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um, now we're going to hear from professorship born when the on getting involved in research. So just a little bit about her. So she born Quimby the consultant office attrition as well as a profession professor of obstetrics. And don't get the biomedical research unit at the University of Work. What's the trouble of Deputy Director Tommy's National Center for Miscarriage? Ah! Research and is involved is a chief investigator on several large scale clinical trials. Work makes it more trouble Relational research into recurrent miscarriage, and she has published It was 75 original articles and numerous book chapters on the subject. Any international recognition, a media interest So over T thank you very much, but thank you very much for asking me to speak. And you can everyone hear me? Okay, yet Fantastic. So thank you for the lovely introduction there. So what I was going to cover in this talk is that is issues, I think, the most important thing to talk about with researchers motivation, I'm afraid, just it's quite a challenging area to be in that I'm going to talk about all sorts of different research methodologies that you could be involved in a buying. I'm going to mention the genital academic training Pathway on for those you're interested. So why do research? It is hard. Well, the most important reason for doing research is to improve the evidence based that you're using for your patients. You know, if you do a research project, you can actually make a really change for patients across the world. And that's the major joy. And that's the major point of doing it. Uh, also, you could make sure your patients are getting the best care. So at the moment with medical education is fantastic. Training on communication skills, fantastic training on sticking to guidelines, fantastic training on ethics on you do get excellent training on that, and you will have opportunities to be excellent doctors in the future. But then, when you're a doctor, you need to think what sort of doctor you want to be on what else you want to do. So I think you've heard about some other avenues. You can go down, but with me, I'm passionate about doing research. So, for example, when you're following a guideline as a doctor, sometimes the guidelines could be very irritating, and you think it's not really very sensible, but the guideline has to be evidence based. And then if you put the evidence, you realize that it's not sensible because the evidence is and all that good and the only way you can really change things is to do research and create that evidence. When you do research these days, it's not something about doing things on your own. You have to be part of a big team on. That's excellent on being, you know, doing research, I think, is one way of getting a lot of job satisfaction. So what can you do? So as a medical students and early stage junior doctors, one of the things that you could and I strongly advise you to think about is being involved in the systematic review. So I often have junior doctors and medical students complained to me because they stay well, One consultant says. One thing one consultant says another. If you're on some sort of rotation, it's quite irritating when in one hospital they do one thing and one hospital, then they do another. If you come across that instead of being irritated, the right thing to do would be to see if someone's already done a systematic review to answer that question. And if they happen, go and do one yourself. You seem you first of all, you need to find a supervisor or someone to help to the systematic review on these. The stage is that you need to go through. Now. A lot of people are doing systematically views, and all these stages aren't things that you can do on on your own. So, for example, that the data extractions having decided your question down the approach cold. You then have to do a literature just research, which the hospital library can help you with, then have lots of papers where you have to extract data all so groups of people couldn't do it or is a medical student. If you've never done a systematic review before, see if you can help another junior doctor doing one. You then get a least eight at doing med analysis and get a publication. This is this whole thing you can present at conferences. At least have a poster, a conference and start getting a taste for research, doing a systematic abuse. A good way to start research because you also realized that problems with people writing their papers badly or not, making their outcome missions tear so that you can't include them. The systematic review, other sort of reviews researched it. I think it's very easy or should be possible. To get involved in as a medical student or junior doctor is qualitative research. Qualitative research involves interviewing. Patients are doing focus groups recording these on, then putting these interviews into a qualitative software on finding themes. So it's a good way of really finding out what patients feel about one disease or another. But the the gold standard medicine. At the moment, it is evidence based medicine, evidence, basements and depends on randomized controlled trials, randomized control, trust actually very difficult things to do. And I think it's really important that every doctor has some opportunity to be involved in a trial, even as a preferred. Hopefully. So you really understand how difficult they are to do so when you read papers about randomized controlled trial, you can read them in the right context, that that's what I've been doing this morning and it's really hard. So the trial I've been doing this morning is I'm trying to find out whether Doctor Cyclen is an effective treatment to prevent miscarriage in people with recurrent miscarriage and chronic inflammation. So that sounds very easy are, but it's actually very hard, So I have to find women. You've had repeated miscarriages. Ask them if they would be in my trial. If they're in my trial after taken endometrial biopsy and then if they do have chronic inflammation, then I have to ask them to be randomized to doxycycline or placebo. So if you think about that from the patient's