Microbiology (Research)

Guest Blog from Sam Watkin: Researcher in a clinical space

girlymicro Academic Life, Guest blog, Healthcare Science, Microbiology (Clinical), Microbiology (Research)

As I continue the slow road to feeling more like myself again I thought it might be nice to have a guest blog from the wonderful Sam Walker on some of the things that have been happening in the research Girlymicro world, so you know I haven’t been entirely resting on my laurels and eating copious amounts of chocolate. One of my favourite papers ever is based on the release of cauliflower mosaic virus DNA into a ward space, to support prospective tracking of where organisms go, instead of trying to guess based solely on where we find them without origin data. Due to a number of technical factors this approach to improving environmental transmission pathways hasn’t widely been repeated………..until now!

Sam is a Doctoral Research Student whose research focusses on the development for environmental surface monitoring protocols to inform clinical risk assessments and infection control procedures. His project aims to develop an evidence base for the presence of nosocomial pathogens in the hospital environment, as well as model the transmission of pathogens in clinical spaces. He obtained an MBiol degree from Aston University in 2020, with projects focusing on C. difficile spore germination.

Infection Control Research

“I imagine the swabbing part will be easy, it’s the data processing I’m worried about”. I think I said this about a month before the largest, and final, sample collection campaign in my PhD project. Famous last words.

A little bit about me – my name’s Sam and I’m one of Elaine’s PhD students. I’m finishing off my third year now (crunch time!). My project focusses on developing evidence-based surface sampling guidance to inform infection prevention and control practice. Practically, this involves collecting a range of samples from different clinical spaces and seeing that they can tell us in terms of microbial communities and microorganism dissemination, then using this information to target guidance for designing the most effective surface sampling protocols. In order to best inform this, we designed a study which looks at the movement of microbial surrogate markers through several different wards at Great Ormond Street Hospital. This involved a lot of preparation and many evenings swabbing sites across four wards. As of last week, all this sampling work has finished and I thought I’d share a few reflections on what the experience of conducting research in an active clinical space was like.

Working across settings is amazing!

For many projects focusing on clinical practice, particularly ones relating to IPC, working in collaboration with a clinical institution is absolutely essential. As my project involves collecting evidence from clinical settings to then process and develop into guidance, in my case this work wouldn’t be possible without this collaborative approach. As the end goal of my project is guidance that will inform clinical practice, not only is it important that the evidence is gathered from clinical settings, but it’s essential we understand the routine challenges faced by IPC teams. We can design the best set of guidance with all the technical detail in the world, but if we don’t take into account every day IPC challenges and what implementing this guidance will actually look like, then in a way it would fall flat. Being in the clinical space also opens up the possibility for conversations with the people who live and breathe IPC all day – the hospital staff! Informal discussions we have had over the course of this most recent sampling project have given me completely new insights and ways to view the work we’re undertaking which I never would have thought of otherwise! Getting this insight from working in clinical settings will ultimately improve both the quality and utility of the work we produce.

Stepping out of my comfort zone

As a lot of project is lab-based, the trips outside of this setting into clinical environments can be a bit of a shock to the system. I’m used to, and probably most at home in, a quiet laboratory space with a few other people at the most, maybe the odd visitor and the trusty PCR machines. The majority of the time I make the journey from UCL to GOSH, it’s to meet either with Elaine or other members of the IPC team, or maybe to pick something up from the microbiology labs there. When it’s time to collect samples however, this is a completely different experience.

The units we looked at in this most recent piece of work we did were two outpatient and two inpatient wards, serving different patient populations. One of the first things I really noticed was just how different these wards all were. I knew that there would be some big differences, for example I knew that the cardiac intensive care unit would be a very different experience to the oncology day care unit. What I didn’t necessarily expect however, was just how different the two outpatient wards would be from each other, and how different the same ward could be on different days.

With these differences came a different way to approach the research at hand. For the outpatient units, that often meant waiting until all the bed spaces were free so we could go in and collect the samples from the environment. This wasn’t always possible though, and sometimes we just had to accept that we weren’t going to get all of the samples we set out to gather. This took quite a while to get used to – my inner laboratory scientist was wincing at the thought of lost data points. Being able to put this to one side and carry on was a skill that took a while to master, particularly when sampling with a team. No-one will thank you when you’ve been on the ward for an hour and a half and you propose “just waiting a few more minutes” to see if a bed space will become free. Having that skill to just move on however turned out to be very useful when collecting the data, as it meant we could focus more effort in the areas we could collect samples from.

All this boils down to how the space is used completely differently. The hospital is first and foremost for providing care to patients, and as a researcher I have to acknowledge that I am a guest in the space. Understanding and accepting that we won’t always be able to collect all of the 65 or so samples we planned to on a given day is just part of the process when conducting sampling in the real-world hospital setting. At first, I remember feeling like this may be frustrating when it came to analyzing the data, and that it would make interpreting my results harder due to data gaps. However, looking back on it now, I actually feel it makes understanding the story the data tells easier, and much more insightful. Being able to relate the information we gathered to how the space was used at the time of collection, even where samples could not be obtained, just makes the story all the more applicable to real clinical practice and, in this case, how microbes could move through the clinical space under all sorts of conditions.

Anticipate the challenges

While embracing the dynamic environment of the clinical space is really important for putting data gathered in these settings into context, it doesn’t mean that there isn’t a fair share of challenges with it. Before I began the sampling campaigns, both my supervisors absolutely insisted that I pre-planned every tiny detail. Down to the exact number of extra swabs I would take for each day. And I cannot think of better advice when it comes to performing this sort of work. Planning is absolutely everything. One of the reasons missing some data points during collection didn’t impact the overall quality of the data was because we anticipated that we may miss some points each day, so planned to take extra to account for this. We planned a detailed sampling sheet, so we could not only check off samples as we took them, but could make notes as we went around the ward on the environment to help with the downstream analysis. I cannot stress it enough; thorough planning made the whole experience so much better.

One challenge of conducting this piece of work was the intensity of the settings. I have a very much academic background, having done my MBiol degree and gone straight into my PhD. In other words, I have no clinical training whatsoever. This wasn’t so much of a problem in wards which were not high dependency, however I really noticed this lack of clinical exposure when we did the sampling in the cardiac intensive care unit. I knew it may be a difficult experience, given the nature of the ward we were going in to, but it still was a shock the first day of sampling there. I’m incredibly grateful for the team I did this part of the work with, who had the experience to navigate the space as well as make sure I was alright being in the setting. I think that this support, alongside taking some time to reflect on the overall experience, was invaluable for this particular component of the work.

This leads me on to the other absolutely key point for doing this sort of research – having the right people with you. As academics, we often won’t have been trained in clinical practice. This can not only make some clinical spaces quite intimidating, but also can make them hard to read. For example, without a clinical understanding of what is going on in a bed space, it can be hard to know whether to ask if it’s alright to take a swab of the bed rail quickly, or if you should leave the space and move on. Having people with you who can help read these situations is so important, both for help with collecting the data but also for supporting the researcher. Another massive benefit I noticed was the links formed between me, the researcher, and the ward staff. Having someone involved who has experience in both worlds can really help break down any barriers on entering the space and help everyone understand the work that is being done, and how it relates to the ward.

Top tips for laboratory researchers gathering samples from clinical spaces

So, having said all that, my top tips on performing research in clinical spaces as an academic are:

  • Planning is everything!
  • Anticipate and embrace the unique challenges of this sort of research
  • Have a good team who can support you in the clinical space
  • And finally, get involved! Undertaking research in clinical settings is very rewarding and I would highly recommend it wherever possible!

All opinions in this blog are my own

Methods for Dealing with Rejection: Remembering there is a difference between ‘that wasn’t for me/us’ and ‘oh that’s bad’

girlymicro Academic Life, General, Microbiology (Research), Research/Academia

Rejection and my ability to deal with it have been on my mind a lot lately. This is because I finally got over myself and started submitting a book proposal linked to this blog and feel like I’ve now become the Bridget Jones of the submission world, overly obsessed with approval and external validation. The thing is only 1 – 2% of books get picked up, which shocked me as it’s even worse than the success for grants, which is about 20%. However, having lived in an academic world filled with rejection for almost 20 years now, it is not like rejection is new to me.

I blogged a bit about the idea of writing a book when I first started playing with the idea, but it’s been a while, and it’s hopefully progressed on a bit. I ummmm’d and ahhhhh’d about keeping the details of this phase to myself, as there is a literal 99% chance of failure, but that doesn’t really align to my values.  It’s also caused me to actively reflect on rejection and how I manage it. As rejection is prominent across all areas of science (and life), I hope by talking about my tips for dealing with it, that I can share my learning and support others who may be going through similar things, whatever the source of the rejection.

Acknowledge that failure/rejection hurts and that’s OK

Let’s start by being honest. Failure hurts. It does. There’s no way around it. If it didn’t hurt, so many of us wouldn’t fear it so much. I have begun to think, however, that the reason it hurts as much as it does is because it forces us to have a look in the mirror and reassess, often with increased clarity. It forces introspection upon us, and that can be a challenging thing.

Failure is inevitable however, it’s a key part of the learning process, and the sooner we embrace that inevitability, the better placed we will be to deal with it when it arrives. Developing coping strategies and knowing yourself enough to manage your response is key. For instance, I have 2 key methods. First, I never only have a single plan. Therefore, if grant A is rejected, I will always have hope that grant B is still making its way through the system. Not having all my eggs in one basket keeps me sane. Second, I allow myself an indulgent 48 hour grieving period for failure. I allow myself to feel, to feel disappointed, to move through the self critical emotions without further self critique by forcing denial. 48 hours. That’s it. After that, I move to a more forward focused place. What’s next? What have I learnt? If I try this without the grieving period, I carry it with me, so I’ve learnt I need to move through the emotional aspects before my logical brain can kick in.

Find your support

As I’ve said, failure and rejection hurt, and like other forms of emotional trauma, your recovery is quicker with friends. From going out for cocktails during a breakup, to tea and cake when a paper is rejected, support is key. During the 48 hour grieving period, I may quite frankly need some bitching time. Some time to make the rejection about ‘the system’ rather than myself, to move towards depersonalising the failure. I may also need someone who can point out that the failure is definitely not as bad as it first appears and that the world is, in fact, not actually ending.

Put it into context

The reason the 48-hour grieving period is key for me is because all failure and rejection come with learning opportunities. The challenge is to get to the point where you can make the most of these. For me, I have to move from an emotional headspace to a growth mindset that’s more based in logic in order for this to happen. My emotions and passion drive my creativity, but when out of control, they act as barriers to seeing the big picture and where the learning lies.

Once I’m in a place where I can undertake a true review, there’s always something I can learn. Be that based on feedback I’ve received, be that based on how I’ve handled either the initial experience or my response to it, or the onboarding of more knowledge linked to the strategic landscape which will enable me to do better next time. Being open to this learning is what moves failure iteratively towards success, and if we don’t find a way to engage with it, we’re just doomed to repeat the outcome.

Evaluate when a ‘no’ is a ‘not for us’ – taking yourself out of the mix

Context is key. Without it, you can’t truly get to a place where you can understand feedback. There is, for instance, a big difference between a no and a not for us. I mean, I know the outcome is the same, but the process of moving forward is different. If something is ‘not for us’ it feels different. A flat ‘no’ can feel like a value judgement. It can feel like the idea/work is bad. A ‘not for us’ doesn’t feel the same. It means that the drivers and vision of the people who are assessing don’t align with your proposal. There are always more people, though. There are always other visions, and so this type of rejection is actually an opportunity, an opportunity to find someone who better aligns with where you want to be. I find one crushes my dream, the other opens a different set of doors.

Focus on what you can control

So much of the scientific and writing process ends in a place where we are not fully in control of the outcomes. That said, in the process, there is so much that you can control. You can control your approach, who you are submitting to, what your aspirations for the work are, and how you balance that with other pieces of work that you have in process. I find I need to trick my brain so that when I have something that has reached the part of the process that I have little or no control over, I am still working on another piece of work where I am still in control of the process, be that a paper, grant, blog post etc. This helps to stop me spiralling and obsessing about something I can no longer influence.

Have a plan A, B, and C

One of the key ways I’ve developed to maintain a sense of control is to understand there is never a single route to getting things done. There are always multiple ways to approach any aspiration and once you acknowledge this, you can make sure you include some of these alternatives in your planning.

The other component of this is to make sure that ‘the plan’ is rooted in realism, in both approach and time scale. There is nothing more disheartening than having a plan/approach that fails due to a lack of research/understanding. This is where your baseline skills as a researcher will come into their own. No matter the task, take the time to familiarise yourself with the barriers and options to ensure your plan is up to scratch.

Take inspiration from those who have succeeded

Big steps take time, and how you feel during this period is rarely static. There are times when I will love a paper, feel completely prepared for an exam, or feel like my dream could be a reality. Then, there are moments when I hate everything I’ve done and question why I thought I could ‘do it’.

At times like these, it’s worth looking to others for inspiration. For instance, Professor Julia Lockheart and Professor Mark Blagrove from DreamsID (https://dreamsid.com/index.html) invited me to their book launch earlier this year. Seeing their dreams made real was really inspiring and provided an extra push to just get on with following my own. When everything feels too far from reality, look to those who can demonstrate the outcome you are aspiring for.

When it’s all too much focus on associated goals

Sometimes, the dream itself is not enough. Running head-on at goal can, at times, be both painful and exhausting. When this becomes overwhelming, it’s sometimes better to choose to come at things sideways or progress associated goals for a while. For instance, if that paper has been rejected for the 4th time, it might be time to write a blog post on it and use that as a different opportunity to think about the core message.

This can be a really useful approach for the lulls that will inevitably occur, either because you’re waiting on responses or because you have to build yourself up to try again. These periods can feel like ‘dead time’, and trying to make more direct progress can just leave you feeling despondent. Understanding this and knowing how you can keep going in a different way helps.

Press the reset button – Decide whether it’s worth the pain – Return to your why

Despite all of these thoughts about how to manage rejection and carry on, I want to make clear that it is also OK to think about quitting. This sounds a bit strange doesn’t it, after all, in science we don’t quit. Except we do. Part of our growth is being able to reexamine our work, be that an experiment, paper, or project in light of new information. When you get rejections, then it is important to decide whether someone has spotted a fundamental flaw that you just can’t fix or takes the work in a direction you just don’t want to follow. This isn’t encouragement to throw the baby out with the bath water, but an acknowledgement that there are times when the right decision is to pause or discard a piece of work and that it’s important to acknowledge that as part of our processing.

Evaluate progress made

Once you’ve decided that you are still invested or that the piece of work you are doing still has value, to you or others, then it’s important to remind yourself of how far you’ve come. It will always be further than you think. This is easier if you had a plan when starting out, but even if not, you can spend 10 minutes just listing all the steps you have proactively taken in moving towards your goal. Listing your rejections and the learning from them is a key part of this evaluation process. Putting everything down in one place may enable you to see opportunities you might have missed or help develop your plan B and C options further. I would advocate doing this regularly, even in the absence of rejections, but it can be a particularly useful re-centering process when things feel hard.

Understand that the only way is through

Finally, if you’ve decided that what you are undertaking still matches your why, and that it is not flawed enough to walk away from, the only thing to do is JFDI (just f**king do it). Keep the faith, both in the work and yourself, and go all in despite how hard it can feel. Have a plan and take a single step at a time, until, before you know it, you’ve reached your destination. Anything worthwhile is worth the effort, and future you will thank past you for your persistence and determination. Have a hard conversation with yourself, and just keep going.

All opinions in this blog are my own

The PhD Edit: Links to some of the Girlymicro posts that may help PhD students

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

During July I’ve posted a series of articles aimed at supporting PhD students and those thinking about entering research or undertaking a PhD. So that you can access them more easily, along with an example of some other posts that might also help, I’ve collated them all for you as a series of links here in a single post. Hope they help.

Tips for when you are starting out

PhD Top Tips: So you’ve decided you want to start a PhD
Things I Wish I’d Known When I Was a Trainee: My top ten tips for making the most of your journey
Clarity is Key: The role of learning agreements in supporting learner success

Tips to help when you are designing experiments or struggling with challenges

PhD Top Tips: Finding the inspiration to develop your research question
PhD Top Tips: How to carry on when the experiment you’re doing just feels cursed
My Best Science Comes from a Cup of Tea: My top tip for Healthcare Science Week
The Second Year Slump: understanding the ups and downs of doing a PhD

Tips to help you share your work

Conference Season Is Upon Us: Top tips for anyone who struggles with networking
Conference Season is Upon Us: My top tips for conference presentations
Writing and Publishing Scientific Papers – Is it as hard as it seems?

Tips to help you get through your thesis and viva

PhD Top Tips: Write a thesis they said, but not like this they said
Surviving Your Viva: My top 10 tips for oral exams
I Passed my PhD 6 Years Ago This Week: What Tips do I Have for Those Who Are in the Process?

All opinions in this blog are my own

PhD Top Tips: Finding the inspiration to develop your research question

girlymicro Academic Life, Healthcare Science, Microbiology (Research), Research/Academia

In the last of July’s posts focussing on PhD tips, I thought I should probably spend some time focusing on research questions and creating an environment that supports having ideas. This sounds like the simplest thing, but I think it’s often an undisclosed struggle for many and a source of silent pressure that might benefit from being acknowledged, especially when you’re just starting out.

I think this area probably ties into who you are as a person. I, for instance, have never found ideas to be a particular issue, but I think that’s because I’m by nature a starter and not a finisher. I often have too many ideas in my head to be efficient in any form of implementation. You may, however, be the other end of the scale, great at implementation, but struggle at the start with staring at a blank sheet of paper. Both of these traits have their unique challenges when it comes to finding ideas and taking them through to realisation. As with so much else, knowing how you interact with the world will probably help in finding the best pathway to success.

So whether you are being over or underwhelmed by inspiration and ideas, I hope this week’s post may help you navigate some of the challenges of finding your next research question.

Science is a creative process

As Scientific Director of the Nosocomial Project, I’ve spent a far amount of time now working with people who are based in what is acknowledged as a creative industry. I think one of the things that has struck me is that there is more that is similar in some of the processes within the Arts and Science than is different. Although science is often seen from the outside as a process driven area, at its very heart, and to be successful, it is actually based around ideas, questions, and developing concepts. Both areas require us to be able to ask new questions and sometimes see the world or challenges in a different way to those who’ve come before.

Creativity in itself is a process. It’s something that requires the identification of time in order to allow ideas to be inspired, developed and reflected on. This is true whether you are a natural ideas person, who needs this time to be able to sort and feel less overwhelmed, or someone who needs space to allow the ideas themselves for formulate.

