My name is Cat Atkin, and I’m an acute medical consultant at the Queen Elizabeth Hospital in Birmingham, and Assistant Professor at the University of Birmingham, where I work in the acute care research group. I trained in the West Midlands, and CCTed in 2023.
Introduction
Research in acute medicine is really important so that we can improve the care that we’re giving our patients, through improving our acute medicine services, our assessment pathways and the treatments we can offer. There are lots of areas in acute medicine where we don’t have a good evidence base, and where new services and technologies are being implemented, and we need to understand what groups of patients these work for and how we can use them most effectively. There currently isn’t enough research within acute medicine as a specialty – increasing the amount of research performed by acute medicine clinicians would mean we can answer the questions that are important to us and to our patients. For example, we could improve our understanding of how new models of care, like virtual wards or enhanced care units, can be used effectively.
What got you interested in Research as a special interest?
I didn’t develop an interest in research until after completing core medical training, largely because I viewed research as being largely laboratory based, and often very separate from the clinical world we encounter on a daily basis. In my first acute medicine job, as a CT2, I worked in a department that had clinical researchers, working on projects that very directly related to clinical care in acute medicine, which showed me the potential for research to make changes that could more quickly impact clinical care.
I’ve really enjoyed having the opportunity to learn lots of new skills, which are an essential part of research, that still directly relates to my clinical job.
How did you train in Research and what other avenues are there?
My first research role was as a clinical research fellow, outside of a training post, where I worked half the time as an acute medical registrar and half the time on a research project. During this time, I completed an MD at University of Birmingham, which is a doctoral research degree, involving completing a research projects and writing a thesis. My topic for this was diagnostic delay in myeloma, where I looked at data from a clinical trial where patients had reported the route they took to reach their diagnosis (what their symptoms were, and who they had seen), used electronic health records to look at changes in blood test results before diagnosis, and set up and conducted a trial where we screened patients admitted to AMU to see whether they had paraproteins suggestive of MGUS (https://doi.org/10.1111/bjh.16487). During my MD, I gained skills in applying for ethical approvals, consenting patients to research, statistical analysis and academic writing.
When I started my ST4 acute medicine training, I used my special skill time to work continue working with the Birmingham acute care research group. I then took up an academic training post, working as an Academic Clinical Lecturer (ACL) for four years until I finished my training. ACL posts give trainees that have an MD or PhD dedicated academic time within their training post, with 50% time clinical and 50% research. I split my time into blocks, alternating working for 6 months full time clinical and then 6 months research.
Other options include going out of program, during which you might work towards an MRes with a smaller research project or complete an MD/PhD with a longer OOP. There are also Academic Clinical Fellow posts available at IMT1-4 level, which are academic training posts aimed towards those that haven’t completed a PhD yet, and provide 25% protected academic time for 3 years.
What challenges did you face?
One of the biggest challenges is that research within acute medicine as a specialty is not as well developed as it is in some other specialties. This meant that there was no one in acute medicine locally who had gone through the same training pathway as I had. I don’t think this was necessarily a problem – it meant I ended up getting to know more people outside my own specialty, and developing a wider network, and I now have more links with people in other parts of the country working in research in acute medicine.
Starting out in research involved learning a lot of new skills that I hadn’t had to use before, like how to analyse large datasets, how to present research to the general public, and how to present results in a variety of formats. Although it’s a steep learning curve, it’s been really interesting and these skills apply outside of research as well.
Time management is a challenge – research will expand to fill as much time as you have available!
How does this fit into your consultant working?
I now have an academic post at the University, with 40% of my time dedicated to research, commitments to teaching, and clinical sessions in AMU and SDEC at the QE in Birmingham. My current research is looking at how we structure our acute care services and pathways into the services, particularly SDEC, and so my clinical experience relates very closely to my research. Research as a consultant is possible for those employed by NHS hospitals, often through having a number of PAs for research.
Do you have any tips for trainees who may be interested in research as a special interest?
- Try not to be discouraged if you are in a centre that doesn’t have a dedicated acute medicine research team. You can reach out to acute medicine researchers at other centres, and there are more opportunities for remote advice and support than before
- You probably have a lot of skills that are needed for research already, developed through other things like quality improvement
- If you’re not sure, you can start with something small – you don’t have to dive straight into a PhD, and you can build up skills like QI and teaching that helps show the skills you have.
- There are opportunities available through SAM, like posters and presentations at SAM conferences, and SAMBA, which I currently lead, and can be a good way to gain experience in data analysis and writing
- Research is really broad, from laboratory and translational research, qualitative research, big data and AI, and applied research that helps us understand clinical practice more directly. You might not enjoy all of these, but there is something interesting and enjoyable for everyone.
