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

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

Surviving Your Viva: My top 10 tips for oral exams

I’ve sat my fair share of viva voce exams in my time and I must admit I’ve always been pretty intimidated by them, that said they’ve never been as bad as I feared when I finally got in the room. They’ve been on my mind this week as one of my PhD students is due to have her viva on Friday and so I thought I would write down my top tips in order to bring your best self to the process. This post focusses a lot on PhD viva’s but I think a lot of the principles can be extrapolated to other types of oral exams.

1 – Do your prep

Some people think that the viva process is about what happens in the room. Although you have to ‘bring it’ during the discussion your life can be made much much easier by doing a good job in the prep phase.

If you are having a viva for a PhD this goes all the way back to researching the administrative side of the process and being actively involved in examiner selection. In an ideal world your supervisor would sit with you, talk you through the stages and actively involve you in the discussions, we both know however that the world isn’t always that ideal and you may have to be prepared to do this leg work for yourself.

There are some benefits to owning this phase of the work. For my PhD there was a communication breakdown towards the end and my supervisor wanted me to delay submitting for another year and therefore refused to sign the submission paperwork. I knew that I needed to submit on my current time scale as I wanted to sit FRCPath in my NIHR funded time. I also knew because I’d spent time researching the administrative side of things that I wasn’t required to have sign off, that part just meant that UCL weren’t responsible for any failures. So I submitted anyway and passed. I also researched, found and submitted my examiner paperwork and choices.

The downside to selecting your own examiners without supervisor support is that you run the risk of only selecting based on academic publications or area of interest. I was fortunate as I personally knew plenty of people in the field of IPC and so could select with greater context. If you only select on the basis of publications you can end up with an unbalanced panel or one that doesn’t support you to have a discussion that really represents you or your work to the best of your ability. So if you are in a position where you need to lead on this make sure you also find out what kind of examiner they are, and whether there are any political conflicts of interest before making a final decision.

2 – Have a practice

Whatever your situation it is always worth having a practice viva, preferably with people that scare you just a little. Ask that amazing post doc who has always been a little intimidating or the person that always asks good but challenging questions at lab meetings. You don’t want to destroy your shaky confidence at this point but if set yourself a challenge you will amazed at how much easier it is when you are in the room for the real thing.

One of my other PhD students had their upgrade recently and his other supervisor and I ran a mock. Now I apparently can get a little intense when I’m asking questions about science and very rarely I’ve been called ‘the destroyer’ when it comes to challenging the science presented by reps if I’ve found it to be misleading. It was therefore reported back that if you can survive a mock with me the actual event will be a walk in the park. I don’t know if that’s true, but what I do know is that if you have a relationship with your supervisor that permits this kind of mock session, your supervisor will know the strengths and weaknesses of your project intimately. They will therefore be able to ask ALL the questions that you hope your real examiners will skip over or not pick up on. The purpose of us asking these questions is not to discredit what you’ve worked so hard on, all work has weaknesses, it’s to help you develop a strategy to answer those questions.

These sessions can also be useful to prep the paperwork you’re taking into the viva with you. I had my thesis labelled up with colour coded tabs and had post it notes within it to remind me of key points in case I got flustered (Bayesian modelling haunts me to this day). A practice viva will help you work out whether what you have done works and if you need to change anything before the real thing.

3 – Know your examiners

I’ve already talked a little bit about researching examiners before you select them, but in the run up to the big event there are last minute things that are worth doing. Firstly, check any of their publications that have come out since you submitted your thesis. I had these printed out and annotated to take into my viva so I had prepared for discussion based on their latest work. Second, when your doing your thesis notes think about highlighting your examiners papers that you have referenced and be very aware of how they have linked into your narrative. They will also have published papers adjacent to your work which you may not have referenced, be aware of these and where the conversation topics may therefore drift to in order to help you be prepared.

Third, and this is a bit more work but worth doing if you have time, check out who they referenced. We all have go to references and authors, your examiners are no different. By looking at the reference lists in their papers you can see who their go to authors are and you can see where your over laps are. Also, be prepared for questions if you haven’t cited the same papers. Finally, check the latest publications within the big name journals within your field. Examiners may occasionally ask questions about the latest big work in your field, even if it’s not directly related to your work, to see how well read you are and if you have a wider interest. This isn’t a pass or fail question, but your PhD project may be different to where you end up as a post doc and it helps to gauge how you might make the transition to working in academia more generally.

3 – Think how you want to present yourself

This may seem like a given but it’s really useful to think about how you want to be perceived in the room. How much this matters, in part, is dependent upon some of the research you’ve done. There are some examiners who would immediately think less of you if you turn up in the room and aren’t suited and booted. The main thing In terms of clothing and outfit is that it’s important to be comfortable, whatever route you choose to go down. You may be sitting in that outfit for 6 hours and so you don’t want to have to constantly be adjusting necklines or moving waist bands that are cutting into you. You need to be in the moment and so choose an outfit that helps that by making you feel comfortable in your own skin, preferably professional enough that you don’t risk upsetting anyone. You may find wearing a T-shirt under that top that sums up who you are is helpful or having a mascot in your pocket that you can slip a hand into a pocket and grip if it gets stressful is useful. I genuinely don’t believe there are any hard and fast rules here other than to plan it before hand and make sure you give your an outfit a dress rehearsal to make sure it empowers rather than distracts you.

To be honest appearance isn’t something that is important to me when I examine, being present and polite in the room is waaaaaay more important to me. I find body language is really key in this kind of face to face assessment. You really need to be aware of what your body language is saying. No matter how you feel it’s going it’s important to stay open, smiling and responsive in terms of your body language. If you have a ‘resting bitch face’ it’s worth being aware of it as you don’t want to come over as angry or defensive when you are dealing with the questions. Mostly because you won’t get your point across anywhere near as clearly as it will be distracting for the examiners.

4 – Answer the question they ask not the one you’d prefer

This one is true whether it’s an oral exam or written paper, answer the question you are asked not the one you wish they’d asked. Now as part of your viva prep you will probably learn to answer some of the difficult ones like a politician, where you acknowledge the questions and then deflect to a strength when following up. This is different to just not answering the question. I’m so guilty of this one. I tend to be holding a conversation in my head at the same time as being in the room and so I will proceed to the next question in the conversation I’ve planned rather than listen to nuance of the one I’m actually being asked. I have to really force myself to be calm and really listen to the question. I always make sure I have water or something I can drink in the room and try to force myself to take a sip before I answer a question when I’m feeling stressed or nervous in order to stop me jumping in and make me focus on the question. Hearing the question can be especially tricky in a PhD viva when the questions may be long and multi-component. I took in a pad so that I could write down sections from multi-component questions (just words as prompts) so that I could try to ensure that I was answering everything that was asked of me.

Remember that in a PhD viva you are also able to take the lead in some of the discussion, this is your chance to really talk about your work after all, but it’s important that you bear in mind the point you are trying to make rather than meandering or going down rabbit holes. If you go off topic too much it can give your examiner doubts about your ability to prioritise key points, which can indicate a lack of thorough understanding.

5 – Don’t try to blag it

If you don’t know the answer please just say so, it’s OK. There is nothing worse than having someone try to pretend they know the answer or watching them actively make things up in a viva. Science is about the unknown and there will be numerous points in your working life where you don’t know the answer. If you try to blag it can indicate that you might not acknowledge key failings or points in your work/field you don’t know/understand, not just in your viva but in your practice. This can be a really big red flag and will mean your examiners push harder and dig more to uncover what other weaknesses may be present. It is perfectly fine to acknowledge that you are having a blank and would prefer to come back to a question later, or say that is not something you actually have a concrete answer for but you would consider X, Y, Z in finding an answer. Practice responding to questions you don’t have the answer to, it will stand you in good stead for conference questions and all kinds of other situations in the future.

6 – Give credit where its due

A lot of PhDs and other pieces of work contain sections where you supported rather than led. You may have had some statistics, bioinformatics, or sampling support. I’ve had a couple of (non examination) situations recently where instead of acknowledging this individuals have obfuscated the support they had. If this happens in an exam situation then it’s really concerning, if it comes out in an exam situation and has not been acknowledged in the thesis this is also really not good. It is OK to have work that has been co-created or even led by others, as long as this is well acknowledge and there is enough in your thesis that is unique or led by you. Again, hiding these other contributions makes your examiners question the level of your contribution and they will get the spades out to start digging. Science and medicine is a team sport, don’t be afraid to acknowledge that. Being able to work with others is a strength and not a weakness.

7 – Be prepared to talk about your why

Although PhD viva exams can feel like they are all about the data that’s not actually true. They are also about you as a person, not just the science. It is important therefore to be prepared to answer questions to help the examiners get to know more about you. What was it that made you want to do a PhD? What were your skills and interests when you started? What were your learning outcomes that you were aiming to complete by the time you finished?

A PhD is effectively an apprenticeship in research with the aim that you will become an independent researcher at the end. All that is about more than just data collection. What skills and techniques do you feel like you’ve picked up along the way? What other transferable skills have you learnt? Have you mentored masters students? Presented at conferences? Written papers? Have you undertaken any science communication or public engagement – what have you learnt? Which courses have you undertaken as part of your PhD? What networks have you become part of? What collaborations have you formed? Thinking and preparing to answer questions like this will give your examiners a much greater idea of where you came from and help to bench mark how far you’ve come.

8 – Prepare to talk about the future

The other thing that you should be prepared to talk about (after where you’ve come from) is where you are going to. A common question is ‘if money or resources were no object how would you change the work you have done so far and how would you plan the next steps for your project?’

You will have had plenty of time to reflect on the weaknesses of your work, this is the moment where you get to talk about how you would address those weaknesses by discussing what the next steps for your work could be. Practice both a realistic ‘I would put in a grant to X funding body to continue Y aspect of my work because….’ answer as well as a super ambitious version for if someone took away all of the resource limitations placed upon you.

You should also be prepared to talk about your plans for the future. Are you going to stay in academia? Are you interested in transferring to industry? Would you like to become a clinical academic? This a great way to help examiners understand why you may have made some of the choices of direction you’ve made linked to project, for instance taking a more clinical bent. It is also a good way to have a conversation that may help your thinking about where you want to be in 5 years and if you’re lucky gain advice from some very experienced people on next steps.

9 – Know we’re rooting for you

A lot of people go into the examination room thinking that it will be adversarial setting, the opposite should be true, we are rooting for you. Our job is to support you through the process to get the most out of both you and your work. Everyone understands that you will be nervous, everyone in that room has sat on the other side of the table, has sat in your shoes, they know therefore both how it feels and what it means.

Don’t be afraid to talk about challenges your have faced, in fact you will often be asked to talk about the biggest challenges within your project. It is important to think about what you want to discuss in response to this question: what was the challenge? how did you respond to it? what was the learning you took from it, both about yourself and the work? These questions are important for the examiner not just to understand what your progress to viva has involved but also how you think and respond. This is a great opportunity to talk about things that matter to you and to help the examiners get to know who you are as a scientist. By doing the work to prepare you are doing all you can to help your examiners achieve this. Stay open, stay engaged and stay hopeful.

10 – Keep calm and carry on

Finally, this is a big one. No matter what happens in that room know that it is rarely the end. For good or bad almost everyone comes out of that room with further work, with something more to do. That is very much part of the learning. A lot of people who haven’t done a PhD think that the viva is the end of the process, the big hooray, but I must admit it didn’t feel real to me until I stood at a graduation ceremony in my robes knowing it was truly done.