Now, I’m not going to say good ideas because I believe you don’t know whether an idea is good or bad until much further down the line, ideas aren’t weighted at the start, they are just ideas. Sometimes, the most far out one’s turn out to be best and sometimes the most solid appearing ones turn out to be a waste of time. Which brings me to thought number one: inspiration shouldn’t involve a value judgement. Being open to ideas requires time and occasionally bravery, but the shifting process, where you consider whether an idea has legs, comes later.

Make time for inspiration

One of the biggest challenges I’ve found with the way I see this and even when I’ve been writing this blog, is the temptation to describe and discuss productive time. The thing is, the creation of time for ideas is key but often doesn’t feel productive. I think this is because the very word productive links the time to a value judgement about the ideas produced, whereas creating the time for ideas is where the value lies, whether those ideas end up being genius or merely a stage in process.

This is one of the challenges with science being a process driven environment, with a focus on outputs. If we are not ‘doing science’ time is considered to be wasted. One of the things I try to encourage in my students is that a walk in the park just letting your mind wonder, or staring at the rain through a window to free your mind, is sometimes the most valuable time you will spend during your PhD. Especially if you’ve come up against a tricky problem. Staring at something head on can only get you so far.

Sometimes it’s hard to be passive, I’m really not that great at just ‘being’. If you are like me therefore you may decide a kitchen disco is the best way to free your mind or to go for a run. Finding a way that allows you to distract your mind to enable you to see things in a different way, whatever way that works for you, is the main thing.

Spend time reading and reflecting

Occasionally, the pressure to solve things or come up with ideas can feel a lot like writers’ blocks. Staring at empty screens, lab books, or grant templates. Although space often helps, sometimes you need a kick-off point. I find reading (or going to listen to people speak) can often be helpful at this point. I’m not talking about reading for critique here but reading for inspiration.

Often, when we are reading papers etc we are reading it to evaluate how good it is or to support technical understanding. I think reading for inspiration is probably a different skill. It’s the opposite of the trying to focus on the details we normally do. It’s reading and almost actively listening and recognising those little side tracking ‘what if’ thoughts that we would often try to ignore.

When reading for inspiration, you may also want to try different content that you would normally engage with. You might want to read about your subject from a different disciplines perspective, for instance, infection control but from a human factors perspective. If you are working in a translational area, you might want to read about another use of the technique that isn’t within your specialism or some fundamental science papers. You may even want to read articles and blog posts from patients or advocacy groups in order to get a different perspective. The main thing is to be cognisant in your approach and be open to going down some mental rabbit holes to see where they lead.

Sometimes, you need to act on your thoughts

Once you’ve done your reading for inspiration and have your thoughts the next step is deciding what to do with them. This requires some form of action, often doing some further reading or sitting down to grow that thought, and specifically reflect and write about how that germ of an idea might grown into a more fully formed question or piece of work.

This step is not always easy, but I think it is the part that most of us are more used to as scientists. That said, there are some days where my mind is a hell to me, and I think if it was visualised, it would just be a cloud of buzzing flies. On days like this, I write. I write blog posts. I write postit notes. I scribble notes in books. Writing things down, even if not to do with my research thoughts, creates a little space so that I can see the wood for the trees. It empties my mind on specific topics so I can gain clarity on other things and do the development work needed.

If being overwhelmed isn’t your issue, this is probably the time to hit the reading for research portion of development. This is where you would read more closely around the idea itself and start to see what others have done, undertake your gap analysis, and begin to think about the practicalities of undertaking the work.

Be prepared for failure

A wise person once told me that ‘science is 80% failure’ and that ‘the earlier I got used to that concept, the easier my journey would be’. As you hit the evaluation phase of idea development, you need to be OK with throwing out or needing to redefine a bunch of the thoughts you had in the earlier phases. This is the phase where you take your researched concept and try to change it into a fully formed research question or practical experiment. It is also the phase where you find out whether your idea truly translates into something workable.

Although this part can feel painful, it’s actually the core part of being a scientist and where a whole heap of the learning that occurs. The more you do it the better you get at spotting a good idea in the earlier stages, and actually the easier it is to be inspired and have ideas as it’s a skill that needs to be developed like anything else.

Sometimes it’s better to just start

Because the question develop part can be painful it’s something that, if you are like me, you may procrastinate over. You may just want to sit in the lovely inspiration phase where all your thoughts are still possibilities. The truth of the matter is that it is easy to justify staying in the thinking phase as it can be hard to know when you’ve done enough thinking and prep to move an idea to the next stage. However, if you never try moving from an idea to a reality you will also never succeed, and so sometimes we all need to pull off the psychological band-aid and just try it out. There are also times when you just frankly need to stop being scared and JFDI it to see where it goes.

Appreciate the role of translational reasearch

In my kind of research, which is clinical as part of Infection Prevention and Control, I have found something else that sometimes helps. Sometimes it can be easy to become hyper focussed on scientific issues and challenges. On days when I’m stuck and just don’t feel a way forward I play a little mental game with myself. Now, it’s no secret that I spent a bunch of time in hospital and experiencing healthcare as a child, and I now work in paediatrics. I therefore run myself through different scenarios as a paediatric patient visiting or being admitted to hospital. Scenarios with different incidences, organisms, and experiences. Sometimes inspired by real patient challenges I’ve been involved with, sometimes entirely theoretical. I then try to use that process to better understand what might be important to me, what the significant moments may have been and where we could do better. I find that running this from a patient centred viewpoint can provide me fresh perspectives, which in turn enables me to have better ideas. If you don’t work an environment where you meet patients, but your work is on a specific organism for example, maybe reach out to an advocacy or similar group, to help you also get a fresh perspective, or even just speak to family and friends about their lived experience.

Don’t worry too much about everyone else

I wanted to finish by talking about something that has been a bit of a theme in my academic life and the main thing I have learnt to manage it. That is the fear or reality of ideas being taken by either those more senior or those with more power/access. I don’t think I can say with any good conscience that this doesn’t happen, I have myself previously come in to access my desk to find a senior PI searching it for my lab books containing data they weren’t working with me on.

The thing I’ve learnt is not to hold onto any one thing too tightly. This isn’t justifying the fact that this behaviour exists, it’s just the way I have learnt to maintain my mental health and wellbeing. There are times when you need to defend and maintain ownership of concepts, especially if something is key to your PhD. For the most part, however, I’ve discovered that I will always have other ideas, and there will always be different ways I can spin the original concept. Some of my best work has actually come because of the external push due to someone published some of our shared work as a solo author instead of together. It forced me to take the next thought step and develop more than I may have otherwise.

So I’d like to finish on the note that no matter where you are on your scientific journey, trust yourself. Trust your instincts. Trusts you will always have another idea. Trust that you will always be able to come up with a plan B. Trust that there are people out there who will want to help and support. Sometimes, developing and maintaining that trust is our biggest challenge as individuals working in science, but it is worth doing the work as it will provide long-term dividends both in and out of work.

All opinions in this blog are my own

PhD Top Tips: Write a thesis they said, but not like this they said

girlymicro Academic Life, Healthcare Science, Microbiology (Research), Research/Academia

Dear gentle reader, let me tell you a tale, a tale of a naive PhD student and of her nemesis, the notorious villain known as The Thesis. Grab a comforting beverage, as this tale is filled with both thrills and peril for your delectation.

The final 12 months of my PhD were tricky. I had simultaneously signed up to do FRCPath and a PGCert in education on top of thesis writing, which in hindsight was beyond stupid, but made a strange sense at the time. So I was writing not only a thesis, but a Fellowship of the Higher Education Academy (FHEA) portfolio as well, and trying to submit my thesis a year early in order to allow revision time for my final clinical exams. I’d also run into supervision challenges as my primaries vision of my thesis, both in the required level of content and how that content was presented, was different to mine.  Needless to say, it was a bit a grim time.

Fast forward to my viva, I have submitted my thesis without supervisor sign off, and to be honest, there was a good chance I was entirely wrong and had set myself up for failure. The viva had lasted an hour, including having a cup of tea with my examiners. This is either a really good or hella bad sign, right? I’m standing outside the room whilst they deliberate, and I am seriously considering just running away as I’m in the midst of a full-on panic with my rational brain having entirely left the party. Suddenly, I hear them laughing, and I know that I am doomed. I’m about to just leave when the door opens, and they are standing there, staring at me expectantly. I have no choice, I enter the room to hear my fate.

The first words out of their mouths are “can you take a seat, we have some bad news for you and it’s probably better that you’re seated whilst we go through it”. At this point, I almost vomit, and it takes everything I have not to cry. I had been wrong. My primary was right, I’m a disaster, what was I thinking. I sit, and all I can think is that I just need to get out of this room and back to Mr Girlymicro, and the sooner I get it over with, the better. They look at each other and then at me, the external says “we have to ask for some changes and I’m afraid that they are substantial” they look at each other again pausing for what felt like forever before continuing “we need you to add an extra page of conclusions and it MUST NOT be more than 350 words”. They burst into laughter and shake each others hands and then mine. I stare at them blankly and ask them to repeat. When they are done laughing with each other they say, “also, when you have PhD students NEVER show them your thesis, show them a chapter of your thesis, that’s what a thesis should look like”. They then dump the examiner copies of my thesis into my hands to carry from the room so I can experience the weight….still smiling at each other, and the whole thing is over.

I therefore include my PhD thesis below not as an example of the thesis you should write, but perhaps as an example that is so long you might get away with a short viva and the examiners saying they never want to see it again. I also thought that this week I might include some of the lessons that that 12 month period taught me, as well as what I have learnt since from being both a supervisor and examiner.

Elaine_Cloutman-Green_final_soft_bound_Thesis_for_submission_dated_2015.pdf._REDACTEDDownload

Your thesis should tell a story, so be aware of what serves the tale

You may have a much better vision for your thesis than I did for mine, but whatever that vision is, it needs to involve telling your reader/examiner a coherent story. You may have done 20 small bits of work that you did because they were individually interesting, but when it comes to your thesis it’s time to put those together into chapters that read like you’d planned all of them together and a tale that hold logical progression from 1 chapter to another.

There are plenty of different ways to do this, and you can take any approach that makes sense for your work, but there are a few things to consider:

  • Think about having a thesis structure diagram so how your work hangs together doesn’t have to be intuited by your examiners, but is clearly laid out
  • Think carefully about the number of chapters and chapter order to ensure they are supporting the overall tale you are telling, be that of scientific discovery or adversity over failure
  • Try to embed being clear about your why and impact throughout, especially if you are doing a clinical PhD. Be conscious about picking the points where you can make your ‘so what’ clear
  • Rationalise what you should include to serve the story you are telling. You do not need to include every single thing you’ve done, in fact it could make it harder to read

Think about what purpose your thesis will serve

This one may sound a little weird, as surely everyone’s thesis serves the same purpose, to convey the work done during the PhD and provide a route for assessment. That is true. However, in terms of longevity, some thesis serve a different purpose. For me, as my research area is also in my area of work, my thesis is a manual I still go back to to remind myself of how to do pieces of work, such as decontamination validations. This won’t be true for some people. Some people write a thesis that will never be read again,  and so the thesis is written to please their examiners as a primary function. Mine, as you’ve read, was less pleasing to my examiners, but acts as a reference text for me to this day, and so fulfils the purpose that I had in mind when I wrote it.

Know your process

We all work differently, but the more you understand how you work the more you will reduce your stress around thesis writing. Are you a, write it up as I go kind of person? Are you a, I need to have all the info to decide what my story it before I start gal?

My process was that, because I was still working clinically part time, I took a month for each chapter of my thesis.  Week 1 I undertook a literature search and collated all the relevant papers, read them and made bullet points, week 2 I created figures and started writing, week 3 I finished writing the chapter,  week 4 I edited and sent it out for comment. Repeat for 5 months, and I was pretty much done.

My PhD students are far superior to me, they are well read, keep spreadsheets of notes, as well as writing up as they go along. As I was balancing responsive IPC and my PhD that just never worked out for me. There’s no point in pretending to be in a category that you aren’t or wishing it were different. Discover how you work, acknowledge it, and then find a practical framework where you can use it to your advantage.

Do your research

Now we are getting the nitty gritty of what I had wished I had known before I started, and this part all comes down to research. There are a few things which I wish I’d invested more time in before I even started writing my thesis as they would have removed a bunch of the wall contemplation and anxiety, as well as saving a heap of time:

  • There are lots of different ways to structure a thesis, and as long as you obey the broad university rules, the detail of how you do it is up to you. Spend time looking at other people’s, as the best flattery is to borrow, to identify the bits you like, the bits you don’t like, and find inspiration for what works for your way of thinking. All of the UCL ones are available online, and I’m sure many other universities are the same
  • Learn how to make/edit writing templates, or find ones that are pre-done. This may be the old person in me but I just didn’t know enough about how to set up word or other document templates to auto generate lists. My poor friend came in at the end and spent 8 hours correcting my thesis so all of it would work and I didn’t have to manually change my indexing
  • Find reference software that you like and spend time making sure your inputs are high quality and not missing details. The last thing you want to do for hours pre submission is to correct hundreds of incomplete references as you didn’t check on upload
  • Know your university submission rules inside and out. You will hopefully never be in the position I was in, where I had to know what would happen if I submitted without supervisor sign off, but even so it is worth familiarising yourself. These rules will help you choose examiners, understand time scales, and be sure your thesis structure is acceptable. Best always to be prepared.

More is not always better

As much as my thesis was long at 95,000 words plus references, for a short time it looked like it might be even longer and I was going to struggle to keep it under the 100,000 word limit. I had an entire other data chapter to put in and just had a lot of self doubt about dropping it as I thought it was the ‘lazy’ option (BTW I often struggle as I think of myself as a pretty lazy person and so find it difficult to self check). The thing is, it didn’t serve my story, and I would have been adding it in just to show how much work I’d done. That really isn’t the purpose of a thesis so in the end I was persuaded to edit and drop it out. It was such a good call but required the help and support of others. Making sure that you are either able to do a brutal edit yourself, or can call in the support of someone else who can, will make your thesis so much better.

Find a critical friend

Which brings me onto having critical friends. These are the people you like and trust to tell you the things you may not want to hear but will make your work better. You need to find a couple of these who will read though and discuss your work with you, preferably ones who will also help edit as they go. You need people doing this who understand what you are doing and you have pre-existing relationship capital with, so it won’t destroy your friendship when they point out that something isn’t making sense and you haven’t slept for a week. Pre build these relationships ahead of time during your PhD, nurture them, they will stand you in good sted, not just for your thesis but for life.

Take advice, but have the courage of your convictions

Writing a thesis is like planning a wedding, once you mention it everyone will just start offering you advice. I understand the irony of this statement in the context of this blog post, but it’s true, and honestly no one is forcing you to read these words 😉 All of this advice can become very challenging, as the likelihood is that some, if not all of it, will end up being conflicting, especially if you have too much of it. It’s one of the reasons I suggest having just a couple of good critical friends, obviously in addition to your supervisors.

I would also suggest reviewing all of the advice you receive on the basis of three things before you take it onboard:

  • The level of knowledge and experience of the person giving it you in the specific task you are doing – accepting a history PhD’s thoughts on your genomic thesis may not be that helpful, although they may inspire a new approach that could work
  • Understand the drivers behind the advice – some people will give you advice just because they feel they have to contribute, and some people will genuinely want to help. Not all advice is benign, however, and so understanding the drivers behind it is key
  • Evaluate whether the suggestion works for the way your mind works – some people will have really good suggestions that don’t work for the way you process the world or your vision – ideas are like dresses, the same ones don’t fit everyone

Be prepared to find your own way forward as you are the person who needs to write it. Keep enough of an open mind to accept a challenge that will lead to improvement, but don’t try to incorporate everything, otherwise you will lose your voice at the centre of it.

Be prepared for revisions

It’s so tempting to think that if you put enough time into your first draft that you will be saving time further down the line. The problem is that that is not always true. Sometimes, spending a lot of time on your first draft just means you go further down an inappropriate rabbit hole. You can lose not only lose a lot of time when you have redo it, but it can also become challenging psychologically to make the change. Think me and the Adenovirus chapter, unnecessary agonising occurred which took up emotional band width and time. In the initial structural work up phase, it is probably worth therefore getting early commentary before you are too attached to a specific approach, so that if you have to pivot you can do more easily.

The other thing to note is that it will always take you waaaay longer to edit than you anticipated. For most of us, we have never had to work on a document this long, and so don’t generally have good projection skills for the length of time it will take. You will also want so many more versions and edits of your thesis than of any other document you’ve done, as you won’t want all those spelling mistakes coming back as corrections, and I for one didn’t realising I would be on ‘final version’ 20 something.

Finally, your supervisors and others reading and editing it will take much longer to get it back to you than other things you’ve sent on because they also have to find larger chunks of time than they normally would. It is also worth knowing ahead of time how many times your supervisors are prepared to look at it, so that you make the most of the opportunities you have and pick the key moments for input. Make sure whatever time you think you’ll need for editing is probably tripled on your project plan.

Remember to take time to decompress

I write this as someone who quite literally lost her hair and developed a bald patch during her PhD, make sure you take breaks. Your brain is processing vast amounts of information during your writing up period and it is easy to become laser focussed. That’s good but it can also be trouble. You need to walk away from a piece of work to see the problems and the gaps within it. From a basic point of view, you will get to the point where you read what you think is there rather than what it actually is there, and that is no good to you in the long run.

So, from someone who didn’t and still lives with the physical consequences, make sure that both your mind and body are able to do what it needed of them by ensuring you rest. Sometimes, all you’ll need is a day in the lab away from the laptop, but some days you will need to have a long soak or a walk in the woods to enable your mind to see what’s right in front of it when you return. Also, I highly recommend booking a holiday between submission and your viva date so you walk into that viva room in the best physical and mental shape you can.

Your thesis is YOUR thesis

Your thesis, like your PhD is one of the few times in your career where the work should be entirely yours, and at the end of the day you will be the person sat alone in a room to defend your choices. I’m not advocating ignoring your supervisors, they will have huge amounts of experience and it is always worth getting the benefit of what they have to say. If the crunch time happens however you can’t use the ‘my supervisor told me to’ defence when you are sat in that room and looking your examiners in the eye. Your work has to make sense to you and be presented in a way that you can walk someone else through and defend it, there’s a reason a viva is called a defence in the US. So, as much as it’s important to get the best possible advice, input and support, when it comes to being in that room you are alone, and so you have to own the decisions you’ve made and the work you’ve done. You will come out of that room all the more developed as a scientist because of it, and whatever happens you should be proud of what you’ve done.

In the end, this princess and general could have chosen to slaughter the villainous Thesis, but instead she adopted it and made it her friend. Now it serves her as a memory charm and library guardian for all the work that came before, and acts as a reminder for her to be kind to all those that are following in her footsteps.

