Clinical academics are uniquely placed to bridge the gap between the lab and patients. At CRUK, we recognise the value in bringing those with clinical skills and perspectives into the research world, so we provide support for clinicians to launch and progress their research careers while continuing with their clinical roles.
Two of our recently funded CRUK Clinician Scientists, Drs Samra Turajlic and Simon Buczacki, reflect on the rewards and challenges of making the transition into this dual clinical and research role.
Samra, CRUK Clinician Scientist Fellow (CSF) at the Francis Crick Institute and Consultant Medical Oncologist at the Royal Marsden Hospital in London, has found that the dual role of a clinician scientist carries a number of advantages when it comes to her research. “When I design my research projects I think about how they could help patients in the long term. To me the two aspects of my role are synergistic: I want to make a difference to cancer patients overall, not just to the individuals that I treat, and my clinical work helps me keep sight of why I’m doing the research.”
She also likes the fact that, with research, there is an extra element of innovation. “It’s exciting and always varied, just like clinical work, but there is an added layer of unpredictability about research and making discoveries.”
My clinical work helps me keep sight of why I’m doing the research. The two roles are complementary – I could be in the lab in the morning using a drug on cells seeing how it behaves, then go to the clinic in the afternoon to give a different formulation of the same drug to my patients.
Entering the world of science
Changing fields and navigating through the options available in academia, is not without its challenges. Samra explains: “I didn’t know how people became principal investigators or how you could combine this with a clinical career. I was inspired by Charlie Swanton and knew I wanted to work with him if I could – I was introduced to him by my clinical supervisor during my PhD. Charlie offered guidance and highlighted CRUK funding available to me post-PhD.”
Samra points out that even when clinicians have successfully made the leap into the lab, they face a range of unique challenges in their careers, stemming from the difficulties of maintaining clinical practice whilst securing funding and finding time to carry out research.
The career pathway and critical gaps
Historically, clinicians have followed varied routes to move into a clinical academic career, largely because of gaps in the funding available, including one at the critical transition following a PhD. “There were few funding opportunities for clinicians to do postdoctoral research, other than the intermediate fellowships such as the CSF offered by CRUK,” explains Simon Buczacki, CRUK CSF at the CRUK Cambridge Institute and Consultant Colorectal Surgeon at Addenbrooke’s Hospital.
Encouraging more clinicians into research is so important to many funding bodies that several of them, including CRUK, recently undertook a review of career pathways of clinical academics in the UK. The resulting cross-funder report, published by the Medical Research Council, explored the experiences and career paths of early-career clinical academics, to understand enablers and barriers to their progression, identifying support needed at critical stages along this journey.
Only a small minority found it easy to pursue a clinical academic career, with difficulties reported across: the availability of funding and positions; balancing clinical and academic commitments; and a lack of integration between academic and clinical departments. However, the report identified key ways to improve the career path for clinical academics, including offering mentorship at critical career stages, providing greater flexibility in fellowship funding and improving support for clinical academics at universities and hospitals.
Supporting clinical researchers throughout their career
Over the last year we have overhauled our funding opportunities for clinical academics to ensure we provide the right support at critical points in the career pathway.
To address the gap that existed post-PhD we introduced a new bursary to provide funding for clinical trainees, enabling them to remain active in research after completion of their PhD.
Professor Tony Green, Chair of our Clinical Careers Committee, says of the changes: “CRUK has substantially revised the way it supports Clinician Scientists and now provides funding schemes appropriate to all stages of their career. Providing the right support at the right time will be crucial for nurturing the leaders of the future.”
Our ambition is to double the number of fellowships we fund to build a pipeline of world-leading clinical academics in cancer research. We have increased the funding available for CSFs and developed a more flexible framework to expand the duration to five years allowing more time for awardees to carry out research. We have also introduced a new Advanced CSF, offering senior clinician scientists the opportunity to develop independence and leadership in their field of academic research.
Both CSFs and Advanced CSFs are paired with a senior clinician on the CRUK mentorship panel for the duration of the fellowship. Mentors are usually based at another university and can offer independent and confidential guidance as well as regularly checking in on progress.
Whilst funding is the core element, non-financial resources and support are equally crucial. Simon explains: “The annual CRUK fellowship meeting, where all clinical academics meet up, is very useful. We get an update on current funding schemes and developments and a bit of science. Having this all in one place is really helpful.”
Looking to the future
Supporting more clinical researchers is so important if we are to build capacity in this area of critical need. Peter Johnson, CRUK’s Chief Clinician, explains: “We depend on having people who understand the clinical problems and can help bring the power of our research to bear on them.”
Finding and helping to train the next generation of clinical researchers is vital for us to achieve our goal of reducing deaths from cancer.
Through the recent changes to our funding schemes and providing continued support for our clinical researchers we hope to build a world-leading community of clinical academics in cancer research. There is still some way to go before we overcome all existing barriers, however, these changes bring us a step closer.
In this article
CRUK Clinician Scientist Fellow, Francis Crick Institute and Consultant Medical Oncologist, Royal Marsden Hospital, London
CRUK Clinician Scientist Fellow, CRUK Cambridge Institute and Honorary Consultant Colorectal Surgeon at Addenbrooke’s Hospital
Chair, CRUK Clinical Careers Committee, and Professor of Haemato-Oncology, University of Cambridge
Chief Clinician, CRUK, and Professor of Medical Oncology, University of Southampton
This story is part of Pioneering Research: our annual research publication for 2015/16.