Whatever happens you will work out of that room with a whole bunch of concrete information that will allow you to put a bow on what will already be (probably) one of the best pieces of writing you will ever do. You will also have learnt more than you could dream in the process of prepping for the viva and during the event itself. You will come out of it as a stronger, better person who will have learnt so much about yourself and what you can really achieve when you put your mind to it.

So as much as any oral exam is terrifying, know that you will actually benefit so much from the process. It’s one of the few moments in your life where people will be forced to listen to you talk about a topic you will know more about than just about anyone in the world. Enjoy the captive audience and if you can try to be in the moment and make the most of the experience.

All opinions on this blog are my own

Guest Blog: Claire and Sam take over the Environment Network

Today is the Environment Network 2022 event: The Role of Surfaces and Surface Decontamination in Managing healthcare association infection (HCAI) and as @Girlymicro is busy running the show she has tagged in her willing PhD student Sam Watkin, and regular contributor Dr Claire Walker to live blog this event. Let’s get started #EN2022.

What Is the Environment Network?

The Environment Network works to support people in clinical, engineering and scientific roles who are interested in environmental infection control

Do you want to know more about what to do with your water screening and air sampling results?  Are you keen to understand the evidence behind equipment cleaning and the role of the environment in healthcare associated infection?

Then welcome to the Environment Network!  This is a network for people in clinical/scientific/engineering roles within the NHS and other associated organisations who are interested in the role of environmental infection prevention and control in preventing infection. 

The aim of the network is to support infection prevention and control professionals involved in commissioning, environmental audit, water, air and surface testing within their Trusts.  By working together we can share best practice between Trusts; as well as circulating the latest evidence and discussing personal experiences. 

We are so excited to be live blogging the wonderful EN conference this year. Dr Elaine Cloutman-Green BEM opens the conference setting the scene for a wonderful day of networking, learning and discussions with our clinical, industry and academic colleagues. We’ve all come here today create a friendly network of experts. Because sometimes we all need to phone a friend at 4.30 on a Friday when everything is going wrong, and this is the perfect opportunity to grab every experts number.

Morning Presentation Session

The esteemed Professor Jean-Yves Maillard from Cardiff University leads us through his thoughts on options for surface clean and surface decontamination. This topic is very much at the forefront of our minds in the EN, and whilst there has been huge progress in hand hygiene (thanks COVID!), Prof Maillard’s fascinating talk demonstrates how many factors have to be considered to really make a surface ‘safe’. There are so many variables to consider; what product to use, how effective a product is, what factors impact on that efficacy and unique multifaceted challenges we face in this field particularly when it comes to training and developing best practice across healthcare specialisms.

He raised a very interesting and important point when thinking abut surface decontamination – how do you define a “safe” surface? Let’s talk about norovirus – when we consider that it takes 10 virus particles make you sick and there are one billion virus particles per gram of vomit or faeces – you best hope your cleaning strategy works or the whole cruise ship (or worse hospital ward) is going down. The difference between looking clean and being safe is shown, just because it looks shiny doesn’t mean that you can eat your dinner off it!

As we come to discussing decontamination chemicals, the focus turns to compliance with surface decontamination protocols which are essential in maintaining environmental decontamination efficacy. Prof Maillard raised fascinating points on how products are used and why this matters. Different delivery methods, such as spray, foam or pre-wetted wipes, have significant impacts on the efficacy of compounds and their proper use is often hard to consistently achieve.

Further complicating the issue, different microbes have different susceptibilities to different decontamination agents. Wipes that can remove a Gram-negative pathogen can do very little against a Gram-positive. We know that some key pathogenic organisms like Clostridioides difficile require higher levels of disinfection compared to others, but other pathogens often have different requirements to each other. Multidrug resistant organisms can often be resistant to quaternary ammonium compounds meaning you may be able to clean off antibiotic-sensitive Klebsiella, but the drug-resistant ones could remain. Similarly, despite some company claims to the contrary alcohol gel does nothing against C.difficile spores.

Prof Maillard detailed just how important this is by describing some shocking cases of where cleaning has gone wrong. The use of inappropriate compound concentrations and a lack of consistent training on new products can have truly terrifying consequences in the hospital environment. In untrained hands, cleaning can actually make the situation worse not better, for example poor cleaning with can spread viruses around a patients room rather than remove them. We all have so much to learn from not taking detail for granted and how basic precautions like ‘one wipe, one direction, bin it‘ can prevent healthcare associated infections.

As the talk comes to a close we ask can we trust claims of residual activity of decontamination products? Does it really leave a surface ‘clean’ and ‘safe’ for 48 hours? Do these products really work as well as companies or their representatives claim? Prof Maillard says we really can’t trust everything we read. A disinfectant used improperly can select for microorganisms resistant to that product. This highlights not only the importance of choosing the right disinfectant compound, but on using it correctly too. With pandemics in the press, it’s more important than ever that we have an open dialog and solid evidence base for what we use, how we use it and when to use it to create safe environments for both patients and staff.

In our second presentation of the day Karren Staniforth from UKHSA explains the role of novel decontamination techniques in healthcare

It’s important to acknowledge that in decontamination, one box does not fit all. A high risk patient post chemotherapy has very different requirements to a healthy adult popping to the GP to ask for a repeat prescription. Furthermore, we know can’t sterilize everything. It simply doesn’t work that way, so we need to be decontaminating to an appropriate level for the site. If we can avoid high-level sterilization we should as they are expensive, potentially damaging to the site and generally involve harmful chemicals. So how do we manage surfaces categorized as ‘low risk’? For those of us who aren’t so familiar with disinfection in the low risk setting this means something that comes into contact with intact skin. A huge number of different products are available but today Karren is are talking about UV light, and gases and vapours – why we might want to use them and how we might automate these systems.

Karren raises an important issue that automated decontamination techniques don’t remove human error, particularly as they generally require humans to set them up. We still need manual cleaning of rooms when using these, so they very much are there to support environmental cleaning and decontamination, not to replace manual decontamination. However, there are some incredible advantages to an automated system – not least that they are highly reproducible thus much easier to audit and, with proper calibration, should be highly precise and accurate.

Karren tells us why it is so important to use and understand what disinfectant efficacy really tells us, and why it is crucial to be sceptical and to question the manufacturers claims about their products. She details a fascinating history of working in infection prevention and control, and the journey from cleaned rooms actually causing MORE infections to introducing novel technologies and strategies that are proven efficacious. Her talk is peppered with wonderful real world experience of infection, prevention and control. Simple strategies like removal of felt notice boards from wards also had a huge impact in improving cleaning strategies to rid geriatric wards of C.difficile. As a member of the EN steering group (Claire), I am heartened to hear how sharing our stories can improve real world patient care.

Karren closes her talk with some fascinating points about cleaning frequency rather than specificity. We really need to thing about exactly what we are trying to achieve in each setting, and often a bespoke mixed-approach will be what fits the bill.

Post Coffee Talk Session

Claire has been let loose on her own now – with Sam giving his presentation next.

Revived by our coffee we move onto the much anticipated talk by our pal Sam who, with the knowledgeable Helen Rickard, is guiding us through monitoring microbial surface loads – how we should approach it in healthcare and some key findings from their exciting work. Monitoring let us pick up presence and movement of clinically relevant microorganisms in the hospital setting promoting surveillance and targeted treatment programs. This is done routinely in hospitals, but can be stepped up after an outbreak or when transmission is unexpected.

Sam gives us a step by step guide to the different samples and how you might process them to identify the microbial population present. His data demonstrate how important continual sampling is – just counts of microbial species are a snap shot of the situation, and when repeated sampling is done microbial persistence is revealed telling the whole story.

Helen Rickard walks us through why sink surfaces are so important in HCAI. Sinks are the perfect environment for microbes to thrive, and the presence of running water disperses and aerosolises bacteria. They are also often very close to patients. Helen is interested in the impact the patients will have on sink surfaces. Her exciting preliminary data reveals that numbers of organisms detected on sinks double when patients inhabit wards, and numbers of human commensals massively increase. We’re already excited for Helen to come back and tell us more when she is further along into her project.

Dr Marco-Felipe King from the University of Leeds is up next, telling us all about how one can model the impact of surface decontamination. Dr King’s work links airborne and surface contamination, looking at the impact of ventilation on surface contamination, and then transmission onto human fingers. We watch an incredible computer generated model depicting how viruses spread across a ward onto surfaces challenging the myth that viral particles don’t deposit on surfaces. Dr King’s enthusiasm for understanding microbial recontamination of surfaces (why microbial loads sometime increase after cleaning) is infectious. He showed several delightfully complicated formula to model these (and explained them very well!). In Dr King’s own words, “something funny is going on” with the data, which inspired lively discussion amongst all the delegates. He showed how much relative humidity matters for transferring organisms to hands when surfaces are touched – basically proving you should never lick your fingers when on the tube.

Dr Lena Ciric from University College London brings our morning session to a close with a fascinating talk all about the importance of surface loads, and how they differ in healthcare and the community.

Dr Ciric kicked her talk off by discussing the challenges of achieving low surface loadings in the healthcare setting, explaining that while we want microbially clean surfaces in hospital, we have evolved to live with microbes. She highlighted how few guidelines actually exist for surface loading levels, and the challenge this presents to standardisation. Dr Ciric’s data looked at colony forming units collected from a range of locations – hospital wards, the FA cup final, the Brits and even the Tube – to understand what a safe level of microorganisms on surfaces should be. Safe to say we are never touching a surface on the tube again. But it’s not simply a case of how much of something is there, we need to understand what microbial species are present. Her data on presence of SARS-CoV-2 presence showed that colony forming units (CFU) didn’t reflect how much SARS CoV-2 RNA was present on the tube, so whilst the CFU guidelines are interesting more work needs to be done. Really highlighting the importance of, in Dr Ciric’s own worlds, ‘you’ll find what you go looking for’!

Reflections on Surfaces

What an absolutely brilliant, informative and lively morning. It’s difficult to condense such a varied and thoughtful set of presentations into a few take home messages.

  • The importance of moving past the marketing – we really need to question how good products are, validate them for use and develop sound guidelines.
  • Human factors are hugely important – without proper training even the best tools are not helpful
  • The overall takeaway for the transfer of organisms to people’s hands: “it depends”

TLDR: @girlymicro let Claire and Sam loose on her blog, who had lots of fun but she should definitely have provided a word count.

All opinion on this blog is my own

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

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

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?

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

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

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

Celebrating International Day of Women and Girls in Science Day: A view from the Girly Side

This topic means a lot to me. It wasn’t by accident that when, in 2012, I chose my twitter handle: I chose Girlymicro/Girlymicrobiologist. It has felt to me, since I started as a working scientist in 2004, that it was considered unprofessional to bring my whole self to work: to like pink and purple, to bake, to talk about science fiction and gaming. It was the start of the journey that I am still on, to show that we are better scientists when we bring our whole selves to work. Anything that acts as a barrier to that not only harms us as individuals, but also harms what we can achieve as a collective.

