Podcast – Why, how and what it’s like to work in hospital research

Voice Over:

Welcome to the NIHR Dementia Researcher Podcast, brought you by dementiaresearcher.NIHR.ac.uk. In association with Alzheimer’s Research UK and Alzheimer’s Society. Supporting early career dementia researchers across the world.

Adam Smith:

Hello and thank you for listening to the Dementia Researcher Podcast. I’m Adam Smith, and earlier this week I had the pleasure of hosting a Twitter spaces discussion with five fantastic healthcare professionals. Over the course of the next hour, you’re going to hear the recording from that session. We apologize for the audio quality, which isn’t up to our usual podcast standards.

Adam Smith:

Hello and thank you for joining the Dementia Researcher Spaces discussion. For those who don’t know, Dementia Researcher is a UK based international service to support and inspire early career researchers. So, with that in mind, I’m delighted to be joined by five healthcare professionals who are all involved in research in different ways as the aim of today’s session is hopefully to make the case for why clinical research and trials are important and persuade some of you to consider getting involved in research yourself.

Adam Smith:

So, today’s chat is primarily aimed at clinicians and healthcare professionals. By that we don’t just mean doctors, although admittedly most of our guests are actually doctors. We also mean nurses and psychologists, speech and language therapists, OTs, physios, and all other kinds of healthcare workers. Both those who already work in this, but also students or people who are studying and on the path to that career. But before I set the scene, let’s welcome our guests and get them to introduce themselves. We have Dr. Antoinette O’Connor, Dr. Brady McFarlane, Dr. Ross Paterson, Dr. Emma Broome, and Dr. Alex Tsui, I think.

Dr Alex Tsui:

You’re absolutely correct.

Adam Smith:

Excellent. Hey Antoinette, would you like to go first and introduce yourself?

Dr Antoinette O’Connor:

Hi everyone. So, I’m Antoinette. I’m a neurology trainee originally from Ireland and moved to the UK to do a PhD and work as a clinical fellow at the University College London. And I worked mainly in kind of blood biomarkers or pre-symptomatic biomarkers of Alzheimer’s disease. So, I finished off my PhD just over a year ago now and I’m now back in mainly clinical work but still keeping a hand in research and I have returned across the Irish Sea to Ireland, but still kind of involved with ongoing work and research at UCL.

Adam Smith:

Thanks Antoinette, and Brady, why don’t you go next?

Dr Brady McFarlane:

Thanks. So, I’m Brady McFarlane. I’m a consultant and old age psychiatrist. I work down in the New Forest in my clinical role. So, I work in a community mental health team, mainly memory clinics and things like that. But I also work two days a week at the Memory Assessment and Research Center, which runs lots of trials for [inaudible 00:03:07] impairment and dementia based in South Hampton. And I guess my interest is in commercial research trials and that sort of thing.

Adam Smith:

Brilliant. Thanks Brady, and Ross, your turn.

Dr Ross Paterson:

Hi there. I’m Ross Patterson. I’m a principal research fellow at the Dementia Research Center, which is part of the Queen Square UCL Institute of Neurology. And I’m also an ordinary consultant neurologist at the National Hospital for Neurology and Neurosurgery. And I run a specialist cognitive clinic at Darent Valley Hospital in Kent. My academic interest is in fluid bio markers in neurodegenerative diseases and specifically using stable isotopes to measure protein turnover in cells and in humans.

Adam Smith:

So that’s a bit of a reach. So, I didn’t realize you work in Kent and in London as well.

Dr Ross Paterson:

I do. And I usually cycle there, which is a nice start to the day.

Adam Smith:

Yeah, I’m impressed. Will you be keeping that up as the weather changes now as well?

Dr Ross Paterson:

I actually prefer to cycle in the cold weather, so I’ve just had my summer break from cycling.

Adam Smith:

Like any true Scot. Hey Emma, you’ve been on one of our talks before. I don’t think, maybe not on spaces though. Would you like to introduce yourself?

Dr Emma Broome:

Yeah, thanks Adam. Yeah, so hi everyone. I’m Emma Broome. I’m a research fellow based at the Nottingham Biomedical Research Center. So, I feel like an imposter in two ways because at the moment I’m based within the hearing theme. So, I’m primarily working on research looking at ways we can support patients when they’re first prescribed hearing aids. But my future research will be looking at people living with coexisting dementia and hearing loss. So, the other reason why I’m an imposter is because I’m just an academic, I’m not a clinician. So, I’m here to eavesdrop and find out how we can support clinical colleagues to become more involved in research. I work with clinical colleagues at the BRC on a day-to-day basis as part of a research delivery team and I’m really keen to involve clinical colleagues in my research. So yeah, thank you for inviting me and I’m looking forward to hearing more from all the other panelists.

Adam Smith:

No, not at all. It’s great to have you. So, I’m interested because I think last time you were working in the arts as well, did you originally train as an audiologist then or something like that?

Dr Emma Broome:

No. So my background is in psychology but I’m just purely an academic, so I haven’t worked clinically at all. But in all of my postdoc career and in doing my PhD, I have been keen to include clinical colleagues in our work because they just have a level of insight that I don’t have as an academic. So yeah, so imposter as not a clinician, but very keen to hear more and find out how we can work together on research both as academics and clinical academics.

Adam Smith:

Well, it’s great to have you here. Thank you for finding time to join us tonight. And last but not least we come to you, Alex.

Dr Alex Tsui:

Hi everybody. Hi. I’m actually a consultant geriatrician. I’m based at University College London and also at St. Pancras Hospital. I actually come to dementia from a slightly different approach. So, my interest is by acute illness and delirium and my two areas of interests are actually through population epidemiology and also data sciences to use prediction algorithms to look at adverse outcomes from acute illnesses, delirium, and then of course outcomes such as cognitive impairments and dementia.