All opinions in this blog are my own

PhD Top Tips: How to carry on when the experiment you’re doing just feels cursed

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

A decade ago, I posted this on my Facebook page:

The thing is, it will not have been the only bad science day I will have posted about. You see, science is wonderful, but some days, it can also be heartbreaking. Before the breakthroughs, there is often a period where it feels like nothing is ever going to work again. I currently have a few PhD students who are in the ‘I just need data phase’ and so I thought I would take this week to acknowledge how challenging it can be and share some things I learnt that got me through.

The results of your experiment do not define you as a scientist

I want to say this first, and I want to say it loudly and on repeat, especially for all of those PhD and other scientists who are currently struggling with experiment failure – failed experiments DO NOT make you bad scientists! I shall say it again – failed experiments DO NOT make you bad scientists! All scientists fail, some of us have failed for months at a time, and challenging science is the name of the game. If you were doing something that had been done before, you wouldn’t be doing PhD level work. Therefore, failure, far from being a flaw, is to be expected. The sooner this is accepted, the better your mental health will be.

It’s incredibly challenging some days, but we all have to remember that our success at ticking actions off our list does not define who we are as people. Science is also far more than undertaking experiments. Did you sign up and deliver some kick ass outreach? Did you ask a great question in lab meeting? Did you make your struggling peer a cup of tea or help them with a figure they couldn’t get right? Sometimes, when the thing we’re obsessing about doesn’t go right, that is all we can see, and we ignore all the rest that is going well, make sure to acknowledge the good stuff.

Sometimes, you need periods of failure to get to the success

PhD’s are apprenticeships in research, and all of the failed experiments are far from a waste. They are part of the learning. You will use them to create your method development sections of your thesis, and they will give you great discussion points for your viva. In fact, if you had a completely clean sailing PhD that might be the more unexpected thing if I was your examiner, I’d be forced to dig more about where your learning happened.

Also, and I hate to do this as it’s the most trite thing ever, but some of the best science comes from mistakes and screw ups. Think Fleming and penicillin. The main thing is the mind set through which we view the failure. If we take it personally and let it get in our heads, all we can see is failure. Some of my best science has happened when failure has made me take a step back and pause, and suddenly I’ve seen the problem in a new light, or it’s forced me to make connections I wouldn’t have normally thought about. Sometimes, we need to be sure we see the failure as an opportunity rather than the end of hope.

It can be soul destroying when an experiment you’ve worked on for weeks or months crashes and burns, but the thing I’ve learnt is that often that happens when I push through too much, or don’t give it the attention it deserves. For me, experimental failures can also be warning signs about the pace and intensity of my work and can, in the end, offer a useful way to self check and force me to review my working patterns to give me a better more sustainable pathway to success. If you are crying over a failed run, it’s probably an indication that you need a break or to work differently.

Know when to continue down the rabbit hole and when to pivot

One of the biggest lessons I’ve learnt during my time working in science and doing research is that sometimes you have to be prepared to stop what you’re doing. During my PhD I spent 18 months trying to separate Adenovirus from viro cells using centrifugation to reduce whole genome sequencing read loading towards monkey rather than viral DNA. You know what, I got a bit of a reduction, but not enough to make a real difference, and to get that I worked till midnight for months as that was the only time the ultra centrifuge was available. What I didn’t do was a) set some success criteria b) stick to them and c) have a cut off that was based on effort vs reward. I just carried on…..and on……and on for very little payoff when I should have just stopped.

There will be times when you just need to persevere, as the work you are doing in central to the project and definitely achievable (anything core should be designed at the project level as attainable). There will, however, always be other aspects that need to be evaluated for the resource they are requiring (time, money, etc) vs what they are adding to your body of work. There is no point in spending 18 months on something that will be 2 pages in your thesis, there is point in spending 12 months fixing something that will be a chapter or more.

So one of the main skills I’ve had to develop is the ability to step back and see where the piece I am currently working on fits into the whole, and I can then evaluate what level of effort it is worth. If you haven’t set your success criteria etc beforehand it can be super painful to reach this decision and to walk away. This can be why having a good project timeline for your work/project/PhD can be really helpful. It helps you make pragmatic decisions and gets you out of the weeds in order to help you move forward with a view of the work as a whole.

Some days, you need to walk away to gain clarity

One of the things that has helped me with the ‘rabbit hole or pivot’ conundrum is getting to know myself enough to understand when I am in a spiral. My willpower and persistence are probably the only reasons I’ve managed to get as far as I have. The downside to these aspects of my personality is that I become hyper focused on a goal and the fact that it has to happen, I get in my own way and can’t always do the needed reflection piece. The end result of this is that it takes me longer than it should to realise I should have stopped (this is true of everything for me, not just experiments).

Believe when I say that it is worth developing the self-awareness to be better at this, as combined with the self reflection skill described above, it will be a powerful tool throughout your career. For me, this involved knowing when I need to walk away and distract my brain with some trashy TV or process it by writing a blog. My husband wishes it was the decision to go and load a dishwasher or clean, but no one can have everything. Pre-pandemic it was also things like going for a run, although I have to be honest and say I haven’t got back there. Whatever your technique, it took me a long time to realise this was a key part of my process. I needed to distract my brain, and the very process of doing this enabled me to gain clarity. Far from berating myself for my prevarication, it was actually key to achieving my aims and objectives.

Know when to get support

Frankly, sometimes you can’t manage alone. In fact, in my case, I hardly ever can. It’s why I really believe that science is a team sport. Sometimes, you will need someone else to help you recognise that it’s time to evaluate. Sometimes, you will need the support of others as part of the reflection process, and when it comes to troubleshooting why things are not working, two heads are definitely better than one. Far from being a sign of weakness, seeking support and building networks so you have identified that support are key parts of your career development. There will always be people out there who have more experience than us and learning from them so we don’t just replicate each others mistakes is just good resource management.

Always have a plan b, and ideally c and d

As I’ve already said, failure is just part and parcel of science. There’s no escaping this fact. What I have learnt though is there are routes to being more savvy about anticipating that failure. I had a fairly horrid experience during one of my masters degrees, where the project was designed as just one thing that either worked or it didn’t. Inevitably it didn’t, and I was forced to write 10,000 words on 3 results. This taught me 2 valuable lessons, 1) never blindly follow a project designed by someone else, if you feel it isn’t right for you own the fact that it is your project and you need to input to get it where it needs to be, and 2) never design a project that is entirely dependent on plan A working, as the chances are it won’t.

Taking a modular approach to any project design will enable you to combine parts that work and still have an over arching narrative that makes sense and enable you to succeed, even if individual components fail. If you are designing a project around a core component that you are then attaching spokes to, that component needs to be guaranteed in terms of process success, even if not result outcomes, as you can discuss the results in the context of your work, but you can’t risk not being able to get them. Take time to map this out and to undertake a SWOT analysis, so you can pre-plan for how you will manage any failures. That way you won’t lose time panicking when things go wrong, as you will have a defined pathway already.

Don’t benchmark against the success of others

A lot of the way in which we experience failure is defined by how we emotionally respond to the context of that failure. Sometimes benchmarking against others can be helpful, but more often than not if you are already feeling challenged it can just add to the pressure you are already feeling. I think this especially true when taking a PhD, as both you and your project are highly individual. It can be to look at others and their outputs and not compare, but the truth of the matter is you are likely comparing apples and oranges. PhD’s by their very nature need to be unique pieces of work, and so someone can appear to be killing it but their track record will look different to yours as they might face their challenges in the future, or may have to justify their work in a different way. So look to peers for support rather than affirmation of your progress, as every pathway in different. Otherwise you can make a challenging time even worse for yourself.

Know that we have all been there

I started out by saying that failed experiments do not make you a bad scientist and I want to finish by saying that the way I know this to be the case is that I have yet to meet any scientist who hasn’t spent dark days dealing with failed experiments, or just failure in general. No matter how lonely it feels in the moment, know that we have all been there. That may not make it feel any better, but I hope it empowers you to reach out and let your supervisors/peers know how you are feeling in order for them to support you through it. No one should judge you in this, because in judging you we would be judging ourselves. Science can be a really lonely profession, but it doesn’t have to be, and so reach out to your networks, and if you can’t reach out to them reach out to me. The better job we do of supporting each other the better placed we will be to create work that matters and improves the world just a little bit.

All opinions in this blog are my own

PhD Top Tips: So you’ve decided you want to start a PhD

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

It’s that time of a year, the time of year when I get a number of appointments put into my diary from people who want to talk about doing a PhD. This will range from undergraduates, where I’ve taught on their course, to established healthcare professionals with over a decade worth of lab or clinical experience. I thought it might be useful, therefore, to write a post where I go through some of the stages of discussion that take place in these meetings in order to help anyone else thinking about the same thing.

Over the last decade I’ve spent time talking with a lot of people who come to me saying they want a PhD and my first question is always why? I ask this not just because it is the question you will always get asked in your PhD interviews but because your answer will determine a number of things, some of which I’ve covered below.

How much thinking have you done?

Starting a discussion with someone where you ask why they’ve decided to do a PhD is a good way to check how much thinking they’ve done about a) what a PhD actually is and b) how it will enable to them to achieve their aspirations, a PhD is not the end game after all, it’s a step on a pathway. Now, if someone is an undergraduate, they may be focussed on a PhD as the next educational step and not yet have clarity about where it will lead. However, for someone whose already a working scientist, this question holds a lot more weight as they are more resource limited (in terms of time) and probably need higher levels of clarity prior to committing. The way someone answers this question (and it’s one I also use in interviews) helps me gauge how far along in the thought process someone is. In an interview, it also helps me gauge how committed someone is, as they have invested the time to really think about their why and how it serves their purpose and values.

This then leads onto some more specific questions:

  • What subject of PhD? are you looking to progress via a scientific route or via other channels in leadership or education.
  • What type of PhD – if you are coming to me as a Healthcare Scientist looking to progress a traditional research doctorates are no longer your only option. You can now undertake a professional doctorate via a number of different routes.
  • Where do you see a PhD taking you to in 15 years time? Which doors will it open? Are any of these restricted by doctorate type?
  • Why now? What are the opportunities or support you have available to you now. How have these changed (if you’ve been in post) to allow this to be an option now and how might they change in the future? Could any of these changes impact you in the time course of the PhD?

Thinking about what route to PhD you will want to follow is key. Some, like fellowships, come with substantial resource in terms of matched salary and both educational and consumables funding, but are highly competitive and will likely take you over a year to prepare. Others are much more under your control, like self funded, but require you to have resource of your own to begin with.

The route that might work best will therefore depend a bit on where you want to end up, but also on personal factors, such as finances and available time. Some of these routes may also limit progression down certain pathways, if you want to become a full research academic for instance you will probably need a research PhD rather than a taught doctorate. If you choose your route without knowing your why you could therefore close off some possibilities without truly being aware at the time:

  • Unfunded route, where you register but undertake an unfunded PhD alongside your post. Often your employer will pay your PhD fees and you apply for consumables money
  • Self funded route, where you take time out to do your PhD but you fund your own fees and consumables, usually in an academic department
  • Stipend funded, the route most people think of when undertaking a PhD. You apply for a project where the funding and requirements of the PhD have been set out by a supervisor. These are more like fixed term jobs where you deliver on a set of parameters
  • Fellowship, this route in probably the most competitive and requires substantial preparation. On the other hand it can offer a route by which you can undertake a PhD whilst still retaining your salary, and have access to funding for training and consumables
  • Training post, this route will often offer a taught doctorate rather than a traditional research PhD. It is also a way in which you may be able to develop clinically at the same time as developing leadership and research skills, and so might be the most appropriate route if you are aiming to undertake a PhD in order to get a specific role

How much research have you done?

When I talk about research here, I’m not talking about the academic kind, I’m talking about the fact finding and speaking to people kind. One of the ways I can often judge how seriously someone has thought about undertaking a PhD, and establish how far they are along with the process, is talking in a little more detail about what kind of research questions they are thinking of and the practicalities of undertaking a PhD in that area, such as what institution? or what supervisors? This is where the nitty gritty really starts to matter:

What thinking have you done on your research question, how far is it progressed? Do you have a broad subject like Clinical Microbiology, a more specific subject area such as Gram negative sepsis, or something really developed, such as comparison of molecular detections of antimicrobial resistance techniques and their impacts on antimicrobial prescribing decisions. There are pros and cons about having reached different levels of thought. It is good to leave enough conceptual room where your supervisors can support you in ensuring that your research question is both achievable and of PhD level. Coming in with only the broadest level of thinking however, tends to imply you may not have thought about it enough and may limit how much support and sign posting someone can give you, as it will be harder to tell which funders might be interested or academically where it might sit.

Who are you thinking in terms of supervision? Have you approached anyone? Making the right supervision decision is key, not just in terms of topic but also in terms of PhD experience. It is therefore always worth doing your due diligence in terms of research who is working in the area, but also in asking what is their working style? What is the experience of others in their lab? Can they help you in the kind of career path you are envisioning for yourself? If you want a clinical career you may not want to go and work with a fundamental scientist, as their networks will be different and may not support your trajectory.

What institution are you thinking of? Have you read up or spoken to others about what is like to study there? Institutions, like supervisors, tend to have a specific style, and it may be one that works for you but it also may be one that doesn’t. Your institution in some ways may be determined by your supervisors, but you may have the option if you are doing a combined clinical/academic placement to choose. You may also want to bear the institution in mind when identifying your supervisors in the first place and use it as part of your matching criteria. Sometimes, you may also have no choice in institution, especially if you are studying linked to a training scheme – in which case, be aware of travel or other requirements, when decided your route to PhD, as it may impact your experience.

Have you thought about the realities?

PhDs can often be idealised as experiential learning, the reality of them can be very different however, and I’ve already posted about the challenges of the second year slump. The truth of it is that all PhDs are challenging, and sometimes I think that achieving a PhD is more a measure of stubbornness and refusal to give up than of academic competence. There are some things that can be made much easier if you think about them and how they will work for you and your life style before you embark on this particular journey.

The first of this is how will you balance a PhD with your other life commitments? Each of the routes to a PhD have different pros and cons. If you don’t have loads of money in the bank, and like me don’t have a lot of savings, then doing a self funded PhD may not be an option for you. Other options, like a PhD with a stipend, may also be off the table, if you need your current salary to make ends meet. This in itself may determine which route you take. You may have resource in terms of finance but not in terms of time, you may therefore want to self fund or do an unfunded PhD, in a way that enables you to stretch the process out over several years, so your annual time commitment is less. On the other hand, you may be time limited and need to get it done in the next 5 years, and therefore not have the time resource to put all your eggs into the same basket and apply for a fellowship that takes a year to prepare and has a 20% success rate. Being honest with yourself about the different drivers is essential so that you can make the right choices in terms of route.

It is also key to know what kind of learner you are, I’ve already posted a bit about learning agreements, but even in the absence of one you still need to be aware of your needs. Do you need a supervisor who is going to have a lot of pastoral time? Do you want to be in a group with plenty of other PhD students so you have access to peer support? Do you hate micro management and pretty much want high level accessible support when you need it, but a light touch the rest of the time? These things will determine what kind of supervisor and setting you will need to identify, and the questions should be asking (outside of the scientific) in the process.

Finally, and this one is oh so important, what’s your end game? If you want to end up as a Consultant Clinical Scientist but have little interest in a research career, a taught doctorate may be right for you, it will not be the right choice if you want a Clinical Academic career however. If you want to follow a clinical pathway you may want to ensure that this aspect is retained in your research question, to enable follow on post docs and other progression that supports your clinical role. Not to harp on, but if you don’t know your why no one else can, and it can mean that you make decisions that close future routes rather than keeping progression pathways open. Also, did I mention doing a PhD is hard? If you don’t know your why it can be super challenging to just keep going when the tough times do arrive. If you know your why however, at least you can cling to that vision and end game in order to get you through.

I hope this post helps show that there are many different choices open to you if you are thinking about undertaking a PhD, but that it’s worth doing some thinking and fact finding as part of the process to make sure you make the decisions that are right for you and your life style. For those of you who decide to jump down this particular rabbit hole here are some things I wish I had known when I started, and good luck, you will rock it!

All opinions in this blog are my own

Would You Like That Explained in Words of One Syllable? Thriving in the world of a mansplainer

girlymicro Academic Life, General, Healthcare Science, Leadership, Microbiology (Clinical), Microbiology (Research), Research/Academia

This post is in honour of international women’s day, I hope by talking about this and sharing some thoughts it will make us all more able to stand up for ourselves and support others in moments like the one below, when we encounter the mansplainer in their natural habitat.

I was at a conference last week, and I was struck yet again by the number of questions that were asked that were commentary and not indeed questions. I paid attention, and, in this case, 100% of those undertaking this behaviour were older men. The reason I started to pay attention was because the first session I attended was filled with a panel of young female scientists. The Chair of the panel, however, was an older man, and when this commentary occurred from one of the attendees, instead of shutting it down, he actively participated and even exacerbated the issue. Not only that, but the commentary was also inherently incorrect and was not even helpful. I must admit I found myself becoming pretty infuriated and later found other women who’d been in the room who found it equally maddening. So this week I thought I would channel some of that science rage into a productive place and talk about survival in the world of the mansplainer.

NB please note I recognise that there are also some women that exhibit these behaviours routinely (and we probably all do periodically). In this post I talk about mansplaining as the behaviour and not linked to gender, unless I’m recounting specific personal experiences.

In the interests of full disclosure, I’ve also had a fair amount of men recently lecturing me about what it is I do and do not know, as well as some ‘interesting’ comments on my blog. I therefore may not be feeling as balanced about this topic as I would otherwise. The thing is, it’s not like it is as unusual as it should be, and you would think, therefore, that I should be less bothered by it. In fact, the opposite is true. Now I’m aware and see it happen to others. I’m even less tolerant. I’m pretty fortunate that it only happens to me 3 or 4 times a year to a level that irritates me. It happened less when I became a Consultant, and I suspect that it will happen less (to my face) now I’m a Professor. Even so, with all of these benchmarks of knowledge and experience, it still happens. So here are my thoughts on living in the world of the mansplainer and how we might all work together to make it more tolerable.

Don’t worry little lady

Let’s start with talking about some classic mansplaining that has happened to me. I’m partly starting out with this because I had a really lovely male boss who just didn’t believe that these things happened as no one had talked to him about it. By putting it down here prior to talking about what we can do in response, I hope to contextualise some of what it’s like for any allies out there who have experienced it less as individuals.

My all-time ‘favourite’ example of mansplaining that has happened to me was an email sent to myself and a female colleague that actually started with the words ‘don’t worry little ladies’. The email in question was sent in response to a query about engineering standards. Now, these days I would respond with ‘that’s Professor Little Lady and I am worried so please explain………and what you are going to do about it’. At the time, though, I was completely thrown by how 4 words could effectively minimise my years of experience, my authority to ask the question, and impact my feelings about my ability to follow up. In my defence, I did follow up and insist on further information and a review, but something so small could actually have impacted my ability to do my job and would never have been undertaken with my male consultant boss. These comments, therefore, are not insignificant when, especially in healthcare, they could lead to a reduction in safety. That said, did I escalate? No, did I forward the email to his boss and explain? Also, no. It’s so normal that it never even occured to me. I suspect if I had, it would have just been called ‘banter’ and waved off.

