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Blog written by Florence Cook, Head and Neck Oncology Dietitian and Chief Nurse Research Fellow UCLH
I have been a dietitian for ten years and over the last eight, I have worked my way towards a specialist role in head and neck oncology. During this time, I have become very experienced in many clinical skills in my area so searching for a new challenge seemed natural. The obvious next step as a senior allied health professional in the NHS is operational management. This didn’t feel like the right fit for me. Another path is clinical academia. Research has always been something I have been interested in but it was my manager who helped me realise just how fascinating I found it. She mentioned in one of my annual appraisals that it came as no surprise to her that I was thinking about a career as a clinical academic. This had been obvious to her from the various audits and service evaluations I completed whilst in clinical practice to improve dietetic care locally.
In order to make the transition from being a clinician to being a clinician scientist, it is imperative to have a good research mentor. I have been incredibly fortunate to have a wonderful Clinical Academic AHP mentor within the head and neck department and my area of practice. She has helped me work through my research ideas, probed me where necessary and helped me navigate the clinical academic pathways offered for health professionals outside of medicine from pre-doctoral level and upwards. She signposted me to the National Institute for Health and Care Research (NIHR) / Health Education England pre-doctoral bridging programme which was accepting applications for new fellows. From this process I learnt how to write a competitive application and how to interview for research funding. I was subsequently awarded a place on that programme which included monthly supervision and lectures in research design and proposal development.
What fellowship was I awarded?
I recently completed the UCLH Chief Nurse Research Fellowship. This award is similar to the NIHR Pre-doctoral Clinical Academic Fellowship bridge, but locally available and has enabled me 2 days per week protected time from my clinical role over 10 months to develop a competitive application for a doctoral fellowship.
I have used my fellowship to finalise my research question and approach, my supervisory team to ensure I have expertise in my proposed methods, alongside practice supervisors to support my professional development. I have also undertaken training in statistics and preliminary patient and public involvement work to inform my research. Furthermore, I have used this time to improve my publication outputs. One example was showcasing the research skills I acquired from undertaking the NIHR Associate Principal Investigator scheme (DOI: 10.3233/ACS-220021). During my fellowship I have also accessed the fantastic support available from the Royal Literary Fund to help me improve my writing skills with certain aspects of my proposal such as my lay summary.
What is your proposed research about?
It is well known that nutrition is vitally important for recovery from surgery as poor nutrition is associated with decreased wound healing, increased complications, morbidity and mortality. Therefore, my proposal is about how we can optimise nutrition for people with head and neck cancer in the acute post-operative period.
How have you found working in clinical practice alongside research?
My clinical background has helped me conceive all my research ideas. It also means that the questions I have are grounded in problems I have encountered directly in practice together with what patients tell me is important to them. I hope this means that research I undertake will make a meaningful difference to the dietetic care of my patient group. What I hadn’t realised prior to taking serious steps into clinical academia is that having an idea is one thing but turning it into a research question and then selecting the right methods to answer it, is another. This process of research design has stretched my thinking in ways I could not have foreseen and has been challenging, enjoyable and enlightening in equal measure.
On a practical level, juggling two ‘jobs’ is difficult. It is easy to get pulled into clinical work during dedicated research time. I try and separate the two roles but I have also found being flexible is also important. It is vitally important to have a team and senior managers who value clinical research both for encouraging access to research opportunities for clinicians but also to ensure protected time to undertake this. I remember attending an event where our CEO spoke about the ‘circle’ of a successful hospital and the role research has in driving hospitals as commercially investable propositions. He stated that ‘Patients want to come to research-active hospitals. It develops philanthropy’. This is something I often think about; in my clinical work I implementevidence into practice, but I can also be part of developing the evidence remembering that patients want both. Furthermore, research is imperative for maintaining the excellence of UK NHS hospitals and being a clinician makes me uniquely placed to do that.
What makes a good researcher?
Since becoming more involved in research I have become much more exposed to and aware of the traits that help you become a good researcher. Patience and flexibility are important but if I had to pick only three words, I would say curiosity, resilience, and integrity.
You need to be curious, it’s what makes you want to do research in the first place and maintains enthusiasm. You also need resilience to deal with the rejection that often comes. Integrity is a given, to uphold good research ethics and practices.
How do you see your future?
My current goal is to be awarded funding to undertake a Clinical Academic doctoral fellowship to enable me time, resources, and training to undertake a PhD in head and neck cancer. My long-term goal is to become a Consultant Clinical Academic Dietitian with my own research group. I hope to support other AHPs undertake research and improve our representation in clinical academic roles across the NHS.