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President's Column

We have the beans

A year ago, in the President’s Column, I likened the career progress of research-minded trainee pathologists to the story of Jack and the Beanstalk. With a mixture of hope and anxiety, the young Jack has already taken a risk in agreeing to exchange the family cow for a handful of mysterious beans. Now, from amongst the spreading tendrils of the huge beanstalk Jack gets a glimpse of a lush new country and a distant, treasure-laden castle…..

Andrew Wyllie

In the real world, I think I meet many Jacks - and Jacquis -  at the regional ST1 Training Course. Some have discovered Pathology almost by accident during their Foundation Years (unsurprisingly, since Pathology can be strangely invisible as a career option in many undergraduate courses). Many are in Pathology today because they were attracted by the possibility of having more time and opportunity to understand disease. Several have already tasted research through an intercalated BSc and are keen to retain elements of enquiry and discovery in their future career.

But the real world also contains imperatives, through which the lush country and beckoning castle of our dreams are replaced by the serious business of survival. Undergraduate medical curricula and the post-graduation foundation years provide a good start to medicine in general but can be largely empty of the skills needed in diagnostic histopathology, so the ST1 year can feel like starting at the beginning all over again. There are milestones that must be passed: the year 1 assessment including OSPE, two major College examinations and regular reviews of professional competence. Disturbingly, the real world seems likely to be an unfriendly one in which consultant posts are not as available as they were only a few years ago. It is easy to feel that this is not a good time to step out of straight-through training for three years as a PhD student in order to chase a dream.

In the story, however, Jack emerges from his life-changing decision with a commodity that he hadn’t possessed before or even been aware of: his beans. So are there really beans that, carefully planted, open the way to a career in which the saltiness of research training is attained in parallel with professional excellence?

 

As it happens there are, and the Pathological Society has a handful of them.

Each assists a career step on the route from undergraduate student, through Specialist Registrar, to young Consultant, via a research-rich path. You can find them in the Grants, Lectures and Awards section of the Society’s website. Research running costs are available to specialist registrars through the Small Grants Scheme (up to £10,000) and new techniques can be learned through visits to appropriate laboratories, assisted through a Visiting Fellowship (up to £5,000). These awards are available to members of the Society (who may be supervisors or applicants), and assist the generation of the early data that are essential for the next stage: application for a Research Clinical Training Fellowship from MRC, or similar awards from national charities such as CRUK or the Wellcome Trust. Such a Fellowship then permits around 3 years’ research training, usually leading to completion of a PhD.

Preparation for this application is a definitive step in developing a research oriented career. Several centres have won finance to help create up to 9 months of ring-fenced research training time for Specialist Registrars with aspirations in that direction. This is the “Walport funding”, generated following the report in 2005 of a subcommittee of the UK Clinical Research Collaboration, chaired by Sir Mark Walport. This influential report led to the institution of an Integrated Academic Training Path, a career structure designed specifically to create UK-wide opportunities for research-minded Specialty Registrars. Not all Deaneries have Walport-style posts in Histopathology on offer, but it should be remembered that these tailored posts are only one way up the academic beanstalk. The essential career move is to have a good research idea, identify a wise mentor, and put together sufficient pilot data that the bid for a national Research Fellowship is successful. Some Clinical Schools have their own awards for Registrars that provide financial support for the entire PhD period, or for enough to materially assist the subsequent winning of external support. The Pathological Society is considering launching its own 3-year Clinical Fellowship too, to provide robust support for this critical period.

The natural time for the PhD period lies just after the first part of the MRCPath has been successfully put away. Aspiring Jacks and Jacquis should therefore try to put in place, alongside the first three ST years, the early research experience that makes this step possible. However, there is flexibility in the route up the beanstalk.  Finding the right mentor is more important than the precise timetable.

 

So now the climb is nearly over.

You have your PhD, and with it a sheaf of new competencies, a self-confidence born of experience, a new standpoint from which to view the world, and  - not least - a helpful ticket for an academic post. This is likely to be a clinical lecturer post, beyond which there lie, should you wish them, University clinical academic posts for which the beanstalk climb has made you a serious candidate. The castle is in sight. But what about the CCT?  The Pathological Society can help here again, through its Career Development Fellowship. This provides the salary for a research assistant with running costs (up to £50,000 per year), for up to two years, so your research life can be kept going during the return to and completion of formal professional training.

Soon you will be running your own lab. You may wish to apply to the Society for PhD funding (to support a three-year PhD Studentship covering stipend, fees, conference allowance and consumables costs of up to £12, 000). Amongst your undergraduate students you will spot new, youthful Jacks and Jacquis who want to follow you up the beanstalk but don’t know if or how they can. To help them take their first steps in research, you can come to the Society for a vacation bursary (up to £150 per week for 8 weeks) or funds to underpin the fees and research costs incurred in an intercalated BSc (currently up to £5,750).

We have the beans.


Andrew H Wyllie
Department of Pathology
University of Cambridge

 
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