The Road Is Long
With Many a Winding Turn
That Leads Us to Who Knows Where…

You may not know this, but I started out as a zoologist. I adored it, I loved it, but there were no jobs in it. My undergraduate dissertation was on the ‘Demographics of Witchcraft Accusations from 1625 to 1715’. You may think that has nothing to do with what I do now but you’d be wrong. Studying human and animal behaviour helps me all the time in understanding some of the group decision-making that occurs in healthcare. The hours of my life spent learning how to undertake statistical modelling was not wasted. What I didn’t study a lot of was microbiology: I did a single module of microbiology during my whole degree.

I then went on to study not microbiology but the physics of biological interactions at surfaces as an MRes. This was where I learnt some microbiology and developed a love of applied science. When I started as a trainee Clinical Scientist, I had so much less experience of microbiology than any of the other more traditional trainees. I once asked why they hired me and the wonderful Dr Margaret Sillis, who acted as my mentor, responded ‘We can teach you microbiology, it’s much harder to teach you how to think’. I still think about that and the transferable skills I picked up by studying other disciplines still come in use all the time.

This trend of not following the standard path has continued. It’s why I ended up in Infection Prevention and Control rather than microbiology. Although the traditional paths are in some ways easier, as you will be able to walk the path that others have walked before you, don’t be afraid to wander the path untrodden if you think that it will be a more satisfying journey for you as an individual. You will learn so much along the way and open up new roads for others to follow.

Making the Invisible Visible

During the last 10 years, one of the things I’ve consciously decided to do is to be visible. In 2015 I was asked if I would be filmed for a project that the Royal Society of Biology were organising called ‘Biology: Changing the World’. For some years I had been told, by my lovely (male) boss, that I shouldn’t do media and shouldn’t be seen as ‘courting attention’ as it a) detracted from the work, and b) people were looking to make a story out of you. Don’t get me wrong, there is some truth to this. It also results in a fair amount of negative feedback, often from female colleagues, about grandstanding and attention seeking. You know what it also does, however: it hopefully means that when a girl in 20 years time is asked the question I’m asked in this video about what female scientist inspired her, there is a chance she will have a name. Not that I think I’m going to be that person. I’m not going to win a Noble Prize or have a Wkipedia page. I do, even today, remember very clearly the male science undergraduate who came and spoke to my primary school class about his job, I can be THAT girl. The one that someone meets up close and personal and shows that normal everyday women can work in science. That the door is open to them. I can shine a light and make the career path visible to those who might follow. So, next time you are invited to do that piece of outreach, that radio interview, that blog and your mind questions your worth, ask: if not me, then who? I promise you that the next person will not be more qualified than you, more worthy than you, more appropriate than you. So please say yes.

The Importance of Valuing Difference

The above point brings me onto something a bit trickier. I’ve been fortunate enough to win a number of awards for myself and with my wonderful team and partners for undertaking STEM engagement. Doing this work requires energy and time, both of which are frequently given on weekends and evenings. Or, in the case of today’s blog, annual leave. I feel a moral obligation to do this work as well as it being an important part of maintaining my registration to practice. The interesting thing is that it is frequently not viewed this way in either my clinical or academic environments. It is not seen as ‘work’ and I have on more than one occasion been told that if I was serious about my career progression I needed to ‘do less of that nonsense’. Sadly this isn’t a unique situation for me, but is something that many women in science face, especially in academia. In these areas women spend a greater proportion of their time undertaking public engagement and utilising ‘soft skills’, which are not valued when it comes to promotion panels.

Over time I believe I have started to change perspectives, but it takes even more work and investment in time. I’ve taken on additional positions, such as Joint Trust Lead Healthcare Scientist. This position has enabled me to speak to senior leaders about the benefits of the work in order to raise awareness and to capture impact. By actively working with wonderful colleagues on projects nominated for awards, such as the Advancing Healthcare Award for Reach Out for Healthcare Science, with Dr Philippa May, and with Nicola Baldwin for the Antibiotic Guardian Awards and CSO Awards for Nosocomial, I have started to make inroads into changing the conversation. Awards aren’t everything, but they do support you in re-positioning what you are doing in a way that fits into the ‘traditional way’ success is captured.

Whilst I’m on this particular topic, I would also like to make one of the points I often respond with when talking to colleagues who aren’t so engaged in public engagement and outreach. The days of healthcare workers being considered to be ‘the authority’ are quite rightly coming to an end. Those of us working in healthcare need to be engaging and working collaboratively with patients and the public to co-create what the future of healthcare might be and should look like. We can’t begin this work until we get out there and start having conversations. Rather than being ‘nonsense’, this work is key to future of the NHS and, especially, Healthcare Science.

“Amplification” is Where It’s At

During the Obama administration, despite it’s progressive nature, women found it hard to get their voices heard.

We’ve all been there. The meetings in which you make a comment or a response and you’re ignored, only for a man in the room to repeat the comment and have everyone react as if it is the first time they’ve heard it. As women in science, we are often the only women in the room and so making ourselves heard can be difficult.

The women in the Obama administration came up with an “amplification” strategy, where women in meetings repeated each other’s ideas as well as deliberately crediting the women who came up with them.

I work with some amazing women in Healthcare Science (Jane Freeman, Anna Barnes, Ruth Thomsen, Kerrie Davies and so many more) who do an excellent job of this amplification. I’d like to think that we all have a definite and deliberate attitude of amplifying each others voices and not falling into the trap (that happens way too often) of competing with each other. Be deliberate when you are in spaces with other women who may not be heard, actively listen and repeat. Focus on those moments that could make a difference and ensure that everyone in the room is heard. It requires active effort, but it definitely changes the course of conversations.

So how our male colleagues can help? This is definitely one of those areas. There are often not the women in the room to do this and so having allies who are happy to support in the same way is a definite help.

Change the View for One That is More Pleasing

One day the super-inspirational Dr Lena Ciric and I sat down over a cup of coffee and engaged in one of our regular consolation sessions. This was because, yet again, I had written a grant that had been successfully funded but it didn’t have my name on it. It had the name of one of my male professors. Lena had experienced similar things over the years and also the reviewers’ response of ‘not enough experience’ as a result of grant after grant that didn’t credit us. This cup of coffee was different: it was during this session we decided that, if we couldn’t change the playing field, we could change the view.

What do I mean by this? Academically, we were applying for funding within the clinical microbiology environment. A landscape that was already filled with vastly experienced and (mostly) older male medics. We were not going to succeed in breaking through the glass ceiling by applying within this space. Life lesson: we needed to find another space. So we very deliberately looked across the different funders to see where there was a landscape that wasn’t crowded with people like us and where we could constructively add something. We found it. We ended up putting in our first million pound grant to the EPSRC, an engineering research council who were looking to fund healthcare research and were not getting applications from researchers with enough clinical experience. We got the grant first time! Now we had a million pound grant AND we had the track record that means we can not only continue to apply in the new landscape but that also enables us to apply in the old arena.

Sometimes, if you continue to bang your fist against a closed door all you will get is a bloody fist. In these circumstances you need to take a step back and review whether there is another way to get to where you want to be. If there is, do it, you may not only succeed in your original goal but learn some other valuable skills along the way.

Finally, I wanted to finish with the above image of Shonda Rhimes. I am as guilty as the next person of talking about how lucky and fortunate I am, and it is true. That said, own your success: you’ve earned it, you’ve put in the hours, you’ve sacrificed, you’ve made it happen whilst balancing families, health issues and all kinds of other demands.

Be the badass I know you are!

All views in this blog are my own

Celebrating International Day of Women and Girls in Science Day: A view from the Girly Side

I’ve been asked to write a number of blog posts this year for International Day of Women and Girls in Science. I wanted to write an extra one that wasn’t so much a career guidance document, but more to celebrate some of the great approaches I have seen as a woman working in science. This post is based around some of the points that came out of a twitter conversation last week.

This topic means a lot to me. It wasn’t by accident that when, in 2012, I chose my twitter handle: I chose Girlymicro/Girlymicrobiologist. It has felt to me, since I started as a working scientist in 2004, that it was considered unprofessional to bring my whole self to work: to like pink and purple, to bake, to talk about science fiction and gaming. It was the start of the journey that I am still on, to show that we are better scientists when we bring our whole selves to work. Anything that acts as a barrier to that not only harms us as individuals, but also harms what we can achieve as a collective.

The Road Is Long
With Many a Winding Turn
That Leads Us to Who Knows Where…

You may not know this, but I started out as a zoologist. I adored it, I loved it, but there were no jobs in it. My undergraduate dissertation was on the ‘Demographics of Witchcraft Accusations from 1625 to 1715’. You may think that has nothing to do with what I do now but you’d be wrong. Studying human and animal behaviour helps me all the time in understanding some of the group decision-making that occurs in healthcare. The hours of my life spent learning how to undertake statistical modelling was not wasted. What I didn’t study a lot of was microbiology: I did a single module of microbiology during my whole degree.

I then went on to study not microbiology but the physics of biological interactions at surfaces as an MRes. This was where I learnt some microbiology and developed a love of applied science. When I started as a trainee Clinical Scientist, I had so much less experience of microbiology than any of the other more traditional trainees. I once asked why they hired me and the wonderful Dr Margaret Sillis, who acted as my mentor, responded ‘We can teach you microbiology, it’s much harder to teach you how to think’. I still think about that and the transferable skills I picked up by studying other disciplines still come in use all the time.

This trend of not following the standard path has continued. It’s why I ended up in Infection Prevention and Control rather than microbiology. Although the traditional paths are in some ways easier, as you will be able to walk the path that others have walked before you, don’t be afraid to wander the path untrodden if you think that it will be a more satisfying journey for you as an individual. You will learn so much along the way and open up new roads for others to follow.

Making the Invisible Visible

During the last 10 years, one of the things I’ve consciously decided to do is to be visible. In 2015 I was asked if I would be filmed for a project that the Royal Society of Biology were organising called ‘Biology: Changing the World’. For some years I had been told, by my lovely (male) boss, that I shouldn’t do media and shouldn’t be seen as ‘courting attention’ as it a) detracted from the work, and b) people were looking to make a story out of you. Don’t get me wrong, there is some truth to this. It also results in a fair amount of negative feedback, often from female colleagues, about grandstanding and attention seeking. You know what it also does, however: it hopefully means that when a girl in 20 years time is asked the question I’m asked in this video about what female scientist inspired her, there is a chance she will have a name. Not that I think I’m going to be that person. I’m not going to win a Noble Prize or have a Wkipedia page. I do, even today, remember very clearly the male science undergraduate who came and spoke to my primary school class about his job, I can be THAT girl. The one that someone meets up close and personal and shows that normal everyday women can work in science. That the door is open to them. I can shine a light and make the career path visible to those who might follow. So, next time you are invited to do that piece of outreach, that radio interview, that blog and your mind questions your worth, ask: if not me, then who? I promise you that the next person will not be more qualified than you, more worthy than you, more appropriate than you. So please say yes.

The Importance of Valuing Difference

The above point brings me onto something a bit trickier. I’ve been fortunate enough to win a number of awards for myself and with my wonderful team and partners for undertaking STEM engagement. Doing this work requires energy and time, both of which are frequently given on weekends and evenings. Or, in the case of today’s blog, annual leave. I feel a moral obligation to do this work as well as it being an important part of maintaining my registration to practice. The interesting thing is that it is frequently not viewed this way in either my clinical or academic environments. It is not seen as ‘work’ and I have on more than one occasion been told that if I was serious about my career progression I needed to ‘do less of that nonsense’. Sadly this isn’t a unique situation for me, but is something that many women in science face, especially in academia. In these areas women spend a greater proportion of their time undertaking public engagement and utilising ‘soft skills’, which are not valued when it comes to promotion panels.

