why should i be an academic pathologist ? 10.10-10.40

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why should I be an academic pathologist ?

10.10-10.40

Phil QuirkeRoyal College of Pathologists

YCR Centenary Professor of Pathology

University of Leeds

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Contents

• Why do research

• Careers– Academic clinical fellows

– Clinical lecturers

• Future

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why do research?

• You can make a difference

–Prevent a disease

–Cure it

–Reduce its effects

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why

• Service career– Reports 2,000 surgicals a year– 35 year career– 70,000 patients– 50 colorectal cancers a year :1,750– GI biopsies: 17,500 each

• Variable private practice• Increasing management interference• Decreasing independence• Increasing commercialisation

– USA, Australia, SERCO…….

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Academic impact - Research

•Research•Helicobacter pylori observation •50% of the worlds population?

– Duodenal ulcer – 4 x106

• Gastric ulcer• Gastric cancer• Gastric lymphoma

Warren 2005

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Leeds - Research

• Bowel cancer 1.2M worldwide– Observations on surgery

• Total mesorectal Excision

• Abdominoperineal excision

• Colon cancer

– Screening – Implementation

– Change

– Flexisigmoidoscopy

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Leeds research

• Can we prevent bowel cancer ?

• Abnormal microbiome• Faecal transplants?

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Academic impact - Teaching

• Teaching– Undergraduates

• Influence 230 students per year • 8,050 doctors over 35 years• Create the next generation of pathologists

– Postgraduates• FRCPath

– 10 years training committee 300• PhD’s/ MD’s

– 40

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why?

• Patient benefit• Excitement• Challenges• Independence• Consultant for 35 years• Technology changes• Cutting edge• Self interest - jobs• Self confidence• Self satisfaction

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why?

• Variety• Influence policy• Change practice• Travel• Opportunities• Reward

– Building your own team– Seeing the success of others– Following their achievements– Pay progression/patent/startups/consultancies

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Lecturing/training/influencing

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Why do research?

• The thrill of discovery• You work in a worldwide community• Similar aims• Competition/friendship

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Academic careers

• Never a better time• Major shortage• Ageing population• Council Heads of Medical schools

– Worst Pathology/Anaesthetics

• 5x the chance of holding a Platinum award• International market• Freedom to explore your ideas

NIHR Trainees Coordinating Centre www.nihrtcc.nhs.uk

Integrated Clinical Academic Training Pathway

NIHR Trainees Coordinating Centre www.nihrtcc.nhs.uk

NIHR Academic Clinical Fellowships

• Academic and clinical training • For entrants to Specialist Training• 25% is academic component• Support in making application for training fellowship or

educational programme leading to higher degree• Up to 3 years (4 for GPs)• All ACFs except medical education are run-through• 250 posts each year

£4,500 over 3 years to fund research training and conferences

NIHR Trainees Coordinating Centre www.nihrtcc.nhs.uk

Opens Closes

ACFs Round 1 Early November End January

ACFs Round 2 Early February End March (following year)

ACF Recruitment Timetable

NIHR Trainees Coordinating Centre www.nihrtcc.nhs.uk

NIHR Clinical Lectureships

• Academic and clinical training for those with a higher degree• Available to qualified GPs and GDPs with higher degree• 50% is academic component• Support in making application for Clinician Scientist Scheme or

similar• Up to 4 years• End point marked by CCT and substantial piece of post-doctoral

research or educational work• 100 posts each year

£1000 for travel per year

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Pathways

• Service Consultant• ST1• ST2• ST3• ST4• ST5• Consultant

• Academic and service• ST1-3 / Academic

Clinical Fellow• Out of programme

experience PhD/MD• Lecturer• Senior Lecturer• Reader• Professor

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Out of programme experience

• 3 years funded by fellowship– NIHR– MRC– CRUK/ARC/BHF– College

– PhD/Publications – Presentations

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Senior positions

• Senior Lecturer 5 years

• Reader 2-3 years

• Professor – established Chair/personal Chair – career position

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

What happens

• All– Understand the literature– Undertake a research

project– Present their work at

national meetings

• Some– Publish papers– MD/PhD– Awarded grants– International meetings– Specialist reputation

• Few– Professional academic– Own research

programme– International reputation

• Fewer– Head academic grouping

within University

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

What is the connection between Black and Decker and Pathologists

InformationWhat do we do?

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Threats

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Opportunities

• Digital world 3D and digital pathology• Integration of genotype and phenotype• Stratified/personalised medicine

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Opportunities – Digital pathology

• Integration of the microscope and computer

• Efficiency

• Breaks the limitations of the microscope

• Anytime/anywhere

• International opinions

• Learning/teaching/quality

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Stratified/personalised medicine

• Prognosis – aggressive/benign outcomes– Her-2 amplification – Mismatch repair

• Prediction – which drugs– Her-2 breast and gastric cancers– Ki ras EGFr antibodies– Focus 4

• Toxicity– DPD deficiency– UGT1A1

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Future medicine

• Whole genome • Now £5000• 2 years £500• Association of genotype

with phenotype• Deep sequencing for

rare events• Copy number variation

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Next generation sequencing

TPD52

Copy number variation

In house 1-50Fluidigm 144Haloplex 4,000

Mutation detection

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Maldi-Tof imaging

• Protein visualisation without antibodies

• 30um resolution• EGFR• Amphiregulin• Epiregulin

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Leeds

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Programme

• LURE• iBSc• aFY2• ACF• Clinical lecturers

• ACF position to be advertised November start August 2013 Lecturer position

Leeds Institute of Molecular Medicine

Pathology and Tumour Biology

Questions?