Adam Smith:

Brilliant. And the connection to delirium is really important. In fact, it’s something that’s on our list of podcast topics to make sure that we cover. So, watch this space, you might be getting an invite from us to join one of our podcasts soon.

Dr Alex Tsui:

Would be delighted to.

Adam Smith:

Well thank you very much all of you for finding time to join us. So, anyone listening will realize straightaway all of our speakers are UK-based. So, if you are outside of the UK, we hope you’ll keep listening as the experiences and issues we’re discussing are just as important here as they are elsewhere in the world. However, obviously some of the tips and discussion about how to become involved and some of the resources that we might signpost to will vary in your part of the world. So, let’s set the scene properly.

Adam Smith:

I hope you’ll agree with me when I say that research is important and beneficial to people and patients. Breakthroughs enable earlier diagnosis, more effective treatments, prevention of ill health, better outcomes, and faster returns to everyday life. Our focus is on dementia but of course this applies to all illnesses. But research is also beneficial to healthcare professionals and it’s often those people who are best placed to develop imaginative solutions for real [inaudible 00:07:57] problems, best placed to improve care and increases their job satisfaction as well.

Adam Smith:

Research is also beneficial to the NHS systems. We know that hospitals that are more research active, I’m putting speech marks around that, have a lower mortality rate than those that are not. And this is effective, is not just limited to research participants, the effect rather. The researchers who do this could also be thought of in broadest terms because there are a multitude of ways that they get that badge, the term researcher. At one end of the spectrum, we could be simply talking about being aware of research that’s going on and openly talking to patients and staff about that or being involved in and working in the NHS where almost all clinical trials are being done and leading supporting delivery of trials is another way to get involved. Testing new drugs or delivering new types of interventions, and healthcare professionals of all kinds are involved in that.

Adam Smith:

Or at the other end of the scale, we have clinicians who undertake research training alongside their clinical work or who take a break and return or never return. And that’s what we’ll be talking about today as well as generally how to get involved and we’ll give you some examples of how you could have evolved in the different ways, what that looks like, the benefits, challenges, and where they can go for support. I should definitely have read back my introduction before I read it out because I think, hopefully that made sense.

Adam Smith:

So, I’m going to start, that’s enough from me I think, but I’m going to start by going back to our guests who really know what we’re talking about and ask some easy opening questions as to why they became involved in research or became a clinical academic. Emma, I’m going to come to you first as to why did you get involved in research, you said you originally trained in psychology.

Dr Emma Broome:

Yeah, thanks Adam. Yeah, so both of my grandparents lived with dementia. So, my grandfather was diagnosed with Alzheimer’s I think in 2002, and I helped my mom care for him and my grandma actually. And I remember when he was first diagnosed, his impression was just, well there’s not much hope for me then and that was kind of it. And I felt like he didn’t have any hope and I think as a family we felt that research gave us some hope and that was kind of what spurred me on my academic career path. You mentioned that my background was in the creative arts, so I started running a music group at a mental health facility for people living with dementia, mental health complaints, and just saw the power of music and that was kind of what’s took me on my academic career to get an Alzheimer’s society funded PhD studentship.

Dr Emma Broome:

Now I’ve moved kind of a bit broader, so now I’m based at the BRC, so I’m working, so we’re based at [inaudible 00:10:55], which is a hospital, so we’re kind of really embedded with clinicians and clinical colleagues as well. And I’ve just found it so helpful for my research in making sure that what we are doing, we involve patients a lot, but also, it’s really important to have clinical input so we know what the challenges are in their systems of working and how we can encourage patients and clinical colleagues to become involved in our work.

Adam Smith:

Well, you make a really good point there because I think quite often, we kind of group people together as kind of care researchers who must work in social care sector or university based and clinical based researchers are in hospitals and then you’ve got the people in the labs in universities. So, it goes to show that you don’t have to be clinical to work in that clinical setting to support research delivery still.

Dr Emma Broome:

Yeah, absolutely. Yeah, as I said, imposter here, not a clinician at all, but work very closely with clinical colleagues on a daily basis and just from having interaction with them every day purely on a research delivery note, we’ve been able to get them involved in literature reviews and setting up their own projects and we’re learning from each other and I just think when we work in that way it’s beneficial for everybody. So yeah, I’m really curious to hear from others what their experiences are too.

Adam Smith:

Well let’s go to Ross next, because Ross, I think you could wear the badge of clinical academic, because you originally qualified as a doctor and now you work academically as well as clinically. Why don’t you tell us how you came to be in that, follow that path.

Dr Ross Paterson:

Yeah, sure. So, that’s right. I work as a clinical academic, so I’m 70% academic and 30% clinical. And well how did I get into it?

Adam Smith:

Wait a second. That’s my next question, I guess I’m supposed to start with why you got involved in researching in the first place.

Dr Ross Paterson:

Oh yes. So why, well, I guess when I was at medical school and the way that I’ve always sort of thought about clinical medicine is to try and find the underlying cause of problems, to try and make a diagnosis where possible and try and provide a mechanistic answer to a clinical problem. And in the cognitive clinic you’re aware very quickly that you reach the boundaries of knowledge and the boundaries in terms of what you can offer people. So, I think in that situation it’s natural to engage in research and want to do research and try and answer some of these questions. And I suppose there’s also a personal element as well, like Emma, my grandmother had Alzheimer’s disease and I lived with her in my first year of university. So, I think that kind of set the scene early on for what I might do.

Adam Smith:

And let’s see, I might be wrong, but I think that what you explained there I think is a common theme that runs through the clinical academic community that I’ve spoken to, is that kind of inspiration that you start working clinically and then want to see issues and want to make things better or get involved in research. But let’s see, let’s come to Antoinette next. Why did you get involved as a researcher Antoinette?

