Spotlight on: research

The North East Thames rotation has a strong track record in research, with a high percentage of trainees completing PhDs, MDs or other research projects leading to publication. We have seen success recently for a number of trainees who have won highly competitive funded research fellowships and there are also a number of opportunities available currently which could facilitate entry into an academic post through an alternative route. Many trainees are interested in talking time out of training to delve into a subject of interest and leave a lasting legacy on the pages of Pubmed, but the process is not always clear. So here is our spotlight on research, to complement the information on the research pages, which we hope will help answer some questions and inspire you to pursue current opportunities.

From: http://bit.ly/1IWofnb

Fellowships

Congratulations to two trainees who have recently won fellowships:

• Dr Jessica Potter has won an MRC Research Fellowship, and will be doing a mixed-methods (although predominantly qualitative) study exploring the experiences of recent migrants to the UK with TB of accessing UK healthcare services.
• Dr Laura-Jane Smith has won a Wellcome Clinical Research Fellowship and will take up her grant in October, pursuing both epidemiological and qualitative research in a project entitled “The last year of life in COPD: prognostication, preparation, palliation.”

Jess applied for her fellowship whilst out on ‘soft funding’ and LJ applied for hers whilst still in a full time clinical job. There are advantages and disadvantages to both approaches and both Jess and LJ would be happy to talk to anyone interested in pursuing a PhD about the process. Obtaining a fellowship requires a significant amount of time and planning, and their advice is to pursue something you are really passionate about, and plan far, far ahead! Why not catch one of them in the pub after next week’s training day to hear all about their experiences of the application and interviews? Or, if you can’t be there find them on email or Twitter: @drjesspotter @drlaurajane. Further tips are on our research page.

Crick Fellowships

The new Crick biomedical research institute has some clinical training starter fellowship posts that provide an excellent springboard to obtain an MRC or Wellcome clinical research training fellowship. Anybody from any specialty can apply, and the Crick interviews them and pick the best candidates, and the candidate then selects which research project to do from a long list of potential projects. Prof Jerry Brown has an exciting project on that list for translational research into ABPA (the value of transcriptomes for diagnosis and monitoring treatment). If this might be of interest please contact Prof Brown as soon so possible, and he will support you through the application process. The deadline is very soon: April 28th

Please visit the Francis Crick or the UCL Academic Careers Office website for information about the fellowships and how to apply:

• Crick – http://www.crick.ac.uk/about-us/jobs-and-study/clinical-fellows/
• ACO – http://www.ucl.ac.uk/slms/aco/cat/clinical_phds/brc/nihr_ucl_brc_crick_crtf
• UCL HR job advert – https://atsv7.wcn.co.uk/search_engine/jobs.cgi?owner=5041178&ownertype=fair&jcode=1459589

There are 3 fellowships available at UCL ( 2x UCLH BRC & 1x GOSH BRC). There are 12 projects in total including 5 projects at UCL Please see link for projects and supervisors – http://www.ucl.ac.uk/slms/aco/cat/clinical_phds/brc/accordian/research_areas

UCLP research showcase

The UCLPartners linked organisations are some of the most research active in the UK and one of their aims is to link those interested in research with those leading research across the geography. As a first step, UCLPartners is hosting a research opportunities evening that will include talks from: Dr Charlie Davie, Director of the UCLPartners AHSN, Professor Lyn Chitty and Dr James Lyddiard from the NIHR Clinical Research Network North Thames (CRN) – the most successful CRN in the country – and Professor David Lomas the incoming Vice-Provost for Health, UCL and Director of UCLPartners (and pioneer in the field of alpha1 antitrypin deficiency).

The evening is hosted in partnership with Professor John Wass, Churchill Hospital Oxford and Academic Vice-President of the Royal College of Physicians, who will discuss the role Royal Colleges can play in trainees’ professional development. The evening will conclude with an open forum with the opportunity for you to ask these leaders in research, questions relevant to your own aspirations. The event will be 6-8pm on Monday 27 April 2014 at UCLPartners Boardroom, 3rd floor, 170 Tottenham Court Road, W1T 7HA. Please book via Eventbrite.

Research Presentations

Another great opportunity to get inspired about research is the research presentations at the training day this week. Trainees who have recently completed research will be presenting their results in order to find fame and win an as yet un-named prize! Oooooh! We look forward to hearing about their experiences. Many will be available in the pub afterwards for further chats and the inside info on local labs and supervisors. We look forward to seeing you on Thursday.

Following the research presentations at the Training Day, I have added tips from the speakers. Further tips are on our research page. 