Over time I believe I have started to change perspectives, but it takes even more work and investment in time. I’ve taken on additional positions, such as Joint Trust Lead Healthcare Scientist. This position has enabled me to speak to senior leaders about the benefits of the work in order to raise awareness and to capture impact. By actively working with wonderful colleagues to nominate work for awards, such as the Advancing Healthcare Award for Reach Out for Healthcare Science, with Dr Philippa May, and with Nicola Baldwin for the Antibiotic Guardian Awards and CSO Awards for Nosocomial, I have started to make inroads into changing the conversation. Awards aren’t everything, but they do support you in re-positioning what you are doing in a way that fits into the ‘traditional way’ success is captured.

Whilst I’m on this particular topic, I would also like to make one of the points I often respond with when talking to colleagues who aren’t so engaged in public engagement and outreach. The days of healthcare workers being considered to be ‘the authority’ are quite rightly coming to an end. Those of us working in healthcare need to be engaging and working collaboratively with patients and the public to co-create what the future of healthcare might be and should look like. We can’t begin this work until we get out there and start having conversations. Rather than being ‘nonsense’, this work is key to future of the NHS and, especially, Healthcare Science.

“Amplification” is Where It’s At

During the Obama administration, despite it’s progressive nature, women found it hard to get their voices heard.

We’ve all been there. The meetings in which you make a comment or a response and you’re ignored, only for a man in the room to repeat the comment and have everyone react as if it is the first time they’ve heard it. As women in science, we are often the only women in the room and so making ourselves heard can be difficult.

The women in the Obama administration came up with an “amplification” strategy, where women in meetings repeated each other’s ideas as well as deliberately crediting the women who came up with them.

I work with some amazing women in Healthcare Science (Jane Freeman, Anna Barnes, Ruth Thomsen, Kerrie Davies and so many more) who do an excellent job of this amplification. I’d like to think that we all have a definite and deliberate attitude of amplifying each others voices and not falling into the trap (that happens way too often) of competing with each other. Be deliberate when you are in spaces with other women who may not be heard, actively listen and repeat. Focus on those moments that could make a difference and ensure that everyone in the room is heard. It requires active effort, but it definitely changes the course of conversations.

Some of the comments on my twitter feed were about how our male colleagues can help. This is definitely one of those areas. There are often not the women in the room to do this and so having allies who are happy to support in the same way is a definite help.

Change the View for One That is More Pleasing

One day the super-inspirational Dr Lena Ciric and I sat down over a cup of coffee and engaged in one of our regular consolation sessions. This was because, yet again, I had written a grant that had been successfully funded but it didn’t have my name on it. It had the name of one of my male professors. Lena had experienced similar things over the years and also the reviewers’ response of ‘not enough experience’ as a result of grant after grant that didn’t credit us. This cup of coffee was different: it was during this session we decided that, if we couldn’t change the playing field, we could change the view.

What do I mean by this? Academically, we were applying for funding within the clinical microbiology environment. A landscape that was already filled with vastly experienced and (mostly) older male medics. We were not going to succeed in breaking through the glass ceiling by applying within this space. Life lesson: we needed to find another space. So we very deliberately looked across the different funders to see where there was a landscape that wasn’t crowded with people like us and where we could constructively add something. We found it. We ended up putting in our first million pound grant to the EPSRC, an engineering research council who were looking to fund healthcare research and were not getting applications from researchers with enough clinical experience. We got the grant first time! Now we had a million pound grant AND we had the track record that means we can not only continue to apply in the new landscape but that also enables us to apply in the old arena.

Sometimes, if you continue to bang your fist against a closed door all you will get is a bloody fist. In these circumstances you need to take a step back and review whether there is another way to get to where you want to be. If there is, do it, you may not only succeed in your original goal but learn some other valuable skills along the way.

Finally, I wanted to finish with the above image of Shonda Rhimes. I am as guilty as the next person of talking about how lucky and fortunate I am, and it is true. That said, own your success: you’ve earned it, you’ve put in the hours, you’ve sacrificed, you’ve made it happen whilst balancing families, health issues and all kinds of other demands.

Be the badass I know you are!

All views in this blog are my own

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

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

Talking About the Taboos: My Journey to being an ‘Obstinate Headstrong Girl’ Whilst Working in Science

I’ve had a few encounters recently that have led me to write this blog. I’m not writing it as an expert; This isn’t anywhere near my field. I’m writing to share my experiences and learning in case it helps others. Apologies, as it’s not a short read.

I’m challenged by some people I that I’m too worried about raising the profile of women in science, of talking too much about ‘female’ issues, and of challenging my colleagues too frequently. A really respected mentor once said to me that he didn’t think actions against women in the workplace still happened. I shared some stories and pointed out that they still did, they just didn’t happen to him, where he could see them or when he was paying attention to them. I count myself lucky that nothing really serious has ever happened to me at work, but I shouldn’t have to count myself as lucky: they just shouldn’t happen.

I have another post brewing about everyday sexism in the workplace, but this one is different. This one is about why I set out becoming the ‘obstinate head strong girl’ that I aspire to be!

I finished my undergraduate degree in 2002 and spent a year working before returning to undertake an MRes. This was my first experience of full-time ‘proper’ work. I took a six month temp contract for a council, working in their business development office. It was a mostly male floor, supported by myself, two other part time admin staff (both female students) and a lovely older lady who managed the team. My job was to support the officers in tasks such as typing up letters. Yes, they wrote by hand as some of them still didn’t know how to use a computer; I also ran reception, took minutes, that kind of thing.

The Problem is that You are Too Friendly

I’d been there about a month when I was in the post/stationary room stamping that day’s mail. One of my older male colleagues came up behind me and stuck his erection in my back and grabbed my breasts. I stood there, stock still, in complete shock. I didn’t know what to do. These things didn’t happen to me: I was the nerdy girl not the pretty girl, I had no experience of how to handle this kind of breach (I am not implying that pretty girls should know, or have to put up with this either). After what felt like hours (but was more likely a few minutes) where he spoke to me about what we should do next, I shoved him away and ran out of the room.

I went to my boss, the person responsible for me, and told her what had happened. She said she would speak to her boss, who also happened to be the boss of everyone on the floor. I recovered from my shock and got angry whilst I waited, but I was sure there would be censure and we could all put this behind us. She came back and we talked. She explained to me that I was overtly-smiley and chatty with my colleagues. This could be misconstrued and, in future, I should probably just take steps to not be alone with the man that had done it. That was it. The married man with multiple children could do what he wished as it was my friendly demeanour that was the issue.

I spent the next four months being hyper-aware of when I could go into rooms on my own, to be friendly, but not too friendly. As my contract end-date rolled up, I experienced a similar repeat performance from the same individual. It wasn’t as bad this time as I had learned from the first event, but I just couldn’t let it go. What if he went further with someone else, what if he did it to someone else who wasn’t in the privileged position I was in to ‘let it go’. On my last week with the council I emailed HR directly to express my sadness over the way the situation had been handled. They told me to get a cab down and speak to them. I did. I recounted the event, the way it had been handled, the way I felt. The guy got suspended on full pay whilst an investigation was undertaken. I was called back in to repeatedly account for the event and my actions. It was determined that as it was my word against his nothing could be done. I learnt early that even when people listen, accountability is not always the result. No policy was changed. At least the guy had a note on his record in case he did it again so that it was no longer the ‘future girls’ word against his.

I’m ‘lucky’: that was the worse thing in a workplace that has ever happened to me. We all the know of the labs where you wouldn’t apply to work at because of the way the PI behaves, or the ‘expectations’ placed on the post docs if they want to advance. It didn’t interfere with my progression. It did, however, teach me an important lesson about the importance of bystanders. However annoying the bad behaviour of the individual was, the worse thing for me was that the people I trusted and who held responsibility for my safety at work chose to make it about me being too smiley, rather than address the action of the person who had breached barriers and made me feel unsafe. I swore that I would never be that bystander and I would support others so they would not feel as alone as I did in that workplace.

The Problem is that You Are Not Friendly Enough

Roll on some years and I’m now working as a scientist with a part-time academic contract. I’ve learnt the lesson taught to me about not being too friendly, about boundaries at work, about always keeping it professional so my actions couldn’t be used against me. I’m working as the only microbiologist on a research project. The PI on the grant begins to spend a lot of time with the other female researcher. Late night drinks, wine in the office, that kind of thing. I stick to my guns about being valued for what I can add to a project: that doesn’t require me to be available to have drinks with the boss at 9pm. Suddenly, protocols are written that are not technically appropriate, papers are written without a standard authorship order, and presentations and conference trips are handed on the basis of time spent with the PI. When queries and issues are raised, I’m now told that I’m not committed enough, not friendly enough, I’ve not invested enough in building relationships outside of work structures. Unlike before, my future is impacted because I have not walked the tightrope of being approachable well enough. The difference this time is that, although I cried, I simultaneously empowered myself to leave by looking for funding to support an exit. Again, I was fortunate enough to have a way out, to be a clinical academic rather than academia being my only option. I had also started to learn the power of finding my tribe, and making sure that I always had support from other embedded around me. This enabled constructive challenge of my perceptions, but also assurance when things went awry.

Why are you Reacting to Such Little Things? It’s only people being friendly/joking

I’ve now been working as a scientist for 17 years. Issues crop up less frequently the higher you climb up the ladder. However, when they do they always feel like high stakes. I’m no longer in a position where I could easily find another post, co-applicants on grants are harder to switch around as the world we inhabit is small, and relationship building is a key part of my role. So do things still happen?

Sadly, the answer is yes. The thing that makes the incidents happening now worse, in many ways, is that they get laughed off as being linked to me being overly sensitive. I still try to embody the friendly girl I was at 22 without opening myself up to unwelcome physical acts at work. I have, however, on 3 occasions being kissed full on on the mouth in unsolicited encounters with male members of staff. None of it threatening, like when I was in my first job, but still unwelcome. Blocked doorways that, as you’ve tried to go through, have resulted in a facial assault because ‘its Christmas’ or because it’s someone’s ‘last day and they just want to say thank you’. I’m by no means prudish but the only person who gets to kiss me on the mouth is my husband! Uninvited physical intimacy is just not OK. It always comes as a shock and it always takes me back to being a 20 year old with no coping mechanisms standing in a post room.

What happens most frequently however are the comments. Just before the pandemic I was in Paris at an academic meeting. The organiser forgot to book my second night in the hotel. I’m sitting there in a room full of senior male academics at the dinner when the organiser came through and said I had no room. The most senior man in the room responded by saying ‘don’t worry about booking her in the extra night, we’re in Paris, there are more than enough brothels where she could go and work in’. Every man in that room laughed. No one called him out, no one indicated that the comment was humiliating and inappropriate. I didn’t know what to say and so sat there in silence as they laughed away. This isn’t a one-off event. The ‘little ladies’, ‘sweethearts’ etc. may feel innocuous enough but are too frequently used in conversations to undermine women in the room. That’s not to say I’m anti-endearment. I have plenty of colleagues where we have built up relationships over the time where I welcome this reinforcement of our relationship. It is different to do it when your relationship capital doesn’t justify it, or when you are doing it in order to enforce power or hierarchy.