Dr Antoinette O’Connor:

Yeah, so I would echo that concept of, I was again working clinically in kind of general neurology clinics in Ireland and just seeing patients with dementia but who were quite far down the road by the time they got a diagnosis. And you kind of see the importance of early diagnostics and also the need for better supports and treatments and it felt like there was a real gap there and that research would be the way to make progress in those areas of unmet needs. So that was kind of a big driver. And then I guess in a back along, one of the reasons that I had gone to medical school is I used to work as a care assistant in a facility where many people were living with dementia. So, I could see that unmet need throughout, even before med school. So, it was something I was really interested in getting involved in from a long time back, I guess.

Adam Smith:

Thank you. I’m going to come to Brady next. Brady, so you were, is research something that you always wanted to be involved in. Is that something you’ve done always as a clinician or did this come later on?

Dr Brady McFarlane:

Oh well, I’ve always been interested but I didn’t go down any traditional academic path. So found me working purely clinically as an old age psychiatrist. I got my first consultant job down here kind of 12 years ago and worked clinically. And gradually over time, over that time I’ve just managed to carve out a job that combines clinical work with more and more dementia research stuff. So, I’m not an academic at all, but I managed to work in dementia trials. So, as I said, I’m an old day psychiatrist, I spend most of my time, most of my clinical work with memory clinics offering diagnosis, treatment support for people with dementia. As I spent more time in the job, it just seemed a natural progression to get more involved in dementia research trials.

Dr Brady McFarlane:

And I loved Ross’s phrase about the boundaries of what is possible because I guess you quickly reach that with memory clinic work and it’s so exciting to be able to offer more than, I guess some of the frustrations that we’re able to offer quite limited support normally. So, I love being involved with latest science, latest breakthroughs, latest treatments, be able to offer loads of great opportunities to my patients. But from a more selfish point of view, it leads to a much more satisfying job for me. So, combining day to day clinical work with research time. So, as you said in your introduction, it really improves job satisfaction, keeps me motivated, keeps me interested every day and it’s made a real difference to my working life.

Adam Smith:

Actually, because in my other hat of course I was involved in setting up join dementia research, which is a public service in the UK for people to volunteer to become involved in research. And when we talked to clinicians about why should they promote that, that was overwhelmingly one of the reasons why they do it was because of course at the end of giving somebody this devastating news that they’ve got Alzheimer’s disease or some other form of dementia, the treatment options of course were very limited, but being able to sign people to research actually gave them some hope, which was good when you had limited alternatives. So, I can understand why that was a good motivating factor for you.

Dr Brady McFarlane:

Yeah, absolutely. Absolutely.

Adam Smith:

Alex, how did you end up being a researcher?

Dr Alex Tsui:

I think I’ve got to echo quite a few things that Brady’s just said, actually. So as a geriatrician I also didn’t come into this in any formal pathway either. And at the same time, I also have to echo that from a personal perspective, job satisfaction is fantastic as a clinical academic. In terms of getting into it in the first place, as a geriatrician you cannot help but feel the futility sometimes of the limits of what you’re able to do in the context of delirium, in the context of dementia, and the limits of what’s sometimes we are able to tell patients is unfortunately we can help you live with this with very little on the horizon. And that’s not really a great approach in terms of an outlook.

Dr Alex Tsui:

So of course, trying to change something, having a motivation to change something is something I’ve always wanted to do. The variety of my day-to-day work, clinical work, but also having a different dimension it as whereby I’m able to do something, answer questions, ask questions, the autonomy of actually asking questions which haven’t been asked before, greatly improves how I view my job on a day-to-day basis. And I think we all have a degree of baseline curiosity which has led us to find solutions to problems and that’s why we are clinicians and scientists in the first place. And I think that’s one of the main reasons I got into it as well.

Adam Smith:

Which is a good counter to this argument because I would imagine that there’ll be, listening back to this there’ll be jobbing NHS clinicians who are saying I’m way too busy to be considering doing this. But actually, it adds value, not takes away, it improves the experience overall. And I’ll trust, with your experience with the, I’m guessing you work in NHS trust at that time, were they supportive as well of that decision? Did you get the proper help and advice you needed?

Dr Alex Tsui:

I think there’s a variety of outlooks that you can get from NHS trust. I think there are arguments to be made of the clinical value that you can add. I think you’re a better clinician sometimes when you are able to just ask that question a little bit beyond what has previously been known. And I would say also conversely as an academic it’s quite important to find the questions in your clinical work to then ask them in your academic world. NHS trust do need convincing that there is research, which is important, but it’s how you approach it and how you try convincing them, I think.

Adam Smith:

And I guess as you say, a different trust will have different views. And I know, I think there are very few trusts in the country that aren’t doing some form of dementia research and of course we’re not just talking about drug trials but non-drug interventions and other things as well, which all happens still within the NHS. Thanks Alex.

Adam Smith:

So that’s helped I think, give us an idea as to why everybody got involved in research. But let’s get into this and talk about, next we’ll talk about how you all got involved because you’ve all had slightly different career paths. So, let’s talk about how you practically went about this and then we’ll move on to talking about what your days look like. So, Ross, talk us through how you, so you finished medical school, how did you then go on to become a clinical academic?

Dr Ross Paterson:

Yeah, well I guess like many things in my life, it was somewhat unconventional. So rather than doing the PhD in medical school or fairly early after foundation training, I had done most of my clinical neurology registrar training before I started in any formal academic training. So, this is certainly against the conventional pathway, but that’s not to that I wasn’t research curious during my clinical training because I did get involved in writing up case series and doing a bit of work with Professor Angela Vincent in autoimmune and [inaudible 00:21:48], which I enjoyed a lot.

