A number of challenges are faced by those wishing to pursue a career as an academic clinician. Perhaps the most obvious hurdle for those at a junior stage of research career, is achieving sufficient academic success to attract ongoing research funding, whilst achieving the clinical standards required for the completion of training and in due course, revalidation. The introduction of the integrated academic clinical training program has helped address this balance, improving opportunities for research at junior stages of clinical training, and raising the profile of academic careers within the modern NHS. The potential rewards of an academic career are significant including ongoing intellectual stimulation, freedom to pursue ones own ideas and interests, travel and opportunities for collaboration. However, the journey may not be straightforward and enthusiasm, persistence and willpower are required to deflect worries over job insecurity, time-pressures, and a feeling of being behind ones peer-group. Furthermore, a clear focus on ones goals is required, including frequent reassessment of the where am I going? and what do I need to do to get there? questions. Other skills may be developed during this period including working efficiently, prioritizing and planning, negotiating and to some extent, managing uncertainty. Identifying independent mentors may be hugely beneficial and may help overcome many of the challenges faced. However, the ideal outcome is a synergistic balance between clinical and academic work; using patients to inspire important research questions, and applying research methodology and an inquisitive mind to the provision of clinical care.