Ability is of little account without opportunity - my journey from clinician to academic
There are many popular misconceptions about academic medicine. But you don’t have to be the cleverest of your peers or have a photographic memory and you certainly don’t need to be a social recluse to pursue a career in research. I know that because I’m now an Honorary Associate Professor in Paediatric Emergency Medicine. However, I didn’t receive distinctions or awards at medical school or at post-graduate level (and you’ll just have to take my word for it that I have friends!)
I’ve spent 18 years working in busy paediatric Emergency Departments and wards helping treat sick and injured children. It’s a job where there is joy and tragedy. My passion for the role comes from its rewards in practicing strong communication and a need for a positive mindset - children don’t respond well to grumpy doctors!
My path in research began when I entered an NIHR Academic Clinical Fellowship (ACF) in paediatric emergency medicine in March 2008, which opened the door to further NIHR research awards, training and development. My interest was triggered by a fellowship in Australia I had undertaken after obtaining MRCPCH (Member of the Royal College of Paediatrics and Child Health). I’d become increasingly interested in why doctors make certain clinical decisions and how these, at a system level, impacted on patient care. Essentially I believe research is just the natural extension of the conversations we have in the canteen, “What if? Why? And how can we?”
Protected time to develop research ideas
An ACF gives fellows access to Masters-level training for those wanting to develop a career in research alongside clinical training. This helps you develop academic competencies and decide whether a research career is for you. I was fortunate to have my own office - essentially a desk in a blood taking room with painfully bright lights and a buzzing ultra-low temperature fridge. But it gave me breathing space away from the nurses’ station and my bleep. It’s this protected time that is important.
Ownership and development of an idea by the ACF by fellows is considered good practice and I would say essential as it is both enjoyable and frustrating to develop a project. The learning process involves being able to formulate a research question which is practical, achievable but most importantly fundable. Many suggestions will be placed on a back burner as, they are just not possible in the time scale. Experienced advice is needed in order to develop your ideas and developing that advice is a useful first lesson. In my first year I had 42 distinct meetings with various individuals and groups and many more ad hoc encounters with my research supervisor.
Fate can play a big part in opportunity. I was lucky enough to become involved in a project called Spottingthesickchild.com - an award winning website containing hundreds of video cases of children to help educate doctors and nurses in managing the acutely unwell children. My question was “how do we know it’s actually any good?” Therein sparked a PhD proposal to develop a framework to evaluate e-learning interventions.
My initial research proposal was subsequently revised 13 times before an acceptable version was submitted for an NIHR Research Doctoral Fellowship.
The application was unsuccessful but during the next year my supervisor and I refined the question and developed a project group containing academics with specialist interests not present in my academic department. My second attempt succeeded.
Boosting clinical and academic skills
I enjoyed three years as a Doctoral Fellow fully funded by the NIHR. This opportunity allowed me to keep up clinical skills and develop a wide range of academic competencies, many leadership based, which have stood me in good stead for leading research grants now. After completed training I and was appointed as consultant in Paediatric Emergency Medicine in a job containing academic time. This was an NHS, rather than a University appointment and my employers felt my fellowship and academic experience would benefit our department.
Following this my research interests took a slight turn as I began to evaluate some of the improvement projects that I’d undertaken as a trainee.
Pathway to further research
What really keeps me interested in research, and clinical practice, is that my work is relevant to both. I’m not in the labs growing cells which have nothing to do with the patients I see during my shifts. Some of the research I’ve conducted I use day-in and day-out on in my job in the Emergency Department. This combination, and protected time in each, prevents burn-out and keeps me constantly engaged.
The best lesson I’ve learnt is to collaborate. I’ve been very lucky in being part of three NIHR funded grants, two as chief investigator. They all revolve around improving the recognition of sick children and they’ve brought together a solid group of people who enjoy working with each other challenging the misconception academia can be quite isolating. I’ve always enjoyed the community nature of the work I’ve been involved in. I’m glad now, as chair of PERUKI, a paediatric emergency research collaborative covering the UK and Ireland, I can apply some of this learning as solutions.
The next steps of my career are to develop my own research group and consider larger and more complex grants. I am very grateful for the ACF programme for allowing me to develop, succeed, and fail, in equal measure. I look forward to future challenges and further collaboration.
I’d thoroughly recommend taking your next step in research and applying for an NIHR training programme such as an ACF. The NIHR will support you with time, and the expertise, to develop critical skills such as leadership and project development you’ll need in whatever path of medicine you eventually follow. You don’t need to want to be a Professor for the programme to benefit you, but if it leads you there then that’s a great outcome!
My experiences can be summed up in this quote from Napoleon:
“Ability is of little account without opportunity”
There are so many clinicians who have the skills to make a difference in research, but you need to give them the freedom to learn and develop their skills to reach their full potential.
Damian Roland’s research includes:
Dr Damian Roland, Honorary Associate Professor in Paediatric Emergency Medicine, at Leicester Hospitals and University; NIHR Doctoral Research Fellow and former NIHR Academic Clinical Fellowship (ACF) awardee
To find out more about the campaign visit the Your Path in Research page on the NIHR website.
More information on the NIHR ACF is available online. Applications are open for the next round between Monday, 7 October to Monday, 4 November 2019.
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.