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Summary

This informative on-demand teaching session focuses on academic and research opportunities in genitourinary medicine and HIV. Med student and speaker Lucy introduces speakers Professor Vera and Dr. Coley, who have extensive experiences in this medical field. Professor Vera introduces his professional journey from an interest in infectious diseases and HIV to becoming a clinical academic. He stresses the importance of ongoing research to tackle global challenges in HIV and sexual health, mentioning the current neglect of sexually transmitted infections (STIs) and the strain HIV puts on global healthcare. The session covers basic scientific research, applied health research and the social sciences, discussing how each of these fields intersect within HIV and sexual health. He explores how climate change, conflict, and socio-economic challenges are interconnected with health outcomes. Those interested in tackling these significant issues in HIV and STIs would greatly benefit from this session.
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Description

Would you like to be at the forefront of new GUM discoveries? Do you want to push the boundaries of sexual health knowledge?

If you have ever thought about getting involved in academia and research as a student, trainee or during a career in GUM, this is the talk for you!

We will be hearing from Professor Jaime Vera (Professor of HIV medicine, Consultant Physician) and Dr Manik Kohli (Clinical Research Fellow & GUM SpR) as they share their experiences as GUM doctors and researchers.

Meet the speakers:

Professor Vera

Jaime Vera is a chair in HIV medicine at Brighton and Sussex Medical School. He obtained his medical degree from the Columbian School of Medicine followed by training in general internal medicine in London. In 2008, he was granted a National Institute for Health Research (NIHR) Academic Clinical Fellowship in HIV Medicine at St Mary’s Hospital, Imperial College London, where he subsequently completed his specialist training in HIV and Genitourinary Medicine. In 2011, he was awarded Wellcome Trust Translational Medicine and Therapeutics Fellowship. During his PhD, he investigated the pathogenic mechanisms associated with neuroinflammation in HIV using novel brain imaging and immunological approaches.

Jaime is also a Consultant Physician for the Lawson Unit at University Hospitals Sussex NHS Foundation Trust where he is the clinical lead for the combined HIV and geriatrics, neurology and memory clinics. Jaime is also an investigator for the Clinical Research Facility based at the Royal Sussex County Hospital, and the research lead for the Department of Global Health and Infection.

Dr Kohli

Dr Manik Kohli is a Specialty Registrar in GUM and Clinical Research Fellow at UCL. He studied Medicine at the University of Edinburgh, and later completed an MSc in Reproductive and Sexual Health Research at London School of Hygiene and Tropical Medicine. Dr Kohli started higher specialty training in GUM in 2019 and was appointed an NIHR Academic Clinical Fellow at UCL. Dr Kohli’s clinical and research interests include HIV treatment, LGBTQ+ health, and STI epidemiology, treatment, and prevention. He is undertaking a PhD focused on antimicrobial resistance and microbiome impacts of antibiotic STI prophylaxis.

Learning objectives

1. Understand the global impact of HIV and sexually transmitted infections (STIs) and their associated morbidity and mortality. 2. Comprehend the importance and scope of academic and research opportunities in genito-urinary medicine and HIV. 3. Explore the different facets of research in genito-urinary medicine, including basic science, clinical research, applied health research, social science research, and global health research. 4. Appreciate the role of advocacy in influencing policy changes and improving access to the treatment of STIs and HIV. 5. Recognize the current challenges in the field of HIV and STIs, including climate change, war, political changes, and migration, and how they affect access to treatment and prevalence of infections.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Why is this? For some reason, my dog turned the television on. I don't know how that happened. Hi, thank you for coming in tonight's talk um which is academic and research opportunities in go. My name is Lucy. I'm a Birmingham med student and also the Birmingham ST ambassador. Um Tonight, we have two speakers, Professor Vera and Doctor Coley. Um and just a reminder to everyone, you'll get a feedback form for tonight, which is really important to fill in um both the speakers and the stash um for future talks. Professor Jamie Vera is Chair of HIV Medicine at Brighton and Sussex Medical School. He obtained his medical degree from the Columbian School of Medicine, followed by training in general internal medicine in London. In 2018. He was granted National Institute for Health Research Academic Clinical Fellowship and HIV at Saint Mary's Hospital at Imperial College, London where he subsequently completed specialist training in HIV and genitourinary medicine. In 2011. He was wa awarded the Welcome Trust Translational Medicine and Therapeutics fellowship. During his phd, he investigated the pathogenic mechanism associated neuroinflammation HIV using novel brain imaging and immunological approaches. He's also a consultant physician for the Lawson Unit at University Hospital, Sussex NHS Foundation Trust. Where is the clinical lead for Combined HIV and Geriatrics Neurology and memory clinics. Jamie is also an investigator for the clinical research facility based at the Royal Sussex County Hospital and the research lead for the Department of Global Health and Infection. So hand over you first to talk about. Well, thank you very much. That's quite a long introduction. Maybe next time I just have a short biography, but thank you very much for inviting me. I'm just gonna check the slides and then we can just and mm mm. Ok. Shut screen window. Mhm. Let's have a look. What do I do? Check the PDF? Is that the best thing to do? Yes, it does. Ok. So I don't I don't think try again J PDF. Just a slight it's uploading. Really sorry. But uh I think this is a a good opportunity to talk a little bit about um what an academic career in janitor medicine and HIV is like and what sort of opportunities are out there for, you know, for students and other doctors that are interested in, in pursuing this is um this path. So maybe you can listen to my biography, you could see that I have a little bit of that journey from an interest in mainly infectious diseases and HIV and sexual health to actually becoming a a clinical academic and and and doing the research. So let's talk a little bit about why doing academic career in HIV and sexual health. I mean, I think it's very clear that there is still a lot of issues going on for a start as S TI S sexually transmitted infections globally. It is still a big problem. And I would say that is one of those neglected conditions or neglected diseases, but we know a lot of attention is going into it, but there is a lot of issues with morbidity and mortality associated with ST is, that's not even talking about HIV, which is perhaps essentially transmitted infection that you're more familiar with and the global impact this is having because there is still about, you know, between 39 and 40 million people worldwide that are living with HIV. And we still get quite a lot of diagnosis. There's been a lot of progress and in terms of the management of HIV, with a lot of people accessing antiretroviral therapy. But then we're gonna have new challenges ahead which again need to be investigated and need academics to be able to investigate and similar in terms of sexual health. And uh uh and, and TI S there is a problem with access, particularly of key populations to testing and access to treatment and linkage to care. And that's one of the biggest problems that we have