Dr Ross Paterson:

And then after I was three, four years into registrar training, I decided to do visiting scholarship to the Memory and Aging Center at UCSF, so in San Francisco with Professor Michael Gershwin. And they ran this really lovely program for visiting scholars where they arranged practical research experience from pathology right through to different clinical presentations and clinical trials. So that really fired me up with quite a lot of enthusiasm and led me to do a PhD at Queen Square at the Dementia Research Center. And I’ve remained within the research since then and enabled by an NIHR clinical lectureship which really was very valuable for staying within the field. But doing it this way round, I think it is reasonably unusual but I think I would recommend it to those who are considering doing research because it’s easier I think to keep up with the field, rather than going back to do four or five years of registrar training, it means that you can stay in research and you don’t lose the momentum the same way that you might do if you do your PhD earlier on.

Adam Smith:

And is that fairly typical then? I mean do most clinical academics who come from a medical background, do they wait till registrar level or do they, sorry, I know it’s all different, it’s changed from when I worked in the NHS where you still had [inaudible 00:23:16] and things back then but is that the time when people come in or do they do that earlier as well?

Dr Ross Paterson:

Yeah, so I think there are less entry points now and certainly with some of the programs in the academic jobs and the MD PhD opportunities within undergraduate, I think a lot of people are under the impression that they have to do their research training much earlier on and lots of people seem to feel that they’ve missed the boat if they haven’t done research or done a PhD by the time they’ve started their registrar training, which I just want to emphasize is not true at all. And really that there are opportunities for academics to declare themselves at any stage in their career, even if it’s post CCT, I think you can do a PhD at that stage if you want.

Adam Smith:

I’ve just actually tagged a tweet there at the top of this conversation because of course you mentioned there that the NIHR was one of your funders. Did they fund your PhD as well?

Dr Ross Paterson:

They didn’t fund my PhD, no, I was funded by ARUK for my PhD, but they did provide 50% academic funding post PhD. And the NIHR clinical lectureships really are brilliant and I’m not just saying this because you work for the NIHR, but they are a unique opportunity to be able to study within some limits but you get a lot of freedom to start asking your own research questions and developing your own research niche and it’s allowed me to do a much more ambitious program of research that I wouldn’t have been able to do through other funding streams. So, I would definitely encourage people to consider this route.

Adam Smith:

Thanks very much Ross. I’m going to come to Antoinette next. Of course, you’re a clinical academic as well, how did you come to this role? How did you find your way in that?

Dr Antoinette O’Connor:

So yeah, I did medical school and similar to Ross, had done little bits of research, nothing extensive while I was working clinically. So contributed to case series but no kind of dedicated research time, not any kind of parallel clinical academic path. And I was doing registrar work but knew I wanted to do research and particularly in the area of cognition. So, I reached out to kind of bosses and mentors from the clinical world about where they thought would be good places and for advice and they put me in contact with people they’d done research with. And from that point of view, I was able to go over and work in the dementia research center for a year and from there applied for funding from the Alzheimer’s Society and got a funded clinical fellowship from there. So, that was kind of my avenue in. So, I think it shows the importance of talking to mentors and having mentors who can signpost you and put you in contact and network with established academics.

Adam Smith:

And is that something you have to then do really off your own back? Was there support, was there somewhere to go to get that advice or did you have to go out and look for these funding streams? We should add there because the NIHR isn’t the only funder of clinical academic work, as you mentioned there, Alzheimer’s society, Alzheimer’s Research UK also fund these kinds of positions as well.

Dr Antoinette O’Connor:

Yeah, so I think is, there’s an array of different funders, it’s just kind of figuring out what you’re applicable for and what stage you’re at and what you also want to do. Do you do want to do a dedicated PhD. But I found it reasonably easy to navigate of which things I was applicable for, but I could have obviously missed things because you don’t know what you’re missing unless, until you’re talked about them afterwards.

Adam Smith:

Thanks Antoinette. Emma, how did you get into this?

Dr Emma Broome:

A good question. So, my PhD I applied for, it was an Alzheimer’s Society funded PhD as part of a doctoral training center. So, it was a collaboration between the University of Worcester and the University of Nottingham. So, I was based at Nottingham. So again, because I wasn’t working as a clinician and I wasn’t kind of following the clinical academic route, not sure how relevant my experience would be, but as the other panelists were talking, I was just reflecting how at the moment as an academic I’m supervising BMedSci student projects and we’ve had some other undergraduate students who’ve been on summer internships who are really interested in becoming involved in research. And as an academic I’ve put forward some project ideas specifically relating to dementia and hearing loss and the uptake has been really good and really positive. So, I guess for people at the start of their academic career or clinical career as medical students, there’s opportunities even then to look to become involved in research. So, I just thought I’d highlight that as a different route into research as well.

Adam Smith:

And of course, as I mentioned at the start, we have of course clinical psychologists that do work in the NHS of course, can also apply for NIHR funding and through the doctoral program, which is the tweet tagged at the top of the conversation, and go on and do a PhD. And I think there’s a lot of flexibility within that, that allows you to continue to work clinically or negotiate with the trust about how much time you do this. Of course, the more time you dedicate to it, the quicker you do it, and then of course you can return to clinical practice. We have some great blogs by Dr. Emily Oliver on our website who was a nurse who left nursing, went, and did a PhD, and then came back, became the lead dementia nurse at Portsmouth Hospitals. And she’s written extensively on our website about her experiences of going off to do her PhD and then returning to clinical practice and didn’t carry on becoming a fellow or senior fellow. The experience she got, she then applied back into her day job. Thank you, Emma. And I’m going to come, Alex, you’re not always going to be last on my list, I promise. I’ll come to you next.

