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



Contents

• Why do research

• Careers– Academic clinical fellows

– Clinical lecturers

• Future



Why do research?

• You can make a difference

–Prevent a disease

–Cure it

–Reduce its effects



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…….



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 - Research

• Bowel cancer 1.2M worldwide– Observations on surgery

• Total mesorectal Excision

• Abdominoperineal excision

• Colon cancer

– Screening – Implementation

– Change

– Flexisigmoidoscopy



Leeds research

• Can we prevent bowel cancer ?

• Abnormal microbiome• Faecal transplants?



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



Why?

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



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



Lecturing/training/influencing



Why do research?

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



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 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


Opens Closes

ACFs Round 1 Early November End January

ACFs Round 2 Early February End March (following year)

ACF Recruitment Timetable


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



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



Out of programme experience

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

– PhD/Publications – Presentations



Senior positions

• Senior Lecturer 5 years

• Reader 2-3 years

• Professor – established Chair/personal Chair – career position



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



What is the connection between Black and Decker and Pathologists

InformationWhat do we do?



Threats



Opportunities

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



Opportunities – Digital pathology

• Integration of the microscope and computer

• Efficiency

• Breaks the limitations of the microscope

• Anytime/anywhere

• International opinions

• Learning/teaching/quality



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



Future medicine

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

with phenotype• Deep sequencing for

rare events• Copy number variation



Next generation sequencing

TPD52

Copy number variation

In house 1-50Fluidigm 144Haloplex 4,000

Mutation detection



Maldi-Tof imaging

• Protein visualisation without antibodies

• 30um resolution• EGFR• Amphiregulin• Epiregulin



Leeds



Programme

• LURE• iBSc• aFY2• ACF• Clinical lecturers

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



Questions?

why should i be an academic pathologist ? 10.10-10.40

Documents

clinical training

academic componentsupport

academic pathologist

research training

clinical lectureshipsacademic

training fellowship

ideasnihr trainees

conferencesnihr trainees