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Good evening and welcome, everybody. My name is Alexander is a grand, and, um, I am the asset academic representative for this year, Um, and an academic trainee in plastic surgery at UCL and World Free. Today, we're delighted to welcome you to our preparing for a career in academic surgery conference. Um, we have five esteemed speakers who are going to be talking to you, um, taking you about across their experiences from across the whole pathway, starting from the SFP, right? The way through to professorship. So thank you very much for waiting. Without further ado, I'd like to introduce our first speaker, uh, Stephanie Smith, who, uh, is an academic doctor in urology. Um, is affiliated with the University of East Anglia. I was, uh, reading through, uh, through her research, a lot of excellent work looking, uh, prostate, Um, and also at stones. So I'm sure she'll have, uh, very many interesting experiences to share with you. Thanks very much, Alex. Uh, so thanks very much for inviting me to talk today. I'm going to be talking quite generically about the academic clinical fellowships as well as my own experience. Um, so I'll talk about about What? What the academic Clinical Fellowship program involves what my career journey to date has entailed, Um, reflects a bit about my A C f experiences so far what the advantages are of doing an a c f how to choose an a CF program, and we'll go through a bit about the application. Uh, and selection process. Um, so for those of you who don't know, um, the A CF program it's part of the integrated clinical academic training pathway. You can enter it between ST one up to S T three level, Um, typically last three years in duration. If you do it full time, it can be extended up to five years if you want to do it part time. The main benefit of doing it is that you get this 25% dedicated academic time to put towards research activities or medical education, and then you get your 75% protected clinical time. The main benefit all of this is it helps you to prepare for PhD fellowship posts or perhaps doing an MD. Or, if you've already got a PhD or further degree, you might want to prepare for a postdoctoral fellowship application so in terms of sort of looking at where this fits into the grand scheme of your surgical training, Um, you can see it comes after the Academic Foundation program or the Specialist Foundation program, as it's now called. Um, it is desirable to have done the Academical Specialized Foundation program, but it's not a requirement for application or selection. So, you know, if you've not done it, then don't let that put you off following the A. CF. Most people will go on to do either an MD or a PhD before then going on to a clinical lectureship, although some people do revert back to the clinical training pathway after doing an A C F. So it doesn't commit you to forever being on the academic pathway. So in terms of my journey so far, um, so I went to medical school back in 2009 at Cambridge, and that was when I first got my first taste of research. Um, I also did the welcome trust vacation student ship. So during the summer holidays, um, I spent a bit of time in the lab. I didn't integrate a degree in pharmacology. I then went on to do the academic foundation program in the Cambridge region. So I spent my F one year in Peterborough Hospital. My first job as an F one was in neurology. At that point, I didn't really know what specialty I wanted to do. Um, I went on to do my F two in Adam Brookes in Cambridge. Um, and at that point, um, I actually had a translational medicine themed academic foundation program. But at that point, I'd done my MRCS, and I was looking towards surgical career. Um, so I arranged to do a four month research placement in the transplant department. Um, then after that, I wasn't quite sure whether I wanted to do general surgery or urology, so I applied for generic court surgical training. Uh, got another job in the east of England. Um, so I did 12 months of general surgery. 12 months of urology. Um, at that point, I committed to urology as a specialty, applied for specialty training, got a national training number up in the northwest. So I moved up there, um, spent a bit of time in Crewe up north, Um, and then the job that I currently have, um, down in orange got advertised. So there was an A c f post, um, at the ST three entry point, which I applied for. And that's where I am now. So at the moment, I'm Nestea five. Um uh, a CF, which is in an eye, a child post. Um, And as I said, 25% of my time, I can put towards research and academic activities and then 75% of the time, um, is your standard clinical training? Um, So in terms of the clinical work, it's what you would do as a registrar. So a mix of elective and emergency theater participating in the on call emergency take doing flexible cystoscopy is outpatient clinics, Um, and then in terms of academic work in knowledge, they fund you to do a part time MSC and clinical research at U E. A, which is really good. Um, so that's a modular course. Um, it's assessed partly through exams, coursework, and then the final year, which I'm doing at the moment is a dissertation. Um, and then, in addition to that, I'm doing some lab based research at the Bob Champion Units, which is just across the road from the hospital. So, um, my research interest