There are a number of good reasons why all clinicians should take some part in the health care research and development (R & D) process and there is even, unsurprisingly, a NHS target that 10% of clinical contracts should involve research participation. In well-developed health care systems such as the UK NHS improvements tend to be incremental rather than great leaps forward and this often requires large multicentre studies to demonstrate the health benefit of new treatments which can only be conducted with the help and co-operation of NHS clinical staff. This article is biased towards clinicians acting as local principle investigators for trials involving new drugs but the same principles will apply to the testing of surgical procedures, medical devices or indeed any research project involving human subjects or human tissue. The words in italics refer to websites given at the end of the article.