Tuesday, 23 July 2019

My name is Gareth, and despite conventional wisdom, I'm a man trying to do two things at once.

Understanding how to become a clinical academic is not as straight forwards as it should be, unless you know one. I hope this blog can help. My name is Gareth, I’m an MSK physio, and I’m trying to become a clinical academic, and this is how I got ‘here’. Clinically, ‘here’ for me is being 39 years old and one of a dying breed of NHS physio’s. I’m a physio without an acronym. I’m neither an ESP, or an ACP, or an FCP, because ultimately, I want to be a physio. But I want to be a physio with the ability to challenge practice and try to answer some of the many questions I have, and luckily, I’ve stumbled across a way in which I hope I can do that……one day.

I’ve been through the standard clinical journey.
Phase 1 - Knowing nothing
Phase 2 - Immersion in as many paradigms for assessment and treatment as possible.
Phase 3 - Disillusionment with the lack of consistent outcomes and now thankfully,
Phase 4 – some peace with the uncertainty of clinical practice and often equipoise.

This long, expensive journey included numerous courses, lost weekends, a masters, quite a lot of reading; and you know what? It’s been great and I love being a physio despite the uncertainties. I remain jealous of those who have strong opinions, despite the uncertainty surrounding musculoskeletal diagnosis, mechanisms of treatment effects and how to measure them. I know I’d be a rubbish NHS manager and I’ve never wanted to be an ESP (as utilising more invasive treatments in this world of uncertainty doesn’t suit me). What I want to do, is see if I can answer just some of the questions, I have from clinical practice to improve outcomes for patients. It is this desire that has brought me ‘here’, on a pathway to hopefully achieving an NIHR fellowship. The journey so far has been a world of exciting opportunities and challenges that have given me the best years of my 18-year career. If you choose to read on, then do so knowing that this is not a ‘look what I’ve achieved’ kind of blog; and is far more of a ‘I really would like to raise awareness that these amazing opportunities exist for physios like me and Chris Littlewood twisted my arm a little bit’ kind of blog.
In 2014, having been a Band 7 physio for 10 years, I achieved a split clinical / research role which allowed me two days a week, working in the Research and Development team at my NHS Trust. Here I acted as site lead for physio-lead orthopaedic studies (principal investigator) and was provided with training on the practicalities of setting up and running a research trial. This mix of training and on-the-job experience whetted my appetite to start to do my own research. However, finding a vehicle for this ambition is not easy. In 2017, however, I discovered the Health Education England (HEE) funded Masters to Doctorate Bridging Programme (MDBP).

This competitive internship supports clinicians who wish to become clinical academics via the HEE-NIHR funded Integrated Clinical Academic fellowships (link below).  This internship provided me with 15 hours of taught lectures on a variety of research topics, gave me access to the University library, provided with a network of supportive people with the same ambition as me and most importantly, provided me with the essential academic support I needed in the shape of Dr Chris Littlewood and Dr Seth O’Neill. From this point onwards, despite numerous challenges, I haven’t looked back and I will now be applying for the Clinical Doctoral Research Fellowship in April 2020. A fully salaried 3-year training fellowship which will allow me to develop the skills necessary to become a researcher in my own rite, whilst developing as a clinician and ensuring that my role can be integrated into my department on completion.

Working with Chris and Seth over the last 18-months has been challenging and rewarding in equal measure. We first constructed a plan back in November 2017. A publication plan to answer questions that will inform a trial that will be part of my fellowship (should I be successful). So far, I’ve published 2 papers as lead author, presented posters at national and international conferences and completed my first platform presentation this year. I’ve got one or two papers in the pipeline and more presentations later this year. I’ve obtained smaller HEE grants which have funded travel, accommodation and training opportunities which have enabled me to collaborate with international experts in my field of interest (Greater Trochanteric Pain Syndrome, if you’re interested..).
The working relationship with my academic supervisors has gone well and has opened more doors for me. It has also enabled me to obtain a 10-month secondment at Keele University to lead on a qualitative research study which is embedded within a pilot RCT.

This experience of working in a Clinical Trials Unit, has also been invaluable. The chance to discuss and develop ideas with people from such a range of backgrounds is such a privilege and makes my clinical work even more rewarding. Even better still, I’ve met some great people and enjoyed a beer or two along the way. Its not been without its challenges. There are plenty of hurdles to overcome and juggling of priorities to manage. It’s also hard work; I feel like I’m almost doing a PhD, just to get on another one at times! But it has been really, really rewarding.

If you have got this far then part of you must want to pursue a career as a clinical academic. As you can see, my path has not been conventional. I took a split physio / research role almost 5-years ago now and only now really feel like I have some momentum. It can be challenging and frustrating and you HAVE to grow a thick skin pretty quickly! But there are opportunities out there that will help buy you time and most importantly, help you develop a team (YOUR TEAM IS EVERYTHING!). Once you’ve got those things then doors open and with a fair amount of hard work, you too could be ‘here’ or wherever it is on the clinical-academic pathway you wish to be.

If you’d like to get in touch about any of the above, please feel free. I’m happy to share my experiences; warts ‘n’ all.

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