is in prostate cancer diagnostics. Um, prostate cancer is the most common cancer affecting men in the UK. Um, one of the issues is highly heterogeneous disease. So some men have prostate cancer, which is very slow. Indolent doesn't cause many problems, But then other men have a very aggressive disease which can rapidly metastasize. And as many as you know, the most common bio marker for prostate cancer is P S. A. But this isn't perfect. It can be raised for all kinds of things other than cancer. The other issues that the investigations for prostate cancer, such as, um, prostate biopsy, have side effects. The main treatment for prostate cancer, uh, prostatectomy and radiotherapy also carries significant side effects. Um, urinary incontinence, impotence, which can really impact patient quality of life. So one of the key clinical challenges in the field of prostate cancer is how can we reliably identify those patient's with the high risk disease and avoid unnecessary investigations or overtreatment with those with the low risk disease? And what this has done is it's driven research into the development, um, and validation of non invasive biomarkers. Um, for both diagnosis as well as risk stratification, uh, and disease monitoring of Patient's on with prostate cancer. Um, so a lot of the work at U. E. A. Uh in the Cancer Genetics group, which is led by Professor Cooper, has been looking at a novel urinary biomarker called the Prostate Urine Risk. And this is a 38 jean readout, which is based on prostatic micro vesicular RNA, which is extracted from the urine. The main benefit for this is it's entirely noninvasive. It can even be collected at home. Um, so what I'm doing at the moment is preparing my doctoral fellowship applications for PhD study and onward funding. So I'm hoping to apply to various funders, the N H R M R, c and welcome trust. Um, and what I'll be doing is investigating the prostate urine risk biomarker as a predictor for clinical outcomes in prostate cancer. So I'll have to two aspects of the project. I'll be looking at 10 year outcomes from a cohort of patient's. You had the urine test done back in 2012 and seeing what happened to them and the other aspect of my project will be looking at a separate cohort of new men having this urine test and seeing what the role of this test is in active surveillance of prostate cancer. Um, in addition to all of this, I'm doing a systematic review and meta analysis as part of my dissertation for the part time MSC. So what have I gained from my a c f Quite a lot. So, um, clinically, obviously, I've progressed in terms of my urology specialty training. I'm now at S t five. I've had the benefit of having a fully funded MSC in clinical research doing that part time at U. E. A. Um, in terms of academic work, it's enabled me to have a really thorough background knowledge in prostate cancer diagnostics, terms of lab work. I've developed lots of different skills, Got some preliminary data, attended the fortnightly lab meetings. I've been able to establish collaborations with different urology units to collect urine, which will hopefully be useful for my intended PhD project. Got a couple of manuscripts in preparation for journal publication. Um, I've had lots of networking and presentation opportunities, both locally and further. A field. Um, and I've also had the opportunity to do some PPI work with our prostate cancer patient support group. So, um, the A C F is potentially quite a busy time. Um, which leads me onto the the challenges potentially that you might face during an A C f. Or indeed, at any point in your academic training. And I think it's important to say that you need to be very organized from day one in order to successfully juggle all of the demands of being an academic surgical trainee. Um, so making sure that you're up to date with your log book your S C P u A R C p targets. Making sure that you're keeping to your MSC deadlines if you're doing an MSC, um, different sceneries obviously do different things in the east of England. It's very trainee lead. So, um, we have to do monthly presentations at the Dean. We teaching on different topics for the F. R C F F R C s preparation on the academic side, um, you'll have to keep up with your research supervisor expectations bearing in mind that they probably think you're not there all of the time because you're busy in the hospital. Um, you also have to do your PhD application preparation, which is quite a lot of work. You might have internal university review deadlines in addition to the funded deadlines, but also bearing in mind that this is an exciting time potentially for life outside of work. Um, So, for example, recently, we've done a house renovation project, and this here is our dog that we adopted last year. Um, so why should you do an A C F? I think the key thing really is it gives you that protected academic time. Um, and that's really important to. Firstly, if you're not sure about whether you want to commit to research for the rest of your career, I think that's a great opportunity to figure that out. If you're if you are sure it's then it's a perfect time to develop your PhD proposal. It's a time where you can get some formal training as well in research methodology, Um, and the thing that I've really found very helpful is that you can get both the NIH are and university support when you