One of my other favourite things (not really) is when I’m called into a room to have a technical discussion, and when it becomes apparent I’m not convinced by the argument, the room full of men call in yet more men, not to enhance or bring more information to the discussion, but because they somehow believe that having more men in the space repeating each others words will somehow intimidate me or force me into conceding that their science is suddenly correct. I do not enjoy conflict and I generally believe it’s bad form to point out the flaws in someone’s argument in front of others, in a way that could be seen as aggressive or embarrassing for the individual. However, if you pull >20 men into a room to lecture me on, for instance how HPV works, when you are neither a microbiologist or have any experience with viral loading or kill, and think that calling in a further 10 will change the underlying fact that I have just finished writing about it for my thesis, my argument is unlikely to change. All that will happen is that I will cease trying to cover up my level of knowledge in order to play nice and I will quote papers and research at you until you let me leave.

Have you thought about?

One of the other scenarios I’ve found where some interesting male commentary occurs is on some of my blog posts. Now, don’t get me wrong a) most of the commentary I receive on my blogs is super supportive and is what gives me the impetuous to continue to write them and b) I acknowledge that by writing and (over)sharing the way I do I also invite engagement and discussion of the content I put out. Every now and again I get a comment that I don’t approve for public sharing and just leave in the archives as I’m not sure that they are part of the discussion I want to have.

When I posted earlier this year about being overwhelmed and shared some tips that have helped me to get through I received some comments from various male subscribers. These comments were very different from those of my female subscribers, who shared how grateful they were that we were talking about the fact that everyone has days when they struggle and that coping mechanisms are key. These comments all came from a place which I assume was kind and supportive, but ran along the lines of ‘if you feel overwhelmed maybe you should have spent the extra time working and clearing your emails rather than writing this blog’.

On the surface I kind of get it, but also a) it is my right to choose how I spend what free time I manage to have for myself, without commentary from others as long as I’m breaking no laws and hurting no one b) blog writing, for me, has become a method of processing my work load and stress levels and therefore suggesting I abandon it would be removing a key coping strategy I utilise c) the blog post was about sharing experiences and methods to move through feeling over whelmed, not a pity party post about how it sucks, therefore the suggestion that I focus my time on not supporting my community is against the ethos of what this blog is about and frankly kind of sucks and finally d) the assumption that I wouldn’t have considered doing less and not over stretching myself probably doesn’t give me very much credit in terms of self reflection or self awareness. So, I suppose my point is this, sometimes by stating the obvious and your opinion about it, it can come over as pretty patronising, as if it wouldn’t have occured to me and I haven’t done the thinking myself. That said, intent matters, and I don’t believe that these are often meant with any ill intent, so I leave them as unapproved and a source of future consideration and move on.

If you look for it, you will see it

Frankly, some of this is insidious, as I discussed in the intro, I only really started paying attention at the conference because there was such an extreme version of it that it drew my attention and I became deliberately aware of it. Sadly, when I posted about it on twitter the almost universal response was ‘only one’ to my retelling of the male commentator. It’s so universal as a stereotype that we laugh about it, but my thinking is also what can we do to challenge it or support others when we see it.

Summary.   

Role incredulity is a form of gender bias where women are mistakenly assumed to be in a support or stereotypically female role — an administrative assistant, nurse, wife, or girlfriend, for instance — rather than a leadership or stereotypically male role, such as CEO, professor, lawyer, doctor, or engineer. While this slight or mistake might seem innocuous, it can have real ramifications for women. Women must expend extra energy and time to assert and prove their role. Their words may lack the credibility and authority inherent in their position. And when women are not seen as a leader, they may be less likely to be hired into male-dominated roles or to be considered for promotions.

While the real issue of role incredulity is systemic, there are steps organizational leaders, workplace allies, and women themselves can take to prevent and correct it., including setting organizational norms, being an ally, owning your mistakes, and, if you’re a woman, proactively identifying your role.

https://hbr.org/2021/12/when-people-assume-youre-not-in-charge-because-youre-a-woman

I suspect there are few women amongst us who haven’t been asked to ‘sort the coffee’ despite being one of the most senior people in the room, or who haven’t had their bank card saying Dr handed back to their partner. These are little things, and I for one am completely OK with getting coffee, but not because I’m a woman, but because I think we should all take our turn and hierarchy shouldn’t remove us from that. I find it hard therefore to know when to draw the lines over such things, I’m a team player and want to do my part, but I also don’t want to sustain a stereotype that might negatively impact others. Honestly, even thinking about these things in the moment and having that constant dialogue with yourself can be pretty exhausting when it happens over years or decades.

Do these things actually matter?

Even though I feel that I own my place and have so much more strength than I did when I was younger, these comments, decisions, and moments still take up cognitive space. I may rebound more quickly but I still go through the ‘experience-self recrimination spiral-replay’ cycle in order to process it and decide where fault may lie with me or where the learning is.

“What we found was that women largely had negative outcomes as a result of being mansplained to, whereas it didn’t affect men as much,” said Briggs, whose research was published in the Journal of Business and Psychology. “They tended to register that their competence was being questioned more than men did, and to attribute this to a gender bias – so, maybe this person doesn’t think highly of me or doesn’t like me because of my gender.”

This feeling wasn’t shared by male volunteers who were given a condescending explanation by a woman. “Maybe they perceived it as ‘this person is being rude to me’, but they didn’t perceive it any differently if it came from a man or woman, and they didn’t attribute it to a gender bias,” Briggs said.

https://www.theguardian.com/science/2023/feb/03/let-me-mansplain-studies-reveal-negative-impacts-of-behaviour?CMP=Share_iOSApp_Other

It may be therefore that we have to acknowledge the role we play in how we receive the information and the fact that some of the behaviour we experience really does not have any ill intent. However, that also doesn’t mean that those undertaking such behaviours don’t equally have a responsibility to understand how their behaviour impacts others, and in some cases leads to the active detriment of the women who are the recipients. Especially if this behaviour is endemic in institutions/settings or originates from the same individual over protracted periods of time.

So, how do we handle it?

I’ve previously posted about how I learnt to own the place I found myself in with some tips on managing this as individuals. I do think that dealing with direct interactions rather than our own imposter syndrome needs a different set of skills, ones that may indeed help with how we see the world over all. It all starts with being conscious of ourselves in the moment, where do we sit, what do we say when we introduce ourselves, how do we respond in the moment and how do we let our view of ourselves drive these dialogues?

Below are some areas of thinking that have helped me and I hope might also help you in traversing the particular challenge.

Decide which truths to believe

I am often considered over emotional because I wear my heart and values on my sleeve. It’s a running joke within my team that I have absolutely no poker face, and the time to be concerned when in a room with me is when I stop being expressive, as it probably means I have become coldly annoyed.

For a long time, I thought that this was the biggest weakness. I had many a person (male and female) explain to me that I couldn’t be successful as I was and that to proceed I really needed to change and fit the stereotype of what a boss/consultant/professor should be. Well, frankly, screw that. Hiding who we are and pretending to be someone else should not be the only path to success. Being open and honest about my values and who I am is not a weakness. It requires integrity and fairly often bravery to function openly as who you are. We are supposed to be assertive but not too assertive, smart but modest about it, passionate but not emotional. I, for one, don’t want to play that game and, in many ways, just opted out and found ways around it. I strongly believe that we no longer need to play by the rules of those who came before us, let’s set our own rules, let’s choose our own truths and empower the future to be different and better for those who will follow on behind us. Choose your own path and let that be your truth.

Practice makes perfect

Now, I’m not sure I would be comfortable saying any of the below as they are written, I think I would be too scared of coming off as aggressive. For all you women out there who could and own being that assertive, I am not worthy. That said, I have used many of these responses, if not these exact words, in order to manage conversations.

The thing for me is you need to know what language you are comfortable with and practice it before you need it. In the moment I am often surprised and lose my mental footing, therefore if I haven’t practiced how to hold my ground and be assertive I lose it to hesitancy and upset. Practicing enables it to almost be a reflexive approach that you can draw on, so that you don’t have the cognitive additional load of making those nuanced word choices in the moment. So the sentences above may not fit you, but find ones that do and try them on for size well before you need them.

One of the things that also helps me is wearing a different head space when I go into rooms where this is likely to be an issue. ‘Dream’ would never hold up in these spaces, and when I leave them, she often crumbles in the replaying of the moment. Professor Cloutman-Green, however, is much more able to hold her own. It’s almost like my science shield enables me to suffer less from impact in the moment and so allows me to maintain or re-establish myself in that moment much more readily. This is different from not being my authentic self in a space, I am still me, but it gives me the emotional distance to process things later rather than being overwhelmed in the moment.

Self-awareness is key

Ever walk into a room, and there’s a single chair left and you offer it to everyone else who comes in after you? I do this all the time. It’s just polite, right? Absolutely. However, if you are in a room that internalises hierarchy and everyone sitting is a Consultant like you and everyone else standing is more junior, by undertaking this action you are unconsciously giving away your seniority in the room. You are signally you’re difference to your other consultant colleagues. Being aware of your surroundings and what cues you are sending out is important.

Ever sat listening whilst a colleague towered above you? The person who deliberately chooses to lean against your door frame whilst you sit in order to explain X or Y to you. Dominance positioning is a thing, we are primates after all. If we have small and closed body language it says a lot more than our verbal responses in the conversation. Sometimes, when you find yourself in a mansplaining situation the mere act of repositioning yourself can impact the conversation. Stand up, gesticulate using wide body language when speaking. It may be that this merely changes the way you receive the exact same dialogue, but sometimes that is half of the battle. If it also supports you in using some of your practiced dialogue, all the better!

How do we help others?

When sat in the conference room mentioned at the start of this article, I had so much rage at the way these young scientists were being treated. My PhD student who saw and understood my response asked ‘are you going to say something?’. I responded ‘no, these girls are going to handle it’, and they did. They did so perfectly. I think one of my biggest pieces of learning over recent years is not to run in like an amazon warrior to save people, as this can in actual fact be diminishing and takes away their opportunity to act. My response now is to be there as a back up if they signal they need help and to offer support and reinforcement with ‘you were amazing in how you handled that’ afterwards to let them know how successful they were from an independent observer view. By rushing into save we can be as bad as the mansplainer as it indicates we don’t have faith in their ability to handle the moment. That said, if I’d had an official role, such as Chair, I feel it would have been my responsibility to stop the situation from happening in the first place. My take home is this, how you respond has to depend on your role and the situation.

I still love the females from the Obama administration who used their voices to amplify those of other women in the room. Not all actions need to be direct or confrontational, sometimes just being there to repeat the voices of others is enough. I wish that I had been able to breath through my rage and find an amazing follow up question to allow that panel to shine even more in that moment, but I didn’t and that’s my learning. That moment wasn’t about me, it was about them and next time I will have practiced how I can then act to amplify them better in the moment, rather than worry so much about the mansplainer in the room and giving him my energy. Every day I learn a little more.

Right, I’m off to the growlery until I find myself in a better mood. See you on the other side.

All opinions in this blog are my own

Pinching Myself Again: Switching out Dr for Professor

girlymicro Academic Life, Microbiology (Research), Research/Academia

While I was away on holiday, I got some pretty amazing news, and now that the contract is in and signed, I finally feel like I can share it. I made Professor! You may think that as I’ve known for a couple of weeks this is coming, this blog post would have already been written, but I didn’t really believe it would come through until I got the official letter so I’m afraid I’m playing catch up.

As you may have picked up, I am still blown away by the fact that this has happened and because I genuinely never thought that someone like me would get here, I thought I would share a little about what it means, why it means so much and how it happened. I do this to inspire others to follow, not to crow, although in the spirit of full disclosure, I am super happy that it’s happened.  Also, a warning, I can only talk from my experience, and that is linked to a somewhat unconventional path. Please read the below in that light.

What is an Honorary Professor anyway?

Now, before I go any further, it is an Honorary Professorship as I’m still employed by my Trust rather than UCL, and because of that, it is also not a Chair. It is a title given to someone, who is not employed by a university, but who contributes to the work of that university, in my case via grant funding, paper writing, lecturing and student supervision, but unlike a Chair I am not involved in management. It is also worth noting that, like the academic professional pathway itself, it changes between universities and my only experience is with UCL.

In the UK, this (Honorary Professor) is the highest title to be awarded to individuals whom the university wish to appoint, honor, and to work with. These individuals are not university staff nor employees. An external person is usually recommended by an internal university academic staff, and recommended for approval by the head of department, for which the documents are then forwarded to faculty dean, vice president and president (or deputy vice chancellor) for approval.

https://en.wikipedia.org/wiki/Honorary_title_(academic)

As the title is Honorary, I’m allowed to use the title, but no, I do not get an office, a pay rise, or anything other than a webpage 🙂 My father may have asked me a few times. The success is more about reaching an academic benchmark and achieving recognition for both your work and it’s impact. It also is the final significant step on my journey as a Clinical Academic. I was always told that I should try to ensure that I move up both professional ladders in order to demonstrate success in this area, and so for me, this is as big an achievement as when I became a Consultant in my clinical work.

Why the surprise?

Let me start out by talking about why this felt unattainable and why, therefore, it is such a surprise. I’ve been developing a Clinical Academic career since 2008, so the best part of 15 years. In that time hardly anyone has suggested that making Professor could be something I should aim for. Worse than that, it is in fact an aspiration that I have been told more times than I can count is out of reach for ‘someone like me’. Now, the ‘someone like me’ description changes between the advisors, but a sample have been: you’re a scientist in a medics world, you’re too emotional, you’re too open/honest, you don’t play enough politics, you’re too young, you’re a woman, you will never publish in good enough journals as you work in Infection Prevention and Control.

To put this in context, my medical colleagues automatically make Associate Professor the moment they become consultants, irrespective of their publication or funding track records. They are therefore lined up for the next step and the pathway is fairly established. That said, very few of them go on to take it, partly because that next step is more like climbing a mountain. Put that together with the fact that only 3% of people who graduate with a PhD get to be a professor, and you can see why many people may not decide to pursue it, and why this moment feels momentous to me. Being able to show the world that this is actually what a professor CAN look like is really important to me. To be able to show you can not fit into the stereotype and still get there.

It’s not just about time served

Meeting the criteria to become a professor is not about length of time in post or time served post PhD, there’s quite a lot more to it. You have to be able to demonstrate a diverse portfolio that ticks a number of boxes. One example below is for progression linked to research, but as you can see, you also have to demonstrate not only suitability in the research domain but also in at least 2 other domains.

Progression through the above grades might be expected to be attained by demonstrating an ability to meet:

the threshold research criteria at the next level; and

several of the core and/or specialist research criteria at the next level; and

at least the threshold education criteria or some of the criteria in either of the two other domains (enterprise and external engagement; institutional citizenship) at the next level.

https://www.ucl.ac.uk/human-resources/policies/2021/oct/academic-career-framework
Research thresholds

Along the way, you will meet a LOT of people who will have an opinion on how you should develop the CV to enable you to eventually apply. One of the things I learnt early was to not listen to those who just said I shouldn’t do try. That’s different from not taking advice. It’s different from heeding the advice of people who say not yet, because there is more to do that will increase your chances of success. These people are often the ones who are wishing you well on the pathway and have some knowledge of the process requirements. The ones who can’t share your vision are the ones to thank for their input and move along. The ones who contribute to your process are incredibly valuable, even if sometimes the truth is hard to hear.

Education thresholds

I’m only an Honourary Professor, but even so, I have to meet the same thresholds as my full-time colleagues, as there is only a single standard. As I said above, the Honourary bit really links into your employer rather than the standard you have to attain.

What kind of things do you need to do?

It was International Women and Girls in Science Day this weekend, and I wanted to take a moment therefore to recognise why it can be much for challenging for women and people of colour to attain a Professorship, why it can be difficult for women to find the support they need. I mentioned that some of the stats say that only 3% of PhDs become professors, but the numbers are significantly worse if you are female, and worse still if you are a female person of colour. I’m no expert in this area, but I think it’s worth talking about and raising awareness. There are articles from those better informed than I to talk about it:

Are Female Professors Held To A Different Standard Than Their Male Counterparts?

Ratings-and-bias-against-women-over-time

Talented-women-of-colour-are-blocked-why-are-there-so-few-black-female-professors

Why so Few, Still? Challenges to Attracting, Advancing, and Keeping Women Faculty of Color in Academia

One of the first lessons I learnt was that you are going to struggle to get to the finish line if you try to do it alone. I’ve said it before, and I genuinely believe it, science is a team sport. It will be that team who enables you to demonstrate the breadth, as well as the depth needed. I have a wonderful academic colleague who supported my application, and my research group have always pushed and supported me to aim for the sky. That said, it strikes me that when I say science is a team sport, and that a team is what is required to get you to the finish line, sometimes women are not invited into the same rooms that support others. I’m so aware of the pub nights, meeting clubs, etc, that I’ve been briefly involved in, where names are thrown around prior to meetings, where relationships are built and plans are made. The hours I work generally preclude me from the ‘just popping to the pub’ crowd and the ‘medical discussion groups’ I’ve been to were just too linked into the Old Boys Network tradition for me to feel comfortable. I’m lucky though, at least occasionally I get asked, and therefore I could make an active choice about my path. That isn’t true for everyone. I chose to make my own path, I chose to play with a team that works for me. The word choice is key, and it speaks to my privilege that I get to use it.

The other factor is that women often have ended up being the ones that do the majority of some of the ‘non core’ activities, such as chairing diversity committees or undertaking public engagement. These activities are often things I love and the breadth they provide have always been important to me. The problem is that you have to have enough ‘core’ to secure promotion. You have to be getting grants, publishing papers, and supervising PhD students. Without these, you won’t be able to move forward, no matter how wonderful or talented you are. There are only 2 ways to handle this, keep doing more (and therefore having no time to be ‘in the club’) or be really clear with your boundaries to maintain time for core activities, and this can be easier said than done. To change the stats we have to support each other enough to be able to help with this. Someone’s worth for progression shouldn’t depend on their ability to say no!

It’s a marathon and not a sprint

There are so many boxes to tick and things to be achieved that making Professor is definitely a task of years, on average 15 years post completion of a PhD. I can’t say it enough times, however, that it is not merely about years and time. There are so many things to learn about yourself and your work before it becomes a possibility. What kind of supervisor are you? What is the work that inspires you? Even before you start on the knowledge accumulation.

