Scottish science is set to receive a multimillion pound boost to transform training for doctors who undertake cancer research – and help retain women scientists in the field.
Cancer Research UK is to award over £6 million to its research centres in Edinburgh and Glasgow to train early-career clinician scientists – doctors who also carry out medical research.
The joint Clinical Academic Training Programme Award* will transform clinical research training in Scotland.
Clinician scientists play an essential role in cancer research, helping to bridge the gap between patients and scientific research. Working across both the clinic and the laboratory, they are in a unique position to reflect the needs of people with cancer in the development of new treatments and tests.
But the number of clinician scientists in Scotland is in decline, particularly in senior posts**. Traditionally, the path to becoming a clinician scientist involves doctors taking time out of training to undertake a PhD, before returning to complete their medical training in their chosen specialisation. But many clinicians don’t come back to research after qualifying as consultants – particularly women.
Among the possible reasons for the attrition is that around this time of life many women contemplate starting a family.
To address this problem Cancer Research UK’s £6.2 million programme in Scotland will introduce new measures – including more flexible training options and improved mentorship and networking opportunities – to better support women clinicians who want to get involved and stay in cancer research.
Michelle Mitchell, Cancer Research UK’s chief executive, said: “Training early-career clinician scientists is a vital part of our work to save lives through research. Clinician scientists have a very important role to play by bringing their knowledge and experience of treating people with cancer to scientific research.
“If we’re to bring forward the day when all cancers are cured, we need all our doctors and scientists to be able to reach their full potential. That’s why we are taking action to introduce more flexible training options for early-career clinician scientists, as well as better support and mentorship. We want to encourage more women clinicians to get involved in cancer research and create powerful role models that will help attract and retain more clinician scientists in the future.”
In particular, the funding will enable the Cancer Research UK centres in Glasgow and Edinburgh to offer the MB-PhD*** qualification to early career clinicians – which would allow them to study for a PhD earlier in their medical training.
Research in the US shows that offering this qualification retains more women in clinical research, with 70 per cent of women there who have undertaken the US equivalent – an MD-PhD – staying in the field****.
As well as more flexible training options, the programme will take a more continuous approach to mentoring clinician scientists both during and after their PhD, when support to apply for follow-on funding to continue their research is important. There will also be a focus on building a stronger clinician scientist network in Scotland.
Dr Karin Oien is a clinician scientist and mum-of-three, based in Glasgow. An Honorary Consultant in Liver and Gastro-Intestinal Pathology at the city’s Queen Elizabeth University Hospital, she is also Clinical Reader in Pathology at the Institute of Cancer Sciences at the University of Glasgow.
It took 17 years from the time when Karin started out as a medical undergraduate before she embarked upon a clinician scientist fellowship. It was only then that she started thinking about having a family. Karin had her first child when she was in her late 30s.
Karin, now aged 50, said: “Ultimately as doctors, our aim is to do our very best to care for our patients. By qualifying as scientists, we are also asking questions and conducting research that will help the patients of tomorrow. This is vital in the fight to beat cancer.
“However, it can be challenging balancing a young family with clinical work, teaching and research – finding the time and especially the extra bandwidth and thinking time you need.”
As a pathologist Karin examines tissue samples from patients to make a diagnosis and predict if their disease might progress, and to help decide which treatments might work best for them. As a researcher, working on projects funded by Cancer Research UK, she helps to examine specific DNA changes in tumours to predict which treatments cancers may respond best to. She also studies cancers of unknown primary – where cancer has been found to have spread in a patient, but it isn’t known where in their body the disease started.
Karin studied medicine at the University of Glasgow, taking two years out of her training to do an intercalated science degree in pathology. After completing her medical training, she decided to specialise as a pathologist which involved a further five years of training. Keen to continue in research she took some more time out to do a PhD in cancer, before returning to finish her pathologist training and being appointed as a consultant. At the same time, she was awarded a Cancer Research UK fellowship to continue her research.
She is now Chair of National Cancer Research Institute’s UK-wide Cellular and Molecular Pathology (CM-Path) initiative*****, and she leads the Medical Research Council-funded Glasgow Molecular Pathology Node******.
Welcoming Cancer Research UK’s overhaul of clinical training in Scotland, Karin said: “Lots of good progress has been made in terms of increasing funding and flexibility for parents, carers and people with additional responsibilities – both within universities and the NHS. The situation isn’t perfect yet, but there is an increasing awareness of the issues and certainly there are many fantastic role models at our universities and in cancer research across the UK.
“This new programme of training and support for clinician scientists is another significant step forward. The increased flexibility it will offer, and additional funding and support after doing a PhD that will allow more time for doctors to do research, is a big step change in Scotland.”
She continued: “There is more work to be done to increase the number of doctors who do research in Scotland, by making sure there are more clinical academic posts available at consultant level.
“But this investment by Cancer Research UK will deliver a highly enthusiastic and educated workforce in Scotland that will not only be able to deliver new diagnostics and treatments but, working within the NHS, they will also be able to help discover and develop them in the first place.”
Scotland’s First Minister Nicola Sturgeon said: “I welcome these clinical research training awards from Cancer Research UK to support research careers and the development of more talented medical research scientists in Scotland working to improve cancer diagnosis and treatment.
“We recognise there can be obstacles recruiting women into science based professions and we are delighted that CRUK are joining us in the effort to tackle these inequalities. Workforce is a key ambition of our £100M cancer strategy and we aim to have a diverse, sustainable, workforce caring for people with cancer.”
Professor Moira Whyte, Head of the College of Medicine and Veterinary Medicine, who will lead the new training initiative at the Cancer Research UK Edinburgh Centre, said: “We are delighted to have secured this Cancer Research UK funding and to work with colleagues at the University of Glasgow to offer new and flexible training opportunities for doctors who will become the clinical cancer researcher leaders of the future.
“This will undoubtedly lead to benefits for Scottish cancer patients in the longer term.”
Professor Owen Sansom, Centre Lead at the Cancer Research UK Glasgow Centre, said: “To find new and better treatments for cancer, it’s vital for our scientists to be able to work together in the lab with clinicians at all levels and specialities.
“This funding to train more clinician scientists is fantastic news for Scotland. It will support us to make the most of the excellent research environment we have here to train the next generation of doctors and scientists who will help even more people survive cancer in the future.”
* The Cancer Research UK Clinical Academic Training Programme Award has been awarded jointly to the Cancer Research UK Edinburgh Centre and the Cancer Research UK Glasgow Centre, which includes the Cancer Research UK Beatson Institute. The Cancer Research UK Edinburgh Centre is a partnership between the University of Edinburgh and NHS Lothian. The Cancer Research UK Glasgow Centre is a partnership between the Beatson West of Scotland Cancer Centre, the Cancer Research UK Beatson Institute, the University of Glasgow, the University of Strathclyde and NHS Greater Glasgow and Clyde.
** Between 2004 and 2017, the number of clinical academics in Scottish universities at Reader/Senior Lecturer level declined by 33 per cent: https://www.medschools.ac.uk/media/2491/msc-clinical-academic-survey-report-2018.pdf
*** Bachelor of Medicine (MB), Doctor of Philosophy (PhD)
**** Harding CV, Akabas MH, Andersen OS. History and outcomes of 50 years of physician-scientist training in medical scientist training programs. Acad Med. 2017; 92(10): 1390-1398