Dr Alex Tsui:

Well, I actually took a [inaudible 00:29:47] route to dementia research actually. When I was at medical school my area of interest having been exposed in my bachelor years to Parkinson’s disease, I was actually very much into PD research. But actually as that went on, I went into my specialist training in geriatric medicine, it was through a completely chance encounter at the end of a [inaudible 00:30:12] teaching day when I just had one of those chats at the end with one of speakers who ended up being my mentor and PhD supervisor in, of all places, the Everyman Cinema in Baker Street, London.

Dr Alex Tsui:

And he said, why don’t you come and have a look and see what this population epidemiology thing looks like. And so, I went along, and we did a bit of work, learned a bit of stats and I took a one-year OOPy at that time from the program, I did a year as a research fellow. Enjoyed it so much that I actually then subsequently went and applied for an Alzheimer’s Society PhD clinical fellowship. And so that’s what I did my PhD in. And as things progressed, I then got increasingly interested in beyond traditional statistics and that’s how I then developed interest into machine learning. The route into all this of course was of course the delirium as its interactions and the outcomes into dementia. And so, there are very many different ways of I suppose arriving here.

Adam Smith:

That is fascinating. And it goes to show as well that not everybody who goes on to become a clinical academic has to stay along a certain path. I mean moving into using machine learning and the data and epidemiology side is something you might traditionally more associate with public health or university-based researchers.

Dr Alex Tsui:

Quiet. And I think it takes doing something into a certain degree of detail and then realizing its benefits, its limitations, and then actually asking yourself, well what was the next thing that I can answer this question I really want to answer? And that’s how I arrived at the kind of more data sciencey part of all this.

Adam Smith:

And keeping your options open, that you can still flex your time, for those who really love their clinical work and don’t want to go off full-time in academia, this just goes to show you don’t have to, you can flex the two.

Dr Alex Tsui:

Quiet.

Adam Smith:

Thank you very much Alex. Right, let’s talk about what your days look like. For those that are listening and can’t really picture exactly what a day looks like for you. I’m going to come back to Brady because Brady, so Brady, you’re a consultant geriatrician, you were working clinically that way, you were inspired to get involved with research through your patients and colleagues and now you’re involved in the delivery of clinical trials in addition to your day job. So, what does a normal day look like for you?

Dr Brady McFarlane:

Thanks Adam. I’m an old age psychiatrist rather than geriatrician.

Adam Smith:

Sorry. You’re right. The others are geriatrician, you’re a psychiatrist, apologies.

Dr Brady McFarlane:

That’s all right. So, my research days are spent at the memory assessment research center in Southampton. We start the day with our morning team meeting. We meet as a research team, we discuss some plan, what the day is ahead. So, what patient visits we’ve got, et cetera. So, we’ve got nurses, research assistant psychologists, study coordinators, doctors, pharmacists, et cetera, in that meeting. And I guess the first bit of the day is spent seeing patients for whatever the study protocol specifies. So, these are normally things like safety checks for drug studies, blood tests and physical examinations, that sort of thing. Perhaps giving patients medication infusions and lots of cognitive testing as you’d understand from dementia studies. I’ll probably meet the study coordinators and check how trial participants are getting on, how they’re getting on in each individual trial. I’ll spend time with unit manager on the setup of new trials and that requires a lot of logistical planning.

Dr Brady McFarlane:

We run a lot of both commercial and grant fronted trials. So, I’ll probably spend some time with my academic colleague’s kind of coordinating resources and finding out what kind of things they need. One of the hardest bits of commercial trials in dementia is it’s often really complex to get the right patients into the right study. So, a lot of time we spent on screening for trials and also the really hard work of recruitment. And a lot of the work is also in meeting clinical colleagues and teams and promoting the benefits of research and what studies we’ve got on. And it’s very hard for clinicians to remember exactly what work is going on. So, we spend a lot of time trying to reinforce the benefits of research and how they should get involved. And on top of that then it’s a lot of meeting with drug companies, sponsors and that sort of thing.

Adam Smith:

And the colleagues you mentioned there, you said like study coordinators, psychologists and nurses and other doctors. Are they all, I mean guess some of those will be full time just working on research and others will be like you where they mix their time?

Dr Brady McFarlane:

It is. We’re slightly unusual in our unit, we’ve got far more dedicated people to the research just because we’ve got a slightly different funding model to other teams. So, we’ve got a lot of people who just work for us. What we’d like to do, what we’re trying to do more of, which I actually think is a bit more traditional, is having that mix. Because I think that’s a great benefit. So, it’s quite easy for doctors I think, my time is relatively straightforwardly spent between my clinical work and the research time. But actually what we’ve been modeling and trying to do is get nurses working on the ward or nurses working in community health, mental health teams to be seconded to have some time in research and I think that’s a great benefit both for their input into patients but also exactly what we talked about before with job satisfaction and that sort of thing. And that works with psychologists and pharmacists and all sorts of other people as well.

Adam Smith:

And as you mentioned, recruitment to clinical trials is tricky, isn’t it? So I guess, and we know that people living with dementia have multiple comorbidities, so I guess if everybody in the trust knew all the trials that were going on, it would be quite handy when it came to recruitment because you could then just say, hey look, we think we might have a patient for you, to refer to your clinic. And I guess is that why you spend so much time talking to colleagues around the trust?

Dr Brady McFarlane:

Absolutely. And it sounds like a glib statement, but actually the whole concept of embedding your research into clinical pathways is actually a really important thing. So, we spend a lot of work actually trying to do that and getting into a research trial should be a point of a clinical pathway. And so yeah, we spend a lot of time trying to develop those types of things.