So why have I written this post? I want to let people know that these behaviours happen. It’s unwelcome and it’s not up to the women involved to modify who they are in order to not tempt others to behave badly.

Here, therefore, are a few of my thoughts about how we can all act differently:

  • Don’t be a bystander! Know that if you are in the room you have a duty to act as the impacted individual may not be in a position to do so.
  • Find your tribe so you have support for when (and hopefully if) these events occur.
  • Talk about your experiences so that we can raise awareness, share learning, lead improvements and, most importantly, so others don’t feel alone.
  • Know that you have more power than you feel like you do. There are people out there who are ready, willing, and able to support you.
  • If someone comes to you with their story remember that you have a duty of care. Don’t brush things under the carpet because it is easier to do nothing than deal with a situation.

Finally, to all my obstinate headstrong women out there who are standing up and challenging, I applaud you. I appreciate all you are doing now, I appreciate the fact that you are leading the way and that you are members of my tribe. To all those who consider me difficult for calling out these situations when I see them, I understand why I make you uncomfortable, but I have no plans to change. In fact I plan to grow into this role more. In my opinion we could all do with a channelling a little Elizabeth Bennett from time to time.

All opinions in this blog are my own

Dealing with Writer’s Block: How I Write When it’s the Last Thing I Want to Do

It’s just gone 6am on a Saturday morning and I need to get some writing done this weekend for a project that is overdue and has a final final deadline on Monday. It’s been a really long week and I don’t have much in the tank. To be honest, all I want to do is sit on the sofa with a pot of tea and spend the weekend watching Netflix with my hubby. I think we all have moments like this, and, to get me into the right head space, I’m starting my morning by writing this blog. I hope this might help some of you who are in the same place.

Know When Procrastination is Part of the Process and When You Are Just Wasting Time

When I was writing papers and my PhD thesis, I used to get really angry at myself for wasting time.I would spend the first three days wandering around and doing anything but putting words to paper. When I did sit down, I would just get words out. In general it takes me about two days to write a paper. I would then be even madder at myself for not getting to it earlier as I felt that I could achieve so much more if I just focussed.

Over the years I’ve discovered that the reason the words come easily when I sit down at a laptop is precisely because I’ve spent three days prevaricating. During that period of wandering around I’m thinking. Thinking about the story I want to tell with my results. Thinking about my top points. Finally, thinking about structure. It is all of this thinking, not all of it active, that enables me to hit the ground running when I come to actually write.

This isn’t to say that I’m not guilty of procrastination. There’s a reason this book chapter is late. I’m tired and finding it difficult to concentrate, which means that everything just makes my mind wander. It is really important to know yourself enough to know when you are in ‘preparation phase’ vs ‘procrastination’: one is useful to you and the other isn’t.

The Fear of a Blank Page

I find blank pages intimidating. I do. I know that I should see them as full of possibility and exciting, but I see them as a physical representation of how far I have to go. One of the first things I have to do, therefore, is get stuff onto that page in the least stressful way possible. How to do this depends on what the project is. For papers, I often just start by getting headers down. If I’m lucky enough to have some previous text on the subject I will copy and paste bits in as reminders. Usually I keep these highlighted so I know they are old text that needs re-working/replacing. If it’s something completely new, I will populate with lines from papers that I’m going to build reference structure around.

When I was writing my thesis, I wouldn’t even start chapter writing until I’d done a reading phase to help avoid the ‘blank page fear’. I would spend a week reading all the papers linked to the chapter I was about to write. During that reading phase, I would write the key points and linked references down in a Word document. I’d then shuffle them by topic. When I got to the week allocated for writing I would then have lots of text to import into my structure so I could avoid the blank page terror.

Structure is King

I’ve spent quite a lot of time writing different types of documents and I’ve discovered that there are only so many types of underlying structure, even though they often look different. Papers are a great example of this. One main advantage to them is that you can clearly see what that structure is, and you have access to all the information you need to help you.

When writing papers (and I’ve blogged about this before) you can look and see how many paragraphs that journal tends to have under discussion vs methods vs results. This helps you know where you need to focus the majority of your words. The same is true for grant applications: if you look at a section’s word count, it gives you a clue about what the readers will want to see. For less formal writing, I still tend to look at other pieces of content that have come out and decide if any of them fit what I want to write. It saves re-drafting and focusses the mind.

Structure will help you write. I will use bullet points under headers to show what my structure is, i.e. a bullet point per paragraph. If there are three paragraphs (such as tends to be used for an introduction) I will use them as follows:

  • Paragraph 1 – What’s the setting/problem?
  • Paragraph 2 – What are the knowns and what are the unknowns?
  • Paragraph 3 – What am I going to do? what’s the plan of action?

By planning my paragraph structure I try to avoid falling down too many rabbit holes and maintain the story of what I’m telling. I am then able to do the same with each of the paragraphs:

  • Line 1 – State what I’m going to tell you.
  • Line 2 – Tell you what I’m telling you with all the detail.
  • Line 3 – Reinforce my key point and link to the paragraph that will follow.

Doing this means that I’m not worrying about what comes next when I’m writing. I’m just hanging words off a structure that helps me as well as leading the reader.

Sometimes The Only Way Is Through

There are times that, no matter how much research I’ve done, no matter how prepped I am, I just can’t make the writing work. I’m lucky. it doesn’t happen to me very often but the pandemic has made it a more frequent event. Normally I hate working in silence. I’m not good at doing one thing at a time. I need music or TV when I work to actually help me focus. I know this may sound odd to many people. When I hit a particular wall, however, I’ve learnt that I have to shift from the way working normally works for me. In these circumstances I call upon my husband, Jon. I tell him what I need, i.e. I must work for 3 hours to break the back of this document. I tell him the night before and let him know the timeline. The next day he banishes me to the office, frequently supplying me with tea. On these occasions I work in silence and need enough dedicated time to get into ‘the zone’. Because I don’t want to do it, anything that can make me distracted, will make me distracted. I therefore retreat to a space where all the things that usually help me aren’t present. This shift allows me to trick my brain enough to make progress. Finding your Jon to push you when you can’t push yourself is super helpful.

The other thing I do is make deals with myself and – most importantly – stick to them ,i.e. I am allowed to go and bake that cake I want to if I’ve done three hours. I am not allowed to do it if I do less than that. There’s no letting me off for good behaviour. This is a Yoda moment ‘Do or do not, there is no try!’. Being honest with yourself is key: after all, there is a good chance you’ll know when you’re lying. Make the reward proportional to the effort, i.e. when I run a half marathon successfully I buy myself a nice dress, for 3 hours work I get a new pot of tea.

Know When to Walk Away

Some days, be aware that writing is just not going to happen. This can happen for a bunch of reasons: tiredness, illness, last minute invitations to a cocktail bar. It is only possible to enjoy the freedom of walking away if it’s a) not a project that has to happen or b) you’ve left yourself enough deadline time so that you can come back to it later. If either a or b are true then sometimes it is better to just not punish yourself and return to it later. That’s completely OK. You may need more thinking time; you may be having a super bad day. Lets not punish ourselves more than we already do. Embrace the fact that you have project-managed well enough to let it go for a bit. Also, be aware that you only have so many free passes before you are sitting here early on a Saturday morning and there are no more to take. Use them wisely!

Top Tips:

  • Let the frustration with yourself go as it doesn’t get you anywhere. Work out the source and find a way through or around.
  • If you do the research on structures beforehand you may find the writing process easier and more efficient.
  • Know when you have time to defer and when you need to push through. Make an active choice rather than defaulting to the last minute.

All opinions on this blog are my own

It’s Recruitment Season in Healthcare Science and Academia: What have I learnt which might help

It’s recruitment season in both Healthcare Science and academia right now. Many promising young scientists have applied for the Scientific Training Programme, whilst others are applying for PhD positions and taking their first steps to becoming independent researchers. I’ve been having lots of conversations and I’ve been getting lots of emails/tweets about what I would be looking for as part of this process. I’m also going through a recruitment process myself and so this has been on my mind. I’m going to share what I look for, but I want to be very clear this is just that, what I look for. Others may have different opinions and so it’s always worth canvassing more than just one person as there are people out there who are experts in this.

There are obviously two big sections to this, the application process and the interview. If you get to the interview then you will have got there because I believe that you can do the job. At that point it’s about team dynamics and shared vision and it’s as much about you interviewing me as it is about me interviewing you. So for this post I’m mostly going to focus on the application process and getting that foot in the door.

Photo by Andrea Piacquadio on Pexels.com

Know Your Audience

When you are applying for a post you will have access to a whole bunch of information, some of which will be more apparent to you than others. There will be names listed, names of specialisms, names of the recruiting staff, all of which will give you a clue as to how to get information on the type of people who will be interviewing you.

Getting to know more about the people involved in the recruitment process will help you prioritise the information in your proposal. Is the Trust and department you’re applying to research active? If not then you might want to use that word count about your undergraduate dissertation for something of greater interest to them. For STP applications you should include reference to the fact that you’ve spoken to people who work in the field to demonstrate an understanding of the job. For PhD applications make sure you include specific references to the papers the hiring academics have recently written in your cover letter so you have shown you know who they are. This enables your to start out building a relationship with the people who are shortlisting, they know you’ve taken the trouble to know more about them and it’s a sign of respect that will stand you in good stead.

DON’T do what once happened to me when I was interviewing a male candidate. The panel was entirely female and the interview was going well, the candidate obviously had done his homework on us. The last two questions blew it however. We asked him about research experience and he proceeded to tell us that he had looked up our work and how he could guide us in doing it better. He then followed up when asked if he had any questions with ‘When will you let me know I have the job’. Needless to say that call never came.

Do Your Research

Following on from knowing your audience is doing your research. I’m going to be super honest here. When I applied to be a clinical scientist I kind of knew what it was but I wasn’t super confident. That was because there weren’t the resources out there to give me more information. That is no longer the case and there are a lot of internet resources available. This means that if you’re applying for this kind of post now it is expected that you will know not only about the job, but also to have defined answers about why you want to do it and why you are suitable for the post.

For PhD positions doing your research is even more important. I want it to be clear on your application why you want to do this particular PhD. What is it that attracted you to the topic, what work have you already done in this area, what reading have you done to demonstrate your interest. The one thing that many candidates don’t come with to the interview that makes them stand out is what questions their research on the PhD so far has raised in their mind, what questions are they are interested in asking. Even during the interview I want to see the scientific curiosity that will make you a great scientist and separate you from your competition.

DON’T send me an application that is generic and hasn’t been personalised for the position. If you can’t put in the effort to research the post and personalise your application then I won’t put in the effort to interview you as it will feel like you’re not really that interested.

Obey the Rules

In every job advert there will be information and guidance about how to apply. You would be super surprised at how often applicants don’t pay attention to the guidelines. Now most of your scientific career will require you to apply for things, business cases, grant funding, conference attendance etc. If you can’t demonstrate the care and attention to detail when applying for the post it indicates that you may also not adhere to the guidance when applying for these other things, directly impacting your chances of success and career progression. I’m all for individualism and for thinking outside the box, but an application process is about enabling me to do a side by side comparison, which I cannot do if you side step what’s requested.