because a lot of the tools are still out out there. But the problem is that the people that really need them they are not accessing them. Ok. So I think, you know, sexual health and HIV is, is great in terms of research because I it's so varied. You can look at it from the basic science side of things and, and you know, in my own experience, I did a little bit of that with my P HDI. Did brain imaging look, you know, investigating neuroinflammation in people with HIV. So I have to recruit patients to do that. I did some work, you know, some animal work as well. Uh did of working in urology, you have to kind of go to the lab and do some petting and so on. So you can do a lot of things with basic science. And similarly, a lot of issues with clinical research which involves mainly just recruiting patients testing different medications, testing different info in in different interventions. There is a lot that you can do in terms of applied health research and this is about how you use and translate all those findings for basic science, all those findings for clinical research, how you implement that in clinical practice, how you make it actually work in clinical practice. And I think this is very important and something that um it is is perhaps perhaps a bit more rewarding as a physician because was a clinical academic because you actually can see how an intervention can have really an impact on, on, on people's and patients lives. Uh and that is important and I think this, this, um, academic and sexual health and HIV allows you to do that as we know S TI S and again, HIV as well. Um, they have a lot of intersectionality with social issues with, uh, even political issues and I think social science play a huge role and I think there is a lot of branches of social sciences. I tend to kind of go and investigate these, these, these aspects of uh sexually transmitted infections and, and HIV. And as it is, we know, it is an infection, it's a communicable disease. So it has to do with public health as well and all the aspects of infections, but also all the aspects of sexual health, including promotion of sexual health, contraception and so on. II would I would argue that global health is all the, all the health that we do even within the UK. But there is aspects of global health that are very important in this, not only the burden of HIV, affecting um places particularly in the global South, but also the impact that S dis are having in places where they don't have all the resources to be able to kind of identify diagnose these conditions and even treat them properly. There is the concepts of planetary health that sometimes get a little bit mixed up with global health. It's, it's kind of similar, it's about taking into consideration of other aspects of, of, of globality, really like the environment, for example, like social issues we talk about and social determinants of health and so on. But I think one really, really interesting aspect of research in, in, in ST is and sexual health and HIV is the advocacy role that we all play as investigators. And I think that has been something that has been very, very much the case in HIV, just writing the agenda trying to kind of move uh policymakers to change the way that we do things. I mean, one aspect, for example, you, you, you've been kind of connected to the news recently is the, is the fact that because of advocacy work because of work from the community and also from researches, you know, the government has actually provided quite a lot of resources to perhaps, you know, have, have an opportunity of eliminate HIV transmission. Uh One of these things is about doing testing of uh of HIV, opt out testing in emergency departments. So that again, is, is it that advocacy that we, that we, that we can actually all do working together with the community and that's something quite unique about HIV and sexual health because again, it, it tends to affect vulnerable populations. See, and there are many challenges ahead, right. There are lots of challenges ahead. We start thinking about the possibility of eliminating HIV transmission by 2030. We even talk about, you know, how can we eliminate conditions that we know are the conditions that can be treated with antibiotics as easily as syphilis, for example. But one thing that you need to think about the challenges that are ahead is what is happening in the world. Now, climate change, for example, people in places like in the global south, places in Sub Saharan Africa where we are doing some work. Um they are struggling with drugs, they are struggling with, you know, finding water in some places. And the least thing that a person that is living with HIV is gonna think about if they don't have a job and if they don't have water, it's about taking anti therapy. So I just give you an example of how all these things are interconnected and how many opportunities are out there to be able to go and investigate that we know the impact that also working have the significant impact that can have in, in, in, in health systems. And I think an example of that is the work in Ukraine, for example, where a lot of people living with HIV in that area have to actually very quickly have to move to Poland to be able to access care because there were no opportunities in, in a lot of these places to be able to actually get access to treatment quite safely. And again, political changes and you know, L GTD rights or the fact that in some places like in Eastern Europe, it is difficult to access antiretrovial therapy. It is gonna have an impact in, in rates of, of HIV and other conditions like tuberculosis and similar est is so you can just to kind of give you an interest on all these things that are happening right now that really need really enthusiastic and motivated academics to go and investigate and, and this is what's happening as well. I mean, we are facing this right now with lots of people moving across the channel. I mean, there were some news about a boat yesterday, 100 and 80 people that were trying to, to cross the channel. About three of them, I think that died. And you know, all these people are very vulnerable as well. They've been traveling for a long time. There are issues about access or poor access to things like sexual and reproductive health. We know that for example, a lot of the populations are actually uh uh from refugee and asylum seekers that actually get HIV they don't get it in the place of origin. They actually are getting it uh during the the movement that they are having and all these things are gonna need again work and we are doing so work in this area at the moment and even in places like Colombia, for example, where about 2 million refugees from Venezuela ended up kind of crossing the crossing the border to Colombia, really, really having a significant impact in health systems in terms of access to antiretroviral therapy for example, and even things that in Colombia were not seen for many, many years, like loss of these AIDS, aids, diagnosis or opportunistic infections that are caused by HIV. Again, lots of research that can be done in this area and just to give you a flavor of the challenges that are ahead and all the opportunities that might be out there for, for you if you are interested in, in, in sexual health and HIV, to actually go on and investigate. Uh we have a problem. We have a problem in terms of research really, in terms of equality, equity and reality. We have an issue about social determinants of health. And I think we learned a lot about this during the COVID pandemic, we, we realized actually a lot of the differences between groups were not caused by COVID itself. But other things like economic stability, like social and community support, access to health care, even issues about the education and access and quality of education and also the racial and health inequalities as well. So this is becoming more and more important and it's an area that is very under research. But also the fact that a lot of the