As I said above, there is also a lot of growing to be done, and I’m nowhere near finished yet. Being able to set boundaries, being able to say no, knowing when to say yes, all of the leadership challenges you can imagine, on top of trying to be creative and deliver new thinking in order to move your research area forward. Just making the networks and finding your collaborators in order to make this happen will take years, and it takes time to build trust and relationships. So buckle in for the ride, and know there is no shortcut for gaining experience.

You will fail and fall many times, but like most challenges in life, it’s about having the passion and persistence to just keep turning up. To turn up after the failures and the difficult conversations. To turn up and take the learning and the growth. To always see the opportunities and develop the knowledge of how to circumvent the barriers. Keeping true to who you are and your values in the face of that failure and the criticism that sometimes comes with it. All of these things, if you don’t let them change you and make you bitter/cynical, will make the successes oh so sweet. Then it’s your job to pay it forward.

Take the time to know you

Like every long-term career journey, becoming a professor requires you to take some time to also know yourself. I’ve said that I got a lot of advice and one of the things I took away from it was that, because it’s a process of years, no 2 people will go about it the same way. From the criteria listed, you can see that you can put a lot of the puzzle pieces together in different ways. Therefore, it’s important to develop in a way that works for you as an individual. What aspects of the role bring you joy? What helps you thrive instead of feeling burnt out? It’s OK to focus on these things and maintain them within your portfolio of practice.

I also think knowing what you are not good or are weak at is also key. None of us are good at everything. None of us enjoy everything. You will have to pick up some core tasks that may not intuitively suit you, but knowing when they are core and when they are not will help you make better judgements. Also, being aware of your weaknesses will enable you to approach those areas more strategically in order to allow you to overcome.

It’s not just what it means to me

I actually don’t have words to express how grateful I am for the responses I’ve had since I shared the news. Part of me always worries about the fact that I might get ‘well why you’, I think it’s the imposter syndrome. Everyone has been so supportive, more than that, a lot of comments have talked about it showing to others that it can be done. This, to me, is SO important. There are so many wonderful Healthcare Scientists out there, so many wonderful Clinical Academics, but so few of them are Professors. It may sound trite, but you can’t be what you can’t see. If you don’t know this is an option, it’s hard to aspire to it as a path. So thank you for your support. Thank you for being my cheer leaders and for sharing what is such a joyful moment for me. In return, I share with you the email my father sent out to my old school teachers and his friends, in order to demonstrate that I know both what this means and how fortunate (or badass) I am. I’m off to break open a bottle of bubbly!

Congratulations to Elaine Cloutman-Green

Thank you to anyone and everyone who has contributed to Elaine’s development by offering advice, education, knowledge, guidance, comfort, discipline!!!!!!!, culture, sophistication!!!!, fellowship and friendship.

Especially her soulmate, mentor and amazing husband Jon.

Plus a small contribution of determination, intelligence, gin!!, character, industry, more gin!!, worldliness, industry, even more gin!!, nouse and a chunk of good, old fashioned, inherited Yorkshire grit from herself.

Who would think that a coalminer and car worker’s grand daughter,
born in Good Hope Hospital of common stock,
Villa Holt End season ticket holding fan,
whose education was via Northfield Manor Junior, Hillcrest and Shenley Court Secondary Schools,
then Liverpool University Biology (BSc 2.1), Physics(MRes) departments, UCL (Msc Queen Mary’s Med Sch) and PhD
Who could forget reading her thesis “The role of the environment in the transmission of Healthcare Associated Infection”?
Fellowship of the Royal Society of Pathologist could achieve such high academic status.

Deputy director of Prevention and Infection Control at Great Ormond Street Hospital,
Pathology consultant
British Empire Medal in the New Year’s Honours List for work on Covid
Freman of the Worshipful Company of Plumbers (I would not let her turn on a tap!!!!)

Now UCL, University College London have for her research work on the prevention of the spread of water bourne diseases and academic teaching programmes about Virology and reducing the spread of disease have in their infinite wisdom have honoured and rewarded her making her:

PROFESSOR ELAINE CLOUTMAN-GREEN

Very well done
Eeh ba gum, sh dun reyt gud tha’ nose!, anno we’er chuffed to bits,
Her sister Claire would have been even prouder of Elaine than her Dad of her success

Dr Alan Green January 2023

All opinions in this blog are my own

Clarity is Key: The role of learning agreements in supporting learner success

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Clinical), Microbiology (Research), Research/Academia

It’s that time of year again and many of us will be taking on new trainees, getting to know new students or supervising new PhDs. I thought it was time therefore to share something that I’ve found increasingly useful and have now set out to cover in initial meetings with learners, and that is the development of learning agreements.

What is a learning agreement and why is taking this time worth while? Surely everyone knows what they’ve signed up for when they take a training place? The truth of the matter is that students often know the logistics of what they’ve signed up for, but any learning placement is a whole lot more than just the nuts of bolts of the curriculum. There’s a lot of expectation setting/management required for one thing. We’ll cover what learning agreements look like in a bit, but in short they are agreements based on conversations between the learner and their supervisor where they actively set out the expectations and boundaries of their relationship.

At STP/HSST and PhD level it can be the learners first experience of formal education routes within a professional setting. As supervisors we often expect learners to be able to undertake independent study at this point, identifying their own learning objectives and being responsible for any escalations. If this is the students first experience however, they may believe it will follow the pattern of the prior learning they have experienced, which may have placed a lot more focus on structure and consistency.

What is a learning agreement?

In light of these complexities what is a learning agreement and how can it help? Well they take quite a few different forms depending on what it is that you want them to fulfil. In short they are a working (and therefore dynamic) agreement between you as the supervisor/education officer and your new student/trainee. I tend to refer to them as learning agreements rather than contracts as the term contract to me implies penalties and learning contracts are what I escalate to if challenges occur during the time someone is with me.

They can include all kinds of things:

  • What topics are in or out of the learning objectives
  • How deadlines will be set and a broad plan of work
  • Expectation setting around students identifying additional learning objectives
  • Ideas for how the learner will benchmark their progress and/or learning
  • How the educator will assess progress/learning

Although the above is often the framework the most valuable parts of a learning agreement for me are less structural. It is my time to ask:

  • What kind of learner are you?
  • What kind of support do you prefer (close vs supportive supervision)
  • What are your main objectives that may or may not be topic based?
  • What are you hoping this will lead to?
  • How do you prefer to communicate, face to face, email etc?
  • Why this course? Why this training? What attracted you? In order to understand their drivers

Making the implicit explicit

In general I think most of us are good about talking about the nuts and bolts of what a course/placement entails. We are good at giving the ‘this is the bathroom’ tour and ‘this is where your desk is’ plus ‘our supervisor meetings are on Tuesday’ type of information. What I have discovered over the last few years however, is that imparting curriculum or logistic based information just isn’t enough to support a good supervisor-learner relationship, where both get what they want out of it.

I think as supervisors we have quite a lot of expectations that we don’t necessarily voice, after all for many of us this is something we do a lot of. It can therefore be easy to make assumptions about the level of awareness of these expectations from someone coming into that supervisor-learner relationship with us. The thing is, you may have been doing this a loooooong time, but your learner almost definitely hasn’t.  They won’t have that implicit and often organisational linked cultural knowledge that you have been embedded in for so long. Worse than that even, they are likely to have a whole lot of different assumptions based on their last educational experience that they are bringing with them. Unless we all work therefore to make things that we implicitly understand explicit, you won’t know where those differences in practices and expectations lie.  It is when this happens that problems often occur that could easily have been addressed early on, but have significant impacts on learner experience and supervisor stress levels.

Supports orientation to a new field/culture

As I’ve said a few times culture matters, as culture and cultural norms are intrinsically linked with the expectations we all have. Having these conversations is about more than expectation management however. Learners are coming into an environment that may be pretty alien to them. This can make students feel like they are floundering, right from the start, meaning that they don’t feel like they fit. A small percentage of students are likely to walk away because of this, not really understanding the cause. This is often combined and amplified by the fact that they may have moved or lost their support networks in the transition.

Talking about your role (and similar roles) with learners helps, not only to build your relationship and set expectations, but also to support them in making the transition into being a scientist in practice, not just in name. It took me years to feel like a scientist, to feel comfortable calling myself that, to feel like I belonged. Having conversations where students understand what it takes to succeed as a scientist, not just in a placement, can be invaluable to learners re-establishing support networks. Also, supporting learners to find other trainee groups,  to join twitter, or of timings for lunch clubs, can help them settle into their new role and their future profession.

Setting matters

Having these conversations can feel uncomfortable and challenging, mostly because of the fear of the unknown. They may also take time we may not have. All of these are reasons to make sure they are done correctly and given the time required. If you are nervous having them with your learner then imagine how nervous they may be to have them with you. You are asking for a lot of honesty and self reflection from someone who doesn’t know you well, in a relationship where trust may not yet have been built. Furthermore, you are asking for all of this in a relationship where you probably have all the power and where your learner is likely to be highly keen to please, rather than representing their true self..

So how do we hold these conversations and support them getting the best outcomes? I think there a couple of things we can be mindful of. The first is not dropping them on the learner. If we want the conversation to deliver we both need to do the work. I need to be honest with myself about time and also what kind of supervisor I am. The student needs to be given the questions or a framework beforehand and supported to have time to reflect on themselves to be able to answer the questions asked. They may need to be encouraged to speak to friends or family to support them in this reflection if they’ve never done it before. They can then start the process of reflection by thinking in the presence of people they trust, if needed.

Think about where you physically want to have the conversation. I tend to take learners out, to a none Trust space where we can have tea and cake (or other suitable consumables). I’ve written before about the power of tea. The main reason that I do this is that it means we are no ones turf, we are in a neutral space, and the provision of food further helps to reduce/remove hierarchy. When thinking about where however, you need to consider privacy. Your learner may need to share things that are private or important to them, and so considering the type of location is also important.

The other important thing about getting the conversation right is setting the conversational scene before you start the conversation itself. You need to be clear about the objectives that you want to achieve, why they are helpful to both parties and set some ground rules. It’s key to say that honesty is the most important part of this process. It’s OK to have styles that don’t match, by knowing this early you can sign post and find additional support to ensure that the learning process itself still works.

What happens when the expectations don’t match

Hopefully by going through the process of creating a learning agreement you will avoid any significant bumps along the way later on. The process needs to be done thoroughly though, so you don’t just hear what you’d like to hear. As stated above it’s ok to have areas of difference, it’s what you can flex in response to that information and how you respond that matters.

For example, I am never going to be a good micro manager, I have neither the time or personal inclination to work this way. I have fallen foul of not having had the learning agreement conversation and subsequently had learners who felt they were inadequately supported. If I find out that I have a learner who feels they need close support I need to therefore make some pragmatic choices. Is it they will need close guidance for the transition period? If so I can likely change my style for a period of a couple of months in order to support that orientation to a new location. Is it that this is their learning style long term? In this case I need to think about pairing them up or seeking support from a colleague who is better able to provide that close support during the periods in between our catch up sessions.

I have also struggled previously with learners who have not met the outputs that I had expected. This may be more of an issue with PhD students, but to be honest if I’m not clear about publication expectations how will they know? Therefore if it becomes apparent that the timeline expectations don’t match it is worth considering drawing up a broad, high level, delivery plan so you are both working towards the same mental models

Finally, it may be that learners make it clear that they have pastoral care expectations that you may or may not be able to support. Prior to going into these sessions it is important to be aware of the different additional support services that learners have available to them. Whether they need them or not in the moment it is crucial that you sign post to these, especially if you are not the kind of supervisor who will take on this kind of support role. Additionally, there are likely to be plenty of networks that offer peer support that you can sign post learners to. There will always be things that they want to talk about that they won’t want to talk to you about. Let’s be honest, no matter how well you get on there will be times they need to moan about you as a minimum. Being open about this being OK and linking them into peer groups can be incredibly valuable

No matter what you hear in this space it’s important to be open and judgement free, in order to support honest sharing. If you hear something you don’t agree with it’s important to take a beat and try to understand the drivers of that view point. By being open to opinion and challenge now you are investing in success later on. I don’t know about anyone else but I studied in a different time, my undergraduate degree finished 20 years ago. My expectations of learners and learner experience therefore is, to be frank, well old. I’ve also worked in one place for 18 years. It is naïve therefore to believe my experience and expectations are going to perfectly match the learners who are coming through now.

There is a big difference between being someone’s educational supervisor and someone’s manager. In some cases we are both, but we need to understand that they are different roles with different requirements on both sides, and be aware of what hat we are wearing when. Techniques such as learning agreements can help make sure that we do the ‘education’ part better by having the kinds of conversations you would not have with someone you just had a managerial relationship with. It encourages self reflection, expectation management and consensus forming. All of which are skills that we should be modelling for those learners we are supporting. If you don’t ask, you’ll never know. So let’s start this new academic year by having conversations better and talking about how we can all be the best we can be.

All opinions on this blog are my own

Happy but Struggling: Welcome to my third year of the SARS CoV2 pandemic

girlymicro Healthcare Science, Leadership, Microbiology (Clinical), Microbiology (Research)

Its 6am and I’m sitting listening to fire alarms go off in my hotel room at FIS/HIS. I’ve been up since just before 3 in a shame spiral of all the stupid things I said during day one of the conference and only just got back to sleep at gone 5am when the alarms started sounding. Frankly this feels like a metaphor for how my life has felt for the last 2 years, long and short the constant sound is exhausting and stressful. An hour later the alarms are still going and I’m now doing the only thing possible, which is to leave my room in some highly elegant nightwear and take myself, a laptop and a cup of tea to sit in reception to write. I may be looking a humiliating level of baggy eyed exhausted shell but at least it quieter and I have caffeine; which brings this metaphor all the way up to 2022. It’s better, I’m happier but oh lordy am I still broken. So as we sit in our 3rd year of dealing with the pandemic how are things different and how are they the same?

The things I love doing are so close to being back

One of the things that is currently saving my mental health and well being is that you can almost now envision the point where normality could return, or the new normal anyway. I know that if you have listened to politicians and social commentators recently you would think that normal is already here, but for me we’re not there yet. I can however do things like think about booking tickets for the future events (I cannot wait for Eurovision!) and hope they will go ahead, I’m contemplating planning trips and have started seeing friends in slightly less controlled ways. I’m even sitting here typing this at an in person conference, which has been surprising lovely and not stressed me out in the way I thought it would.

This being able to vision is important to me, it’s also important to me in the day job. For a long time all there was was SARS CoV2, you couldn’t plan, you couldn’t see a time when you would be able to do anything else. Now though things that give me so much joy in terms of education and research are coming back, papers are being drafted, grants are going in. I can see that we can begin to focus on other things with changes and improvements that need to happen. It may still feel like a shock but after all healthcare is NOT all about respiratory viruses and there are things beyond that which impact patient care that we need to take some time to focus on as well. All this said however, I have to re-state how tired I am and it is yet to be seen whether I have the inner resources to hit the ground running in the way that I would like.

Back on the carousel

Having just said how happy I am to be getting back to doing some of the ‘normal’ work of Infection Prevention and Control, there’s no getting away from the elephant in the room. We’re still dealing with a global pandemic, which a lot of the world seems to have forgotten. We’re still managing guidance changes, testing cases, investigating and managing hospital cases, but now with all of the funding support withdrawn and whilst being expected to also manage ‘business as usual’ on top of everything else. All that with having had 2 years of no sleep and no rest. In some ways, and this could be me, everything else is also more of a mess as we’ve been in crisis mode for so long. It’s not even as if the ‘business as usual’ is straight forward no even taking into account how much re-training needs to be undertaken.

Because of all of this sometimes it’s hard to tell whether you are on a nice gentle carousel or are actually on the waltzers, trying to manage everything thrown at you in a landscape that is still constantly changing it’s priorities and demanding responsiveness to everything that is being put in front of you.

Single interventions don’t work

Everyone in the world still appears to be an expert in IPC and there still seems to be so much reductionism linked to the idea that a single change will revolutionise everything. I’m a little ‘over’ trying to have the discussion with people that covers the fact that almost all IPC is about introducing packages of measures/interventions. It’s what is often frustrating as a researcher, in that single interventions are therefore quite difficult to evaluate for their impact, but the world we live in clinically requires us to be able to control multiple risks and therefore manage multiple risk mitigation strategies simultaneously. The truth of the matter is that a single change will rarely control risk in the complex environments that our patients are in, even without adding the complexities of human behaviours and human interactions. I’ve written about this before, but I strongly believe we need to become comfortable with complexity and that part of our role in IPC is to assimilate complex multicomponent information, process it to make a balanced risk based set of decisions to establish a strategy, and then to implement that strategy in a way that appears simple and practical to those that are implementing. Taking the complex and processing it so that it can be disseminated in an accessible way is, I believe, one of the key talents of many IPC teams. We need to communicate this better as being one of our strengths and move away from single intervention focuses.

Could do with a little less ‘interesting’

I don’t know about anyone else but i could do with less (take your pick) of monkeypox/lassa fever/polio/Burkholderia/invasive Group A Strep or any of the other ‘interesting’ alerts that we have had lately. I would normally love something novel to get my teeth into, but right now the ‘interesting’ seem to be coming thick and fast and I for one am only just managing getting back to MRSA and resistant Gram negatives. The constant ‘organism of the week’ just means that any return to balance feels like it’s going to be slow coming. I hate routine, it’s one of the reason I got into IPC, but even I could do with a little routine and boring for a while to find my centre and recover a little and recharge those batteries before embarking on the next new thing.

Summer down time isn’t so quiet

I think this has all been compounded by everything that has happened over spring/summer. Summer is usually the time in IPC where you can catch your breath a little, where you can plan for the inevitable challenges of winter and do the visioning piece to work out how you want to develop the service and move it forward so that everything works just a little better. This summer though there’s been little to no respite really, between new variants and waves earlier in the year and the new and ‘interesting’ since. Summer has been anything but quiet. This means that you know you are going to go into, what is predicted to be, a difficult winter without catching your breath and still trying to spin plates, with even more work having been pushed back to 2023. I think we will all still pull it off and I truly believe we will manage most of the things we were all hoping to achieve during the summer lull, I just fear that to make that happen we will carry ourselves into another winter running on empty. I think therefore we need to have the conversation with ourselves now about being kind, not just to other people but also to ourselves, and where you can plan accordingly.

Do more with less

All of this comes at a time when we are all very aware of the pressures on services and the resource limitation issues we are all facing. We can’t just do the same with less but we have to do more with less. The COVID-19 money has gone, the extra staffing support linked to it has gone, but a lot of that work hasn’t disappeared as we are all playing catch up on waiting lists and clinical work. It is easy therefore to feel pretty disheartened about the hill we need to climb, having already given up so much, both as individuals and as a collective.

