Research training support from NIHR Academy equipped a practising GP and clinical academic for doctoral research into improving primary care support for young people who self-harm.
Published: 08 February 2022
The NIHR In-Practice Fellowship offers pre-doctoral academic training to fully qualified GPs, GDPs and Community Dentists, to develop expertise in research alongside their clinical careers. It is one of three awards within the NIHR’s Integrated Academic Training Programme for doctors and dentists.
In-Practice Fellowship paves the way to a clinical academic career
Talking with patients about mental health problems every day in his surgery, GP Dr Faraz Mughal saw the potential for primary care research to do more to reduce the risk of long-term mental illness, particularly in children and young people.
For Faraz, as a GP with no prior formal academic role, the NIHR In-Practice Fellowship (IPF) was the perfect first step into a clinical academic career. The IPF funds pre-doctoral academic training, with award-holders splitting their time equally between training and clinical practice. Faraz explained:
I really enjoy seeing patients in general practice, however, I knew I wanted an opportunity to lead research on a topic I am passionate about. The NIHR In-Practice Fellowship was exactly the type of scheme I was looking for.
Patient perspectives on primary care
Faraz was keenly aware of the issues, having already published a number of papers on young people’s mental health. While around 10% of adolescents reported self-harm, it was thought that much more stayed hidden in the community, yet there was little research focused on primary care.
The IPF gave Faraz the support he needed to start addressing this research gap, providing funding both for research skills training and protected academic time. His academic base at Keele University facilitated skills development in areas such as methodological approaches, ethical approvals and academic writing. He also won a NIHR School for Primary Care Research (SPCR) Evidence Synthesis Working Group Training Scholarship to train in complex reviews at the University of Oxford.
Although the IPF focuses on skills training, Faraz was able to undertake some studies to help develop his application for doctoral funding and contribute to his attainment of an MPhil in Primary Care and Health Sciences. The MPhil was awarded by Keele University and funded by the IPF.
His systematic review concluded that although GPs recognise self-harm as a serious risk factor for suicide, some feel unprepared for managing self-harm given the multidimensional nature of their role in self-harm care.
A qualitative interview study, with research costs funded by a RCGP Scientific Foundation Board grant, then gathered the evidence of young people aged 16-25 who had previously harmed themselves. They reported mixed experiences in consulting GPs, which influenced how they sought future help. The study, published in The British Journal of General Practice, concluded that GPs can encourage young people to access GP care by establishing relationship-based support, through a deeper understanding of each individual.
Patient and public involvement was central to the study’s success. Faraz established and led a new group which improved the quality and relevance of the research by informing recruitment strategies, interview topics and interpretation of findings.
Reflecting on the experience, Faraz said:
“In my IPF I worked half my time as a GP in the NHS and half undertaking my IPF studies and training. I found continuing in clinical work provided insights that undoubtedly enriched my academic work.”
Next steps in research to benefit young people’s wellbeing
The IPF laid the foundations for Faraz to develop further research in this area, whilst continuing as a practising GP. In 2021 Faraz commenced an NIHR Doctoral Fellowship at the School of Medicine, Keele University.
Faraz says the IPF had a significant impact on his clinical academic development and future direction. His doctoral research aims to develop the ‘COPING’ intervention to be delivered by GPs. COPING is being developed in equal partnership with young people who have self-harmed and GPs, and will be tested in general practice. Faraz concluded:
“I see research as an integral part of my future career path, closely intertwined with my clinical work as a GP, so I am delighted to be able to continue my research funded by NIHR. I am excited by the potential of the COPING intervention to improve patient experience, increase GP confidence and skills, lower NHS costs and reduce self-harm, suicide and death in young people.”
Three years into his NIHR clinical academic career Faraz has a growing reputation for his expertise in young people’s mental health and primary care. He presents at national and international conferences and is a regular member of expert advisory groups and committees, including the National Institute for Health and Care Excellence (NICE) self-harm clinical guideline development committee.
Find out more about opportunities for doctors and dentists with NIHR’s Integrated Academic Training Programme.