research that we're doing, we're doing it mainly in the global North for some conditions. And, and at the bottom here, you can see just uh a piece of work that one of my phd students did. Just looking at all the studies in aging and HIV that essentially have been published. And you can see here that the majority of these studies have been done mainly in the US and Europe, very few of them have been done in places where actually the burden of HIV really is, which is in, in, in places like the global South. So there is a need for a lot of investigations to actually go and, and you know, provide that data, we, that we need to be able to inform um interventions and policy makers in those regions. Because it's the only way that we would really be able to not only improve quality of life for people with HIV, but actually reach those goals of eliminating things like HIV transmission. It's the only way we can just kind of work together. So what are the research opportunities out there? Then if you are a medical student, if you are just in the early years of training, what are the research opportunities out there? And I want to just to start with this because there is uh a pathway that wasn't really there when I just started um kind of my journey and it really is about how can we integrate academic training within clinical training. And this is what I don't know, some of you might be now in medical school and it depends on which medical school you are, you will have opportunities to do some research and to get involved. Uh either by doing a PSE or uh doing a an independent research project. Like it is, for example, in, in, in Brighton and Sussex Medical School with medical students can actually do an independent research project. And uh I think year four, year four, year five, they can do this. So they can, you can start getting involved as well. We have a student that sometimes just come and want to work with us just for the summer and do a small project. So you have an interest in academic curiosity, which is absolutely important. If you want to do academic medicine, the best thing to do is just to just to email people just if you are interested, you know, in sex health. Um If you, you can just email one of the academics and I'm sure that they will be able to kind of help with any project. There is always a need for motivated um sort of individuals to actually help us to either collect some data and so on. And you can start learning that getting a flavor of what it's like actually getting hold of some data and going through the whole process once you cannot leave medical school and you enter the foundation program, there is the academic foundation program and F two and F one and F two. And we do get um a lot of academic foundation doctors rotating to our service to do AAA PERIOD, a protected period of research. And that's why important because it means that you have an opportunity to have three months or four months of our rotation is gonna be attached to research. We don't necessarily need to do any clinical work. You will essentially will be doing um a piece of research and we've been quite successful with some of our foundation doctors. Um Normally, when they contact quite early, we can start planning a research project. And by the time that they start the, the foundation program and and the rotation, they are essentially ready to go and, and they usually end up, you know, learning through the whole process, how to design the study, how to write ethics, application, how to write the protocols, how to set up the study, how to conduct the study and then how to kind of analyze the results and then disseminate them. And I'm gonna show you an example of a few of my own sort of foundation doctors that having that up and pretty much doing the whole the whole journey of integrated academic training pathway. Once you finish academic foundation program, you're gonna be doing all your sort of core clinical training. And there are opportunities also out there. And NIH R the National Institute of Health Research offers the possibility of of a a pathway through academic clinical fellowships and at a more senior level in training through academic clinical lectureships. And you're gonna hear from Mali who is one of our academic clinical fellows about his own journey. Through this, I was one of the first ACF S uh when the whole process is started, I was one of the first cohort of a CS. And if you think about my journey, I didn't do a foundation or academic foundation that didn't exist before I started this process as an academic clinical fellow, then went to do a slightly my own personal training fellowship. I didn't kind of apply for a clinical lectureship because I was in, in a sense I II managed to get funding for a phd and then complete my sort of postdoctoral training to then move into our senior position. And I think what is expected in the academic clinical training pathway is that you are gonna become the next clinical academics. And that means that you are gonna be a senior lecturer. Uh and you know, later on, you might become a AAA clinical academic, a professor. I mean, that's the journey and that's the aspiration that you need to have. You might think wow, from here to there, this is just very difficult but trust me, yes, it is, but it's very rewarding and you will be able to get there if you kind of work through, through those pathways. As I mentioned before, the NIH R offers this kind of pathways, academic clinical fellowship and a clinical lectureship. And I gonna talk a little bit about more about this, but there are other opportunities out there that you need, you could look for and it depends on where you are in the country you might be able to access to some of them. You don't necessarily need to be on ACF to be able to do research. It's just that it's a bit more difficult to actually achieve that. Mainly it is because you need to, you're gonna need some time to be able to do research. You cannot really do clinical training and research at the same time, it will be quite difficult. I think it's, it's it's very challenging. It is possible, of course, it is, but it is quite, it is quite challenging, particularly with the way that clinical training is, is is working at the moment, you might be able to get out of program, get a clinical research fellowship in, you know, in a research unit, work for a year and trying to kind of work your way to then with the aim to get a um funding to do an MD or a phd and then kind of enter the journey. The advantage of the N I chart is that it offers you the possibility of getting a training number along with protected time to do research. And that really is a big advantage. And that's what really the N I chart academic clinical fellowships are. So they are specialty training posts. So you will be allocated to a particular specialty of your choice. In this case, it would be the G OM that incorporates academic training. Uh You will be spending 75% of your time doing a special clinical training and 25% undertaking research training. In the case of our ACF S, they tend to kind of have about three months. E CF for three years, protect the time to do just research and the objective really the outcome of this is that you're gonna be preparing for a AAA competitive application to get funding for your phd or MD for a doctor. That's really what this time is about is getting you ready, getting your pilot data, getting everything ready. So then you are very competitive to be able to apply for a phd or an MD. OK. That's the end point of the ACF once you kind of get that you will be off program out of program doing your phd, you know, learning lots and then there are other possibilities out there. Once you finish your phd, once you are now a double doctor, then you have the possibility of becoming an academic clinical lecturer, lecturer, lecturer. Um getting one of these NIH R clinical lecturer shifts uh which are special training posts that also incorporate academic training. But now the