For NHS posts you need to be demonstrating in the personal statement section what is asked of you in the job description (JD), as this is what you will be scored against. If you don’t cover the points then you cannot get the marks required for short listing. Also pay attention to where you are expected to demonstrate the skills, knowledge etc. It will usually say whether it is on the application, or during the interview. If it stated during the interview and you are limited on words use them to tick the ‘demonstrate in the application’ boxes. Also use the ‘demonstrate in interview’ descriptions as a hint to what questions you are likely to be asked during the interview process.

For PhD posts make sure you send what you are requested, make sure that your cover letter contains the information requested in the advert and that your CV reinforces your key points.

DON’T send a CV to an NHS job application and miss stuff off your personal statement as I won’t look at it. If you’re applying for an academic post don’t just send a CV without providing the information specified in the advert as I won’t look at the CV if I consider your application incomplete.

Know Your Unique Selling Point (USP)

When I applied for my trainee clinical scientist post there were 240 applications for 4 positions. The scheme has only got more competitive since then and PhD positions can be equally if not more competitive. Although interview questions will vary across post types you will almost always get asked why you? Why do you want this post? Why are you suitable for this post? How will this post get you where you want to be? What is your 5 year plan?

It is therefore worth taking the time to think about what it is that will enable you to stand out from the competition and make sure that you have clearly stated it in your application. Are you applying for a PhD post and already have published papers, got a travel grant or partaken in science communication activity? Make sure that it is there and easy to see, as this will enable you to stand out from the field.

Are you applying for an STP post and have already done work experience in a clinical lab, worked with patients or have a lived experience that could help you? Make sure that this is clear as it will help during the short listing process.

Remember that for both PhD and STP positions they are effectively graduate training schemes. These are first steps in a career that will last a lifetime and so knowing where you want to go on that journey is important to both know and to communicate to your recruiters.

DON’T hide the things that could make you stand out. Think about what your USP is and make sure it is clear and easy to find. The person trawling through these applications is unlikely to have the time to read every line you write and so make sure you grip them in the first couple of paragraphs so that they will keep on reading.

Make It Easy

This year for the STP programme there are over 6000 applications to shortlist. I have had to go through over 150 applications for PhD programmes before now. I would like to say that I always have the time to give each application the time it is due, but the honest truth is that I am trying to make this work on top of a very busy clinical job. You’re application therefore needs to stand out and be really easy to process.

For NHS applications that means using the terminology used in the JD I am scoring you against, ideally using sub heading and bunching information together so I’m not searching for whether it is present in your personal statement. It also means that if it is key information I would include it in more than one section so I’m less likely to miss it.

For PhD applications it means being very explicit in your cover letter showing that you have: an interest in the topic, that you have researched linked to the work and why you want to undertake this specific PhD. It also means making the information in your CV related to the PhD proposal really easy to find. Don’t put down every technique in the world if only 25% of them are applicable to the topic you’re applying. List in detail the relevant ones and the group the rest and bring them up at interview if appropriate.

Put your USP up front and clear, put it a box, underline it, give it it’s own paragraph or sub-heading. Do something to make it easy to see when your application is being skim read.

DON’T send a 150 page CV containing every certificate you’ve ever achieved. I will just toss it on the no pile without reading it.

I want to wish everyone the best of luck in the posts you’re applying for now and in the future. Remember every job is different and you will obviously want to tailor some of these tips to whatever you are going for but my top tips are:

  • Personalise the application
  • Say who you are and why this is the post for you
  • Read the application notes carefully so you give the short listers what they are after
  • Make it easy for whoever is looking at what you submit by using techniques such as sub-heading so the information is easy to find
  • Become familiar with the people and organisations you are applying to so you can tailor what you are writing

All opinions on this blog are my own

My Best Science Comes from a Cup of Tea: My top tip for Healthcare Science Week

Welcome to Healthcare Science Week 2021! Depending on how I feel and how busy this week is I’m hoping to post a few times and to make up for not posting much recently as I’ve been unwell. Also, as I’ve been not well I’ve had plenty of time to reflect on the importance tea has in my life. My husband is a sweet heart who makes me many a cup and it is my place of comfort and salvation when the world gets too much. It is also a place of reflection and helps me do my best thinking. So this post is devoted to one of my favourite things in the world and something that helps me be the best scientist I can be…………..a lovely cup of tea. (NB for me this is ideally a cup of Darjeeling or Lady Grey served black. You can I am sure substitute it with your favourite, or blasphemy, even exchange it for coffee).

Tea and Planning

Most of science is not actually in the doing, most of the best of science is actually in the planning. If you get that right then everything else will follow. If not you can spend a lot of money getting a lot of data that is in fact not much good to anyone and definitely doesn’t answer the questions you were asking. When I was starting out, and sometimes even now when a deadline overwhelms me, I thought it was better to be doing. To be in lab getting ‘somewhere’. Needless to say I spent a lot of time getting ‘somewhere’ but that wasn’t where I needed to end up. Tea cannot be drunk in the lab. Sometimes making a cup of tea therefore is a really good way to break the cycle of doing and force yourself to have time to step back and plan. It is one of the reasons I have exceptionally large cups as they give me the time to get into the right headspace and adjust my thinking before I reach the end. It also helps that I drink my tea black so that it also has cooling time. By the time I’ve cooled and finished my mind is usually in the place it needs to be and I’m in planning mode not panicked doing mode.

Tea and Networking

I believe it is no secret to anyone that reads this blog that I appreciate a piece of tea and cake. This is partly because I like to host as it gives me a structured way to talk to other people. It is also because I believe that when we are sitting and eating/drinking with other people it removes hierarchy, especially if that can be done outside of the usually work environment.

This next but may shock you, but I HATE networking. I’m pretty good in 1:1 situations where I know the other person, but I’m rubbish at faces and I’m even worse at remembering prior conversations. It’s definitely not the fault of the person I’m speaking too, it’s just my memory doesn’t work that way. My memory is super context specific. I therefore find the horror of speaking to people who know who I am, who I have spoken to before and me not remembering, one that I regularly encounter. I also hate networking as I actually have no small talk. I spend a LOT of my time working and my geeky hobbies are not ones that many people will engage with on first meeting and so I struggle. It’s one of the reasons I started on Twitter almost 20 years ago. Twitter meet ups at conference meant I had already done the small talk and we already had shared context and so I didn’t have that panic inducing moment where I tried to find something sensible to stay (NB this is still a top tip of mine if you’re starting out going to meetings).

Tea makes me relax. At conferences I can always talk about the food and the tea. It also means that I worry less if I’m talking to a Noble prize winner or someone of international renown. They need to eat and drink just like I do. Also, if you find someone hanging around the tea area with no one to talk to they are probably in the same boat as you and will be super relieved that you are the one that made the conversation opener so that they didn’t have to.

Tea and Sympathy

For all you amazing young scientists starting out please don’t take this one too much to heart, but use it a short cut to help your mental well being. Science is 80% failure. You will fail at grants, you will fail when you submit papers, you will have bad supervisor meetings and elevator pitches and most of all you will have failed experiments. Sometimes in the case of lab work these failures can go on for months or years and be super costly, both in terms of money but also in terms of your mental health. What you need to know now is that this is normal. The most amazing scientists you meet will have sat there in a puddle of tears with mountains of self doubts and fear that nothing would ever succeed again. No one ever sat me down and told me this. For a long time I felt I was alone in the failure. Then over time my colleagues became friends and we finely got to the point where we could voice our fears and disappointments. Only then did I realise that I wasn’t alone. That these failures were crucial points where I learnt and developed and that instead of fearing them I should embrace them.

So my advice now, for all those I supervise and support, is to spend time early developing a few key relationships. Then when you are experiencing the failures you too can have someone who will listen and tell you that it’s normal and support your mental wellbeing as well as helping you get back on track. You will also learn from being the person who supports others when it’s your time to pull out the tea, biscuits and box of tissues.

Tea and Reflection

Moving on from tea with others I wanted to reinforce the importance of tea with yourself. This touches on the Tea and Planning section above but is wider than that. As scientists with are often process driven and tend to be rather task orientated. That means we are great at getting things done but poor at working out why we are doing them. Working as a scientist these days is super complex. Not only are you dealing with regular failure, but you are dealing with complex political environments and career pathways that are anything but clear. When we fail to give ourselves time to reflect and check in with ourselves we can end up going down rabbit holes that don’t get us where we want to go. It also means that our relationships suffer. As you gain students, direct reports and more leadership responsibility it it really important to think about why certain conversations went the way they did. To reflect on things like your leadership style and which situations it’s working in and which it isn’t. As trainees it’s worth taking time to think about why you didn’t get the supervision support you were looking for, did you pick a bad time, did you not manage to articulate what was needed etc. Only by working on ourselves can we really move forward, and this is the one thing we often don’t take the time to consciously do.

Tea and a Pep Talk

So you might say to me ‘what is the different between tea and a pep talk and tea and sympathy’. I would respond that they are actually very different things and both have their place. Tea and sympathy isn’t about trying to ‘fix’ things, it’s about centering yourself when things are going wrong and not feeling along. Tea and a pep talk is more like a coaching experience, It’s about someone giving you constructive support to help you navigate a challenge. It requires a bit of work from both parties in order to try and progress the issue and although it should also enable you to come out feeling better, it should also enable you to come out with a plan of action. You may not be needing a pep talk because you’re upset but because you have a barrier to traverse, a conversation to have, or a direct to pick. You may also want your pep talk to be from someone different to your tea and sympathy as it may be that you want to access knowledge or experience. It is often a conversation that is not so reliant on trust as your tea and sympathy chat may be and you will want to bear that in mind when picking who to have these conversations with. Having tea in these conversations often means you can change their location to outside the working environment (if needed) but also set them up to not be rushed and have the time needed to reach the destination required.

Tea and The Late Night Session

I’d like to say that I have this work life balance thing cracked, but I suspect that my family, friends and colleagues would say that probably isn’t the case. Even if I has I think there is no way of getting around the fact that if you work in science there are going to be some late nights. Sometimes that’s because you are doing a growth curve that is going going to take you 20 hours, sometimes it’s because you have a full working day and then need to do some work for a dissertation and sometimes it’s because of some form of urgent need that means you need to start something for a patient at 6 when you were due to leave at 5.

I used to try and just push through these sessions. I used to think that finishing as early as possible was the best way to balance it with everything else. What I learnt is that when I pushed through I made mistakes. I learnt that for me even when pushing to get things done I need to schedule short ‘walk away’ periods where I could have a cup if tea and move in order to think, especially if I was at work beyond 8 o’clock. Otherwise I made silly mistakes, For the sake of transparency sometimes these wake up ‘walk away’ sessions involved me dancing across the lab with tubes in hand to Lady Gaga, but mostly they involved a cup of tea and ideally a biscuit as I wouldn’t have eaten. My practice is to give myself a 5 minute break to make the tea, go back and do another 20 minutes whilst it cools and then to have a 15 minute zen moment whilst I drink it. I’m sure you will have your own method, but developing one with save you errors and stop you having to repeat these late night efforts.

Now, with this written I’m off to have a cup of tea. Remember my top tea related tips:

  • Find your tea and sympathy peer
  • Take time to reflect
  • Planning will save you time
  • Know how to push yourself and strategies to avoid mistakes
  • Don’t be afraid of networking but think how to make it work for you

All opinions on this blog are my own

I Passed my PhD 6 Years Ago This Week: What Tips do I Have for Those Who Are in the Process?