put together your PhD proposal, Um, most a CFS come with funding for conferences, courses and your local academic training offices as well will have different opportunities to network and training opportunities locally as well. Um, depending on what what stage you're applying, this might be more of interest. So if you're applying at the CT one or ST one level, it also will come with a national training number, which might be an extra perk of doing an A C f um, which leads me onto When is the best time to do an A C F. Because the posts do vary between ST 12 S. D. Three. Um, I don't think there's a right or wrong answer. Um, advantage of doing an A c f earlier in your training means you could potentially do your PhD earlier. Potentially get a lecture ship post earlier in your training. Um, like I said, it comes with a run free training number, which might secure your job in a particular Dean ary, if that's what you're looking for. Um, doing the A c f later in your training. Um, I would say it's it's beneficial because you have more clinical experience, so you probably have a better idea of what it is that you want to research. Um, you probably at that point as well should have already acquired your core surgical skill set as well. Another factor to consider is if you're doing your PhD at a later point in your career, potentially, you'll be having a higher salary whilst you're on the PhD fellowship because you're. If you're successful in getting the funding, then generally the funders will match your clinical salary. And so how do you go about choosing an A CF program? I think the first thing you need to be sure what specialty you want to do and figure that out first, Um like like I said I was coming in are in between general surgery and urology for a while. Um, then when you know what, What specialty, What entry point. You can have a look at the jobs that are available and decide based on those which locations are of interest. Um, I think once you've got that shortlisted, then it would be worthwhile contacting, um, those areas to find out various things. So what training opportunities are available? Um, you want to find out what the format is of the protected academic time because this can vary quite a lot between different places. Um and and the other thing to find out is whether that's flexible. So when I did my job initially, it was day release. But I found that that wasn't too helpful in terms of making progress with lab work. So, um, in S t four and ST five rather than having day release that's been converted to a three month block. Um, but it depends on the nature of your research. If you're doing something more clinical, you might find day release or week release might be better for you. Um, I think it's really key to find out in as much detail as you can, what the research is that is happening in that institution. Um, find out who the supervisors are, what their interests are. Um, what previous academic trainees, if there are any, what their experiences are of working there, um, in terms of how to apply, it's all very transparent on the, you know, a child website. In fact, everything that you could imagine including the interview questions themselves on the website. So definitely have a look at that if you're interested. Um, and the jobs themselves is it's all done through Oriole. Um, the form comprises of there's some factual information that you have to fill in, as with most your medications. And then there are a few white space questions and that will be mapping to the criteria that they will be short listing you against. So, uh, we've already covered a bit of this tonight, but clinical experience, your degree in a relevant subject area Prizes, teaching experience. Um, any scientific publications presentations. And then you'll get a score for your overall academic experience and potential in terms of the interview if you're successful in being shortlisted, um, this is about 30 minutes in duration. You have a panel, probably about four or five people. Before you go into the interview room, you'll be given a bit of data or an extract from a paper or abstract, and your interviewers will ask you about the data to see whether you can explain it to them. Um, they'll also want you to explain that to a lay audience. They'll be assessing your ability essentially to communicate, um, with with different with different audiences. Um, I would say Don't be surprised if it's if it's something that isn't directly related to your job post so when I applied, I think my abstract was in respiratory medicine, which which took me a bit by surprise. But the questions were quite generic. Um, they'll also ask you about your academic achievements and your research experience for the knowledge job. I was given a bit of time to prepare a presentation, so they wanted me to give a short presentation. Um, my past research experience. Um, in addition to that, they will ask you some general questions about your area of interest in research. Um, I want to find out if you've read any articles recently demonstrating your knowledge outside of your specialist interest. Um, you'll also get a question about balancing clinical and academic responsibilities. Um, and I also had a couple of clinical scenarios in my interview as well, depending on what level you are and what level you're applying for. You may also have to have another