breakdown of time is different. You're gonna have 50% of your time doing a specialty training. The other 50% of the time is gonna be undertaking research training. What is the purpose of this, the purpose of this is that you start preparing to become an independent investigator that you're gonna be applying for grants to get money, to be able to actually do a piece of research to follow your research interest. And the idea is that you will be then become a senior lecturer, a clinical academic that will have, you know, part of your time dedicated to clinical training, to sorry to part of your your time to do clinical work if you become a consultant and the other part would be to just do research and academic activities. And what I'm talking about research is an academic activities. I'm not talking solely about uh about research as such. You can also follow uh an educational pathway if you are interested in that too. And there are those fellowships as well available for people that want to do education. So you can see their opportunities and, and you might have some questions about this and I'm happy to answer them later on now. II I'm very interested in research team at the moment and this is the sort of latest thing. Uh and these are I just showing you here some of the priority research teams for 2024 and 2025. So normally medical schools need to apply for these positions of A CS and ACL S and they do it based on these different different uh research teams. It means that it's nobody's specialty initially depending on, on, on, on how the, the sort of applications are done by the medical school. Then it means that all of these ACF S will be attached to a particular specialty. Doing so work on digital. For example, the um some people might be doing work on prevention and public health, some others might do work on clinical therapeutic of pharmacology. And you can see here that many specialties can be part of that, right? So in our case, for example, we had an ACF that was doing so work on prevention and public health and we just got now one ac a position that will be available next year to do some work on dementia uh on mental health. Sorry, mental health mainly related to HIV. And you can see here that there is also a very important theme of clinical education research because that's also important and also multiple long term conditions comorbidities. So this will be advertised, the NIH R advertised all these positions regionally, most of these ACF in janitor medicine tend to be based in London. There are a few up north, there are some also in the Southeast, mainly in, in base in Brighton. And there are also some I think um towards the Bristol area. But the vast majority of the ACF S and ACL S tend to be uh tend to be based in, in the South, which is a bit of an inequality. But again, it depends on how, how universities tend to kind of um apply for this for this um for these opportunities. This is a very helpful website where if you are interested in knowing anything about academic careers, you probably are gonna find some of your answers there. So I invite you just to kind of go Google it. Catch.ac.uk lots of information about, you know, what clinical academia is, what training and careers are. Lots of news there. Lots of information that might be useful for you. You're kind of thinking about pursuing this. And again, this is just to show you normally there is the N I chart tend to advertise these positions and just the 2024 are not, are not out yet, but they will be so keep an eye on them. You might be able to actually go to the N I chart website and just sign up for um for um uh just for you to kind of get AAA reminder when these positions are are gonna be advertised, that's how they normally come. And there is a lot of information also in the NIH R website about academic clinical fellowships, what they are, what the requirements are, what you need and so on. So I think information is power. If you really have any questions or you want to start, the best thing to do is just to go and get all the information and you have any questions trying to kind of look for someone that is more senior that can kind of help you with some of these, some of these questions. And this is just to give you an example of a flavor of some of the clinical academics of my team. So here we have Kevin and they all have consented to kind of give the, the, the sort of photograph for this. But Kevin Martin was an academic foundation doctor with me. He did some work with us looking at mus skele uh pain in people with HIV. He did some of that work in the UK and Zambia, he also did some of that work uh with physical activity in, in Brighton. Then he discovered that actually his area of interest was gonna be access to um sexual and health mainly S ti testing of key populations. So he got a well control phd and now he's working in Zimbabwe doing a very interesting project. Uh Well, he's using point of care testing for S TI S for um Antenatal care services in, in Harare. So really interesting and I think he's planning to go come back to the UK again to Brighton to probably follow an academic clinical lectureship, which we hope will be available next year. So just to see that these journals are there, Kirsten a bit different, she kind of follow a slightly different pathway and she managed to get a, she's a special training as you normally do. She didn't do an academic clinical fellow or anything like that, but she managed to get funding to do her phd. And now she's conducting a phd looking specifically at access to health services of um, of older women in the southeast of England. And that includes also section health services clear, again, slightly different in pathway similar to Kirsten. She was kind of following the usual clinical training, decided that she wanted to do research, started to work with us. Got a small, little bit of money to do some work on TY and HIV. And now she's got a Well Control fellowship and she's working in Uganda. She's gonna be working on injectables and HIV and drug resistance. So you can see the themes here, very different themes, right? A lot of social sciences, clinical research, applied clinical research, global health and so on. We have Harriet who just started with us probably about a year and a half ago as our new academic clinical fellow. She also was at academic foundation doctor and she's working on access to section and the health of refugees and asylum seekers in the UK. And she's just doing all that work that is needed to then being able to get um a, a clinical training fellowship to do a phd in that area. We have Harriet who is actually a diabetologist, but she's so interested in sexual health and particularly interested in HIV, that she's been working with us now as an academic clinical lecture lecturer and mainly working in global health, looking at uh diabetes and metabolic uh syndrome in people with HIV. And then we have probably the start of the show which is Fiona Cresswell. I mean, she's, Fiona was one of our early trainees in Brighton started the same of normal training training journey. Then she got her phd with a welcome trust to go and work in tuberculosis and uh TB meningitis and TB meningitis in, in people with HIV in, in Africa. And now she's got, she got an academic clinical ship and prepared her application to become an independent investigator. And now she's got uh early career, a work with the World Trust. And uh she's gonna become a senior lecturer. She's, she's basically from April. She will be a a consultant. So she's done the whole journey from the very beginning to becoming what it is now a clinical academy. This is just to give you an idea about some of the themes of our own group in Brighton. This is our HIV and sexual health group. And we do quite a lot of work in different areas including HIV, aging comorbidities and the brain. We also do a lot of work on HIV and SDI prevention using kind of innovative digital health technologies. And we are also working in in the areas