The truth of this however is that some of the very pressures that sometimes feel like they are crushing us are also bringing some benefits. I am closer to my team than I’ve ever been. I’m more certain of the things that matter to both me and my service. I have significantly more clarity than I’ve ever had before both about my professional and personal life. Limitations on resource access have meant that we’ve had to worked harder to develop networks and build connections in order to use what we have better, and that connectivity has other benefits. So as much as I hate the words ‘better value’ I can see both sides of the coin, and not just about the money. I can see that it will make how we move forward better as we will move forward more together than we have ever been before.

The inevitable post mortem

One of the things that struck me when I went through my first pandemic, swine flu in 2009, was the way that you could do nothing right for doing wrong. One minute you are heroes and the next you are villains because it’s politically expedient and someone has to be the focus of dissent. I know people that were upset by headlines during the Tory leadership contest that basically went after many of us who had stepped up on top of our standard roles to offer help and support. We stepped up because we felt it was the right thing to do and despite (in many cases) significant personal cost. Sadly, having been here before i was not surprised. Worse than that, I think we need to prepare for the fact that this will be the theme over the next 12 to 24 months, and that we will be used as a political football by many people. Hindsight is 20:20 and retrospective data analysis is a very different beast to prospective decision making. So my advice on this one is that we all need to develop a thick skin, understand what the drivers are for the headlines, and let it wash over you rather than taking it as the personal attack it can sometimes appear to be.

So having said all of this what do I think the next few months will hold? I think we will continue to be challenged, both in terms of the patients that present in front of us and in managing the service demands this places upon us. I do think that IPC teams and healthcare professionals will continue to step up and do what needs to be done to make care happen. As leaders however, we need to be aware of what that ask looks like and have strategies for managing it in an already tired work force. For me being able to focus on the future is how I get through the present, therefore planning for normal times is key to my survival. People ask how I’m putting in grants, drafting papers and planning change. I do it not because I have time and capacity, I do it because I have no other choice. I’m aware that it’s key to my survival, to keeping me grounded and enabling me to cope with the stress that exists in the now. Some people ostrich, I plan. As people are different however, I also know that my planning can stress others and so I try to be aware of how much I talk about the future to those people who are opposite and survive by living in the present. Dealing in the best way possible right now is mostly about knowing who you are. The clarity provided by the last two years of the pandemic has helped me in this by forcing me to know more about who I am and how best to manage myself. I have learnt and I hope to continue to use this learning to grow. So I will continue to hit the day dream button and drink tea……….I hope you find a way that works for you.

All opinions in this blog are my own

Keeping Up with the Kardashians: Your K score and the uneasy relationship between science and science communication

girlymicro Academic Life, Healthcare Science, Microbiology (Clinical), Microbiology (Research), Research/Academia, Science Communication

I’ve talked previously about benchmarking and the pros and cons of trying to work out if you are doing OK by comparing yourself to others. As scientists we have a tendancy to look for evidence, in the form of numbers, to enable us to do this. In terms of research measures the main ones that I have heard of being used are the h-index (Hirsch index) and the i10-index. These numbers are not just used by us as individuals as marker of impact and progress but they are also used by promotion panels at universities and by external reviews as a marker of quality/excellence. The question is are they measuring the right things? More recently I heard of something completely new (to me), the K-index (Kardashian index) and finding out what it was about kind of blew my mind.

What are these measures?

The h-index is supposed to measure both productivity and impact. It’s calculated by using the number of papers published by an individual that have a minimum number of citations, for instance if you have a h-index score of 4 you have 4 papers that have at least 4 citations. You may have published 20 papers but they only count once they have reached the minimum citation score. The i10-index by comparison is the number of papers with a minimum of 10 citations, and so is a similar but simplified version.

As of August 2021 my scores for these benchmarks (as taken from Google Scholar) are:

I had on the other hand had never heard of the K score or Kardashian index until recently. The K-index is a measure of someone’s scientific productivity in relation to their social media score. It is determined by dividing the number of social media followers someone has on Twitter by the number of citations they have in peer reviewed publications. In my case (as of the 10th August) that would be 4939/703 = K-index of 7.03.

What’s in a number?

But what do any of these numbers actually mean. For the h-index a score of 20 for a scientist of 20 years experience is supposed to mean they are successful, 40 is outstanding and 60 is exceptional. Obviously these vary between disciplines, but as I haven’t reached my 20 years yet I’m OK with my 16. For the i10-index, only really used by Google Scholar, for a similar level of experience an i10-index of 25 is considered to be pretty good. Again, this varies between disciplines. It is also likely to differ between settings, as a Clinical Academic I am unlikely to achieve the same metrics as one of my academic colleagues, as I also hold a clinical role.

“I propose that all scientists calculate their own K-index on an annual basis and include it in their Twitter profile. Not only does this help others decide how much weight they should give to someone’s 140 character wisdom, it can also be an incentive – if your K-index gets above 5, then it’s time to get off Twitter and write those papers”

Hall, N (July 30, 2014). “The Kardashian index: a measure of discrepant social media profile for scientists” (PDF). Genome Biology. 15 (7): 424.

What is it that my K-index means then? Well my K-index is above 5 and therefore apparently means I may have a higher following than my scientific research credentials indicate I deserve. If I had a low K-index (i.e. 1 or 2) it would suggest that perhaps my science was being undervalued. This was actually seen for a quite a few female scientists in this rather tongue in cheek study.

Just call me Khloe

So I am a Kardashian, it’s official! Now if I could also be given their pay packet and I also wouldn’t mind someone who would follow me around doing my hair and nails – although that might be a little weird on ward round.

In all seriousness there have been a number of things that struck me about this as a concept.

  • The idea that scientists only attract followers in order to share their own science, rather than to share and discuss science or to raise awareness of the profession
  • That all of these measures try to claim they measure impact but all they do is measure the equivalent of ‘shares’ by scientists to scientists and I would suggest that that isn’t actually a measure of impact – just a measure of how well you are surviving at publish or perish
  • The lack of perceived benefit from science communication undertaken by scientists in comparison to the requirement to produce new publications. This has been seen in a bias against women in the promotions process as they are usually disproportionately involved in activities such as outreach, which are not perceived to have equivalent value. Only ‘hard’ science counts

What does the existence of this metric tell us (even jokingly) about the relationship between science and science communication?

I am aware that the author of this paper said in 2022 that it was satire and a dig at the use of a metric indicators, but I think it goes deeper than that and sheds light on a much larger set of issues and attitudes.

I have been told my people that I both respect and who are very senior that I should do ‘less of my nonsense and focus on both my science and clinical skills’. The nonsense they were referring to is my education and outreach work, work like the Nosocomial Project. The impact of this work in terms of recruiting future scientists, about the democratisation of science, and impacts on decision making, definitely aren’t captured by the number of citations I have on Google Scholar.

I think these metrics also fail to capture things like translation into clinical practice, inclusion in guidance and use by groups who may not be publishing papers, and therefore are not citing your work, but have applied it to their setting. That is the reason that I publish, to support change, not to chase a h-index, and so these metrics represent only a very traditional view of academic impact.

As for the K-index, as far as I’m concerned my research is funded by the public, the results therefore are owned by that same public and there is an onus on me to share with then what their funding has paid for, discuss with them whether they actually feel it brings benefit and where it can be improved for those with lived experience. I think the time of academics living in an Ivory Tower and only communicating with each other should be over. Yes we need to talk to each other, collaborate and inspire each other, but that shouldn’t be as far as the conversation goes.

There is obviously a difference between being a science communicator and a scientist who communicates science. The JD’s and the skill sets are over lapping but different. That doesn’t mean that scientists shouldn’t be out there talking about science with the wider public. I feel very strongly that sites like twitter shouldn’t be a single sided conversation. I’m not just going to talk about my science, I want to discuss and amplify content produced by others. I want to have, sometimes challenging, discussions in order to show that science isn’t about absolutes.

Communication on social media is about so much more than the sharing of data. It is a way to develop networks, show support and amplify, as well as to communicate information that is real time and may not have gone through the academic peer review process, such as guidelines or funding calls. So maybe instead of putting scientists with a high K-index and low other scores into academic purgatory we should look at developing a different way to evaluate the modern version of what it is to be a scientist. A score that could capture all of the invaluable work a lot of academics do to ensure that there is a workforce of the future and to support scientific literacy and co-production beyond the Ivory Towers in which we live.

Anyway, apparently I’m off to the paper mines to prove my academic worth. I intend to continue to smuggle out tweets whilst the WiFi permits however, because as much as its lovely to talk to scientists and people like me, science is more valuable when it is truly shared and available to everyone.

All opinions on this blog are my own

Environmental Matters: Why are environmental risk assessments so tricky?

girlymicro Microbiology (Clinical), Microbiology (Research)

This months posts all have a bit of a risk assessment theme, possibly because I’m back in the land of SARS CoV2 increased prevalence but also because I’ve been contemplating how moving away from a risk assessment led approach to a testing led approach has impacted on how willing people now are to undertake risk assessment. More on that maybe later in another post. What on earth has risk assessment got to do with environmental Infection Prevention and Control? Well frankly it’s the bit that’s often forgotten in terms of our clinical risk assessments. There are also lots of engineers out there making engineering risk assessments for environmental control, and they (for the most part) don’t contain anything clinical. Ventilation and surface transmission have featured linked to the control of SARS CoV2 but I wanted to write something to talk about the environment and environmental risk outside of this, partly because I can’t face writing another SARS CoV2 post for the sake of my mental health, it’s just hard right now.

So back to happier times and how my passion for environmental IPC got started. I joined the IPC team in 2007 after my first three years of Clinical Scientist training. I had a wonderful IPC doctor who was full of vision and aware of the need to increase the scientific technical skills within the team. The thing was that the rest of team wasn’t quite ready to embrace what was a very different approach, all very understandable, at that time IPC was very much focussed on hand hygiene and audits. So I spent some time with the various consultants and it became really obvious to me that there was an area where the introduction of some standardised methodology might immediately make a big difference. Environmental Infection Prevention and Control.

The team themselves were innovative in their approaches to IPC and had embraced environmental screening during outbreaks. The issue with it was there was a one size fits all approach, so organisms were not considered differently in terms of where and how the screening was undertaken. The sampling of rooms and wards involved taking a handful of swabs and just screening places that came to mind. There wasn’t work done on how many swabs needed to be taken within a certain size room in order to have sufficient sensitivity for detection or identification of high risk sentinel sites and how these might need to be changed based on organism. You’re negative predictive value of a screen without these considerations might not be as strong, leading you to incorrectly rule out a role for environmental transmission.

How did all of this work?

My role in the team became very much about how we solved some of these challenges. Undertaking work in patient rooms pre and post clean to define how many swabs needed to be taken. Take too many swabs and you’ll waste resources in both time and consumables, take too few and you’ll end up with false negatives leaving you to miss out on key risks as part of your risk assessment.

One example of this was looking for adenovirus in rooms post clean. Adenovirus can have serious consequences if acquired during bone marrow transplant, and unlike in adults children won’t all have had some form of prior infection. Mortality rates can be as high as 50 – 80%, depending on underlying condition, for a new acquisition. Combine this with the fact that adenovirus can survive in the environment for >3 months and patients can shed loads in the millions via both stool and respiratory secretions you can see that this might be an issue for infection control. I initially started out screening 24 – 30 sites in rooms and then gradually used data from both pre and post cleans to establish sentinel screening sites that are now screened in every room after cleaning to ensure that the next patient is not exposed to environmental transmission risk. We now screen 12 sites, 10 sites was just on the edge of sensitivity, in that if the room failed only 1 site would fail when screening 10 sites. By screening 12 sites if a room fails it tends to fail in 2 – 3 sites which means that the screening isn’t sitting right on the edge of sensitivity.

Even choosing the methods to screen with proved to be tricky, I had to specially develop methods in terms of what kinds of swabs to use, and how to introduce controls that would enable me to understand if the very cleaning agents used to screen were inhibiting my PCRs. Environmental screening is both very similar and very different to clinical processing and so to undertake it properly requires a certain level of work in order to modify the processes to make sure that results reflect actual contamination levels rather than providing false reassurance.

I felt like I’d finally found both my place and my passion. A place where I felt that my scientific background really contributed to the team and could be used to make things safer for patients.

Eventually way back in the mists of time, otherwise know as 2010, I started to develop further some of the work I’d been doing with the team and embarked upon an NIHR funded fellowship looking into the role of the environment in transmission of healthcare acquired infection. The more I learnt about how the role of the environment was considered to be coincidental, the more my own data demonstrated that that just wasn’t true, at least within the paediatric environment. I’ve written just recently about why paediatric IPC is different and the environment and the way that patients interact with it are definitely a big component of that.

ipc-in-specialist-settings-april-2022Download

So what do I mean by the environment?

I set out to talk to more people from different backgrounds about the questions that I had about environmental IPC, this eventually led to me and others establishing the Environmental Infection Prevention and Control network so that we would have a place to continue to have these conversations.

The first thing we talked about is what is the environment? Is it just surfaces? Does it include the surfaces of medical devices? How do things like water and air fit into all of this. Some of the things I include when I talk about the different categories are below. In terms of medical devices I think of these linked to decontamination, which I will post about at some point. This field obviously has a lot in common with environmental IPC but has been longer established and came about because those items have an acknowledged patient risk, whereas the rest of the environment has been slightly ignored in risk assessments.

Most of the standards linked to environmental IPC are either set by engineers, and therefore are based on infrastructure rather than a clinical risk assessment. The other standards include things such as visibly clean with no dust, dirt or debrie. Admittedly if your surface is visibly dirty it is unlikely to be microbiologically clean but it is also possible to have a surface that appears visibly clean and still has pathogens present, they are afterall…………microscopic and not visible to the naked eye. This means there is a real challenge for IPC teams where they need to work between standards with little guidance to really tackle the role of the environment in transmission……..at least back then in 2010. I’m glad to say that this is definitely changing but it still presents plenty of challenges.

Why is managing the environment so hard?

First and foremost it is the thing that everyone interacts with, patients, visitors and staff and that often no one thinks is s risk. Visitors won’t think twice about putting a handbag on the floor and then putting it on a bed so their friend can get something out. How many times have you seen a WOW or portable equipment rolled between rooms, including highly resistant organisms, and rarely have I seen anyone clean the wheels before it goes into the next bedspace. You can easily see how bits get moved about.

We obviously advise everyone to wash their hands in order to control risk. This means that most people associate sink with being the ‘clean’ items in bed spaces. Whereas in a paediatric hospital up to 60% of the sink backs may have faecal flora as the parents are all in nappies. This means if you do what I have had to do, which is balance a clipboard on the back of a sink to permit hand hygiene, you may have just covered your clipboard in bugs that you will happily move to your next location, your pen, your face. This stuff is hard and the solutions are far from straight forward, especially when you can train staff but many of the interactions are linked to people you can’t easily educate like visitors and patients.

Another reason environmental IPC is hard is that it sometimes breaches the basic rules of outbreak investigation ‘linked in person, place and time’. As you can see from the table below organisms once in your environment can survive for a very long time. That means you may just see single cases split over prolongued periods and so it can be very difficult to recognise you have linked cases, especially if you don’t have access to molecular typing.

Finally, even when you get to the point where you think you have a problem it can be difficult to have an environmental monitoring scheme that can rule in or rule out the environment as a source. These can’t generally be developed well on the fly as part of an outbreak surveillance. They really need to be developed and tested, ideally as part of surveillance systems, outside of outbreak scenarios. The problem with this being is that ut is resource intensive and you don’t even know what organisms might be there to judge the success of your monitoring method. You don’t know the dose and initially inoculum location to judge spread and how well your system is working.

How do we understand this better?

Myself and others have been working to create different types of markers in order to help us gain some direct rather than the indirect evidence that learning from outbreaks gives us.

You can do this is a number if different ways. We are working with an artifical marker developed from cauliflower mosaic virus that then allows us to inoculate different markers across units in single locations. We can inoculate items only touched by staff, or families and then monitor the spread out from this single locations across the units. Because we have control of the dose we are putting down we know how much cleaning/hand hygiene will be required for removal. We also know how long it will last. This means that we can investigate transmission routes and intervention failures in a controlled way to better inform our response to outbreaks, as well as making the whole thing safer by better understanding what we are doing well and where we could improve.

Other people are doing great work with visualisation techniques, both to help people understand risk better but also to work to improve design in order to make things safer before they even get into the healthcare setting.

How has it changed my practice?

Without this work I wouldn’t have the amazing job I have today, but more importantly than that I think our environment would be more risky for patients. When we first started screening rooms post adenovirus positive patient discharge more than 50% of them were visibly clean and met the national standard, but had adenovirus still present (we clean with chlorine that degrades free DNA). We now are also doing weekly screening of the communal areas of those wards as it has shown that we pick up intervention failures by a screening failure, hopefully before it is seen by a patient acquisition.

We have an entire policy that includes how we respond to patient cases linked to environmental IPC. If we get Klebsiella acquisitions we screen sinks responsively as sentinel sites, as we’ve found that if the sinks are negative we don’t find it elsewhere in the environment and its probably a different route. If we find it on sinks then we undertake a wider screen.

We’ve also learnt the hard way that you also need typing to support picking up those grumbling transmission chains and so have done a bunch of work to develop in house typing pathways, still as ever in progress.

Finally we’ve launched ward manuals so that our clinical teams get teaching and have information on how the water and air work on their wards, as well waste etc. Environmental IPC is a team sport and if you don’t work closely with the people that are effectively living in the space you will never succeed at making things safer in the long term.

Anyway, if any of you need a sleeping aid here is my PhD thesis on this topic (health warning it’s long and may not be all that good). Also some of my papers linked to this are uploaded here. Finally, if this has really sparked your interest have a look at the Environment Network website which has more info. I hope you will learn to love the world of environmental IPC just a little and even if not appreciate how important it can be to consider when you are thinking risk assessment.

elaine_cloutman-green_final_soft_bound_thesis_for_submission_dated_2015.pdf._redactedDownload

All opinions on this blog are my own

The Second Year Slump: understanding the ups and downs of doing a PhD

girlymicro Academic Life, Microbiology (Research), Research/Academia

I loved my PhD, it was one of the most amazing things I’ve ever had the privilege of doing in my career. It was also the start of my physical decline, the point at which I developed alopecia and started to have auto immune attacks. It was (next to FRCPath) the psychologically most challenging thing I’ve ever done. I don’t regret it for one second, but there are aspects of what it is like to do a PhD that I think I would have been better prepared for if someone had talked to me about them before I started. Now I supervise PhD students myself and I try to have some of the conversations with them that I wish that someone had had with me. 

Completing any PhD is a roller coaster and crossing the finish line is a huge mile stone. There is a lot of road from the start to completion however. So today I wanted to talk about one topic in particular that if I had known about when I started would have meant, when it happened to me, I didn’t feel so alone, out if my depth and like a failure compared to my peers. I’m talking about the second year slump.

