Table 2 Exemplar participant quotes for each subtheme

Theme 1: Clinician researchers prefer roles which are embedded in health services

Clinically active researchers would prefer to maintain links to clinical practice

“I'm a clinician first. And research for me needs to be clinical and at the forefront. … I guess it's the patient that drives me, not the research.”—P33

“The reason that I want to stay in health is because I love seeing patients, that's what I find really motivating.”—P10

Clinician researchers are most effective when embedded in healthcare settings

“I feel like health has the huge advantage of you're where the action's happening, you know what the issues are and why they're an issue, because either you're a clinician on the ground or you go to the meetings where they talk about the pressures of the health service.”—P1

“I really believe that the health service-based researchers are in a much better position to have an impact on the people for which the research is designed to help. They are in a much better position to create change in the health system, to translate research into practice, to have a beneficial impact on the community.”—P20

There are a variety of preferences for combining clinical and research components within a position

“I think having some accepted clinical time to do some research within a clinical space, I think would be sort of what I class a dream position.”—P44

“I'd happily just do a 1-day-a-week clinical role. And then a day a week considering some of that research capacity-building, and then 3 days is actually doing your hands-on research.”—P3

Theme 2: Current opportunities for clinical researcher roles in health are insufficient

Combined clinical practice and research positions are not readily available

“There's pockets of research positions [in health services]. But they're so few and far between.”—P41

“Not from my discipline I don't see that… it's still quite a segregation. It's not an integration within the one role.”—P22

Clinician researchers often have to make their own job opportunities

“It's all accidental or people creating their own opportunities to be honest…It takes a lot of drive, passion and commitment from the clinician to create the opportunity.”—P30

“I think it's often people just muddle it together themselves, and then departments have been really flexible and accommodating the individual people, as opposed to being seen as a standard way of being professional and within the department potentially.”—P45

Theme 3: There are deficiencies in the pathway for clinician-researcher careers

Research expectations of different levels are unclear

“People have said, just make sure it's not taking up all of your time. But how much time is too much time? Like, is an hour a week too much? Is that enough? I don't know.”—P2

“It's very specific to me as a person that there's an expectation that I continue on [with research], …but there’s not an equitable approach to that across the senior staff … across the service, there's different expectations of that same senior level.”—P13

There is an absence of dedicated clinician researcher career structure in health

“There hasn't been a career structure to step into. You're either a researcher or you're a clinician or you're a manager. It doesn't feel at this point [that AH disciplines] support any other kind of role description or role type.”—P15

“I can't see a pathway or structure unless you create that pathway … I don't know that there is a pathway that goes, ‘We recognize you as a clinician and we also recognize you as a researcher, and we'll promote that.’”—P21

Opportunities for progression are limited in current awards

“If you are looking at career progression, I've probably progressed to the point where clinically and even from a research perspective, that's as far as it's going to go… So I guess you'd just be travelling horizontally with a greater research component.”—P39

“At the university you can progress with your career. You can apply for an associate professorship and a professorship. It's not dependent on, ‘Oh, sorry, we've already got eight professors; we can't have another one.’ It's not dependent on roles; it's dependent on you and your achievement.”—P5

The career pathway has gaps at some levels, particularly post-PhD

“You do—definitely, I do feel quite different post-PhD, because when I was doing my PhD, it was just so much focus on this is the next goal, this is the next milestone. And then when you get your conferral, you'll just resume your normal clinical job. There is a real, ‘Well, what next? What next?’”—P13

“When I started my PhD, I was going in it with rose-coloured glasses and thinking, ‘Oh, there can be all these opportunities for me with my career once I've got a PhD,’ and I'm actually finding that's definitely not the case.”—P28

Theme 4: Clinician researchers are not always valued or incentivized by health services

Recognition and value of research experience in recruitment is variable

“I think it depends on who's doing the recruiting… my feeling is that it's patchy. That in some places someone's research capability does get considered as part of a role description, but in other parts it’s more lip service paid to that.”—P36

“I think there's not a lot of incentive for people to do things like research higher degrees or research in terms of, for example, [senior/advanced level] job descriptions. Having a research higher degree is advertised as being desired, but it's not essential, or I don't know that it's given any additional weight.”—P10

Clinical research opportunities are generally less well paid and less stable than clinical roles

“If I went into a research position, I'd have to take a downward slide. And so, for me, it's better from a career point of view as well as a financial point of view to stay where I am and do research on the side.”—P24

“There are few research positions I'm aware of in Queensland Health that are substantive, full time, not defined by a 3-year grant or a 3-year contract.”—P5

The role of clinician researchers is not always valued and enabled in health services

“I’m not entirely convinced [research is valued]. But the health service is always happy to take the glory of the number of papers published and the number of posters …So they're happy to take the glory, but not always happy to support it.”—P34

“There are the exhausting, ongoing issues within the system of health that really are barriers to research … one example is the issues around restricting travel for researchers…That results in that perception of researchers not being valued. So the work that they're doing is not valued.”—P20

Theme 5: The current career challenges impair the viability of clinician researcher careers

Clinician researchers either leave health services to work in academia or become clinicians with little opportunity to do research

“They end up at universities, and I know a couple, maybe one person, has gone back to clinical work because they didn't like research. So I guess that kind of defeats the purpose of having someone have a PhD in hindsight.”—P40

“If I'm going to want to continue my career in research, I either have to go back to being a clinician and do it in my own time or leave and go to a university.”—P28

Clinician researchers are unable to use their full skill sets, negatively impacting both research and patient care

“I spent 20 years doing clinical before I then started on my research career. And unless I'm still in clinical I feel as though 20 years’ worth of clinical expertise sort of gets wasted to some extent … if you're faced with having to choose between a research career or clinical career, then one or the other is gonna lose out; you're not using the full array of your skill set.”—P15

“There is a lack of where do you go from here. Do I want to totally just lose the clinical skills that I've got and all the expertise in my allied health discipline and become a researcher, or do I want to just have the title ‘doctor’ and be a highly specialist clinician who uses evidence-based practice but doesn't do any research. It's a bit of a tension.”-P15

Theme 6: The clinician researcher career path has been improving, and there is hope it will continue to improve

“Five years ago, I don't feel that if I wanted to do research, I would be supported. I do feel like when I finish my PhD, I would be supported to do clinical research.”—P12

“I think things are progressing fairly quickly. So, I'm optimistic that I might get my dream job one day.”—P9

“I have started to see the trajectory go up over the last 5 years, and I'm aware of different strategies and plans that are in progress…it takes time for things to change and opportunities to develop. Its not like there's going be a huge amount of positions in 5 years, but I think there will be more opportunities over time.”—P7

“I think that culture is changing, these positions are starting to emerge. And they're starting to be developed to acknowledge the connection between research and clinical practice and to acknowledge those types of options as being really important. But I don't think it's easy. I don't think it's clear.”—P48