There is no single pathway. The two essential requirements are to complete surgical training and to acquire a solid research training. These can be undertaken completely separately or, as is more often the case, with some degree of overlap or integration, most often by holding a Clinical Lecturer post in the later stages of training. Clinical Lecturers are the major source of clinical academics for the future. In order to compete successfully for an academic consultant post it is necessary to have undertaken a concentrated period of research training usually while holding a research fellowship. In most cases this will consist of a three-year period of research usually leading to a PhD degree while holding a competitive research fellowship from the Medical research Council, the Wellcome Trust or one of the other major medical research charities such as Cancer Research UK or the British Heart Foundation.

Typically such fellowships are taken as a period of out of programme research after starting higher surgical training at the ST1-3 level. However, some trainees may prefer to undertake a research fellowship after FY2. Most trainees while undertaking a research fellowship also carry out a limited amount of clinical work (perhaps four hours per week and some on-calls) to maintain their clinical skills. The decision whether or not to pursue an academic or NHS career is often taken early. In order to enable a small number of interested trainees at a very early stage to sample a surgical research environment some large teaching hospitals have created Academic F2 posts that include a four-month period of research. Three surgical Academic F2 posts exist, for example, at Addenbrooke's hospital.