interview, which will be the clinical benchmarking interview, and that's if you don't already hold a national training number. So what that means is, let's say you're a left to and you're applying for an S t one general surgery a CF. You'll also have to undergo the court surgical interview. But all you have to do is get an appoint a ble score in the corsage court interview. It's just to show that you're clinically safe. Um, in terms of recruitment timelines and things, Um, I believe the applications have have closed. Now for this year. Um, we're now into the interview. Um, period. Um and then I think the office will be in January 19th of January is what's been published. If anyone's interested, I would strongly recommend having a look at the NIH are website because it literally has everything. Um, in terms of the interview, I found out of all the job applications that I've done so far. In fact, the questions were very much what was posted online compared to there wasn't much. That was unexpected. Um, thank you very much for listening. I can see there's a question from Omar. Do you have any resources to practice critical appraisal skills? Um, what I did in terms of preparing for the interview. Um, probably about a month before I would have a look at the New England Journal of Medicine. Uh, and Jama and I was on their email, um, mailing list and I'd have a look at abstracts and then sort of think, what kind of questions could I be asked and challenge myself to try and explain it to a lay audience? So that's what I did. Um, how much time do you get to digest the data? I can't remember, but it didn't feel very long. I think it probably was longer than I expected. Probably five minutes or so before, Um, what sort of clinical question do you get in my CF? So I was obviously applying for a urology job. The question that I got was about a patient with your, Oh, sepsis and the clinical scenario. So they asked me, how would I approach it? Um And then they asked me some specific questions. Like, what investigation would you do next? Um, what would you like to do? What? What management would you do next? Um, I thought it was relatively straightforward. I think it's just assessing that you're competent and managing emergencies. Really? If anyone else has any questions more than happy to you're welcome. I have a question, if that's ok, um, what's the next step? Once you complete your your a c f. You were you were hinting at doing a PhD, but interested to hear what? The next step? Yeah, I'm hoping to do a PhD, so I'm looking to do a PhD, probably in October of next year. I'm just basically, I'm working towards the January February MRC and I HR. Fellowship deadlines. Um, so I suppose it will depend a bit on what what the outcome of those are. But that's what I'm hoping to do going forward. And is that at the same unit as your Yes. Yeah. And in terms of your project, I know you're doing a masters and you're currently doing in a cf. How do those align is a natural continuation of your current project? Yeah. I mean, the masters, it's, um it's something a little bit separate that this is all the side kind of thing. But I've been working on the prostate. You're in risk research. So that's sort of where I'm hopefully going to be doing my PhD amazing. Well, I see another. Another question about what a clinical lectureship means. And I can let you answer that if you like Stephanie or if you want to defer, we have two speakers. You that question will be answered very well. Where People coming after me. You can. But that will be I mean, the clinical lecture ships there with the next phase after the CF in terms of your integrated academic pathway. So typically they have 50% academic time. Uh, and you spend 50% of your time, uh, doing clinical? Do you have to take, um, in terms of taking years out? I think it obviously depends on what your job format is in terms of the the MSC that I've done. I've not had to do additional time as such to do that because I've been doing it on a part time basis. Um, in terms of a PhD, I think most people try and do that full time. I don't I think it would probably be quite difficult to to do it part time alongside clinical training. Um, I don't I'm not sure if anyone else has any experience with that, but I'm not. I'm not meant anyone that's managed to do a part time PhD alongside surgical training, but what you can do is what I'm doing at the moment is apply for a funded PhD fellowship, which Essentially, you get paid a clinical salary whilst you're doing the PhD research, which I think is what a lot of people do. But that is time out of training. Yeah, there's a whole There's a whole spectrum. I I do know people who've done PhDs alongside, uh, training. Um, it's an individual discussion. It depends. You know, once you get to the realms of postgraduate medical training, a whole load of other things come in in terms of life considerations. If the individual is able to sort of balance having a PhD and full time clinical training, which will be very, very challenging, Um, then I think they do proceed with that. But I think the majority of people take time out of training for it. But it's It depends on the individual. So, um, that's great. Thank you very much, Stephanie. A very interesting talk, very to hear about. Your units work on on prostate cancer as well. And I do look forward to reading about that. Um