Frankie: ST6 Anaesthesia Specialist Skills Module (Research)

Frankie

Frankie is an ST6 trainee in anaesthesia in the North Western Deanery. He wanted to get more involved in research, but did not want to undertake a formal higher degree.

Frankie agreed with the School of Anaesthesia that he would undertake a specialist module in research in 2018/19, comprising six months of his ST6 training and counting towards CCT.

“Dr McGrath, my supervisor, has particular research expertise in airway and tracheostomy management in the critically ill, with a wide ranging clinical research portfolio that presented me with a fantastic opportunity to develop my research CV,” Frankie says.

To have some continuity in both anaesthesia and research training, Frankie spent one day per week undertaking research with MACC at Wythenshawe ICU over nine months, with the rest of his time dedicated to anaesthesia training, including on-call commitments.

For three months, Frankie was dedicated to working on full-time research projects, which all added up to a varied 12 months, with six months in total dedicated to research.

Frankie has led on designing a new industry-funded project, including developing the initial research question, literature reviews, developing the protocol, liaising with our funders, costing the study and completing the necessary regulatory approvals.

“I gained invaluable experience in writing grant applications, protocol and IRAS forms, analysing data, presenting and publicising results,” Frankie says.

“I worked with other researchers and R&D managers within MACC to understand how research is conducted locally and nationally. I presented three oral papers at national meeting and two poster presentations.

“I also published two full papers, a letter and four abstracts during my time with MACC. I was supported in attending a clinical research methodology course, anaesthetic research society meetings and national conferences.”

The study planned to start recruiting during Frankie’s time with MACC, and he remains involved as lead author on the subsequent papers and presentations.

MACC was able to support Frankie in completing his Good Research Clinical Practice (GCP) accreditation, attending a research methodology course, presenting at three national meetings, and publishing papers and abstracts, all in the first six months of his appointment.

“I enjoyed my time working with Dr McGrath enormously, for his wonderful support and mentorship,” Frankie says.

Fai: ICM ST6 Specialist Skills Module (Research)

 

Fai a trainee in intensive care medicine in the North West Deanery and chose research for her special skills module during her ST6 year. Fai has written an account of her time with the MACC team which can give an idea of what to expect from this role for future reach trainees. “I enrolled with the University of Manchester on a 12-month MPhil programme in August 2019, supervised by Dr Timothy Felton, senior lecturer at the University of Manchester and honorary consultant in respiratory medicine and intensive care at Wythenshawe Hospital. For my MPhil, I am writing a thesis on the outcomes analysed in randomised controlled trials evaluating ventilator associated pneumonia, over the last decade. I helped set up a systematic review and have extracted and am analysing the outcomes reported in these trials. This is the first step in the development of a core outcome set, as advocated by the Core Outcome Measures in Effectiveness Trials (COMET) initiative. COMET is an international group which aims to facilitate the development and application of ‘core outcome sets’ (COS) in clinical trials, so that researchers focus on a uniformly agreed upon set of outcomes, when performing trials on any given disease. I am doing the MPhil during my standard days, while continuing to meet the out of hours on call commitment during ST6 critical care training. This constitutes approximately 60% research time and 40% clinical time. My MPhil has been partially funded by the Deanery – Health Education North West, and partially by myself. The split in funding was approximately 40% deanery and 60% self- funded. Some great things about a special skills year in research;

  • Learning how to think like a researcher, getting to go to lectures on research skills at the university and learning how to write scientifically.
  • Having an opportunity to attend some of the critical care research meetings and learn about trial implementation on the ICU
  • Completion of Good Clinical Practice Training

Some challenges;

  • Juggling university work with clinical work, different skill sets needed, which do not necessarily overlap at all!
  • Meeting deadlines and doing on calls
  • Feeling out of sync with the administrative and teaching activities going on during my standard days, as these have been dedicated to research.
  • Being flexible with how I use my time

I would thoroughly recommend talking to the team about opportunities to get involved in ICU research, as there is a lot going on across the MFT sites, with plenty of support available for trainees who are interested.”