On my Facebook page, it popped up that I had passed my PhD viva 6 years ago this week. I undertook my PhD in a slightly unusual way, as I did it as part of the National Institute for Health Research Doctoral Fellowship scheme. This meant that I undertook a PhD 50% of the time as part of my day job in Infection Prevention and Control. It also meant that I didn’t start my PhD until I was 30 and, although I was linked to an academic department, I was not really embedded within one. I was pretty much in a team of one. This has its advantages but it also meant that I didn’t really have the peer support of being in a department with lots of PhD students. It also meant that it was hard to benchmark whether I was doing OK. For people who are also undertaking a PhD without lots of peer support, or are thinking of doing one, I thought I would use this blog post to talk about some of the things I wish I had known.

Project Manage Yourself

A PhD is the biggest single project that most people will ever manage on their own as a continuous piece of work. It feels like a huge undertaking and it can often feel overwhelming. Like any project, therefore, it benefits from being split into more manageably-sized chunks. This can feel difficult when you don’t yet have a feel for where you need to end up. It’s often helpful to think of it in three main themes and to set targets for each of them:

  • Project milestones i.e. literature review, initial data collection, key project themes.
  • Personal objectives i.e. developing communication skills, developing teaching skills, adapting to academic and scientific culture.
  • Professional objectives i.e. building networks, learning techniques.

Use these objectives and milestones to create a working document. Know that it is a working document and that everything will shift and change. This shouldn’t be a millstone: it should be something where you tick off the components you’ve achieved so that in the dark days, when you forget what progress you have made, you have something that reminds you of how far you have come. It can also be a really useful tool to help you re-focus when you have a lot of options or things available to you. Use it to prioritise and to decide whether your choices are moving you towards your goals.

Actively Manage Your Relationship with Your Supervisor

Not everyone has a great relationship with their supervisor: some people have supervisors who will take them for cake and a pick-me-up, others have a supervisor who they don’t see for months at a time or who may appear overly critical. Whatever your relationship with your supervisor, there are some things worth considering early on in your PhD:

  • Understand the context – Unfortunately for you, most PhD supervisors do not have supervision as their main job. In healthcare, this is mostly their clinical work; even in academia it’s often the need to apply for funding for their group and publications for their progression. If you can understand the drivers on your supervisor’s time then you will be better able to work with them.
  • Be clear about your needs – I would always advise developing a learning agreement with your supervisor very early on in your relationship/project. Everyone learns in different ways and your supervisor is not a mind reader. By developing a learning agreement, you and your supervisor can work out what works best for you both. Do you want regular contact, or does micromanagement drive you mad? What’s the best way to communicate? Email? Face to face? Phone? How often will you sit down and have a project review meeting? What information will they expect you to have? Do their aims for you align with your goals?
  • Don’t be afraid to ask for help – Understand that a PhD is an apprenticeship in research: you don’t need all the answers. It may turn our that your supervisor may not be the best person to answer all of your questions, some of them may be too technical, or they may not be available enough to assist. Despite that, they should still be your first port of call and should be able to signpost you to assistance if they can’t provide it themselves.

Find Your Tribe and Learn to Speak their Language

The last bullet point brings me onto this point. For many many reasons you will need more than your supervisor to get you through a PhD. You may be like I was and pretty much alone, or you may be surrounded by other PhDs. Whatever your circumstances you will need to find support. You won’t be able to ask your supervisor every time you need to order lab books or where the pipette tips are stored – sadly, they are unlikely to know.

Getting out and attending lab meetings, or other teaching, can be a great way to not only meet people but also to develop the subject specific language you’ll need to succeed. If, like I was, you’re alone, then your funders will hopefully be able to signpost you to other people on similar schemes, and don’t forget about your postgraduate tutor (you should have one) who may be able to make connections for you across departments/buildings. If you are doing a PhD and are part of a professional group (or even if not), social media is often your friend. There are lots of good twitter accounts that can be a valuable source of information.

Do Your Homework

Every University has different processes and management expectations. It is worth understanding early on what these are and what you need to do about them. Is there an electronic log? How many lectures etc. outside of your PhD do you need to attend? What evidence do you need to collate? Do you need supervisors to sign off for specific things? My supervisors didn’t know any of these things and it proved crucial for me to not only be aware of them but to understand how to traverse them. This is especially true if you also have an external funder to satisfy and returns that are expected.

Take the time to learn your cultural norms and consider what authorship order is normal for the subject area. How often are you expected to present? How can you involve public engagement in your work? Are you expected to apply for further funding and to whom?

Learn Your Process

Not everyone works the same way. My amazing colleague, Melisa, will tell you that we often do our best work when just talking through ideas over lunch. This means that my lab book often has many serviettes stuck into it, waiting to be written up. Many people carry notebooks (Mel does) but, for me, this has just ended up the way it works: I can then write it up neatly and in a structured way – that additional process helps me.

Talking of lab books, make sure you have them and that you keep them. Have a structured way of recording information so that you make sure you have everything down and don’t miss crucial details which were blatantly obvious at the time. I can promise you that when you come to look at them three years down the line you will have no idea what that obvious information was. I also colour code mine for different types of work (viruses = purple headers, bacteria = green etc.) because it helps when you’re flicking through years of books towards the end.

It’s also worth knowing what your writing process involves. For a long time I beat myself up for not being able to get on and write straight away. I would berate myself for prevarication as I would tend to cook, run or even, god forbid, clean rather than start to type. Then, after about three days, I would sit down and I would write something like a paper in full. It took me forever to realise this was my process. I would spend time percolating things over, deciding my story, thinking about structure, even if I wasn’t specifically thinking I was processing in the back of my mind. It was all still work and made my writing more efficient and so I have learned to accept that writing is not JUST sitting in front of a computer screen. It’s everything that leads up to those words.

I also want to quickly note here that my process is not going to be the same as yours. You will find your own, but be aware of it and learn to be comfortable with it.

Finally, Give Yourself a Break

All projects are different, and not all subjects are the same. Although I talked earlier about benchmarking you really do need to bear this in mind. Use benchmarking to help you, not break you. You are on your own journey and it will be different from everyone else’s. Also be aware that there are some things that seem to happen to everyone, like the second year slump. No one told me about this and I struggled for ages thinking it was really abnormal. I finally confessed and was told that it happens to just about everyone. The second year slump is where you are far enough into your PhD to have a good feeling for where you need to end up and of the work involved, but you are too far from the end to have really started ticking off the achievement boxes and it all stills feels far away and overwhelming. The second year slump can happen at different times to different people, especially if you’re part-time, but this is just one example of knowing that this is a learning process and sometimes you just have to go with it.

All opinions in this blog are my own

Quality Control in Scientific Publishing: what is it actually like to review papers?

It’s Friday evening and because I’m so rock and roll, or, actually, because I’m so very far behind with jobs, I’m supposed to be spending this evening reviewing papers for four different journals. Confession: I’m actually watching The Craft and writing this instead. I’m hoping it will inspire me to get on with the task at hand.

PhD Comics = So true it’s painful

What is paper reviewing?

Manuscripts (scientific papers/articles) go through a process called ‘peer review’ as part of the publication process. It’s a key part of ensuring the quality of published work, which is then going to reach a much wider and, sometimes, ‘non expert’ audience.

My job as a reviewer is to do a few key things (from my position as a life scientist):

  • Help the editor ensure that the paper is ethical. For instance, I didn’t use animal models when other methods would be more suitable, or that clinical data was misused without permission.
  • Ensure that the paper is reproducible. Is there enough information in the methods that I could take them and try to reproduce the experiment to ensure that it works and can apply to other samples/data?
  • Confirm whether the work is novel and that it adds to the body of scientific work out there. This also means we attempt to identify plagiarism, but I would never claim to be able to know all of the literature out there to ensure this.
  • Respond to whether the work is of a suitable standard for publication. This is very open, but mainly means: is the question they’ve asked of the data the right one? is the experimental design able to answer the research question posed? is the literature and justification presented for interpretation appropriate? Have they correctly reported on the flaws and biases that are inevitably present in any piece of work?
https://blogs.egu.eu/divisions/sm/2016/11/18/harsher-than-reviewer-2/

What is the peer review process?

Once you submit a paper (see my post on Writing and Publishing Scientific Papers), your submission will be allocated to an editor. That editor will then select reviewers from (usually) a combination of the reviewers you’ve suggested when you submitted and the list of reviewers they have on file. One of the reasons it’s so important to choose a journal that matches what you’re submitting is that you want to make sure the reviewers they have on file are going to have the knowledge and expertise in your topic area.

Once the editor has picked their reviewers they will then email out an invitation to review to those scientists. Usually, at this point, the invitee can see the abstract and make a decision whether they have the knowledge and skills to be useful in undertaking the review. I get some truly random invites that I turn down linked to topics I know nothing about and so it is really important that as individuals we’re aware of the scope of our practice and don’t overstretch. Once the reviewer has accepted they then get access to the whole paper and a deadline for submitting their response, usually ~ 2 weeks.

When you submit your review you have to justify your responses and give specific feedback for the authors to address. There are four main categories of response:

  • Accept without revision
  • Accept with minor revisions
  • Accept with major revision (maybe able to request that the paper is re-reviewed as part of this)
  • Reject

Now this is where I have to fess up! I am great at the accepting the invite part. I am not as good at getting the job done because of my other work load. I am probably one of the reasons that your paper reviews take AGES to come back. Sorry about that.

What is it like to review papers and how do I start?

To be honest, I usually have a feel for how it’s going to play out from the abstract. This is why a well-written abstract is so crucial: it gives a really good idea about how the author is going to be able to present their chain of thought and to be succinct in what is a relatively short format of ~4000 words for most papers.

If the paper has good concepts but it needs extra data or re-writing to get there, I will usually take a fair amount of time to give a lot of comments. I know this sounds perverse. However, the more comments I give you, if I give major corrections, the more worthy I think your paper is. It takes time to give feedback and I don’t put in the energy if it doesn’t have merit.

I’m not a rejecter. I don’t often completely reject papers unless they are clinically unsafe. This sometimes happens when non-clinical researchers make clinical suggestions in terms of antibiotic use when they are not qualified to do so.

Two final things.

One – If I spend a lot of time giving a heap of comments to try and make the submission better and it comes back to me without any attempt being made at most of them, I will a) remember as not that much time will have passed and b) not be very happy that my time spent trying to make the work better has been ignored.

Two – Lots of people believe we are paid or get some benefit from reviewing papers. We don’t. We don’t even get a discount for submitting to the journals we review for. The benefit you get is learning and reflecting about what makes a good article and therefore how to make your own work better.

Right! I’d better get on with reviewing those papers now………………….

Top Tips:

  • Think carefully about who you suggest as reviewers.
  • Some submission pages have options to list people who you don’t want to review as they are competitors within your field. This isn’t such a big deal in my world but, if you’re doing pure research, it’s worth considering.
  • Take the opportunity to start reviewing papers early in your career. It will help you think about your own writing and will improve your submissions.
  • Don’t take reviewers’ comments personally – use the gin and tonic method described under Don’t Get Disheartened in my previous post. They are there to help you, so take the constructive and let the rest wash over you.
  • If you are a reviewer remember our job is to be constructive, try not to be ‘Reviewer Three’.

