Why should I be an academic pathologist ? 10.10-10.40

1. Why should I be an academic pathologist ? 10.10-10.40 Phil Quirke Royal College of Pathologists YCR Centenary Professor of Pathology University of Leeds

2. Contents • Why do research • Careers • Academic clinical fellows • Clinical lecturers • Future

3. Why do research? • You can make a difference • Prevent a disease • Cure it • Reduce its effects

4. Why • Service career • Reports 2,000 surgicals a year • 35 year career • 70,000 patients • 50 colorectal cancers a year :1,750 • GI biopsies: 17,500 each • Variable private practice • Increasing management interference • Decreasing independence • Increasing commercialisation • USA, Australia, SERCO…….

5. Academic impact - Research • Research • Helicobacter pylori observation • 50% of the worlds population? • Duodenal ulcer – 4 x106 • Gastric ulcer • Gastric cancer • Gastric lymphoma 2005 Warren

6. Leeds - Research • Bowel cancer 1.2M worldwide • Observations on surgery • Total mesorectal Excision • Abdominoperineal excision • Colon cancer • Screening • Implementation • Change • Flexisigmoidoscopy

7. Leeds research • Can we prevent bowel cancer ? • Abnormal microbiome • Faecal transplants?

8. Academic impact - Teaching • Teaching • Undergraduates • Influence 230 students per year • 8,050 doctors over 35 years • Create the next generation of pathologists • Postgraduates • FRCPath • 10 years training committee 300 • PhD’s/ MD’s • 40

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

10. Why? • Variety • Influence policy • Change practice • Travel • Opportunities • Reward • Building your own team • Seeing the success of others • Following their achievements • Pay progression/patent/startups/consultancies

11. Lecturing/training/influencing

12. Why do research? • The thrill of discovery • You work in a worldwide community • Similar aims • Competition/friendship

13. Academic careers • Never a better time • Major shortage • Ageing population • Council Heads of Medical schools • Worst Pathology/Anaesthetics • 5x the chance of holding a Platinum award • International market • Freedom to explore your ideas

14. Integrated Clinical Academic Training Pathway

15. NIHR Academic Clinical Fellowships • Academic and clinical training • For entrants to Specialist Training • 25% is academic component • Support in making application for training fellowship or educational programme leading to higher degree • Up to 3 years (4 for GPs) • All ACFs except medical education are run-through • 250 posts each year £4,500 over 3 years to fund research training and conferences

16. ACF Recruitment Timetable

17. NIHR Clinical Lectureships • Academic and clinical training for those with a higher degree • Available to qualified GPs and GDPs with higher degree • 50% is academic component • Support in making application for Clinician Scientist Scheme or similar • Up to 4 years • End point marked by CCT and substantial piece of post-doctoral research or educational work • 100 posts each year £1000 for travel per year

18. Pathways • Service Consultant • ST1 • ST2 • ST3 • ST4 • ST5 • Consultant • Academic and service • ST1-3 / Academic Clinical Fellow • Out of programme experience PhD/MD • Lecturer • Senior Lecturer • Reader • Professor

19. Out of programme experience • 3 years funded by fellowship • NIHR • MRC • CRUK/ARC/BHF • College • PhD/Publications • Presentations

20. Senior positions • Senior Lecturer 5 years • Reader 2-3 years • Professor • established Chair/personal Chair • career position

21. What happens • All • Understand the literature • Undertake a research project • Present their work at national meetings • Some • Publish papers • MD/PhD • Awarded grants • International meetings • Specialist reputation • Few • Professional academic • Own research programme • International reputation • Fewer • Head academic grouping within University

22. What is the connection between Black and Decker and Pathologists What do we do? Information

23. Threats

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

25. Opportunities – Digital pathology • Integration of the microscope and computer • Efficiency • Breaks the limitations of the microscope • Anytime/anywhere • International opinions • Learning/teaching/quality

26. Stratified/personalised medicine • Prognosis – aggressive/benign outcomes • Her-2 amplification • Mismatch repair • Prediction – which drugs • Her-2 breast and gastric cancers • Ki ras EGFr antibodies • Focus 4 • Toxicity • DPD deficiency • UGT1A1

27. Future medicine • Whole genome • Now £5000 • 2 years £500 • Association of genotype with phenotype • Deep sequencing for rare events • Copy number variation

28. Next generation sequencing Copy number variation TPD52 Mutation detection In house 1-50 Fluidigm 144 Haloplex 4,000

29. Maldi-Tof imaging • Protein visualisation without antibodies • 30um resolution • EGFR • Amphiregulin • Epiregulin

30. Leeds

31. Programme • LURE • iBSc • aFY2 • ACF • Clinical lecturers • ACF position to be advertised November start August 2013 Lecturer position

32. Questions?