Case study: Finding the balance of a clinical academic research career
For thirty years Lesley Katchburian has worked in the field of paediatric neurodisability and since early on in her career clinical research has always been a key element of her work. She is now leading a research study in her role as Lead Clinical Physiotherapist in Neurodisability evaluating the effects of Botulinum Toxin A Injections (also commonly referred to as ‘Botox') on children with cerebral palsy at Great Ormond Street Hospital (GOSH). Lesley has provided some insight into her path in research including being the first Allied Health Professional (AHP) in her organisation to be awarded the HEE/NIHR Clinical Doctoral Research Fellowship in 2016.
Early career in research
“As a physiotherapist, research is embedded in training from an undergraduate level and it was always an area that I was extremely interested in. But I also knew that I wanted to practice clinically.” Lesley said.
Early in her career, whilst working in community paediatrics Lesley gained a master’s degree in physiotherapy which only added to her passion for carrying out clinical research. Interested in contributing to the evidence base, her thesis centred on the management of increased tone (muscle stiffness) in children with motor disorders; exploring the impact of Botulinum Toxin A treatment on improving the motor abilities of children with cerebral palsy.
Lesley did however experience some challenges in undertaking both clinical and academic roles, she explained: “In the past there weren’t many opportunities to follow a clinical academic career pathway, roles were formally defined as clinical or academic with little opportunity to combine the two at the same level for AHP’s. Fortunately, my role at Great Ormond Street Hospital together with the support of a multidisciplinary team has allowed me to be involved in clinical research alongside my clinical role. These days it is becoming easier for AHP’s and nurses to pursue a clinical academic career and the NIHR provides lots of support with many more opportunities available.
“At GOSH we are fortunate to have a special unit – (the Centre for Outcomes and Experience research in Children’s Health, Illness and Disability (ORCHID)) - which is committed to supporting nurses and AHPs wishing to get involved in all levels of clinical research,” she said.
“I was privileged to be accepted onto the first ORCHID writing internship which was supported by the National Institute for Health Research (NIHR) GOSH Biomedical Research Centre. This opportunity gave me protected time to work on my application to the NIHR to apply for funding to carry out clinical research for patient benefit.”
Gaining an HEE/NIHR fellowship
In 2016, Lesley was awarded an HEE/NIHR Clinical Doctoral Research Fellowship and she is now over halfway through her five-year PhD which is continuing her work exploring the use of Botulinum Toxin A in paediatric motor disorders. She added: “I’m fortunate to be able to carry out my PhD research within my clinical area, with the support of my colleagues in the Motor Disorders Service at GOSH.
“We understand, to a certain extent, what the effect of injections are at the muscular level and their potential ability to temporarily relieve muscle stiffness and pain in the short term but we need to evaluate how these injections affect children in the longer term and ensure that we include outcome measures that reflect differences that are important to children and their families.
“Ideally the next step after my study would be to do post-doctoral research, continuing in a clinical academic role at GOSH in order to compare the outcomes from our core data set at GOSH to outcomes at other hospitals throughout the UK.”
When asked what advice she would give to early career researchers, she said: “There are lots of people out there who are willing to help and support you, so take advantage and build up your networks. Seek out your Trust’s research and development team, talk to your colleagues and look at what support is available from national and international organisations. Look out for mentors who can encourage you in your research journey, and remember, they don’t necessarily have to be in your field.
“One of my biggest tips is to take advantage of all the opportunities that come your way. Don’t be afraid to put your work forward for publication in specialist journals or newsletters or to present your research ideas in the form of posters or oral presentations.
“You should also take advantage of the array of support available within the NIHR. Speak to your local Research Design Service, the NIHR Academy or local Clinical Research Networks.”
What’s next for Lesley
Lesley maintains her desire to continue her clinical academic career on completion of her PhD. She feels research is important to ensure that treatment is evidence based and helps guarantee that patients are getting the most effective and up-to-date care.
She added: “I don’t think research should be an add-on, it’s an integral part of clinical practice.
"It is extremely encouraging that there are more opportunities for AHPs and nurses to have the chance to get involved in clinical research both here at GOSH and throughout the UK. However, I hope that in the future even more clinical academic roles will become available which will result in further opportunities to combine clinical research with senior leadership roles for all professional groups."
When asked if she would recommend an NIHR fellowship to someone considering a clinical academic career, she said: “The NIHR fellowship has been a fabulous opportunity for me and my clinical team; my clinical role gets backfilled which gives me protected time to do the research but still be involved in patient care.
"There is a great degree of flexibility within the fellowships with an opportunity to study part-time or full-time depending on your study design, personal circumstances or clinical commitments -however as clinical commitments are covered there should hopefully be minimal disruption for the clinical environment and patient care as the clinical side is protected.”
Lesley also appeared in episode four of Paul O’Grady’s Little Heroes, watch her talk more about her work.
To find out more about the NIHR's Your Path in Research campaign visit the NIHR website.
More information on the HEE/NIHR ICA Programme is available online.