Adam Smith:

The NIHR does have databases of all the studies. So, if you’re listening to this and you work in a trust and you’re just a little bit interested as to what research is going on in your organization, the link I’m about to post will give you a bit of a place where you can go look and get a sense of that. Thank you, Brady. Let’s come next to Antoinette. So, you are back to practice though, have you been able to carry through in your research back to Ireland?

Dr Antoinette O’Connor:

Currently I’m largely clinically based during working hours.

Adam Smith:

So, let’s talk about your days at UCL then before you returned.

Dr Antoinette O’Connor:

Yeah, no I won’t regale you with tales of clinical work in Ireland. You’ll never come here to visit again. No, what I liked about research in particular was their kind of really a typical day, there was a lot of variability from day to day. So, some days which were your cognitive clinics and a lot of just seeing patients, but also telling them about all the research opportunities and then some people going from a clinical visit to a research visit, which is really nice because you got more dedicated time with them often in research visits. And then there’s other days which would be less clinically or patient facing where you’re doing kind of data collection or data analysis or just reading about the literature of writing. So, I didn’t really, never really felt like there was a typical day during my PhD because there was so much to do from day to day. And that’s one of the great things I think about being a clinical academic is that kind of variability because you to stay interested because everyday kind of seems a little bit new and different.

Adam Smith:

Were you involved in delivery of trials that were happening elsewhere in the hospital as well?

Dr Antoinette O’Connor:

Yeah, so I did some [inaudible 00:38:43] work for some clinical trials and then some kind of [inaudible 00:38:47] work as well for a few observational studies. So, it was nice to get exposure to the different types of studies and the different types of research participants and to see how the differences between clinical kind of drug trials and observational trials but also just have lots of time with patients and to get really thorough assessments done and to give people the time to feel listened to. Sometimes with clinical pressures it can be sometimes a bit challenging.

Adam Smith:

And I’m assuming there’s less out of hours activity. Not that I’m trying to suggest, we’re not trying to lure everybody away from frontline NHS work into research, but I guess there’s a little bit more structure around it in terms of what time you start and finish each day, things like that.

Dr Antoinette O’Connor:

Yeah, and you sort of have a little bit more ownership of your time as well and it’s a little bit more self-driven, which is quite nice. And you can decide, this is the time for that, and you get to be a little bit more in control of your own destiny, which is quite nice.

Adam Smith:

Of course. Yeah, so because it’s all kind of fairly scheduled and planned ahead, you’ve got lesser that suddenly being pulled off in a different direction each day. Thank you. Well, I think the next person who’s going to be able to talk quite well to this is Ross. Let’s come to Ross.

Dr Ross Paterson:

Well, like Antoinette, one of the things that I love about being a clinical academic is the fact that there isn’t a typical day, and I would say that there’s maybe a rhythm to the week which is sort of anchored around clinics and maybe a rhythm to the month, but certainly no individual day’s the same. And I guess a kind of research that I do is maybe a bit different to what Antoinette and Brady do. So, I do some basic lab research which involves cell work and working with mass spectrometers, but I also do translate that right through to clinical work and doing clinical trials. So, they clearly require different skills and different time in the hospital.

Dr Ross Paterson:

The out of hours side of things, not necessarily true for clinical research studies. If you’ve, the [inaudible 00:41:07] that I’ve been doing require overnight visits in the hospital. So, I frequently find myself sleeping in the hospital. But that’s something that you want to do because you’re motivated to do and you’ve got ownership of the study and you choose to do that, which is a little bit different from doing it for clinical reasons. And then there’s also the opportunity for travel. So, I’ve just come back from a month in America where I had a lab visit over there with collaborators at WashU. So again, that’s one of the great perks of being an academic.

Adam Smith:

Actually, you make a good point there, because I guess there aren’t very many healthcare professionals that get to go to national or international conferences, whereas research is definitely still has that key thing to it. You learn a lot from going to conferences, which is a key part of the day job and another benefit of getting involved in research. Thank you, Ross. Emma, what’s a day look like for you?

Dr Emma Broome:

Yeah, I have to agree with them, Antoinette, how every day is just completely different, which I think is just, it keeps things really interesting. But I just wanted to highlight some additional things, so a typical day, well, there’s no such thing as a typical day, but it’s setting up studies, ethics approvals, recruiting patients, looking at data, some are qualitative research, so it could be surveys, interviews, focus groups, workshops. But something I wanted to highlight, there’s some other, the stuff that I really, really enjoy is working with patients. So recently we’ve been doing lots of public engagement, so we’ve been writing blogs with patients, we’re helping patients develop a new way of working where they can mentor each other as they become involved in research themselves. And we’re going to write that up for publication in the BMJ and it’s just, it’s not the typical stuff that you think that an academic would do. So, something else that I’ve really enjoyed is working with an artist to illustrate findings to make our research more accessible to clinicians and to patients as well and then presenting those conferences. So, I just wanted to highlight some of the other things that you maybe don’t think of when you think traditional academic career. So, there’s so much more, so it’s just, it’s very, very varied.

Adam Smith:

So that’s great. So, it can keep your interest and also as well I guess give you opportunities to do things that you wouldn’t normally do. As Alex touched on earlier, hopefully we’ve got Alex back with his machine learning. Thank you, Emma. And the art thing sounds great. In fact, Emma did a wonderful online seminar for us probably a year ago now, talking about her research and exploring arts in dementia, which you’ll find on our YouTube channel. So do go have a look at that. Alex, what’s a day look like for you?