of climate change because that's becoming a an important problem as I was mentioning before. So again, just to give you an idea that actually it is possible to actually do this and do research and just to kind of again, give you a flavor. We do a lot of work in many, many parts of the work. And I think that we are focusing a lot now in, in terms of global health, we have a global health unit. So that's what we do. We do a lot of work in the UK, of course. But also we do a lot of work in, in the global south, particularly in, in East Africa. So yeah, it's very rewarding, you know, is not easy. It is not easy. It's quite sometimes can be quite frustrating. And I, I'm sure D Mali is gonna tell you some of this writing and es application is not easy, right? It takes time, it can be frustrating. In fact, just getting a grant is the easy thing is sometimes delivering the research that is difficult. There is bureaucracy out there, but you will get a lot of skills, you will, you know, get a lot of teamwork skills, communication skills, you have to really develop that sort of thick skill that you need to be able to kind of make sure that you finish your projects. But it's quite rewarding. And I think the more rewarding thing is being able to work with people from all over the world, from different sort of with different skills and different experiences. And that's incredibly rewarding as a clinical academic. It is never boring. My days are never the same. Each day is very different next week I'm going to the US for a conference, then I'm gonna be back again and then um I got some meetings with people from, you know, Zambia and so on. And then the next day I have to do clinic in the morning. So I think it's very different and that, that's quite rewarding. It's not easy, but it is very rewarding. So I think with that, I'm just gonna finish now. This is my email address here. So you happen that you are interested in doing any research. Got lots of things to do in Brighton. So you can always email me. Uh Also if you have any questions, feel free to email me. I'm happy to kind of answer them and yeah, I'm just going on our own chair and pass the baton to my league. Thank you, professor. That was really interesting. Um Now we're gonna hand over to our next speaker, Doctor Coley. He is a specialty registrar in go and a clinical research fellow at UCL. He studied medicine at the University of Edinburgh and later completed a master's in reproductive and sexual health at London School of Hygiene and tropical Medicine. Doctor Coley Stud higher specialty training gov in 2019 and was appointed to National Institute for Health Research Academic Clinical Fellow at UCL. Doctor Kelley's Clinical and research interests include HIV treatment, LGBTQ plus health and SI S ti epidemiology treatment and prevention. He is currently undertaking a phd focused on antimicrobial resistance and microbiome impacts of antibiotic. S ti prophylaxis. I hope. Thanks so much. Be great. Thanks so much for that introduction. Hopefully you can s see my screen that I'm sharing. So, yeah. Um I'm manic, I'm a reg in gum and I'm based at UCL and the Mors Market Center and, and as high me had kind of gone through the academic sort of route. So I was an NIH R academic clinical fellow from 2022 2023. So, um, what I'm gonna talk a bit about is my journey. What a bit about what kind of academic gum doctors do life as an academic clinical fellow. Um, kind of thinking about. Ok, so if you're thinking about a phd in some top tips, um and, and what I'm hoping to impart um really is partly, you know, why I think getting involved with research is really great. Um, but also, um, that actually if you don't know if you're interested in research, that's also ok for now. So the first thing I'd say is it's much more enjoyable to do research when you're genuinely interested in the question. I think this is something that, uh a lot of people come up with particularly early in their careers where, um, you know, if someone had said to me, oh, there's this research study on, I don't know, um, um, you know, complications, POSTOP bariatric surgery. I, you know, I would not be particularly interested in that. But actually, if you're passionate about the subject, if you're interested in the topic, actually getting involved, research becomes much more interesting and much more enjoyable. And so how did I end up in research? I'd say, ok, I'm very interested in sexual health HIV. Um Persistence and I'm gonna come back to that in a little bit. Um I think part of it's chance. Definitely. So just the opportunities came up for me just at the right time. Um and networking. So just making sure that I got to know people um and like was, you know, talking to the right people following up with people pestering them if I needed to. Um And probably a lot of it was by accident. Um If you'd asked me at medical school, OK. So you're gonna be coming in a clinical academic, you're gonna be wanting to do a P HDI think medical school manic would have been like, I don't know what you've been smoking. So my journey, so medical, I did medical school foundation program, I just did bog standard medical school. Um ha and you know, did a BSE did a research project as part of that. But um I generally probably had precisely zero interest in research all the way through that. Um I then did a actually a masters which in reproduction and sexual health research um here in London. Um And um that, that probably was the starting point of my interest in research. I think I went into it. Not necessarily thinking I want to be an academic, but I thought, do you know what nice, boring into it? Um I'm interested in this area and um I basically didn't want to work full time, so I thought masters would be a good idea. And II think that was when I started to maybe develop an interest in um career in academia. And then I started core medical training, which is now internal medicine training. And I think uh uh building on what my um master did research had been on, II think I then started to really become definitely interested in research and I got my first ever publication, actually, it was just at the start of my registrar training um and actually started the Gum Reg, then became a academic clinical fellow and now I'm working as a clinical research fellow and doing a phd. Um and at this point, yes, I'm definitely interested in research and that obviously looks really er, nice, but actually, it's been a bumpy road, I would say. So, actually I applied for an ACF and was unsuccessful the first time. So I started um applied to er, one here. Um it was based at Imperial actually. Um but anyway, I didn't get it. So then I started gum training as a registrar and I reapplied cos there was one up at UCL, which is when I was there, I was, ended up being based and actually I was successful the second time. Right. Um, and then while I was in a CFI was applying for funding to get a P HDI, applied to the MRC to get a fellowship and was unsuccessful, er, at that time. Ok. Er, I then, um, reapplied to the NIH R for a phd fellowship with a much better project, I have to say, um, and a much better CV. And I was successful and I think it's really important um when people are talking about their careers, actually, I'm not just showing you all the things that I've achieved, actually show you that every time I was unsuccessful. And that was why I said at the time, persistence is definitely something that's super important. Um If you want to pursue a career and kind of as an academic and in research, um because there'll be lots of times where you, your grant doesn't get accepted, your abstract gets rejected, your publication gets rejected. Um And you're unsuccessful when you're applying for something and that, that is um part of the journey. Uh And actually learning to deal with that is quite important. So what do academic g doctors do now? I think he already kind of went through a lot of this. Um And I, um so I'm not going to kind of labor the point, but