Now this post is going to focus on PhDs but a lot of the thinking about why this is challenging and hard can be applied to any form of long term project that is high stakes and mostly undertaken in isolation. There are probably points we can all take away for different aspects of our working lives

So what is the second year slump?

The second year slump is the time during the middle of your PhD when you feel like you’ve lost your way. It’s the time where most students have a massive crisis of confidence both linked to their own skills and whether they can ever complete, but also linked to the project itself and whether it will have value. It is a pretty dark and lonely time where everything feels really hard and very isolating.

A question of timing?

Why does it happen when it happens? The second year is that point in a project when you have been doing it for long enough to understand the scale of the project and are so firmly embedded in it that you see both all of the challenges and all of the faults. You are also still quite far away from seeing the finish line or having outputs that make you feel you are really achieving.

Now obviously the second year slump doesn’t always occur in the second year, when it happens depends somewhat on the time scale of your PhD, it may be later if you’re working part time. The thing is it has happened to every PhD student I’ve spoken to at some point and certainly to every PhD student I’ve ever supervised.

One of the difficult things about entering the middle stage of your PhD is that you are getting to the point where you will be actively comparing yourself against others. Am I doing OK? Am I working hard enough? Am I productive enough? The problem is that every single project is different, your learning needs as a student will also be different as everyone starts in a different place. Therefore comparing how you are doing against others is often a fools errand. To compound this you are often benchmarking against peers that are either super enthusiastic as they have just started, or against other peers who are getting outputs (papers/posters) and meeting their success criteria because they are further down the line. Very rarely do you have someone in exactly the same boat to truly compare against, and yet we are rarely told to not compare against others.

The road ahead is all starting to become very real

The other thing about the middle of any long term project is that you are too far away from the end to truly be able to conceptualise what that looks like, and far enough from the beginning that the true challenges of the task are becoming very real. Rather than being filled with lots of enthusiasm and just an idea that it is going to be challenging, you know know quite how challenging the path ahead will be.

At this stage it can often feel like no progress is being made. The increments are so small that you can’t fully judge the distance you have travelled and you are so fully focussed on what is in front of you that you forget quite how far you’ve come. One of the tricks that I’ve been thinking of doing with my new starters is to get them to write notes to themselves for 6, 12 and 18 months as with a reminder of where they are and what they hope to have achieved by that point. I hope that by doing this it will give them something concrete to reflect back on to truly understand their level of progress. Pairing students during the second year slump with new starters can also actually help at this point. As well as developing them as educators it can also stand to show them how much knowledge they have acquired since they were the new starter themselves.

‘Oh, everyone wants to know about me’

It is a truth universally acknowledge that you should never ask a PhD student how it is going. The main issue with this is, if you are anything like I was at this point, I had very little life outside of work and my PhD so I just didn’t have a lot of small talk that wasn’t about my project. The problem is (and I acknowledge the irony here) everyone has an opinion or some advice. People who haven’t done a PhD have nothing to really compare it against in terms of giving you the support you need. We also all know of those other PhD students who use discussion as a way of making themselves feel better by talking about how great they are doing, whereas in truth we know that they were actually doing no better than anyone else. This is often compounded by your supervisor who will have a 1001 different priorities and will be trying to strike a balance between pushing enough and (if you are lucky) caring enough about your health and wellbeing to not push too much.

During the second year slump it can be tricky to find anything positive to say. You can’t babble on about everyone you’ve just met or how great it is to start, you often have nothing concrete that people will understand (like papers and posters) to share, and in all honesty this phase of an experimental PhD is often just filled with a lot of failure which can be difficult to discuss for fear of judgement. These things can all make just simply answering the question ‘how is the PhD going?’ challenging.

Stepping into your future

Finally, and I know it doesn’t feel like it, this is the point at which you really are developing and learning most. You’re at the point where you are starting to take risks and explore what it’s like to do novel work, you are truly beginning to work as a scientist and that can be scary and require adjustment.

At the start of your PhD you will mostly be doing the ‘safe’ work. Learning techniques and building on work done by others, but not initially taking those next big leaps of thought that are required for you to develop your own work. During your second year you are usually going to be making your own intellectual leaps and so the consequence of that is that there is a lot of failure and trouble shooting as you try and work things out. As you really grow into undertaking work as an independent researcher, you make that shift into following up on your own thoughts and really take responsibility for planning your work. That responsibility and the fact that your success is intrinsically linked to how well you develop into this new role can be truly terrifying, but it’s rarely articulated. Most people think the adjustment happens in the first year, but in my experience it is definitely during the second year when this shift starts to occur.

So if you are feeling low and lonely in the middle of any project, know that it is not you, it’s probably a function of the type of work you are doing. Remember that this is hard and that’s OK as you are truly beginning to reach your potential and anything worth doing is not easy, so be kind to yourself. If you are a supervisor or other form of mentor, talk about this with your students that are coming on board, think of ways to make it easier. Last of all and for the love of all you hold dear, don’t as a second year PhD student if they’ve started on their thesis yet, unless you’re prepared to give them a LOT of tea, cake and sympathy.

All opinions on this blog are my own

Celebrating National Pathology Week: What is a clinical academic?

girlymicro Academic Life, Healthcare Science, Microbiology (Clinical), Microbiology (Research), Research/Academia

We are working through an exciting time within NHS careers, especially as Healthcare Scientists. Training pathways are becoming more formalised and alongside this diversity of opportunities are increasing, allowing Healthcare Scientists to have not only more options for their individual careers but also to increase the impact of this workforce across areas including academia, education, leadership, as well as clinical specialisms. Following on from this weeks Guest Blog by Dr Claire Walker discussing the transition from lab to lectern and life working as a Healthcare Scientist within the academic setting I thought I would write something on what it is like to be a Clinical Academic (CA), working with a foot in both camps.

So what is a clinical academic? I suspect that all of you who read this blog regularly will be able to picture my face when I googled and the top entry is the one below from the NHS Healthcare Careers webpage:

what is a clinical academic? – healthcare careers search response

I believe it’s pretty self evident that I am not a medical doctor and that although this description may once have been true it is far from telling the full story.

So what is a Clinical Academic?

Being a CA is not in fact based on profession, or even % time splits. It’s based on the role that is occupied. One of the big distinguishing features is that a CA holds roles both within a University and within a Healthcare organisation, usually one honorary position and another substantive. Throughout the lifetime of a CA career the substantive post may switch between being within healthcare or a University, its the maintenance of both that is probably the most CA universal theme.

The amount of lecturing vs research varies by individual. Most of the CAs I work with tend to be highly engaged with research, especially if they are mainly based in healthcare, as this provides them with funding to buy out their time. In roles where clinics are routine however this provides a buy out route in the other direction. Despite being more research than teaching focussed I still teach on a number of master and undergraduate courses, as well as speaking at conferences etc.

Some typical academic tasks include:

  • Grant applications
  • Publication writing
  • Public engagement
  • Research supervision
  • Data collection (in whatever field that might be)
  • Teaching
  • Peer review (grants, papers etc)
  • Conference presentations
  • Other writing: book chapters etc
  • Guidance and strategic inputting

What are the routes into clinical academia?

On the Healthcare Scientist career chart below there is a box for CA pathways, but to me it still feels a bit ‘to be developed’. This isn’t unique to Healthcare Science but provides particular issues for my colleagues in specialist laboratories, especially within the UKHSA as they don’t have such a clear progression route laid out for them. It currently doesn’t really capture the whole situation as many of us in the Consultant Clinical Scientist box will also hold CA responsibilities and so the pathways aren’t as split as they appear.

There are a variety of roles into CA careers, both formal and informal. There is a fairly specific skill set you need to develop:

  • PhD (usually a research PhD rather than a tought/professional doctorate)
  • Some form of teaching qualification (as determined by your university). Not required for existing post but usually required for new
  • Funding track record – as you need to demonstrate to your employer you can assure an income stream
  • Publication track record – needed both for funding and dissemination
  • These days an interest in public engagement/involvement doesn’t hurt

The most established formal route into a CA career is via the National Institute of Health Research (NIHR) and the Integrated Clinical Academic (ICA) programme.

This is a programme that provides skill development and funding support all the way through from taster sessions to funding support for you to run your own research group. I wrote an article about this route in 2016 for the ACB and not much has changed in terms of the benefits.

The NIHR schemes are great, they match your current salary and give both great training and consumables support. This does mean these schemes are highly competitive (20 – 40% success rate, depending on level) however these days you need a level of research track record (publications and funding) to even enter at Doctoral level – demonstrating a pre-existing commitment to a CA career.

What about the informal routes? As I said the skill sets required are pretty standard and so can be developed piecemeal rather than through a structured programme. It is possible to get funding to do both a PhD and a teaching qualification by going through other routes (I have a post linked to PhD funding coming). The other components, funding and publishing, you will get by applying for funding for the qualification based aspects and during your PhD, it just may take longer. That said the NIHR route is time consuming and far from guaranteed, so both routes require you to know why you want to become a CA and an understanding of the fact that getting there is not a 9 – 5 commitment.

Why do Clinical Academic careers matter?

So having said that it can be a challenging route to go down why should you put in the effort?

There are numerous reasons why CAs are essential in healthcare. Let’s start with individual patient benefits. Research, especially translational research, is key to providing the best possible patient care. If we want to provide cutting edge care then we need to be engaged in the research that is developing that care – from clinical trials to diagnostic development. Getting results that diagnose patients faster has great individual benefits for patients, as they get on the right treatment more rapidly. Being engaged with clinical trials means that patients may be offered treatment or management that would just not be open to them otherwise.

On a Trust scale research enables funding to support infrastructure or translation of new diagnostics/services that might just not be possible with normal budget constraints. I was recently the co-applicant on a grant which brought in over £500,000.00 of infrastructure funding, for both staff and equipment. This means that the initial financial burden of translating over something new is not placed on the NHS and the data to then support business cases for introduction can be collected with minimal financial impact. On a national scale this kind of funding also supports multi site projects which would be difficult to manage in any other way in order to support large scale changes within the healthcare system, meaning that the potential impact can be huge and provide wide scale change.

There are also so many benefits for you as an individual. My career and life changed the day I got my NIHR Doctoral Fellowship. It opened both my eyes and doors to paths that I could never have imagined. I wouldn’t be a Lead Healthcare Scientist now if it wasn’t for the NIHR. I’m not sure I would be a Consultant. I have travelled the world, given lectures to thousands of people, developed future CAs and been able to develop as a scientist and a leader thanks to the funding that was provided. Along the way I hope that I’ve also made a difference for patients both through being involved in national guidance and local change.

What does a day in the life of a clinical academic look like?

As with so many aspects of Healthcare Science no two CAs seems to be the same. The National School of Healthcare Science have a number of different profiles on their webpage which describe some of the different options.

For me my weeks are really varied, obviously for the last 2 years my clinical work has been a priority and so the academic side of my role has been less prominent. I’ve already talked about teaching but for instance this is what I will be doing this month:

  • Organising a specialist conference on Environmental Infection Prevention and Control
  • Reviewing papers for numerous journals
  • Reviewing a grant
  • Reviewing abstract submissions for a conference
  • Meeting with my PhD students
  • Editing a paper for submission
  • Meeting to review SOPs for a country wide clinical trial
  • Meeting to review data for an ongoing COVID-19 study
  • Meeting with the molecular team to talk about how we move our Gram negative typing forward
  • Carrying out an MSc viva
  • Attending 2 exam boards as an external examiner

As my clinical work is currently still pretty hard core a lot of this I’ll pick up for the moment in my own time. Also, none of it takes me as long as when I first started out and so it looks more overwhelming than it actually is – I hope you can see the variety however.

Photo credit – Rabit Hole Photography

There is no getting around the fact that being a CA is not a 9 – 5 post however, managing grant and other deadlines on top of clinical work often requires some significant juggling skills, and in my case a very supportive husband. It’s not something I would advise that people strive for if they don’t love research, if they don’t have so many ideas that they just need to do something with them, it is not a tick box career. You also have to grow to be comfortable with failure, only ~20% of grants are successful, paper reviewer comments can be harsh and your confidence will take repeated knocks. Every time this happens though I get better at what I do, I find the learning and try to make sure I do it better next time #lifeislearning.

Despite it’s challenges being a CA brings me untold joy, it provides me with an outlet for creative thought and means that even though I spend most of my days in an office not a lab, I still feel like a scientist. I get to collaborate with the most amazing people who are at the forefront of their fields to make improvements for patients that would either not be possible or would take years any other way. For me it’s been something that has more than repaid my investment in time, energy and creativity. It’s taken me to places I would never have imagined, introduced me to people that my life is better for having met and provided me with experiences that I didn’t think would ever happen to someone as normal as me. So if you love learning new things, making life better for patients and are happy to spend your weekends in front of a laptop then a Clinical Academic career may be the career for you!

All opinions on this blog are my own

If Not You Then Who? Why seizing the opportunities that come your way is so important

girlymicro Education, General, Microbiology (Clinical), Microbiology (Research), Science Communication

We’ve all had the emails arrive with requests. We are looking for a new member of X committee, a training rep for X group or would you like to give a lecture to Y. For many year when these dropped into my inbox I ignored them. They were being sent to everyone and so ‘they’ weren’t actually looking for someone like me. I wasn’t experienced enough knowledgeable enough, connected enough to ever find success in replying to something like this. Then one year I took a chance and replied. I volunteered to become the HSST lead for the Microbiology Professionals Committee of the Association of Biochemistry and Laboratory Medicine (a LOT of letters I know). They couldn’t reply fast enough with how happy they were I’d replied.

Don’t get me wrong, the ACB weren’t particularly excited that I’d replied……..more they were excited that anyone had. What I’ve learnt since from sending out these emails myself, is that hardly anyone does. The world is full of people who doubt that they would succeed and so don’t put themselves out there and give it a shot. So today I want to talk about all the reasons why, when that email arrives, you should click reply, open the next door in your career and step through it boldly.

You never know where these things will lead

When I sent that email I had no idea where it would lead. Now I know it was the first in a series of steps that took me from where I started to being considered a leader within my profession. At each step I never could have predicted what the one a couple of steps down further down the road would involve. What I do know is that each one I took, I took with purpose. Sometimes I wanted to give back, sometimes I wanted to increase my skills and sometimes I wanted to gain experience. The choices are your own but also not taking those steps and being purposeful is also a choice.

What I hadn’t realised back then is that people frequently ask people they know to get things done, not necessarily because they are the best person but because they are the person they can identify. This means that visibility and being part of networks is key to getting some of the opportunities that would benefit you and your profession.

In my case, that application to be a HSST rep emboldened me to apply for a bursary to attend my first overseas conference in Denver (see pic). After attending my first SHEA conference I was encouraged to apply to their international ambassador scheme, and became the first UK Ambassador. That then led to them paying for me to attend a conference at Disney in Florida, which was not only amazing, but meant I made the connections to sort out a 2 month sabbatical at Boston Childrens Hospital. This helped my NIHR Clinical Lectureship application. That progression helped give me the confidence and experience to apply to become Trust Lead Healthcare Scientist and to become a Clinical Academic.

Gain experience you won’t get in the day job

There are many reasons why it can be difficult to get the kind of experience that volunteering for professional bodies/guideline groups/any external responsibility can provide:

  • Sometimes its hard to be seen in a different way if we’ve been in post for a while, and therefore it can be hard to get identified for opportunities internally
  • Internal committees may find it difficult to accommodate extra people under existing terms of reference
  • Concepts linked to hierarchy may matter more for exisiting structures versus new groups/committees
  • External groups are often specifically looking to engage new people, garner new views and so it can be easier to align personal desires to be exposed to new experiences with the needs of these groups
  • Experienced provided by external groups may just not be provided internally i.e. experience of being a charity trustee

The activities linked to these groups may provide a lower stakes way to get experience. This can include chairing your first meetings, making decisions linked to the success of small pots of grant funding, inputting into a strategic plan. When doing this as part of our day jobs this can feel high stakes and be daunting. If you can gain experience of similar processes in a lower stakes environment you can participate in the learning without some of the stress and anxiety which might otherwise be present.

Often the experience isn’t limited to the activity itself but the experience of working with new people from different backgrounds. This experience helps make us more rounded professionals as well as supporting us in expanding our networks.

Progression is a series of steps

As I described in ‘not knowing where things will lead’ it is often hard to see where taking a series of these smaller steps will take you to. Frequently engaging in these activities is not about ticking off part of a big life plan but about making small progressions that support the whole. If you are a trainee it can be a really nice way of ticking off competencies, if you are already registered it can bring some variety to your CPD for the year. Meeting new people and making new friends is a benefit in itself.

One of the wonderful things about seeing these encounters as small steps is that you don’t have to feel overwhelmed by the big picture, in fact you don’t have to know what that big picture will look like. I talk a lot about having goals in mind, and I stand by that, but there is also joy in taking small steps into the unknown where you just enjoy and value the step in itself. Where you focus on the learning and the experience of that encounter for what it’s offering you in the moment. Taking multiples of these small steps combine to lead to big changes but the little steps have value in themselves and should be appreciated as such.

Don’t be afraid to be seen

I think on some level we all fear being visible, of sticking our heads above the parapet. It feeds into imposter syndrome and our fear that we aren’t ‘enough’. Fear of failure, of not getting chosen, is embedded in most of us from standing in lines to be picked at school if nothing else. I know and understand these fears. Fear is OK, it’s natural, in some cases in the right amount it can even be helpful. The problem comes when it overwhelms, or when we pay it too much heed and therefore we let it stop us from becoming all that we can. I feel this is especially true if it stops us learning, either from the experience itself or from even engaging in the opportunity to start with.

I often sit in my fear for a bit when I’m trying to move forward. This may sound like a strange phrase or a strange thing to do, but sometimes I need to experience the fear to understand it. I don’t dismiss it as I’ve never been able to make that work, instead I allow myself to feel and to ask myself ‘if this fear is real what is the worst that will happen’. What are the worst case scenarios. Then I ask myself, ‘what does this worst case scenario actually mean for me?’. Is the worst case that someone doesn’t pick me? In which case I’ll be a bit bummed out for a few days but there will be more opportunities. Is the worst case that I will make myself look like a bit of an idiot? To be honest I’ve been there before and whether its for this specific reason or not I am likely to be there again. One thing I’ve learnt it that you and your behaviour/embarrassment has way more longevity in your mind than in others. To be frank you are simply not important enough to most other people for them to remember a stupid comment in 6 months time, and those that you are important enough to probably won’t care. Most of the time when I do this I realise that even in the worst case scenarios the event would have little meaning in my life a few months down the line. Therefore the potential cost is still worth it. I don’t talk myself out of fear, I embrace it and that way it doesn’t control me.