Dr Alex Tsui:

I was just going to say, I was talking to myself about how there isn’t a typical day actually. So, I try to keep my days very, very separate when they are clinical and when they’re academic. So, if I’m doing an acute medical take, I absolutely make sure I just do that. And I have a very dedicated few days of the week where I only do research. I find I personally just concentrate better when I do have very compartmentalized time. In terms of the actual research days, again, there is no typical day. I mean it could be absolute anything. You could be in a data collection part of the trial, you could be writing ethics, you could be doing data analysis, it’s whichever parts of a specific project that you’re on, you’ll be doing that bit. So, there isn’t really typical research day I would say.

Adam Smith:

And that of course does come with the downside I guess, of writing the occasional grant application, which most academics would not cheer about.

Dr Alex Tsui:

Yes.

Adam Smith:

Okay. So, we should be honest in this conversation, so it’s not all sunshine but I guess that comes with the job and is incredibly rewarding when you do find that funding because I guess that means you’re on the road to independence. Where again, when we start to think about different ways to become involved in research, of course you could be leading your own research, which it sounds like Alex, you’re doing, Emma certainly I think you’re leading your own research, whilst also being involved in other research that’s funded or somebody else is taking the lead on as well. A lot of flexibility there. Thank you very much.

Adam Smith:

I’m very conscious of time because I said we’d keep this to an hour, and we’ve got a ton of questions we haven’t even gotten through. So rather than aiming this question at anybody specifically, I’m just going to say, what do you see as the rewards, I mean I think we’ve talked actually a little bit about the rewards, but let’s be honest and talk a little bit about the challenges then beyond writing grant applications. Is there anybody who’d like to particularly talk about what you see as the challenges of getting involved in research?

Dr Brady McFarlane:

Brady here, just to add a quick point just as a clinician, just to add to Alex’s point really, is that one of the challenges I find is that compartmentalizing my clinical work and research work. So occasionally things blur into each other and then it does make days particularly challenging when you’re trying to deal with both sorts of things. So, I think Alex has got absolute the right way of dealing with that and I need to be better at that sometimes.

Adam Smith:

Okay, great. So, I think it’s almost time to round up one last question. What top tips would you each have for somebody who’s interested in becoming either a clinical academic or generally involved in research? So, a quick top tip, and I’m not going to go in the order the [inaudible 00:46:53] says, I’m going to go to Emma first.

Dr Emma Broome:

My top tip would be just to go for it and believe that you have so much expertise to contribute to studies. So, just have confidence in yourself and that you have something to offer to different research collaborators.

Adam Smith:

Great. What about you Ross?

Dr Ross Paterson:

I would say make sure that you get a good mentor and that can be either somebody who’s in your field, I think the mentorship advice is generally get someone who’s outside your field and there is the NIHR, no sorry, the Academy of Medical Sciences have a mentorship program for clinician scientists. So, I would encourage people to get somebody who’s more senior who can guide you along the way.

Adam Smith:

And there are different ways to reach out, on the Dementia Researcher Website, if you go to whatever is the tab on the very top right-hand side, you’ll find a section in there called meet the researchers. And we’ve got profiles on over 400 researchers that have contributed to Dementia Researcher Website from all different fields, and they’re categorized by the institution they work at and the research field that they work in. And examples of that we’ve of course tagged to the top of this conversation, the bios of all of our speakers for today.

Adam Smith:

So, you can go and have a look at their bios, and we ask them a little bit about what they research and why they got involved, what their tips are. There are their playlists as well, not that you might want to listen to those, but you’ll find details on over 400 researchers on the website. And I think all of them have Twitter accounts and all of them have expressed when they gave us their bios a willingness to be contacted. In fact, they really like being contacted because it means that somebody’s interested in their work. So, by all means, if you’re looking for a mentor or have some questions or just looking for some advice, find the research field you’re interested in, go have a look at the bios and get in touch with those people there. They’re all very receptive to being contacted. Brady, what would be your top tips?

Dr Brady McFarlane:

Two points, first that there’s nontraditional, non-academic roles into research. So, there are lots of other route you can go down to maintain an interest in research as a clinician. Secondly, your local CRN has a role in supporting you. So, for example, I’ve got the role for dementia in Wessex, the specialist lead and it’s part of my role to be able to sign post people and to put people in touch with mentors and that sort of thing in Wessex for budding, early career researchers and every region will have the equivalent to my role.

Adam Smith:

We’re going to talk a little bit about resources at the very end, but you’re absolutely right. So, all of England has clinical research networks and part of their job is not only to support delivery of studies but also to be able to sign post to other parts of the NIHR, which can help. And of course, you’ve got the NIHR Academy, we’ve got the research design service and all of these facilities there to help you get involved in research in the different ways, which we’ll recap on at the end. Let’s go to Antoinette.

Dr Antoinette O’Connor:

Yeah, I think it’s sort of a mix between Brady and Ross. I think it’s looking at the resources and the kind of senior support. So, whether it be through the CRN or other things like the academic or the Dementia Researcher or various, even people maybe in your own local hospital. But having that kind of mentor or senior support that can kind of guide and advise you. And also, if you are going through a PhD program or that path or joining a lab, I think it’s always really helpful to talk to not only the leader of the lab but also previous PhD students or previous clinical academics who have gone through there and just you get a flavor of what research is going on and whether you like it or it would suit you or not. I think it’s really important not just to only talk to senior people, but also to talk to people on a similar level to yourself when you’re going down that path.

Adam Smith:

And I’ve just tagged another tweet at the top of this conversation, which is a webinar we recorded a little while ago with Annabel Long, Anna Volkmer, Emily Oliver, and Clive Thomas who all have very different career paths but work within the NHS who talked very eloquently about the different ways they became involved in research as well, which were all very easy to replicate. Anna also has written a whole series of blogs for us from, Anna’s a speech and language therapist and she’s written for us since she first started applying for her PhD and she’s now a senior NIHR fellow and she’s written blogs, fantastic, very eloquent blogs throughout this last few years talking about how she’s applied and gone through these different stages in addition to talking about her work as well. So do have a look at those. Alex, I don’t think I came to you on that question did I.

