Staff Clinician

A Staff Clinician is a NIH employee generally appointed to a time-limited, renewable position, or in extremely rare situations, to a permanent appointment (for retention or recruitment purposes) - individuals whose salary levels are at or above Executive Schedule IV (EX-4) are placed in indefinite appointments. A Staff Clinician is a physician or dentist who spends the majority of their time providing critical patient care services and is expected to provide clinical leadership and the highest level of clinical care. Under the supervision of a Senior Investigator, a Staff Clinician may also be the principal investigator on a clinical protocol.

Traditionally, candidates for Staff Clinician appointments possess the following criteria:

• Board-eligible or board-certified in his/her area of expertise
• Provides superior and efficient clinical care
• Works collaboratively to facilitate the conduct of clinical investigations
• Supports the clinical infrastructure by serving on important clinical committees
• Supports clinical training programs
• Shows excellence in clinical teaching activities
• Spends the majority of time in these clinical activities

Staff Clinicians do not receive independent resources to conduct independent laboratory or clinical research. However, the Institute or Center (IC) may provide resources for research on a case-by-case basis. Such research must be sponsored and supervised by a tenured or tenure-track Investigator and undergo review by the Board of Scientific Counselors (BSC).

Staff Clinician 2 is a designation for individuals who, based on their clinical specialty and credentials, require salaries above Executive Level IV. Staff Clinician 2 appointments should be rare. The designation is reserved for individuals who not only fulfill the definition above, but also possess the following HHS-required scientific and/or clinical criteria:

• Recognition as a national or international expert in the field, such as: specific experience (e.g., board certification); invited manuscripts, presentations and/or consultations; receipt of honors and awards or other recognition for noteworthy performance of contributions to the field
• Original clinical, scientific, or scholarly contributions of major significance in the field (e.g., grand rounds presentations)
• Leadership in the field (e.g., attending physician or chief resident, member of institutional committee such as IRB)
• Special knowledge and skills of benefit to the IC or NIH (e.g., high programmatic demand at NIH for the medical specialty)

In 2016, in order to more fully reflect the varied and vital roles that NIH physician-scientists have, such as providing highly specialized clinical care or leading complex patient-care teams to carry out complicated research trials, the IRP has created new position levels: Assistant Research Physician, Associate Research Physician, and Senior Research Physician (Career Development for Staff Clinicians at the NIH). The official NIH Intramural Professional Designation (IPD) will remain "Staff Clinician." All full-time Staff Clinicians must have one of these three titles and a documented agreement with their IC on file (see Staff Clinician Agreement Template). For Assistant Research Physicians, please submit the individual agreements under the heading below in bold. The title of Assistant Research Physician must be given by the IC to all full-time Staff Clinicians unless they are approved for Associate Research Physician or Senior Research Physician centrally at OIR. The title of Associate Research Physician and Senior Research Physician must be approved centrally at OIR by the DDICR (see below under Check Sheets for the required documents for nominations, including templates, CV guidance, and evaluation criteria used). Then use the link provided to submit all the required documents for the nomination package. Only appropriately OIR-sanctioned Associate Research Physicians and Senior Research Physicians may be considered for the role of PI in a CRADA (use the Clearance for Designation of a NIH Associate Research Physician or Senior Research Physician as NIH Principal Investigator for Cooperative Research and Development Agreement).

A Staff Clinician (1 and 2) is a Full-Time Equivalent Employment (FTE) position.

Approvals (Process)

Staff Clinician 2 must first go through the Title 5 exhaustion process, established through the Office of Human Resources (OHR). If a suitable candidate is selected, then the individual must be reviewed and recommended by the NIH Clinical Compensation Panel (NCCP) and approved by the DDIR. If a suitable candidate is not selected through the Title 5 exhaustion process, as certified by OHR and approved by the NIH Principal Deputy Director, then the recruitment of a Title 42(f) candidate can continue. All Staff Clinician 2 appointments are made following peer review and recommendation by the NCCP and approval by the DDIR. This committee is chaired by the DDIR.

Depending on salary level and other pay components proposed, review and approval is required from both the IC Title 42 Standing Committee and the NCCP. Please consult the Title 42 Pay Model for additional information. Additional approvals may also be required for salary levels under specific appointment mechanisms, including Title 5 with Title 38 Pay and Title 42.

Staff Clinicians are appointed using one of the following mechanisms:

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

For clinical credentialing, an additional approval must be received from the Director, CC (or delegate) after recommendation by the Clinical Center (CC) Credentials Committee and the Medical Executive Committee (MEC). For further information, please contact the Office of Credentialing Services, Clinical Center (OCS/CC) at cc_ocs@mail.nih.gov or 301-496-5937.