point of view, this is very hard. So some people have had five miscarriages. They've lost five badly wanted pregnancies, and then I have to up it. Austin. Would they be prepared to be randomized a doctor, cyclen or placebo? And it's double blind trial, so they don't even know which one they took. So you can imagine how difficult that is for the patient's point of view, it's very difficult from the creatures point in you to try and explain to them why it's such a important question why it's so important that were in the trial, but also understanding how difficult it is for them to live with the uncertainty of not knowing what they took and then happened. Um, bark on another pregnancy with that degree of uncertainty so you can actually will be involved in trials. You can go to clinics where people are being recruited. You could have you could even if you're very enthusiastic, you can get small. We called G c P training specific training in that trial, and then you get on something called a delegation log. You really understand how difficult it is to randomized people. And I think this is a fundamental thing that you do need in order to really understand when you read the paper. What is that? The limitations of any trial which obviously imitation is you couldn't you only refers to people who agreed to be in trials and may or may not be generalized able to the whole population. If you get very enthusiastic about research, then you go on to be a a p I or so which is the principal investigator or achieve investigator said that. So I'm a chief investigator and that is, you know, so rewarding career because that somewhere way that you know that you're going to change medicine across the world, hopefully for good, but it's also very hard, and you need to have some memory experience of trials to see if that's really what you want to spend your time doing. The other sort of research that go on a cohort studies so the this's becoming more more popular with the ability to analyze large data sets using things like artificial intelligence. So apparently I get told frequently that I'm dying the sore when I walk, try and discuss how we're going to analyze our large Coke holes on. People think the future will be to be able to use large colds. That's large amount of data that's in in a just a touch base and GP databases Look on, analyze that, but looking for patterns using artificial intelligence. And we all think this is going to revolutionize medicine Exactly how that's going to work. I don't know. Of course, the cynical people say all the head are artificial intelligence, and they and they could tell a woman and they could tell a bite. But when they had the woman in the bike together that let the self driving car around there over because it didn't realize the woman the bike watching the same thing and people keep coming up with them. Uh, examples like that where artificial intelligence doesn't work, but I think it is gonna work, and it is gonna be the future so you could start trying to get involved in the cold study. But there's big issues Teo overcome, which is mainly data security ethics, which I think that could be really exciting area medicine in the future On. Then, there's a bar to be a science if you have some scientific back around, there's a massive revolution in the boardroom based science to get at the moment again because of disability, to analyze large amounts of data on because off the ability to analyze that, using things like artificial intelligence. And so nowadays, a lot of laboratory based science isn't a matter off making an experiment work. It's more about getting a sample from the Pacific first group of people. Then conceit quits the DNA. The are in a of sync or even single cells, and you then take your sample. I isolate there are DNA out of it, send it to America and come back with nine CD rooms were full of data on then take it a by invitation to try and understand the pattern or the information that comes out of that. This whole approach is really just becoming so Jeep that we can afford it on any Jessel and I chart money on. It's really exciting time to be involved in this mechanism disease, and this is how we're going to go to this concept of personalized medicine. So in the future we see that you would have a blood test. They put your secret to Deanna and they say, Right, this person's Would this struggle work on this person? But not on the other one. Very exciting times Very detailed knowledge is needed, but something that would be good idea to get involved with. Whenever you do research nowadays, you have to have what we called PPI, and that's patient in public involvement. So in the old days, what happened was consult like myself that decided the researcher, then gender. So I would say what is the most important issue to sell the miscarriage that's no longer thought to be acceptable. So now you have to work very closely with patient in public involvement groups, So this is actually quite exciting. So for me. I work with a charity called Tommy's on. They have, like several million hits on their website each age month. So when you talk to a pharmacist, how you're actually getting people who are in contact with millions of to patients, and it really, really makes you make sure that the researcher doing is really going to, you know, affect the patients and so you have it. It just is also quite challenging. So in fact, when you want to do research now, it's important to know what patients think. So there's different ways of establishing that This survey's computer charities, um uh, on doing the politics of research. The idea is the patient set the agenda. They're involved in developing the proposal. They're involved in the car in the conduct of a study. They're involved in the impact of that's advertising results and carrying on through this research cycle. So being involved in PPI Group is quite is quite interesting experience. From my point of view, you don't come out unscathed so I could go into a PPI group. It's happened to me a few months ago with my fantastic idea of patients. Do not agree with you and you have to radically change your protocol. So I'm trying to make an app so that women who've had