doctorate, so you know that this type of work is of interest to you. A doctorate qualification will always include research methods training, whether formal or informal. So, if research methods hold no interest, then a doctorate may not be a good fit for you.
There are broadly three different models for a doctorate qualification: a traditional PhD, a professional doctorate, and a doctorate by publication (DPhil). These are all a high level of academic attainment but have slightly different methods of delivery and assessment.
A PhD is a doctorate by apprenticeship and is globally considered an ‘entry’ point into an academic career. Two or more supervisors support you over a three to four year period of study, which is focused on a particular area of interest. The topic area maybe decided for you, if the HEI is advertising a PhD student opportunity, or you may have secured funding to study a topic of your choosing. The student works independently for much of the doctoral programme and drives the direction of the work, with regular support from their supervisory team, peers and training opportunities. The final assessment is a thesis, which is assessed by examiners external to the host institution.
A PhD is usually required for senior academic roles, especially those with a research remit. Grant giving bodies usually require a PhD qualification for post-doctoral fellowships and research project funding bids. If it is a clinical academic or full-time academic career you are interested in, this is probably the best route to go down.
There are a large number of professional doctorates available in the healthcare sector. These vary greatly in their content, with some more focused on work-based assignments, with limited research methods, and others with a substantial research component. They commonly include marked assignments in discrete modules over the course of the doctoral programme with a larger assignment at the end. The modules maybe delivered by different teaching staff, but commonly there is a personal tutor for each student too. The final assignment may be a research project, be termed a thesis and marked by examiners external to the host organisation. The content of these assignments will be focused on your clinical and professional practice.
This type of doctoral study can be excellent if you are keen to remain in clinical practice, and it is advanced professional and clinical practice that you want to focus on. As a previous Director of Studies for a Professional Doctorate programme, I was deeply impressed by the very practical work conducted by students on our programme, and the impact their work had on the patients they cared for at a regional and national level. Many students were either in consultant-level posts, or seeking to move to this level of practice. The level of work in these doctoral programmes is certainly equal to that of a PhD, but by having it delivered in a modular format, this can feel more manageable. It more easily facilitates breaks in study than a PhD, which is one continuous period of study.
Doctorate by publication (DPhil)
This type of doctorate is becoming increasingly common in the UK and is widely conducted internationally, where often there is no distinction made between a PhD and a DPhil. The final assessment includes a collection of published papers that relate to a topic area and the doctoral ‘student’ is the first author or co-author on these publications. The papers are linked by additional text, which describes the student’s role in the work and how the papers contribute to new knowledge in the field. The thesis is examined by examiners external to the host organisation.
This type of qualification can work very well for someone who has worked in a research role over a number of years, or been part of a clinical team who routinely publish their work. Furthermore, registration for a DPhil is usually only recommended once the papers are published, or likely to be published in the coming year, so the student works with one or more supervisors over that year to assemble the final thesis. This makes it a considerably cheaper option than a PhD, as the formal stage of the training is considerably shorter, and requires more limited time away from the workplace. It can also act as an excellent way to recognise and celebrate a sizeable body of work that has been conducted over the course of a career. The limitation is that the volume of work in 6-7 peer-reviewed publications is very large, and publications can take quite a while to come to press.
Currently in the UK, a DPhil qualification can limit post-doctoral and research grant funding opportunities, but where this format of final assessment is awarded a PhD, then those limitations are lost.
How to get started
If you are contemplating any of the above doctoral training routes and not sure where to go next, I suggest approaching the research team in your organisation, or local HEI, or clinical academics you are aware of in your field and asking them for a conversation. In my experience, people are extremely generous with their time and advice as those working at a doctoral level are always keen to increase the number of research-active healthcare professionals. In Community Nursing there are a wealth of topic areas that need further research, and we desperately need more nurses designing and leading research. For example, here are the latest Community Nursing top ten priority research questions that need answering.
Finding one or more people who can act as a mentor for this stage in your career is really helpful. There may be changes in your career along the way, so having a consistent guide and ‘cheerleader’ working with you, who is looking out for opportunities for you and giving you access to their network of contacts can be very beneficial. When thinking about who to choose as a mentor, I suggest looking for someone who is ahead of you in their career and doing a job you aspire to. It may feel daunting to approach a senior colleague with this request, but in my experience, people are very flattered to be approached, and always extremely generous with their time. I have been fortunate to have a number of fantastic mentors along my clinical academic journey and each one has positively contributed to the decisions I made.
If you have decided that a PhD is the best route for you, then I strongly recommend looking at the Health Education England and National Institute for Health Research Integrated Clinical and Practitioner Academic programme
This programme offers a wide range of training internships, pre-doctoral, doctoral and post-doctoral training fellowships. The aim of these very generously funded awards is to develop the next cadre of clinical academics. Applicants at any stage of the pre-doctoral and doctoral training awards are expected to have a stated ambition of conducting a PhD and a long-term career aspiration of working as a clinical academic to lead research at the national and/or international level that directly benefits patient care. These are prestigious but highly competitive awards at every stage.
If these seem of interest then speak to the research team in your organisation, or local HEI to learn more about these programmes and to get the support you will need to complete an application. It is often best to start in the earlier stages of the training programme (internships or pre-doctoral training), before trying for a doctoral award.
If your area of interest relates to a particular disease/population then it is always worth looking at charitable organisations that support these populations as many of the larger charities, such as Versus Arthritis, offer PhD fellowship opportunities.
HEIs often advertise PhD studentships which are funded via a stipend. The stipend will not be equivalent to a clinical salary, so this maybe a limiting factor. The topic area will already have been selected but the details of the delivery of that project may still be open to tailoring by the student. Findaphd.com is a good place to start.
If a modular doctorate programme is more relevant to you, then some charities and professional bodies will provide funding for one or more modules, especially the research module. For example, the RCN Foundation.
The QNI Community Nursing Research Forum has a very helpful list of reoccurring research funding and training opportunities open to nurses.
Studying for a higher degree is not a light undertaking. Even when dedicated, funded time has been secured there will undoubtedly be a good deal of work to be done outside of working hours. Also, life happens along the way and interrupts your plans.
It is really important that whichever form of study you select, you must feel passionate about the topic area. It is that passion that will drive you through the ups and downs of long-term academic study and ensure that on the day you graduate, you feel it was all worthwhile because your clinical practice or patients’ well-being has been improved by your work.
Professor Candy McCabe