All blog opinions are my own

A Week With Antimicrobial Resistance on my mind

This one gets a bit technical in places. Bear with me – the next one will be less so. Pinky swear.

This month has been a pretty one big for me. Last week, a clinical trial I’m involved with kicked off in Mali. 10% of Malian children die before their fifth birthday and this trial aims to reduce the level of infant mortality. The study is called the Lakana Trial and aims to recruit 100,000 infants born in Mali over the next three years.

In a separate post, at some point, I’ll tell you the ‘Mali not Bali’ story, but I’ll need a double G&T in front of me first. (Or register for free for Stand up for Healthcare Science on 6th November.)

At this point you’re probably thinking what on earth does this have to do with antimicrobial resistance (AMR)?

The thing is, to save all these lives, we’re giving antibiotics to every child (some will get a placebo). Nothing special about that, you might be saying, we give antibiotics to children all the time.

This is different because we aren’t treating symptoms of a known infection. We are giving antibiotics in order to reduce infection risk/inflammatory response in asymptomatic (symptom free) children under one.

The antibiotic we’re giving is a drug called azithromycin and it’s from a class of antibiotics called the macrolides (see my A Starter for 10 on Antimicrobials post).

The LAKANA study follows on from the MORDOR study (the best study name in the world, in my personal opinion!) which gave two doses of Azithromycin/placebo to >190,000 children born in Malawi, Niger and Tanzania. The difference between that study and ours: they always gave two doses and the infants recruited were up to 59 months.

Mortality in the MORDOR study was 13.5% lower overall in communities receiving azithromycin vs those that were given the placebo (paper link here if you’d like more detail). Interestingly, there were differences in the survival increase by both country and by age group, with the highest mortality reduction seen in Niger. The greatest effects were seen in the one-to-five month age group which is why the under ones were selected for the LAKANA study.

To decide how many doses of azithromycin are needed to reduce infant mortality, the LAKANA study will gather evidence to answer three specific research questions:

  1. Does biannual azithromycin MDA (Mass Dosing of Azithromycin) to 1-11 month old infants reduce their mortality?
  2. Does quarterly azithromycin MDA to 1-11 month old infants reduce their mortality?
  3. Does quarterly azithromycin MDA result in a greater reduction in mortality than biannual MDA?

What has this got to do with antimicrobial resistance?

The AMR component of this study is the part that is being lead by UCL and the Institute of Child Health and so is sitting with me as a co-applicant. As we are giving antibiotics to children (and not treating a specific infection), it is crucial to understand whether this will impact on the level of antimicrobial resistance detected in them, their families and their communities.

Questions that we’re looking to answer (and that are currently running around my brain:)

  • If we do detect antimicrobial resistance is it stable? (I’ll explain this in a future post.)
  • Does detectable resistance return to baseline after a period of weeks, or does it lead to a permanent shift in their colonising bacteria?
  • Does any resistance detected make a difference to clinical treatment options? Macrolide resistance is usually due to accumulation of single nucleotide changes (single letters in the DNA code changing). This doesn’t necessarily mean the antibiotic will stop working.
  • Is resistance detected only in the Macrolide class of antibiotics, or does it lead to selective pressure that causes other resistance changes?
  • (Not AMR, but fascinating to me) How does azithromycin work? What is the mechanism? You would have thought this is well understood but, despite being available for decades, how it works as an anti-inflammatory is really not understood. Is the reduction in mortality because of its use as an antibiotic or because of this anti-inflammatory action.

What is incredibly important when doing this kind of work is that the first priority is to maintain the safety of participants. To that end we are working closely with the The World Health Organization who have recommended consideration of azithromycin MDA to under-one-year old infants, in areas with high childhood mortality.

Reducing infant mortality is so important: not just to survival but to quality of life and prosperity within these communities. These kinds of studies also need to be aware of their legacy. We are all incredibly keen to build laboratory capacity and infrastructure, not just in terms of equipment but also in terms of skills and skill infrastructure.

It’s early days and we won’t have any results from the AMR section for at least a year. I mostly wanted to record that this work is going on and the questions I have at the start. I also have some questions about balancing clinical outcomes which are pretty philosophical in my mind right now. If we see development of AMR, especially if it’s non-stable, but mortality is decreasing, where is the balance between those two things? How do you perform the risk assessment for the individual about short-term vs long-term outcomes? These thoughts convince me that this study is just the next step on a journey and that (as always) we have a lot to learn and a long way to go.

LAKANA team – Paris December 2019

All opinions in this blog are my own

Science Communication: Reflections from an Ivory Tower

This week I was going to post about Antimicrobial Resistance (AMR) as, in many ways, it has been quite a momentous week in my professional life and it all ties into AMR. I may still… but I wanted to raise something that has been playing on my mind this week in light of the social media reactions I’ve seen to the new COVID-19 (don’t call it a lockdown) tiers.

Let me say now that this isn’t a political post, purely one linked to reflections that have been triggered for me that are linked to some of the pitfalls of traditional communication, medicine and dissemination.

On Wednesday, I saw this tweet. The scientist in me responded with, ‘well of course’ and ‘surely people understand the ramifications for everyone if we don’t find working containment measures’.

Twitter post related to the new YouGov poll

When I see posts like this, I usually scroll through the comments. I think it’s important to read what people are posting and see what the challenge is like, as it’s all too easy to see the world through the eyes of those in your bubble. Those people in similar situations to us, with similar views to us, who then use stats like this to reinforce the positions we already hold.

Then, as part of the comments, I saw this:

My first reaction to this post was to blow out my cheeks and sigh. “The needs of the many outweigh the needs of the few” and all that. That’s an economic problem that should be addressed, not an infection issue: think of the number of people who will die etc.

Then I stopped and realised there is truth to this

I do live in an Ivory Tower

Now that’s not to say that I am rich, and it’s not to say that my response to the the poll is wrong. It is to say that we must reflect and admit the truth to ourselves. I can pay my mortgage. My job is not at risk (although my husband’s may well be). I can buy food and cover my bills. That gives me a privileged position where I can engage with and make decisions about how I feel about the science, the justification, and the way they are implemented. I don’t have to react from a place of worry and fear. That privilege means that I can digest information from a place of logic and not emotion. That privilege also means that I can lose perspective about how others may receive the same information and I certainly have to be aware of that privilege when it comes to judgement.

However the key word in the above paragraph is “receive”. This is where I come to the real point of my post. One of the problems with the current situation is the feeling of disempowerment of being the recipient of information and not the co-creator of response. This has been a problem in the health setting for pretty much as long as it’s existed, but its only in recent years that it’s been recognised as such.

Too many times in medicine we implement from a position of expertise and authority without engaging the lived experience and knowledge of others. I’m a passionate believer in the power of true co-production, where we work in partnership to create something that neither group could deliver on their own. I work in a hospital where we see patients who may be one of only 20 in the world with their condition. It is naïve and arrogant of me to believe that I will understand more about their experience of living with their disease. I can input, support and advise on the basis of biology and my experience. It will never be truly effective without considering theirs.

So my thought on this Friday evening is actually more of a plea. We all have our Ivory Tower, our bubble, our version of the truth. If you work in healthcare it’s important to give yourself time to reflect on what that means for your practice. Are you doing everything you can to move from being the authority in the room to being the person who is prepared to truly listen and co-create the best possible outcome for the patient in front of you?

Are we ready to enter a new period in healthcare where it is much more about the patient in front of us than it is about our years of training and education?

Photo by Adrianna Calvo on Pexels.com

All opinions most definitely my own

Writing and Publishing Scientific Papers – Is it as hard as it seems?

Before I start. In the interest of full disclosure, I’m a published academic but I have fewer than 30 papers, not the 200+ some of my colleagues have. See my publications page if you’re interested. There are reasons for this. One, I’ve only had my PhD since 2015. But the main reason is that I’m not your traditional academic. I have a clinical post which is >50% of my time and so my work is about moving research from the research (academic) setting into clinical practice to improve patient care.

Why I Research

I still really clearly remember the stress that writing and submitting my first 1st author scientific paper caused me. It’s difficult to describe the transition from being a good student to being an academic. As students, we fear failure. I, like most academics, have never failed an exam and have what can only be called a visceral dread of what it would mean. You then move into a world where 80% of grants will be rejected and failure becomes part of everyday life. When I submitted my first paper, I hadn’t come to terms with that yet. I was still worried about what rejection would mean for me and how people see me. Now it’s just a fact of life.

Some misconceptions about publishing.

A lot of my friends mistakenly believe that scientists get paid for publishing their work. The opposite is true. If I want my work to reach the maximum number of people, I have to pay (usually several thousand pounds) for my article to be open access (i.e. free to access). Therefore, dissemination of your work can be really expensive and not necessarily reach the right people, as most clinicians and patients won’t be able to read articles requiring payment. It’s one of the reasons why science communication is key.

One of the other common beliefs is that the collection of data is most of the work in getting a scientific publication. This may be personal to me, but I have never found this to be the case. I always have way more data than I have time to publish; I currently have over 18 papers in draft, as I struggle to find solid blocks of writing time. This could be because I find the planning of experiments and data collection an adventure. The writing is stressful as I’m always trying to fit something that requires focus and blocks of time around a dozen other tasks. I often don’t have the mental space to enjoy it.

What about the publishing process?

There are some main stages to paper drafting and submission which are worth bearing in mind:

  • Journal and editor selection
  • Drafting
  • Co-author edits
  • Submission
  • Revision
  • Hopefully publication (if not, back to the beginning)

Many authors jump straight into drafting without really spending enough (or any) time on journal selection. Many PhD students don’t do this as they see their supervisors just jumping straight in. That’s normally because supervisors know a lot more about the publishing landscape and so already know the background.

Why is journal selection important?

Manuscript publishing is like any other form of publishing. You need to choose the right journal for your content. Every journal will have specific topic areas they are interested in. They will also have specific formats they will want you to follow in terms of length, numbers of figures and tables, as well as referencing style. If you start drafting without having an idea of where you are going to submit you will often not put the correct emphasis on your writing to get it into your journal of choice. You will also waste time you could spend on other things restructuring what you have already written.

Hint 1: Even title choice is linked to your journal of choice. Do they like long titles? Do they appreciate a witty title to draw readers in?

Hint 2: Go through similar articles to the one you are planning to write and look at the length of different sections in order to understand where the emphasis lies. Do they have a long methods section? Do they focus on discussion?

If you get the research right you will save yourself a tonne of time later on with re-writes and rejections.

What about co-authors?

It is obviously crucial to include your co-authors but I have also learnt that it can be helpful to pick the point at which you circulate to them. If you include everyone during drafting, you can end up with too many different points of view that mean you end up with a manuscript that is unclear or meandering. I’ve learnt to include a few key people, get it to a publishable stage and then circulate. Pick your key people carefully if you are working in a multidisciplinary team so that you get the benefit of their perspective, but don’t get too distracted from the agreed paper themes.

Finally. Don’t get disheartened.

Rejection is just part of the process. Papers will become stronger for revisions and contribute more, thus having more impact. Remember that the criticisms are of the manuscript. They are not criticisms of you. My method for dealing with reviews is to open the email and read the comments. I then close the email down, go and make a double gin and tonic and wait 48 hours before responding. The memory of the comments is never as bad as I thought and once you take the emotion out of it you can just crack on.

All opinions in this blog are my own