There are three grades within the NHS career structure. New entrants to the profession usually start in Grade A, as a Trainee. Trainees are usually based in a single hospital Department, but often undertake periods of secondment to obtain wider experience.

Grade A
Grade A trainees are appointed onto a fixed-term contract, usually for two or three years during the training period. All formal training programmes lead, via an examination coupled with assessments by the in-service training supervisor, to a formal qualification. Those in some of the pathology specialities may lead to a Diploma of the Royal College of Pathologists (DipRCPath); otherwise, a Certificate from the British Association of Audiological Scientists, the Clinical Molecular Genetics Society, the Association of Clinical Cytogeneticists, the Association of Clinical Microbiology or the British Society for Immunology; or the Diploma of the Institute of Physics and Engineering in Medicine (DipIPEM), (Medical Physicists, Clinical Engineers) as appropriate. This constitutes the qualification which assists the trainee to secure a post in the speciality at Grade B.

Statutory Registration
When clinical scientists can demonstrate competence to practice, by successfully completing a A Grade training programme and gaining higher training and a wider experience of scientific duties in a clinical environment, they can apply to become state-registered. From 1st April 2002, the Health Professions Council (HPC) has been responsible for the maintenance of the Statutory Register of Clinical Scientists. Registration is essential for career development and ability to work in an unsupervised situation. In order to comply with the criteria for entry to the Register, applicants need to have been in a Clinical Scientist training post for a minimum of 4 years or to have spent at least 6 years in a post carrying out work relevant to a Clinical Scientist.

Further Qualifications
It should be emphasised that a Clinical Scientists training does not end when they leave the Grade A Training Scheme. As with doctors, training is expected to continue in a less strictly supervised form until at least one further vocational qualification is obtained. These qualifications include a membership of an appropriate professional body (e.g. MRCPath or MIPEM) or an equivalent Chartered award (e.g. CEng, Cchem, CPhys). During this period a Ph.D. may also be achieved.

Grade B
Trainees will be expected to apply for Grade B posts in the course of their final training year, and to be offered appointments that are conditional upon their success in gaining the exit qualification from the training grade. Although Grade B constitutes the 'career grade', progression to the top of the grade has to be merited. An ambitious Clinical Scientist should expect to be mobile during training and indeed during his/her career. The most rapid career progression may be achieved by applying for a higher-scaled vacant post elsewhere. Assessors from the appropriate profession appointed by the Department of Health advise employing authorities on all new appointments. They will judge candidates on their track record as well as on the basis of evidence such as publication in peer-reviewed journals, active participation in local, national and international meetings, and candidates' awareness of current developments in the NHS.

Grade C
Grade C is the highest level for Clinical Scientists and carries medical consultant equivalent status. Posts graded thus usually involve the management of a large department or a major departmental section. It is also possible to achieve this status while occupying a post which is actually graded B; this is earned by a consistent and continuing output of distinguished scientific work judged by peers to advance the clinical science as a whole, either in a theoretical sense or in the practice of that science.