Dr Alex Tsui:

No.

Adam Smith:

Can you remember the question?

Dr Alex Tsui:

I do. I’ll keep it short actually. I’m just going to echo a lot about what the previous speakers have said. Number one, find yourself a very, very good mentor. That’s going to be absolutely important. Number two, I would say do what you love because it then becomes far more a hobby that you’re being paid to do than a job. And the third thing I would say is be prepared to deal well with disappointments and have a very, very long reward leash. Sometimes with research things take a long, long time to come to fruition and that’s just the way it is. But that’s okay, that’s part of why we do this.

Adam Smith:

Okay, so let’s just recap. If you are a healthcare professional working in the NHS, the options available to you are at the very basic stage you could go away and have a look on the, be part of research NIHR’s website or talk to your R and D office in the hospital who will be able to give you an idea as to the types of research going on the trials and types of research going on in your hospital and give you an opportunity to, so you can become aware of those and talk to them about your, with your patients or your clients.

Adam Smith:

And then of course as a healthcare professional or as a trainee, you also have the opportunity to go along to your R and D office I think or talk to the NIHR about practically getting involved. Whether you could give over some of your time to go and become part of that team that Brady talked about at the start of the conversation and get involved in the practical delivery of some of these trials. Whether that’s administering cognitive tests or being the pharmacist that’s involved. There are different opportunities there to practically get involved. It doesn’t mean you’re becoming an academic, and it doesn’t necessarily mean you have to lead your own trials, although I think Brady, would you agree, because I know Clive in your trust was brilliant at doing this, which is that’s a great gateway to going on to becoming a PI on some of these trials?

Dr Brady McFarlane:

Yeah, absolutely, absolutely. So, the whole environment there allows academic [inaudible 00:53:59].

Adam Smith:

And then of course other options, you can go to Alzheimer’s Society, Alzheimer’s Research UK, the NIHR, or one of the many other charities that fund clinical academics and consider doing a PhD which can be done in many different ways. Or you can even do that outside of the UK. Either working alongside clinically or fully leaving your clinical work to concentrate on your studies and funding is available for that and there’s some open and available within the NIHR right now. And those are the kind of main ways I think, and those are open not just to doctors but of course to physios, OTs, pharmacists, dentists, care workers. There’s also one for local authorities right now within the NIHR, so if you work in the local authority, there’s PhD opportunities for you to get involved and come up with your own research study there as well.

Adam Smith:

Okay. Antoinette, before I finish up, when we talk about resources, I don’t know if you’ve got any to think to this. Of course, I would argue Dementia Researcher itself, we have a whole page dedicated to careers called the careers festival, and in there are webinars, articles, blogs, links to, and it just jobs that become involved in research, lots of stories from individuals that talk about the paths they took, which will be, I hope, helpful to anybody who’s interested in getting involved in research. Is there anything else that anybody can think of?

Dr Antoinette O’Connor:

The ABN neuro trainees does a nice little website, it’s not on just dementia research but about navigating how to become involved in research and kind of tips. That’s a recently enough set up website there. I think it’s quite useful if you’re starting out and trying to figure out how to get involved in research. But absolutely, the Dementia Research Website is excellent and a really good resource for collating everything together and signposting to other sites.

Adam Smith:

So, you say ABN, is that the Association of British Neurologists?

Dr Antoinette O’Connor:

Yeah, the Association of British Neurologists. They have a subpage in their website for the neurology trainees and there’s within that a research page. I’ll email it to you afterwards maybe. That’s quite good about just generally getting involved in research. So yeah, the Association of British Neurologist trainee section and research.

Adam Smith:

Great. I’ll be sure to make sure that we tag that in the show notes as well. Okay, well I think we’ve given a great overview there to hopefully give you all an idea as to why you might want to become involved in research, the different ways you can become involved and practically what that might mean in your day-to-day life and in your work as well. And as I said, we’ll tag all the links and resources we’ve talked about along with this conversation so you can go and have a look at those on your own time.

Adam Smith:

So that’s all we have time for today. Research changes lives, saves lives and improves outcomes. The pandemic has massively increased research awareness and more people than ever have gotten involved in research during the pandemic with over a million people taking part in Covid research. There’s funding available and many opportunities to get involved. And this is a great time to diversify your career and get involved in dementia research.

Adam Smith:

So do visit dementiaresearcher.NIHR.ac.uk or go to NIHR.ac.uk to find out more. Thank you to our brilliant guests, Dr. Antoinette O’Connor, Dr. Brady McFarlane, Dr. Ross Paterson, Dr. Emma Broome, and Dr. Alex Tsui. Give them a follow, do take a look at the bios as well, which you’ll find on our websites. And as I said, do have a look in the researcher’s section on our website where you’ll find lots of other people that will be, have similar backgrounds to you or are whole happy for you to reach out. Thank you very much everybody.

Dr Brady McFarlane:

Thank you, Adam. Thank you very much.

Dr Alex Tsui:

Thank you very much, bye.

Dr Emma Broome:

Thanks Adam.

Dr Ross Paterson:

Thanks for having us.

Dr Emma Broome:

Bye everyone, bye.

Dr Antoinette O’Connor:

Thank you.

Adam Smith:

Great, well thank you all for listening and do let us know if you’re listening on catch up and you have any more questions do post them for us. Thank you very much and we’ll call time on today.

Voice Over:

Brought to you by dementiaresearcher.NIHR.ac.uk in association with Alzheimer’s Research UK and Alzheimer’s Society. Supporting early career dementia researchers across the world.

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