a history of miscarriage put the details in the apple, and it tells them what they should do. And so on. The first questions on the AC was, What is your height and weight? It would tell you if your body mass index is idea. And I was told you, no uncertain terms of that's defensive on, that all doctors do is not people about there being my on that. If you want to ask that question, that has to be something could move through, so it wasn't very happy, but I accepted that. That's what the patients felt. I thought that being an idea of what you mass index before you embarked on a pregnancy was essential that they said that it wasn't your patients and legend, and they pointed out that adequate body mass index didn't make so much difference in whether you had a baby or not on there. Four patients should be able to move through that question, So that's the sort of where you interact with PPI keeps these days. I was trying to think of some really, really practical advice that you could do it at medical students or early. You know, you know early on in your career so you can actually get this thing called G C P training. That's a little bit boring. But once you've got gcpd training, then you are allowed to be involved in recruiting people to trials using on. Then, if you did least identify by people who are eligible for trial. Most trial. It's like myself so desperate for people to be half their trial that you get some sort certificate for that. I in obstetrics and gynecology, you could do a thing called a a P M. Where is during your clinical training, you can get a special training in research. The best way to get involved in research is to get a clinical research job on the key to a good clinical research job is getting a supervisor who is both good as a good track record on Um, uh, really does motivate you. So the last thing I wanted to talk about was clinical academic training on day, so washed. Some people are very well aware of this other's arms on do I. So I'm involved very heavily involved in clinical academic training up for a medical school. And I'm always a little bit disappointed as to how few people go into this because, quite frankly, if you have got nothing to lose, so you couldn't instead of going for our foundation program F one or F two, you could be academic after one or two, so that means you get a blocked to do research. If you don't like research, you can always go back into specialist training without research. But if you have it, it's part of the academic foundation. Yet least you have the opportunity to see if that's something you like, then having down your foundation. Yes, you then go through the run through training grades. And so here's the so standard diagram. So you could either be a ST one s, t two and s t three on dude clinical training, or you could be an academic fellow. So and then during this training, you get an opportunity to do some research you, me to research supervisor on. Then, if you like that research, the idea is to get some papers and some things on your CV on that would allow you to apply for a clinical research job. If you don't like the research, it's still fine. You still go back through your training, your normal training. You don't have anything to lose a tool if you If you don't go into academic training fellow, then when you apply from a search job, of course, you're competing against people who have done that. So that is what I think. It's something people should look at. You can apply for academic fellowship, academic s training and also apply for the standard training at the same time. So by applying, you don't have anything to lose it all. But I think a lot of people don't apply because that too scared. But it's really important to have a goal of research. See how much you like it on, then change your mind. Having got your The idea is that you go through this academic fellowship, undo your ST 12 s t three training. Then you come out of training into a clinical research job so you get your MD or PhD and then you go back into a clinical lectureship again with a clinical lectureship. That's usually s t four to ST Family. Um, and it is usually about 50% of your time Research. 50% of your time clinical, Um and so your your clinical training takes a little bit longer. So I think it's something should ulcer about very strongly. The best way to find out that it's actually to ask someone who's undergoing the trading. Because then you get really world with by information there. So basically, I thought I was at the end. Didn't do a very long presentation because I really wanted to give you lots of opportunity to ask questions because I wasn't totally sure what sort of information you'd want it your stage there. So have you got any questions? Okay, so we'll take questions from the chat for nonschool to me. Okay. Thanks for that presentation. That's really interesting. Okay, so we've got a question. The chap from Selena, uh, said many thanks. Your presentation. Do you have any tips for those of us about to start a CFC academic clinical? Um, finish it. Yes. Yes. So the most important thing is to is to get a supervisor that you get on well with, so hopefully you'll be allocated one, but with the research, it is really hard and it's emotionally hard and needs a lot of energy. So So So So have it from the first day. You need to find the academic supervisor, have a meeting, discuss what you can achieve, what you want to do. Good question. Is what I would ask. What systematic review can I do? Because that means you going straight into research. You're getting a paper. How much time have I got to research? What are my opportunities? You know, and and those are the really, really, really key questions. So you should have a great time with a C S. Most a CFC also get a master's degree. So you need to say, How do I register for my master's degree? Because it means that, you know, Master's degree is still 9000 year, but as a CF, it's paid for by and then I also get your masters. Get your training, get papers in early on, have a chat with your supervisor. If you don't feel that you're getting on with a scoop of ice. It asked for another one because it's really important that you both get on