Personal Story – The Clinical Scientist

Dr P. Lewis WhitePHW Microbiology Cardiff

Professional Summary

Degree

•BSc Biochemistry (Cardiff University 1995)

PhD

•PhD Microbiology (Imperial University 1999)

Post-

doctorial

•Food Microbiology (IU and IFR 2000)

Clinical Scientis

t

•Mycology (PHW 2000)

Principa

l Clinical

Scientist

•Mycology, WCM, Molecular Biology (PHW 2007)

Education

• Biochemistry BSc 2.1 (Cardiff 1992-1995)– Clearing– Medicine

• Broad Scientific basis– Microbiology

• PhD (1995-1999)– Initially Cardiff, – Supervisor offered Chair in Imperial at Wye– Broadened horizons

PhD• The effects of Environmental warming on

Antarctic soil microbial communities– Environmental Microbiology– Classical microbiology techniques

• Limited success – Lipidology– Molecular biology

• Limited biomass• Difficult sample type

• Enhancing the process of warming• Obtaining samples?

Travel to Antarctica

The Gallery

US Airlines!

Business Class!

The Gallery

Home, Sweet, Home!

Taxi!

The Gallery

Some Scenery!

PhD gains• Technical skills

• Knowledge base– General scientific plus highly specific

• Adaptability – Responding to unexpected results– Working in unusual situations/under different pressures

• Standing on your own two feet– Interpretation of results– Decision making – Project planning

• Difficulty in obtaining grants

2000 - Clinical Scientist in Mycology

• PHLS – Cardiff– CV: No Mention of Fungi– Molecular skills were directly applicable to the

post

• Develop non-culture diagnostics to improve the diagnosis of invasive fungal disease

Career development

• 2002 Lead Role in the Molecular Diagnostic Unit– Virology– Bacteriology– Mycology

• 2004 Scientific lead for the WCM– TB? – Incorporation of molecular techniques for

diagnosis and typing

Clinical scientists

• Develops, evaluates and trouble-shoots – specialist tests for diagnosing, preventing and managing

disease.

• Respond to emerging and emergency situations• Clinical liaison

– Understanding of disease in a clinical context– Understanding the test in a clinical context– Advise doctors on tests and interpreting data

• Perform research– understand diseases– Improve diagnosis– Improve patient management

Evolving

practice

New tools

AcademiaIndustry

Evolving practice

Local, national,

Global policy

Service Improvement, Clinical utility

Design, optimization,

Analytical validity

Clinical validity

Clinical Trials

UK standards published

Appointment 2000

Technical Evaluation Published

Development of Aspergillus PCR

Development of Candida PCR

Clinical Evaluations commenced 2001/2

Initiation of UK standardisation of Fungal

PCR 2003

2005 Candida Clinical

Evaluation Published Incorporation into

patient care pathways

2006 Aspergillus Clinical Evaluation Published

European standardisation

Preliminary evaluation published

2008

European recommendations published 2010/11

Full audit of care pathway published

2013 Research on going

Revision of international guidelines for diagnosis of IFD 2014/15

Clinical demand:Diagnosis of IFD Poor, Mortality rate >40%

High use of AFT at great expense and toxicity

R&D: Assay Design, optimization, analytical validity

Clinical utility: Do results benefit patient and hospital policy: Early diagnosis to minimize mortality and can negative results prevent

unnecessary treatment

Clinical validity: Testing samples with no impact on patient management. Do the assays

detect cases and/or exclude disease?

National R&D to standardize methods

International R&D to standardize methods

Patient management beneficially altered: Cases diagnosed, also IFD excluded, AFT

budgets reduced. Local policy altered

International recommendations provided

International policy under-review

Skills, interests and qualities

• Good knowledge of sciences specific to the field

• Interest in medicine and patient care

• High levels of accuracy and attention to detail

• Ability to concentrate for long periods

• Confidence to take responsibility for decisions

• Enquiring mind and good problem solving skills

• Excellent communication skill

• Teamwork and leadership skills

• Willingness to keep up to date with the latest scientific and medical research.

Modalities• Audiology• Clinical Biochemistry• Clinical Genetics• Clinical Immunology• Clinical Microbiology• Clinical Physiology• Embryology• Haematology• Histocompatibility & Immunogenetics• Medical Physics & Clinical Engineering

Salaries

NHS Annual Pay (£) Cardiff University Annual Pay (£)

Point 21    25,783 21 23352

Point 22    26,822 22 24049

Point 23    27,901 23 24766

Point 24    28,755 24 25504

Point 25    29,759 25 26264

Point 26    30,764 26 27047

Point 27    31,768 27 27854

Point 28    32,898 28 28685

Point 29    34,530 29 29541

Point 30    35,536 30 30424

Point 31    36,666 31 31331

Point 32    37,921 32 32267

Point 33    39,239 33 33230

Point 34    40,558 34 34223

Point 35    42,190 35 35244

Point 36    43,822 36 36298

Point 37    45,707 37 37382

Point 38    47,088 38 38522

Point 39    49,473 39 39649

Point 40    52,235 40 40834

Point 41    54,998 41 42055

Point 42    56,504 42 43312

Point 43    59,016 43 44607

Point 44    61,779 44 45941

Point 45    65,922 45 47314

Point 46    67,805 46 48729

Point 47    70,631 47 50186

Point 48    74,084 48 51687

Point 49    77,850 49 53233

Point 50    81,618 50 54826

Point 51    85,535 51 56467

Point 52    89,640

Point 53    93,944

Point 54    98,453

Lecturer Start point

Senior Lecturer Start point

State registration

• Protected title: Clinical Scientist

• State registration with HCPC– Searchable register– Attain– Maintain

• Regulated by professional bodies– Association of Clinical Scientists (ACS)

• Number of registrants: 4,988 (10/06/14)

Attaining HCPC Registration

• 1st March 2014

• 1.  The ACS Certificate of Attainment– completed a pre-MSC approved training programme– Portfolio - six years relevant experience, three of which must have been

in a clinical scientist role)

• 2.  The AHCS Certificate of Attainment, awarded to applicants who have completed an approved course from the Scientist Training Programme of Modernising Scientific Careers. These combine an MSc and approved work-based training.

• 3.  The AHCS Certificate of Equivalence, awarded to applicants who can demonstrate skills and knowledge equivalent to those who have completed an approved STP course.

Maintaining registration

• Record of continued professional development– Academic– Clinical– Professional

• Maintain professional standards

• Continue working in the field– Maintain satisfactory levels of performance– Advance field as required

Future Progression – Consultant Clinical Scientist

• Managerial role

• Clinical role– Fellowship Examination of the Royal

College of Pathologists (FRCPath)

Something different?

Pros and Cons• Combined academic and clinical role

– R&D, Clinical trials, Publications, Conferences– Without the Academic pressures

• No requirement to publish• No requirement to attain grants• No requirement to teach

– Involvement with patient care – With only occasional routine diagnostic requirements

• Variable commitment• Responding to emerging/emergency situations

– Working within the NHS• Long term/Permanent position• Good salary/Pension• Slow turning juggernaut

Points to consider for career progression

• Be adaptable– Use to difficult situations to your benefit

• Use your skills/knowledge– PhD: Specific skills– Transferable Skills applicable to many fields

• These will underpin many of your specific skills

– Embrace new technologies

• Broad experience

• Good collaborators