I think the main takeaway message I wanted to share was um we do a lot, we do lots of different things. And I've got sort of people in my department that I work with who just, you know, the, the, what the kind of research they do is so varied, whether it's in the UK abroad, whether it's clinical trial trials, whether it's more epidemiology, population based, whether it's lab science, social research, um whether actually it's much more qualitative research, quantitative research, mixed methods and everything in between um policy, digital health, like literally in this specialty, you'll find somebody who's doing absolutely every type of research that you can conceive. And actually, it's much broader than people I think, give um give it credit for as an academic specialty. A a and ultimately, what you're doing as a clinical activist, you're designing research, you're applying for funding, uh you're implementing that research, you're analyzing the data, you're disseminating your findings and you're engaging the pa patients and you're engaging the public in your research. Um And so, you know, as a clinical academic, particularly as a, um if you're uh coming from a medical background, actually, you know, you'll get to be involved in all of these different stages. Um And I'm gonna come on to kind of the bits of it as an acf that you, you do get involved in so life as an academic clinical fellow. So as Harry already pointed out, you get time um for you um which is just to work on academic stuff within your clinical job. Um And my experience was, it was very flexible. So I had time where I was doing 100% academic work. I was times where I was 5050 doing half my week, academic, half my week clinical, I did a period of time, it was 8020. And I was given a lot of flexibility to increase and decrease how much academic work I was doing, how much clinical work I was doing based on, you know, what deadlines I had and as an A CFI was doing a clinical trials clinic. So I was recruiting and following up patients who were in um a number of different trial interventional studies HIV treatment, you know, antibiotics for S TI S um prep. So HIV prevention, um I was given time to work on small projects so often that was just, you know, there is big data setting, they're lying around. Um you know, we have a huge clinical um clinical cohort of patients living with HIV. So um analyzing some of the clinical data um and kind of working on a literature review on an area that I was interested in. And then I was supported to kind of submit abstracts to conferences and papers for publication. And what was really nice is actually I had time in my day job to actually work on these rather than having to do this kind of in my evenings and weekends. And ultimately, as an acf what you're really wanting to do is develop your own research question, your proposal and a funding application for a phd. Now, not every A CFI know has gone on to do a phd for various reasons, they've decided it wasn't for them. That's fine. Other things in life changed, that meant that actually, um they wanted to just kind of finish their training and become a consultant. But ultimately, that's, that's one of the purposes of the ACF program is for you to be able to get your, get a plan together for a phd. And actually then you have time to go conferences, courses, you have a, a separate budget study budget as an ACF um but also kind of as being affiliated to an academic department. There was kind of other uh sort of bits of funding that I was able to use to be able to go to international conferences. Um Other parts of formal informal mentorship, I've met a lot of amazing people and actually, that's been really beneficial. I have an office and my own desk uh with two screens and my own computer. And, you know, um a lot of my colleagues who work in, um you know, I sure if for those of you who do work in the NHS, you know, even as regs, even as consultants, you don't get given to your own office, own desk, you know, people are often cramped to tiny spaces and actually, um it's a little bit nicer in academia, work life balance is, is definitely better. I'd say um OK, work life balance is better, but I think it's the flexibility that's really good. So I do sometimes do work on my own time if I have a funding deadline, you know, I was getting a big fellowship proposal together, a phd proposal together, you know, working um you know, in my own time sometimes. But actually, you know what if I needed to leave work early because my mum was gonna be in London and I wanted to meet her for dinner. I could, you know, could just leave work a bit early and go do that. And actually, academia is much more flexible, um which er, makes a huge difference to your quality of life. And then a, you know, as being affiliated to university, you get access to academic journals um and other, a lot of free resources like that's training mentorship, um online courses in person courses. Um And that, that, that kind of are, are really, really useful um for your career. So you're thinking about a phd now, obviously, probably many of you are not thinking about a phd yet. And II think that's totally fine. II would say my, this is just from my own experience. So I wasn't really sure until after I started my ACF that I wanted to do a phd. Definitely, you know, um I think I was interested in it. I was interested in research and I think it was only once I really got stuck in that I was like, actually, yeah, this is definitely for me. And as I said before, acf time was really helpful for developing my own project and getting funding, but you don't need to do an ACF. So that time he kind of pointed to when he was telling you different stories of different people, you don't have to do an ACF to then go on to do a phd. Lots of people do phd having not had accurate time built into their day job. But I think that that is where you do end up having to do a lot of that in your own time. Or if you're able to get a stand alone research fellow job for a year, if you, if you were interested in research, but you don't wanna commit to a phd. That's totally fine. I know lots of people who've done a year of research, they've done a research fellow job for a year and then said, ok, I've got what I needed out of this, but it's not for me and they've gone back to clinical work and then that's it. I'd say also when you think about phd. So some supervisor departments are, are, you know, they basically have projects and ideas ready to go. So you kind of turn up day one and like, ok, here we want someone to do this. Um And at my department where it's not quite like that they often encourage you to support you to develop your own idea, um which I personally found um really nice. So just to summarize a, some of my top tips really for you at your stage. So be persistent. Um And so that is gonna be, be persistent in terms of if you do get, uh if you do not get, if you don't get the job, you don't get the ACF you don't get the funding. That's totally fine. Reapply also be persistent in terms of, you know, if you want to have a meeting with someone, if you want to have coffee with someone, you want to just get some advice like email. If they don't email back, that's fine. They're probably busy, they just forgot email again. All of us, you know, are happy to sort of speak to anybody who's interested in academia interested in research, but sometimes we'll just forget. So just be persistent. No one minds. If you email them five times um take your time as well, it's ok to be unsure and then say, OK, I might do a master's or I might do a research job for a year or I just wanna locum and then maybe try and build some other um whether it's audit Q I build some other projects into your time, there's absolutely no. R and with academia, everything slows down a bit, takes, everything takes much longer, it takes longer to get your publications out. It takes ages to get your grant funding proposals written and to go through that whole process. Um, so