way. Well, yeah, you can't, Brill. Thank you. We've got a few more questions that have come in. Um, it took me to read them allowed. Or can you see them on the chat, or can you read the you know? Yeah, of course. They got one here from am I? She says they say if you're already in a normal foundation program, what can you do? You know. So So that means you should be about apply for your your run through grade. So all specialties a bit difficult difference. I know office. Um, but I need very well cause that's my field. So in obs ago and you apply for your ST one, you'll run through training on. Then you should apply for the standard training on the academic training in parallel, because you don't lose anything. So if you don't get the academic job, you got the standard training. If you do get the academic job, it's win win, because then you can try that. And if you don't like it moved back. So first of all apply when you apply, There's the it's the you know we have this wonderful fellow fair world on the moon, but that which means that you guys, it's horrible. Elektronik forms on so your academic job they look of not at things like way a point. Point your own potential, but to have potential. You have to have something under the publications in presentation section. So remember, you can present data at things like hospital quips meetings. There are lots of medical student conferences you can percent don't do presentations on. So as a medical student or, you know, or his academic F one really try and get a presentation, a conference, even if it's a case report, you get marked for case report. There's loads of things you can get marks for. So, you know, if you you must. You cannot go through medicine and not see one cases even a bit interesting, that can be turned into a case report, you know, or even asked a consultant. I'm really keen. I want to be academic. Is there a case report I can write up for you? You know, that's just sort of thing to do. To get that I do need to get a systematic you published or least presented get a small hole study or anything presented, but definitely apply. You've got nothing to lose by applying because you still use. You still end up with a job on that. Least another option. Teach Applied for the academic job on me. There. Uh, thank you very much for that. Out of the question. Uh, number are a question from chivalry. Thank you so much. A great talk. I was wondering if you have any advice on getting involved with observing PPI. Say public picture involvement group at the committee's is a junior doctor or medical student. That's a fantastic question, Nosal. Things you should really do. So hospital, hospital, R and D departments have to have a PPI section and I have a PPI lead. So you have to bring up the hospital or in D and say, Can I speak to the PPI lead? And can I attend a PPI group? It's a really, really sobering thing on, you know, you guys, hopefully, we'll learn it from the start. I found it quite hard to learn about PPI is when I started, you did whatever the professors said. Now you do whatever the patients say, and it is a fantastic change, but it's actually is actually incredibly challenging. So must go to PBI again. Asked going up your arm d and say I want to turn up the ethics group. It's really important to go to those meetings Aunt here on DeVry time ago to ethics meetings or or, um, PPI meetings are armed. The meetings. We always have students in junior doctors of those observers. It's really, really good. Except it really good way of understanding. Very highly recommended that grill bronchi. Okay. And then a question here from down. Thank you so much. You're talking. You briefly mentioned the NIH are CPI scheme on your slide on a have me, uh, big baby on, ERM trial about the program. If it's really something you would recommend for getting more involved in the church of these, both at the start Marker is Oh, perfect. Yeah. I don't want to go into too much detail. That's a brilliant idea. So if you're in a in er in the hospital for a year, So so what happens is if you like myself. We run these large trials, like, especially encoded. The croup is completely your whole. It's like a little bit of a nightmare. So one of the ways we're trying to improve the croupiness to have these things called. Um uh Well, they called it. Um, yeah, associate pee. I see. So that's right. You can apply for the associate pee, I It looks good on your TV. You're then encouraged to recruit people. That's a good skill to learn, even if you ate it. It's really important to learn it because I'm learning how to include people. At least you realize how difficult it is to collect evidence on then And then one of the things you associate Pee Isis. We have to put your name on the paper and I expected to know the truth. So you use a win win win thing, you know? So I would definitely, you know, if I was in the hospital. If I knew that there was a trial like that going on, I was going ask to be the associate pee. I I'd say if you make this so so I I will go around and find patients, you know, because the reason people say yes to trials, you know the reason they say yes to my truck is my enthusiasm that you go on and on and on about the ethics and explain the trial and huge details. And then you say, or please be in my trial. I want to make things pressure in the future. Then they go, Oh yes, that's the better. Listen to like this, that they understand there's a doctor who actually really cares that the trial happens. You know, you after filling that was deported about their notes. And who's gonna look at their notes and the patient confidentiality and dark, dark, dark. But they're interested that someone pairs for them and someone cares about the trial. And so learning all that's fantastic at your stage. Like Brill, Thank you on shells. Just put the link in the chapped there for the h r c E p. I scheme in case anyone else to have a little look at that can any and I think that nicely takes us to the end of ah Oh, no. I got one more question. Uh, phone. So how does getting involved with translational research different from clinical trials in terms of what preparation might be useful? That's right. So So a translational