Check Sheets / Checklists

Below are the check sheets and checklists that have been developed and approved by the DDIR for the Staff Clinician designation.

• Staff Clinician-1 Appointment Check Sheet
• Staff Clinician-2 or Staff Clinician-HS Appointment Check Sheet

Individual ICs may have additional requirements and check sheets. Please contact your Administrative Officer (AO) or HR Specialist for additional guidance. For examples of IC-specific check sheets and checklists, please visit:

• Example IC Check Sheets / Checklists

All Assistant Research Physicians must have the IC submit an updated Staff Clinician Agreement at https://nidcrvredcap.nih.gov/surveys/?s=E9LMF73RC4.

Associate Research Physician (AssocRP) and Senior Research Physician (SrRP) Nomination Submissions for Required DDICR/OIR Review

All requests must include the following documents (maximum pdf size of full package with all documents must not exceed 10MB):

1. Memo addressing the criteria for AssocRP or SrRP, as described in the policy (Career Development for Staff Clinicians at the NIH)
2. Candidate’s updated CV and bibliography
   • CV Guidance
   • CV Template
3. Letters of reference, as follows:
   • Associate Research Physician – Three letters of reference from individuals who are not recent collaborators (NOTE: A recent collaborator is one who has made an intellectual contribution regarding the planning and conduct of experiments, clinical trials or publications within the last three years, with the exception of one who has merely shared reagents, patient samples, or whose name appeared on a common publication only as a result of consortia participation). Letters must be solicited by the IC, not the candidate. Please use the template below to solicit the letters of reference for an Associate Research Physician:
     • Associate Research Physician Letter of Reference Request
   • Senior Research Physician – Three letters of reference from non-collaborators outside NIH. Letters must be solicited by the IC. Please use the template below to solicit the letters of reference for a Senior Research Physician:
     • Senior Research Physician Letter of Reference Request
4. Submit at https://nidcrvredcap.nih.gov/surveys/?s=E9LMF73RC4 [NIH Only]

Additional informational documents include the following:

• Evaluation sheets used by the DDICR and Staff Clinician Review Committee (SCRC) to evaluate candidates:
  • Evaluation for Associate Research Physician Candidate
  • Evaluation for Senior Research Physician Candidate

Ethics

Intramural scientists at the NIH, as is true for all scientists, should be committed to the responsible use of scientific tools and methods to seek new knowledge. While the general principles of scientific methodologies are universal, their detailed application may differ in various scientific disciplines and circumstances. All research staff in the Intramural Research Program should maintain exemplary standards of intellectual honesty in formulating, conducting, presenting, and reviewing research, as befits the leadership role of the NIH.

Within the NIH IRP, the ethical conduct of researchers is governed by the following three disciplines:

• Research Ethics
• Government Ethics
• Bioethics

Ethics information may also be available through your specific IC. Please contact your Ethics Counselor for additional guidance.

Pay / Compensation

Pay and compensation for a Staff Clinician is contingent on the specific appointment mechanism.

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

After initial appointment, any increases/promotions will occur at various intervals, and are again dependent on the appointment mechanism.

Recruitment Process / Appointment Mechanisms

Staff Clinicians are traditionally appointed using one of the following mechanisms:

• Title 5 General Schedule (GS)
• Title 5 GS with Title 38 Pay
• Title 42
• Commissioned Corps

Please note that Title 5 with Title 38 Pay is the HHS-preferred method for hiring M.Ds.

For Staff Clinician 2 appointments, please consult the Title 5 exhaustion requirements identified in the Approvals (Process) section above.

For information regarding appointment mechanisms, please visit:

• Intramural Professional Designations and Appointment Mechanisms Matrix

Sample documents, including the role of various committees and/or the IC SD in the recruitment evaluation process, as well as sample letters for solicitation of recommendations are available for review from the Check Sheets and Checklists section above.

Required Periodic Reviews of Staff Clinicians Regardless of Appointment Mechanism

In many cases, Staff Clinicians are not reviewed by the BSC. However, an IC Promotion Committee must review a Staff Clinician’s work at least every four years for all Staff Clinicians, regardless of appointment mechanism (e.g., Title 42, Title 5, Commissioned Corps, etc.).

Renewals

Staff Clinician renewals must follow the policies and processes appropriate to the specific appointment mechanism.

Resources

A Staff Clinician is not granted independent resources by their Institute.

Termination

Termination of a Staff Clinician appointment must follow the policies and processes appropriate to the specific appointment mechanism.