the pace is very different and I think when you've gone from the NHS into academia, it's quite a bit of a sort of a shock to the system when you have to slow down a bit low hanging fruit. So this is actually stolen from, um, one of my, er, bosses, um Professor Sarah Pe and she's always like low hanging fruit. Like what's easy? What's simple? What can you just like, quickly whip up and abstract into a conference? Don't worry about the, the big idea. Sometimes simple, small projects that actually can get you things on your CV, can get you to a conference, can get you a publication. That's what you should focus on early on in your career. Don't try and solve all the problems. Um Just go for the low hanging fruit first networking cos I kind of mentioned at the start, but I think it's really important to if you meet someone who you think. Oh, I like what they do. I'm interested, just try and keep in touch with them. Um, email people out of the blue. I've, I've literally just been like, hi, I read your paper. This is super interesting. I wanted to discuss something with you and I've just emailed a random person who's in Australia exactly like that. And then actually, that's been really useful to develop those kind of connections over the years. So be open minded. I think it's really important. So there's lots of fields within sexual health with HIV. So be be open minded in terms of, ok, I'm really interested in HIV, and aging or I'm really interested in um bacterial ST is I'm really interested in global health. That's great. Um But actually, sometimes opportunities will arise um that are different to maybe what your initially thought your interest would be. Um And actually that so be open minded to kind of take on as opportunities. Um And I think, say yes and say no. So if something good comes up, say yes. Um but something I've learned to have to do now is say no. Um because actually you've got to manage your time and as well as you possibly can as well. So I think for you guys saying yes, definitely. Um But, you know, with a spot, it's like caveat that it's ok to say no if you are too busy. Um So thanks very much. I just got some random pictures that I found from our team and various people um who'd been at conferences at picnic for and II work in an academic department that's been running and working in the field of HIV, since, since the, basically the start of the HIV pandemic in the, in the eighties. Um And it's, it's been so interesting to, to work with people who are just have had so much breadth of and wealth of experience in this field. Um So my contact information is on, there should say at ucl.ac.uk. Um that's a Typo. Um I'm happy to take any questions now. Well, we've got some questions in the charts, I'll start going through those. Um So we've got a question from Archie. Um It says, thank you for such an informative talk. Do specialized foundation programs come under the academic foundation program or are they separate? Maybe I answered this one because I think there's been so many changes to the, basically the semiology of this. I think a specialized foundation program was previously known as academic foundation program. And that is what I was mentioning about foundational academic foundation doctors that provides, you know, an opportunity for foundation doctors to develop research, teaching or leadership is, is that sort of period of time that you get. So it is the same as an academic foundation basically, or the old academic foundation doctors. Yes. But my understanding is that there's been a that they might be getting rid of them. II don't know if you saw that. Yeah. Um it was in the last couple of weeks and there's been a lot of noise about it. So I think tells me that. Yeah, I know, I um a lot of people have not been happy about that. So I'm hoping they might reverse that decision. I really hope that they do that. I mean, I haven't been informed so we haven't and I haven't been, must have been that very much like, yeah, it, it's, it's not II, yeah, I just, I saw some uh press release from the, um, foundation program. People about it. OK. Well, there you go guys. It might not be there but it still, there will be opportunity to kind of work if you want to. II think when you, when you say man, it's absolutely true. If you really want to, there are pathways but you can just do your own thing as well. You're really curious and interested. OK. And we've got a question from Adam that says if someone does their phd before starting special specialist training, is it still worthwhile doing their academic clinical fellowship? Yes. So I think in terms of eligibility for more A CS and again, I don't know if this will change, but at the moment, if you are a medical graduate who obtain a phd prior to medical undergraduate training, for example, you, you will be considered, you will be eligible. I mean, the question is whether your phd is related to the specialty that you want to do? I don't really think that it is important. It actually shows potential that you, you know, you understand what you know what it needs to be done to, to, to kind of do research, you probably would be in a, in a good position I would say. But yeah, it is not, it is in terms of eligibility for an I CFI. It, it shouldn't be a problem assistances. Ok. And then the next question is more direct to do Coley. Did you do your masters alongside clinical work or separately? If together, how doable is it? And are the masters funded during gum training? So, um yeah, I did, I did my masters and then I just locum in ad alongside that and that was fine. Um I'm just about managed to do that. And a lot, actually, a lot of people on my, there was a few doctors, other doctors in my master's program doing exactly that. So they just sort of locum on weekends in the evenings and during the kind of, um, reading weeks and that kind of stuff and it was, um, so it was totally fine to manage that, um, masters are not funded as part of kind of gum training. Uh, when you are in ACF, you do have a study budget so you can use that for, you know, postgraduate diplomas and, um, people, people can put them towards, uh, part time masters. The part of that, that there is money available as an ACF for those. But if you're kind of AAA standard gun trainee, then there is no funding for that kind of stuff. Ok. Um, next question from Tiana. How does go ACF work now that go is full accreted with, where does the academic time fit in with general internal medicine commitments? So, maybe I give my official view and then man gives the real view, maybe we just do that. I mean, officially you should not be time dependent by competency dependent. Uh So it shouldn't be longer the training, but it's all competency based. So if you have the competencies, that's gonna be assessing the sort of, you know, a R CPS which normally have the assessments of, of training. But the reality is that it is quite challenging. So I was just gonna pass it to manic because I think there is still a lot of discussions between the clinical academics uh nationally about how we're gonna be manage this. Yeah, I think it's a great question. I mean, I think the, the first thing is that no one really knows, um, exactly how it's going to work. I think the, the, the reality is that if you are doing academic training and you're doing dual accreditation either actually to do everything within the four years is, um, I think gonna be too difficult now, if you're planning to do academics and you're thinking I might do a phd, you're probably gonna be planning to take time out of training anyway. And this is kind of going back to that point as great. Take your time, ultimately. Um If you're going down the clinical academic route, it will extend everything anyway. Um And so within that extended time period, probably it will be fine to get everything done when you go out of program and do a phd, if, depending on what you're doing and if you manage to do some clinical work alongside that you can count some of that