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Navigating a clinical research career, with Sam Irving and Victoria Butterworth

The King’s Clinical Academic Training Office (KCATO) supports health professionals who are navigating a clinical academic career. Dr Sam Irving, KCATO Associate Director, sat down with Victoria Butterworth, a healthcare scientist who was awarded a pre-doctoral fellowship from King’s Health Partners (KHP) Centre for Translational Medicine, to talk about their experiences of pursuing research as healthcare professionals.

In Conversation with Sam Irving and Victoria Butterworth

KCATO offers advice, best practice and information on navigating a clinical academic career. It’s open to all health professionals based at any of the organisations of KHP. Sam was recently appointed as KCATO’s Associate Director, focusing specifically on professions allied to healthcare – such as pharmacy, psychology and radiography. She is also a respiratory physiologist at the Royal Brompton Hospital and postdoctoral researcher, investigating small airways measurement in children with lung disease.

Victoria is a radiotherapy physicist at Guy’s and St Thomas’ NHS Foundation Trust. As part of this role, she looks after the technology used on the radiotherapy treatment pathway, helping to ensure that people with cancer receive the best possible treatment.

Last year, Victoria was awarded a KHP Centre for Translational Medicine (CTM) Pre-doctoral Clinical Research Excellence Fellowship, which offers one year pump-prime funding to allow protected research time and training for health professionals working in translational medicine. As part of the Fellowship, Victoria has been working on developing external funding applications to support her doctoral research. Her project is looking at using deep learning to predict recurrence in patients with head and neck cancer.

 

Sam: As a healthcare professional, when did you get the sense that research was something you wanted to do?

Victoria: When I left university, I knew I wanted to do a PhD at some point in my life, but not straight away. I wanted to do something more clinically meaningful, so I did the Clinical Scientist Training Programme and during that I did a Master’s project looking at risk stratification in lymphoma patients. I had an inspirational supervisor who’s a clinical scientist with an academic role, which made me realise that you can keep your clinical career and academic career - and they can work harmoniously together.

I then took a research secondment within my department, which is how I met my current supervisor, Dr Teresa Guerrero Urbano. That’s when we started putting the PhD project together.

Sam: I think with those of us from clinical backgrounds, that's quite common isn't it - that sense of wanting to do something clinical before a PhD? I wanted to establish my clinical work and then find a PhD that worked for me.

So far, how have you found having the CTM funding? What does a day-in-the-life look like for you?

Victoria: Having the CTM funding has been really valuable. It’s meant I’ve had the opportunity to step back from my clinical role to actually be able to focus on learning the basics of machine learning, getting some preliminary data together and writing my first paper. These are all vital steps in getting ready to apply for a doctoral fellowship, but they are not necessarily things you’d have the chance to do whilst working clinically full time.

I have fortnightly meetings with my supervisors where we discuss progress with the project. Between each meeting I usually spend a few days exploring and reading up on ideas from the previous meeting, and a few days developing code using Python. Recently, I’ve been putting together a grant application, presenting data in Python and writing up abstracts. I’m repeatedly assured that this all counts as science – though I must admit I do prefer the Python work to the writing sometimes.

Sam: And how have you found being slightly separate to your clinical department while you’re working on your PhD funding applications?

Victoria: That is something that has been different about pursuing the PhD project – not having a whole team around you as backup as you would in the clinic. But I think as I get further into my research, I will gain more research colleagues.

I do still get to work with my clinical department a little bit – we’re working on a project looking at auto-contouring in the radiotherapy clinical pathway. We need to map out where people’s organs are when they’re receiving cancer treatment, and we’re looking at different software that we could use to automate this task that we could implement in radiotherapy.

Sam: I felt the same early in my research career. I was the only one in my department doing research who wasn’t a medic, which was a bit of a shock to the system. At the moment, between my National Institute for Health and Care Research (NIHR) funding and my role with KCATO, I only have about one day a week with my clinical team. But I really enjoy that, because for me it’s about how those clinical and academic paths work together and what synergies there are.

Victoria: How have you found being a woman in science, and your new leadership role with KCATO?

Sam: I work primarily in paediatrics which tends to be more of a female-dominated field. That’s meant I’ve had several very inspiring female professors in my field who were there to mentor me and reassure me that this career could be done while being a woman, and who were also understanding of caring responsibilities.

In a lot of healthcare professions and hospital settings, there tend to be more women. But when you look at clinical researchers, the balance shifts a bit and there are more men. And looking across academia – not just at clinical academics – men are often in senior leadership positions even when they are drawn from clinical professions.

I think there’s difficulty with maintaining women in clinical academia. There are women in these professions who are competent, intelligent and career-driven, who are suitable for going into research, but not many of them try it. Or when they do, the systems aren’t always there to support them – so I think we need to do more to stop this drop-off.

It’s important that we get more women into research, and I think getting more healthcare professionals into research will help that – because more of us are women. It’s great to see schemes like the CTM and NIHR fellowship programme coming through to support clinical academic pathways, because applications are reviewed blindly and there are strong EDI components. And I hope that’s going to make it a lot easier to help keep women healthcare professionals in research.

How have your PhD application plans been going?

Victoria: I think we’ve got a robust project with different work streams and ideas of how the work could be translated into the clinic. I’ve written a Medical Research Council application so far and am currently working on an NIHR one. Each application has different requirements, with a slightly different focus. It feels like a very different world to writing a research paper, so it’s been a very steep learning curve!

Sam: And what is the thing you’re most excited about doing in your PhD project?

Victoria: One of the things we’re looking to do as part of the project is to build an auto segmentation model to try to outline the cancer on patients’ radiotherapy scans. This is currently done by clinical oncologists and takes around 60-120 minutes per head and neck cancer patient.

When planning radiotherapy treatments, we need to know where the cancer is and where the organs are to design the treatment plans to give radiation to the cancer whilst avoiding the healthy organs. There are commercial AI solutions which help with outlining the organs but nothing for the cancer itself.

The clinical ramifications of implementing such a model could be huge – so I’m excited to explore what the clinical and social implications of the work I’m doing would be.

Towards the end of the PhD project, I’ll be designing a clinical trial, which is something I’ve never looked at before – it’s something I’m looking forward to learning about and really excited to do.

 

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