Help your community

Finally, and I think this is so important. Our communities survive because of the fact that we engage as part of them. Guidelines don’t get written if people don’t volunteer to write them, events don’t get organised, outreach doesn’t get undertaken and manuscripts don’t get published. It really is a case of trying to make the sum greater than the parts.

As well as learning experiences in themselves, these opportunities are vital for both our profession and our patients. So much of what we do isn’t ‘paid’ as such, so much of our impact is based on the community choosing to engage and work together towards making things different, and hopefully better than they are today. We reap the benefits from the work of this community whether we volunteer or not, but we benefit so much more if we are part of the process. As each one of us steps forward to support our communities the output benefits, as the contribution comes from a more varied group of people and stands a better chance of therefore representing the society/community it is linked to. So instead of seeing your application as a way to benefit you and feeling stressed or worried about how it is received, see it for what it is, something that will benefit those receiving it and something they will be grateful to open.

Since sending that first email asking to be considered I’ve travelled the world, met amazing people and opened up a world of opportunities I just couldn’t have imagined, just because I hit reply and YES. So give yourself the gift of believing in yourself the way that you believe in others, you deserve it!

All opinions on this blog are my own

Conference Season Is Upon Us: Top tips for anyone who struggles with networking

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Clinical), Microbiology (Research), Research/Academia

Firstly apologies, this post was supposed to go up before ECCMID as I was hoping it would help others attending. Work was just too full on and I didn’t have the headspace to get it written. As there are still a lot of events yet to come I’m hoping it will still prove useful however.

We all know how very important networking is, especially at conferences. So much of a career that makes a difference in science is based on who you know and who you collaborate with. The problem is making those connections and getting to know people, especially in the early part of your career, often requires taking the plunge and being the one to open a conversion with someone you’ve never met.

I have an amazing friend called Diane who is a wonder to behold in these setting. She happily goes up to talk to people who she’s never met and just starts talking to them with great enthusiasm. Shes fearless and draws the best out of those she engages with. If you are a Diane you probably need read no further. For me however, there is little worse than that moment when you enter a room at a meeting/event, get your cup of tea and survey the 100s of people before you. In this moment you know that really now is the time, you HAVE to find someone to talk to. How do you choose who? What on earth do you say that means you don’t come across as an idiot? The very thought of it gives me palpitations. So here are some things I’ve learnt that take some of the stress out of networking at conferences.

Find an in

There are some moments and set ups at conferences when it is easier to start a conversation than others. There is always the chance that the person next to you in an interesting session will strike up a conversation to help them process what they’ve heard but in general they will be doing the same as you, ducking into and out of sessions that trigger their fancy, meaning they will be you focused on what comes next not starting a chat.

I find however there are two key moments when people are available for the cold start up conversation.

The first is at food breaks/receptions. During these moments there will be people who are there solo and also looking to develop their networks. I find the best thing to do in these situations is to get there early. There are always a limited number of tables where people can put down drinks, if you can find one and hold a place then people will effectively come to you. If this fails and there are no tables, just being close to the source of the refreshments often does the same job. Food and drink are great removers of hierarchy and being somewhere visible means that those in a similar position to you will be able to see you and hopefully will head your way. Worst case you make some small talk to the group that comes to your table and you can politely extricate yourself if it all feels too weird by saying you’re popping to get another drink.

The other place where people will be desperate to speak to you is during poster sessions. So many people will be waiting at their posters for an hour in the desperate hope that someone will come and show an interest. This is often a great time to make connections/exchange contact details (see NB below) If you scope out the listing you will know you are speaking to people who are interested in the same kind of work as you. This can shortcut some of the small talk you might otherwise need to make. It also enables you to know whether you are making a connection with a peer or whether you are connecting with a potential mentor/future employer.

The other thing to think about prior to these conversations is what you can offer, what is your unique selling point?

  • Knowledge (technique, setting or organism)
  • Access (organism, patients, research equipment)
  • Support (mentorship, peer-peer)
  • Collaboration (shared goals, shared research, shared implementation)

NB one of my biggest tips for all of these situations is to make sure you have some business cards printed – even if you print them yourself – this means that you can have something easy to hand out or pin to posters if you want authors to get in touch

Find your tribe

Anyone who reads this blog regularly will know that I’m a bit of a twitterholic (@girlymicro if we haven’t met). One of the many reasons that I’ve stuck with twitter since I initially signed up is that it has transformed my networking experiences. Twitter has offered me a way to circumvent the cold start up conversation by allowing me to find my tribe.

These days every conference/meeting has a hashtag. By following this hashtag you can find people who are interested in the same things as you, people who are in the same sessions or who even have shared connections. In many ways its an improved version of doing the poster walk.  Not only does this give you a conversational in but also by tweeting yourself linked to the thread before you ever meet in person it allows you to have a low stakes initial introduction.

One of the things I also love about twitter is it enables me to find and arrange to meet up with people who I primarily know online in order to strengthen my networks by getting to know each other better. It also gives me the chance to arrange collaboration events, like podcast recordings, when we just happen to be in the same place for a limited time.  Both of these can obviously be done by email but can be much easier to arrange when at an event when you suddenly have half an hour free. Especially at big conferences you could wander the halls for 4 days and not meet anyone you know, this way you can make the most of every second.

Take a study buddy

I absorb my learning best when I have someone to talk through my thoughts with. I have a couple of trusted study buddies that I will by preference attend events with. These guys help me get the most out of any event by:

  • Encouraging me to be braver – ask those questions I might talk myself out of, talk to that person that I should really try to connect with
  • Providing me with a sounding board for ideas when I’m in the moment
  • Enabling us to divide and conquer – there are often multiple sessions I want to be in at the same time, this way we can split up and meet at whichever session is actually proving most appropriate
  • Knowing me well enough to give me space when I need down time to re-energise
  • Crucially for me they are also there so I can feel safe from a health perspective if I have issues. They’ve helped me manage severe reactions, broken limbs etc and I trust them to get me where I need to be and give healthcare workers the right info if I need care

Mel and Lena have been my colleagues for years and they can not only get me out of a shame spiral if I do something stupid but also, by having them available to have conversations all together with new collaborators, we can make much more rapid progress on projects from the very start.

One of the other great things about going with a great study buddy is that you can also achieve other goals whilst at the conference. You can start to get papers drafted, do that research return or catch up about PhD students. If you do have supervision responsibilities whilst you’re away, as you have trainees with you, you can also share the load in terms of ensuring you have downtime. A lot of my most creative breakthroughs have happened with these guys whilst we’ve been away, surrounded both by new science and the time to reflect on how we could encorporate new thinking into our work.

Do some pre-work

I can get really insecure when going to high stakes meetings, like some of the ones I’ve been to at the House of Commons. I never really feel like I fit in and I have been known to hide in the bathrooms there until 5 minutes prior to an event start so I don’t have to face the ‘meet a stranger’ chit chat. In recent years I’ve learnt the value of doing some pre-work ahead of these meetings. This has taken different forms:

  • Reaching out on social media to see if any of my connections are attending
  • Approaching a professional body, especially if I’m on their guestlist, to find out who else they are sending so I can pre-arrange meeting at the session
  • Researching the event to look at speakers and attendance list (if available) so I can pre plan who I might want to speak to and what I could start a conversation with

In these events part of the value is in expanding your network and so really thinking about why you are going and what you hope to achieve is really worth it. Then you can match your elevator pitch (who you are, what you do and what you can offer) to your goals to help you achieve them.

Become the person others come to speak to

One of the things that has become lovely in recent years is that I’ve realised if you are presenting/organising/chairing people come to speak to you. This removes a whole lot of the stress of networking. As I mentioned above, people will often come to you even when you are presenting posters. Its always worth submitting work therefore to events you are attending, not only to get feedback on get science, but also to support you in developing your networks.

Even if you are not in a position to submit work then you should think about offering to support the organisation of events. Meetings are frequently looking for individuals who are happy to support the event organisation, both ahead of time and to do things like man the desks during the event itself. This will mean that you get to know other people who are supporting event delivery with you and give you an opportunity to network with delegates and speakers in a supported way. These connections can be transformative in terms of giving you further opportunities down the line.

Know your self and your limits

Most people assume I’m an extrovert when they meet me and I definitely have a lot of those traits. The things is, I can only manage networking for a fixed period of time. I’m good for a couple of meetings but then I need to retreat back into my bathroom office and answer some emails, otherwise I just feel progressively drained. The older I get the more I need my own space. This is usually fine but presents a real problem at places like conferences where I may need to be in full on extrovert mode for 16 hours a day. I find it exhausting.

One of the things that I’ve discovered about networking is that I therefore have to schedule it in a way that works for me. I can’t agree to go to lots of dinners on top of full day events, either from a health or a social resource point of view. I therefore pick the moments that work best for me and don’t over commit. This does mean I sometimes worry about missing out and not making the most of every opportunity but it also means that I put myself and my wellbeing first. It means that I don’t leave a conference unable to engage with work when I get back as I’ve already used up all my resources. Therefore my top piece of advice is to understand that networking is key but find a way to do it that works for you. Pick your key moments and do them well, rather than trying to be all things to all people.

All opinions on this blog are my own

Healthcare Science Week 2022 – Join us on Friday 18th March to talk about blogging, communicating and the importance of drama

girlymicro Healthcare Science, Microbiology (Clinical), Microbiology (Research), Science Communication

Healthcare Science Week performance based on the weekly ‘Girlymicro’ blog by Dr Elaine Cloutman-Green, followed by a discussion on blogging

“So, this is my first ever blog post. Bear with me as I don’t really know what I’m doing. I’m what is known as a Clinical Scientist and I work in Infection Control.”

Thus began the first blog post by Dr Elaine Cloutman-Green, Lead Healthcare Scientist at Great Ormond Street Hospital, in December 2015. It would be five years and one pandemic before her second post, in October 2020, began her weekly blog as ‘Girlymicro’ (‘scientist changing the world one swab at a time’).

Girlymicro blogged at first about the job, to promote Healthcare Science, offering professional exam or interview advice for HCS trainees, before ranging more widely, into women in science, the challenges facing HCS, exploring the limits of what overstretched teams and individuals can achieve, saving lives in labs through insight, accuracy and interpretation.

Each blog written in a snatched hour, Girlymicro became a mental space populated with personal reflection, meditation on loss, favourite microbes, special guests, puppet shows, and… zombies; always with Elaine’s trademark humanity and humour.

‘All Opinions In This Blog Are My Own’ is a showcase of a devised work in progress based on the Girlymicro blog by The Nosocomial Project, adapted by Nicola Baldwin, performed by two actors, Becky Simon and Peter Clements, and two Healthcare Scientists, Anthony De Souza and Dr Elaine Cloutman-Green.

The short performance will be followed by a conversation on writing and blogging. Why blog? What might you learn along the way? Does writing create a safe space for reflection? Or create new pressures? To blog or not to blog…. That is the question.

All welcome

Date and time

Fri, 18 March 2022 15:00 – 17:30 GMT

Location

South Wing University College London

IAS Common Ground, South Wing

UCL Gower Street London

London

WC1E 6BT

please register to attend on this link, please take a lateral flow prior to the event and wear a mask

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Things I Wish I’d Known When I Was a Trainee: My top ten tips for making the most of your journey

girlymicro Academic Life, Microbiology (Clinical), Microbiology (Research), Research/Academia

It’s an exciting time for a lot of people right now, a lot of people are planning new phases of study starting in September/October. In the world of Healthcare Science we have people starting PhDs as part of HSST (people training towards becoming Consultants) and new STPs (people training to be become Healthcare Scientists) all beginning their new journeys. It feels like a really good time to talk about all the things I wish I’d known when I started out in order to make people feel less alone, as well as encouraging them to make the most of every part of this next stage.

It’s never about being the smartest person in the room

When I first started in my role as a trainee Clinical Scientist, and then as a PhD student, I just remember being over awed by everyone is the room. Everyone had amazing titles, years of experience and just an aura that suggested competence and knowledge. Even all these years later I sometimes feel that way, especially in rooms I haven’t been in before. It took me a long time to understand that my contribution wasn’t about being smarter than anyone else, I’ve never been the smartest person in any room. Your contribution will be about offering a new perspective that is unique to you. Sometimes that’s from a technical scientific point of view. Sometimes that will be by who you can connect the people in the room with. Sometimes that will be by offering a different lens through which the situation can be seen, being new to an environment means you will be able to review things without historical bias.

Manage your training officer/supervisor

I’ve been on both sides of the fence. I’ve been the PhD student who couldn’t get time with their supervisor and the Clinical Scientist trainee who just wanted to be included. I am now the PhD supervisor/training officer whose diary looks like a train wreck and who feels constantly guilty about not having enough time to devote to those who she’s training. One of the key skills that I had to develop as a trainee, and now encourage in those I supervise, is to develop skills in supervisor management. This includes things like understanding what your own needs are: do you like micromanagement/close support, or are you more interested in a light touch. Ask how your supervisor works: are they someone who likes drop ins, or are they like me i.e. if it isn’t in the diary it won’t happen. Learn how to support the process by keeping notes of the meetings and emailing them for record keeping/prompts. Finally, spend the time to think about what you want from each face to face to make sure you maximise your time. Also, don’t repeatedly stand them up – it sends out ALL the wrong signals and if you don’t value my time I will value our meetings less.

We all fail, frequently

No one really talks about it but we all fail, I fail all the time. Now sometimes those failures are big and sometimes they are small and minor, like not having a conversation well. I wasted a lot of time at the start of my training by trying to be perfect and as a consequence I feel I didn’t maximise the learning in those first few years. If I discovered an error I quickly (and safely) corrected it, but I had such anxiety over it I didn’t really reflect on it, I wanted to fix it and move on. I also (apart from safety reporting) didn’t really talk about it with my supervisor. This meant that the team as a whole missed out on learning from system based failures. If mistakes happen, especially serious errors, they tend to be compound events linked to multiple failures along a pathway. The best way to avoid these errors to identify the weak points in the system when minor issues occur singly, so it reduces the chance of a compound failure later on. Long and short, don’t be afraid of failure, focus on learning from it and know we are all in this together.

There are no stupid questions

I love people that ask questions, it makes me think, it makes me remember why I’ve made decisions and assess if they are still relevant. When I started out I was worried that asking questions would just demonstrate my ignorance, and at the start of my training I was concerned about what people thought about me coming in as a non microbiologist and being behind everyone else. It takes courage to ask questions and be part of the discussion. As a trainer it is very difficult to evaluate whether you are covering knowledge gaps or pitching what you are doing correctly if the dialogue is one way. As your confidence grows it is also good to question and challenge, there are many different ways of doing things and only by having dialogue can you really understand why certain decisions get made under some circumstances and not in others. If you are an introvert and not comfortable asking questions openly, make notes, email and discuss your findings, find a way that works for you and work for your mentor.

Make copious notes

You will be given a LOT of information when you start, well to be honest all the way through your training, but the start can present information overload. When I look back at my notes from the first week of my training I obviously didn’t know what some of the words meant, let alone the context. By taking copious notes throughout however it meant that once I had found my feet I could review those notes and gain new information I was unable to take in the first time. By reviewing notes when you come back to something, after a break or rotation else where, you will be able to make connections which may not have been obvious to you the first time around. It will also enable you to ask questions better (see above) and have more enriched meetings with you mentor/trainer/supervisor as you will have access to specifics. Not only that but it will mean that you demonstrate attention and will enable you to ask questions that add to your experience. Plus when you look back at your notes from 10 years ago it will make your realise how far you’ve come and how much you have achieved!

Be the master of your own destiny

Every trainee/student is different. Hopefully you will get a supervisor who will have the time to help you reflect on your learning needs, but you need to also be able to develop the skills to do this yourself as you won’t always have access to someone to do it with you. Most training programmes are quite structured but there are always many different ways to deliver on the same learning outcomes. This is a career and every career journey is personal, so the sooner you can get into the habit of thinking about what your strengths and weaknesses are, and what your specialist areas of interest could be, the more you will get out of any opportunities you are offered. Within academia and the NHS you will often not be offered opportunities on a plate, but if you know what you want and find the opportunity out, you will very rarely get blocked from accessing them. Start thinking early about what could enrich your training and find ways to access those experiences.

Sadly this is not a 9-5 but you can do this and have a life

I’ve sat in a lot of lectures from very senior people who talk to trainees about clinical and academic work not being 9 – 5, it’s true but in many ways this saddens me. It gets spoken about as if you can’t have a life, you either choose devotion to this vocation or it isn’t for you. There will definitely be points where you have to commit more than the standard hours, exam revision, dissertation writing etc, but this shouldn’t be all the time. I encourage my guys to take on extra curricula activities such as STEM engagement, which often happen on the weekend, but this is a few times a year. Training shouldn’t be about burn out. To fully learn and develop it is crucial to have mental space to reflect and recovery time. You need to early on find strategies that work for you to manage your time. Do you want to block out every Friday afternoon for paper reading? If you do need to put in some extra hours would you rather do it at your desk to maintain work home separation, or work on the sofa. Be aware early of working to manage stress rather than to manage task and develop strategies to enable yourself to walk away and unwind (my trainees and students will be laughing at the hypocrisy of me writing this line, but do as I say not do as I do, I too am constantly learning).

Have a plan for what’s next

3 years feels like a long time when you start but it’s not really. Before you know, it will be 18 months in and you will need to start thinking about what the next stage of your career may look like. As part of your progress it is therefore important to make sure you regularly check in with yourself about what you’ve enjoyed and you’re aspirations to make sure you’re on track for the career you want. The more you do this, the more you will be able to mould your training around the experiences and networks you will need to help you succeed. A lot of us fall into career choices, but if you can be deliberate it will help you find happiness as well as success.

Reach out and connect

It’s not what you know but who you know. This isn’t entirely correct, but finding opportunities often depends on knowing the people who are making them or have access to them. This is often difficult when you are starting out in a new field or career as you don’t know who people are in order to hear about things. This goes for job posts as well as learning and accessing skills. There are now some ways where you can do this on your own, such as social media, which are less reliant on introductions – join us on Twitter. However this is where extra curricula’s can really help. Join your professional body, find a trainee network, engage in patient and public engagement, go for coffee with your fellow trainees and PhD students. Relationships and connections forged now will pay dividends later and are worth the investment, even if you are busy with other things.

Enjoy the ride

I was so focused on the end goal that I didn’t enjoy the journey as much as I should have. I spent 17 years focussed on making consultant, ticking boxes along the way like PhD and FRCPath, that I didn’t live in the moment. I was always focussed on the next step, the next target and so I didn’t enjoy the freedom that my training presented me with. Being supernumerary only occurs early in your career and gives you a freedom to make decisions and enjoy experiences you just won’t get later on. Learning is your focus right now, free of the demands of the inbox, meetings and other peoples agendas. Make sure you relish every moment as you will have less and less time to just enjoy learning as your career progresses.

All opinions on this blog are my own