time. So it, it, it becomes much more individualized. Um, I think if you're doing just kind of four years ACF plus gum plus general medicine, um, I think that's my view is that, that's not possible to do all of it, to get everything signed off, all your exams done, everything. I think that's just, I think that's the reality that some people unfortunately are not quite willing to say out loud. Um, uh, I'm not, I'm not suggesting that high. Um, but, uh, so I think, but within that everyone kind of accepts that if you're planning to, if you're in a CF and you're planning to a phd, your training is going to be longer anyway because you're going to be doing a phd for three years. So, actually, um, you'll be able to kind of individualize what you need to get done. Um, anyway. Ok. Thank you. Um, Lucas, what advice would you have for those in foundation years? Looking at building their research portfolio in a small D GH, pass it on to you. Yeah, I think, I mean, I did foundation in Ad GH, I worked at Watford General Hospital and, um, I think the key thing is at an early stage of your career. It's, it's not necessarily what you're doing. It's, it's not the big projects. It's, as I said, the low hanging fruit. So actually, if you can just get involved in a pretty big, you know, simple audit, but you're able to kind of um do that and get it into a conference and that doesn't, I mean, I think I took part in some diabetic foot audit as an F one and I managed to get that into a conference and I was like, you know, in the middle of the author list. But, you know, for me that was like, get, you know, that was like, I, you know, was able to leverage that in applications and interviews and that kind of stuff. So I think it's the simple things um that you can do locally that actually they're trying to translate that into something at a conference cos that is uh an abstract or a poster er, later. And actually, it doesn't matter if it's not completely aligned to what you end up doing. If you look back through probably a lot of clinical academic careers, there'll be lots of stuff from their early early careers, which have absolutely nothing to do with what they do now. Um So I think it's a low hanging fruit, simple things um that you can just get into a conference um that will benefit you the most later. OK. Brown RT is there anything undergraduate students can do to make themselves more competitive? I don't know. Again, II was just saying that depending on where you are in Brighton, particularly there is these independent research projects that students can get involved with and then get supervised by either clinical academics or, or just uh clinicians that want to do a project. So they have the opportunity to do that. I know in other, in other centers might be a bit different. But ultimately, it's about your curiosity. And again, what money was saying is absolutely true. If you are interested in one particular area, one particular research group, just email them and try again because we are always really, honestly, we're always happy to kind of hear people that want to work with us and there will always be an opportunity to do even a small piece of work that might mean that you are part of, you know, a publication, for example, and you start building your portfolio and your skills there. So if you have that curiosity, just pursue that, just email, people have a chat, just show your enthusiasm, show your motivation and you will see that you will find you, you probably are gonna have to say no because there will be much more on your way. Um But yeah, I don't know, man, I know that what you experience. I completely agree. And I think like building on the kind of being persistent and emailing and getting involved and then like maintaining those connections because you know, you might be involved in a small bit of a, of a bigger project. So you might help with something small. But actually that's a bigger piece of work that someone else is working on. And actually, if you maintain that relationship, even if you actually don't necessarily contribute much more, what will end up happening, hopefully is that they'll remember. Oh, do you know what you did that bit? You know, two years ago in that part, as that part of that project. Now, things have progressed, but we're gonna submit it to a conference. We're gonna publish this and actually you helped with that tiny bit two years ago, but you've maintained that relationship. So your name is gonna end up on there that if you did that tiny bit of work and then disappeared and never kept in touch again, probably what you did wouldn't justify your inclusion as an author. But because you maintained the relationship, they will include you as an author. Um And I think that's actually really important. It sounds really silly and simple actually, but just maintaining relationships that you make along the way, um can actually be really beneficial even if you don't do any more work with that person. Yes, I think that's important also just to kind of check because there are some sort of summer uh position sometimes to do research, particularly for undergraduate and medical students. And we had one just last summer that did some work with us with some, you know, some data that we have from, uh, uh, a piece of work that we have from Ethiopia on frailty and HIV. And, you know, this is student essentially just did the analysis of that. And because of that, I think she's gonna be part of the publication and so on. So I think it is true is maintaining those relationships is, is extremely important. But if you, and if you don a piece of work as well, just you, you need to be acknowledged for that. You have been involved in, in, in analyzing any data and so on. Um, but yeah, just, just follow, follow email, that's what you need to do. Brill, thank you to me, it says, thank you for the talk. How can we find out about audits taking place that are relevant to go? Mm. So that's a good question. I think the first thing that comes to mind is basically at the moment, um, er, we're rolling out opt out testing for HIV. He HEP C and HEP B in M in as many hosts as possible. That's a big rollout program that's happening. And so a lot of places are rolling that out. So there's going to be a lot of work that actually is, you know, audits of how are they doing in terms of their opt out testing for HIV. Um, so, you know, it's, it's fairly straightforward, I would say as, as a kind of concept. Um, but I think that's the kind of stuff that HIV testing. Um, I would say a lot of people I know who are interested in, um, you know, basically managed to wrangle some sort of HIV testing audit in whatever department they were in. I think one of my colleagues, we were working in a, an ICU in a transplant center and actually the guidelines are that everyone should have an HIV test, but that wasn't necessarily happening. So it's a super simple, straightforward. As always my go to advice is, you know, wherever you're working, whatever placement you're on are people meant to be having an HIV test in that service. And actually can you audit that? And actually that's really um important related to gum and something that's manageable. Er, so that's what I think that's my starting point and also just contacting the local gum HIV services. They've always got audits that there's always consultants with audits that they want done and no one to do it and they will jump at the chance of a student who can help them with that audit. And so just, just email. Yeah, just email. That's it going to the sort of local clinic there will always be lots of things to audit and not enough people to actually do them. Ok, thank you. Very. I think that's all the questions that we had through on the chat. Um, you can give me another second to see if any more pop through, but thank you. For giving up your time tonight um to come and speak. It's been really, really useful and really informative. Great, great, welcome. Thanks so much. Thank. Thank you. Bye. Yeah.