research is now. It's now taking samples off a very specific group of people so very well, phenotype people. So I can only do my area of research. So if I want to do translation research, I would find people who have got really bad history of miscarriages. That's more than five miscarriages in a row, and I take samples of the lining of the wounds on. Then I take it to somebody who could do single cell sequencing, so they isolate the cells on. Then they sequence all the genes and the cells, and then you take that information and then you give it a buying from addition on the pharmaceuticals that with hundreds of color graphs and you spent hours and hours, get them to explain it to you to. And to do that, you need to have the knowledge that you need to understand out the brought to preparation. But the most important knowledge now is this being able to interact with by information's, which means, sadly, a detailed knowledge of statistics. Or you gotta have enough statistics knowledge that when they talk to you, you know what they're talking about. And sadly, I think also I feel that you don't want to have the wall pulled over your eyes because they can do so much statistics and make so many pretty graphs that quickly. It's really hard to be able to critically appraise those without detailed knowledge. So I think it's a fantastic thing to be, and it's going to revolutionize medicine. But you do need a lot of training, and to do that, I think you need to really have a clinical research fellow come out and get training in that area because those kind of doctors are gonna have a fantastic time. But sadly, you really, really have to understand what they've done to your data. But it's a bit horrible, like they've taken my sample and they do all these things and they recommend they know stuff. But you know what? What exactly did you do with the data? How lighter you and you know, these are these The questions you're duration doesn't need to your arse, but it's it's so I think. The previous speakers said that in the old days, in my days you didn't experiment. It didn't work. We spent like weeks and weeks and usually spend it didn't work. You get nothing And being a doctor in a lab with some sort of, quite frankly, close to a nightmare. And that's why the guy said, I'm going to medical education because resentful. But it's not like that now. Now it's working with teams and experts. I'm gathering the knowledge and after doctor to die to have a dialogue with them. So the pain is not, um, there was the experiment didn't work. The pain is understanding the mass or different pain. Difficulty. If you like that pain, have that one. Yeah, fantastic. Thank you. We actually have a few more questions, though, from Reggie Kit on This is what importance to review articles hold in terms of research. So oh, yes, it depends what level you are. So at a medical student on junior doctor level, they're great because their papers on their see be on their peer reviewed as long as it's a peer reviewed really of you article. That's fantastic if you're at my stage. Unfortunately, we get judged on original Oscar so we don't get many. I'm really sorry, but we're under even my stage and a massive pressure team eat targets. So what happens is I get invited to write review articles, but I can't spend time doing that because it doesn't in. My appraisal doesn't counts so much, but I'm supposed to have changed the world every year. It's impossible. So So what I do is, then I go, Oh, God review article I want to do that Don't have the time. So then I find a junior doctor Go. You know, it's your It's a new article on. Then I could, like, do the headings for them. Get them to do it. You know, just that these the subheadings you feel this in and I'll check it for you. So that's a brilliant way to get involved, too. Research. You need to find somebody like me. He's got more of you articles to right. Then they can, and they can do and meet their own told get you see, So it's a brilliant, brilliant, but it's a good idea. So that's why that's why there's a bit of a friction on that. And I always say, I'll only right over your skin. If there's a junior doctor and they mail back go Yes, of course. In other words, we're not gonna do it on your own, so So it's really, really, really good good way to do it. And so it should be a mutually beneficial relationship. You don't you don't know. I'm don't don't feel used to see if it is. Yeah, it is. It is a good, good way because it's good that I don't get any credit for those, but I want to do them. So then you can get all the credits. It's all brilliant. That's great. Thank you. On another question, uh, this is from shot again. Um, do you have any specific courses or degrees which would be useful in order to gain that background in order to understand the by statistics side of things that you mentioned before that bioinformatics. Very interesting, but definitely looked of grass that come because it complicated. Yes. Oh, yeah, that's right. So if you go down the academic part halfway, then when you in my university and in fact it's the same in all universities, when you do your eight yet a CF job, then you do a masters and then you choose modules that are that are in that so that that's what you do doing what and like, if you basically have to be able to program in our to even talk to them. Just warning you. But apparently programming l isn't that home except of your voice for your generation is very doable if someone tells you how to do it. Okay, great. They are rest of the van. How would you describe it? Paging Kating statistics with that? Yeah. So some of you so much like some of you could do. Is that right? Yeah. Yeah, by way of background. Okay. Any other last questions? No, they get so there's a link in the chart there. Uh, just give me a little bit more information about what our is. Anyone is interested? No. Okay. I think that probably closer to the end of, ah, talk there about getting involved with 30. Thank you so much. One couldn't be for doing that. I taught. That was really interesting. Really informative to thank you on. Thanks for asking fantastic questions and have a fantastic career, Everyone. Why? They okay,