1. Dr Ian Stone presented part of his PhD work, focusing on lung disease and cardiovascular mortality. Lung hyperinflation is associated with increased CV mortality (Cassanova et al AJRCCM 2005). Ian’s trial “Effect of reducing lung hyperinflation with fluticasone furoate/vilanterol on cardiac structure, function and arterial stiffness: a cardiac MRI study” is the  first study to show that pharmacological treatment reduced lung hyperinflation with measurable effects on cardiac structure and function. Further work is needed to further investigate the potential cardiovascular risk and mortality benefit.

Ian’s recommendations for people undertaking research:

• ensure your supervisor will be around, and can give useful feedback
• get a feel for the department and make sure you have somewhere to sit!
• establish whether funding is available  for nursing support if you are running a trial – lots of paperwork
• be prepared to bide your time – results are not instant like in clinical work
• don’t rush into registering for your PhD – take time to get preliminary results
• don’t rush back to clinical before writing up your thesis (if only we all listened to our own advice…)

As well as some interesting questions from the audience on the science and analysis, a question was raised about the funding of the study. This was in light of the article in the BMJ this  week questioning whether trainees should do research with drug companies. Ian went to GSK with the idea for the study rather than being asked to do it, which he felt made an important difference to the relationship. He felt it was important to be careful, but that the appropriateness of trainee-pharma research was very much dependant on the project and setup.

2. Dr Ricardo Jose presented the results from a number of experiments from his PhD with the overall theme of “Regulation of neutrophilic inflammation in Community Acquired Pneumonia.” ARDS involves diffuse inflammation as opposed to local inflammation in lobar pneumonia. The hypothesis is that ARDS is an exaggerated inflammatory response, which is driven in part by neutrophil activation. Ricardo used a model of strep lung injury in D39 mice and explored the effects of PAR-1 antagonism. Jose RJ et al Thorax 2001/4? He found that PAR-1 antagonism in these mice attenuated neutrophil recruitment, but that host defence was not compromised. In separate experiments he took blood and BAL from ICU ARDS patients. He found that chemokine receptor switching occurs in CAP-ARDS in humans. Previously chemokine receptors in the blood have been studied, but not the alveolar space, and the profiles are different.

The key question is how many neutrophils do you need? Some are needed to control the bacterial infection, but not too many as an exaggerated response is damaging. Ricardo suggested the future could involve personalised medicine based on chemokine receptor and neutrophil profiles.

Ricardo’s recommendations for people undertaking research:

• choosing your supervisor is key
• moving to basic science need a lot of guidance, particularly if you are using new techniques – make sure you’re in the right group, with people who have the time and inclination to support you

Here is one of his papers: José, R. J., Williams, A. E., & Chambers, R. C. (2013). Proteinase-activated receptors in fibroproliferative lung disease. Thorax, thoraxjnl-2013.

3. Dr Richard Turner presented a number of aspects of his PhD study into “Cough and TB.” Cough is the predominant symptom of pulmonary TB and the principal means of spreading disease. Cough is under-researched, and there are lots of unanswered questions regarding infectivity, transmission and symptom burden. His study involved lots of strands attempting to answer some of these questions, involving clinical research and some genetic profiling. A large part of the research was using the Leicester cough monitor to record cough character and frequency from patients  with TB and compare to those with other lung conditions. He found that smear +ve TB patients cough more frequently than smear -ve or LTBI. However there is lots of heterogeneity in terms of cough frequency. His studies have validated the use of the cough monitor for research in TB.

Richard’s recommendations for people undertaking research:

• Go to the right place – he was in Sheffield, which does not have much TB so he talked to people – e.g. at BTS. Ask around.
• There are highs and lows of research – highs include feeling like an expert, pushing knowledge a little bit and discovering something new and getting data that is meaningful. Presenting work at meetings and conferences is good reward. Publishing data feels like a landmark.
• Research offers a break from clinical work, a different perspective on life, and greater flexibility with time
• Your concept of time changes – wasting time/periods of unproductively can drag. But overall time passes quickly, very quickly
• Funding applications are a low point, especially if they are unsuccessful
• Ethics committees/R+D – can feel like endless bureaucracy
• You spend a lot of time staring at spreadsheets – what do the numbers mean…?
• Start thinking about what you want to do early, and speak to as man people as possible (trainees and supervisors)
• Know why you want to do it (not just for your CV)
• Know your subject – names, papers, research, courses
• Contribute to your subject early – audits, abstracts, letters
• Do a stats course early e.g. UCL/LSHTM
• Befriend a statistician

Things to make your research life easier:

• GraphPad Prism
• PubCrawler
• Mendeley or Zotero (free and fantastic reference managers)
• Read other people’s theses
• Write frequently (see Royal Literary Fund website for advice on writing styles) – from day 1.
• Try and publish early e.g. your literature review
• Go to the ATS – Americans are enthusiastic. It is inspiring.
• Enjoy it!

Prof Graham Bothamley is looking for a new fellow from August. Could this be you? Talk to Richard and the Prof directly for further details.