Thomas: Academic Foundation Year Attachment

I became involved with the Manchester Academic Critical Care research group for four months during my academic foundation year two rotation. Professor McGrath, a national leader in airway research, welcomed me warmly to the team and soon set me up with several opportunities. Considering the challenges that COVID-19 posed, Prof McGrath was very flexible, and I performed most of my work remotely, which suited me. Prof McGrath was keen to ensure that I got the most out of time with them and gave me plenty of opportunities to get involved in paper writing, research methodology, statistics, ethics, and data collection. I also undertook a remote Good Clinical (Research) Practice course (“GCP”) and got stuck in learning to use some statistical analysis packages.

With the Speech and Language Therapy team’s aid at Wythenshawe hospital, we collaborated on several tracheostomy projects. This included an interesting paper looking at tracheostomies and COVID-19 and how that impacts structural and functional laryngeal pathology. Another paper looked at a novel therapy for dysphagia in critical care patients called pharyngeal electrical stimulation.

Additionally, Prof McGrath put me in contact with other academics at the trust, and I was fortunate enough to get involved with a systematic review of hospital-acquired pneumonia under Dr Tim Felton and others’ guidance. This exposed me to a different methodology, and I could appreciate how a detailed systematic review was an essential starting point for many research projects.

I had minimal experience with paper writing before this rotation, and it certainly was a big learning curve. Whilst guiding me, Prof McGrath was keen not to just handhold me through the entire process, which proved very valuable. It meant that I had to discover my own way of writing a paper, and making mistakes on the way was part of that process. I have gotten more out of this experience by being encouraged out of my comfort zone and learning many new skills on the go.

Whilst there were deadlines, it was down to me to manage my time, and this was challenging at times, considering I had just come from a rigid clinical rotation. Whilst sometimes this lack of structure proved daunting, it provided me with the flexibility I had not had before. I could incorporate some clinical time alongside my academic work, and importantly make some time for socialising.

These four months have flown by, and I would greatly recommend this experience to anyone interested in academia. It has been filled with the frustrations of complicated statistics and the highs of finally submitting a paper. As ever, the more effort you put in, the more you will get out, and there is no shortage of academic opportunities. I have thoroughly enjoyed working alongside such experienced academics, and I have certainly learned a lot.

Mark: Academic Foundation Year 1

Mark Brown was an Academic Foundation year doctor at Wythenshawe Hospital in Autumn 2022. He was interested in a career in anaesthesia and research using data science.  

<img id="”>Mark says, “I became interested in Professor Brendan McGrath’s work during my final placement on the intensive care unit at Wythenshawe as a medical student. After securing a position within the academic foundation program (AFP), I was able to spend four months during the second year of the foundation program dedicated to research.

“Prof McGrath allowed me to get ‘stuck in’ to research within the Manchester Academic Critical Care (MACC) research group. The opportunity to be involved with several research projects allowed me to develop my quantitative skills with a meta-analysis and secondary analysis of data from the Tracheostomy Care Quality Improvement Program. Prof McGrath was keen to nurture my development using R studio to explore data for myself and the freedom to try new analytical approaches to answer clinical questions. These experiences have helped me to develop as an independent researcher who can think and do research.

“I had the opportunity to be exposed to a large breadth of research including grant applications, clinical trials, PPIE and even device development. A particularly exciting opportunity was to present a piece of work describing airflow characteristics from a computational model of a patient undergoing above-cuff vocalisation (ACV) at the National NIAA Anaesthesia Research Conference. Under the mentorship of Prof McGrath, I have been exposed to a wide variety of research and given the breadth and grounding to understand the field of academic anaesthesia and critical care. 

“The AFP can be a daunting experience, the pressure to produce output and a newfound freedom for self-directed work is very different compared to the experience of ridged clinical placements. While the academic placement allowed me enough clinical time to continue my training as a doctor most of my time was reserved for academia. Importantly, under Prof McGrath’s guidance, I had the flexibility to manage my own time and pursue topics I was interested.

“I have thoroughly enjoyed my time doing research. I cannot recommend the experience with the MACC team enough! A group keen to give young researchers like myself real opportunities to be clinical academics, who also support your development as a professional and enjoy research.”