Author: Sue Mason / Editors: Charlotte Kennedy, Govind Oliver / Codes: CC20, HAP29, SLO10 / Published: 02/05/2019
I am a Professor of Emergency Medicine employed at the University of Sheffield. I hold an Honorary contract with Barnsley Hospital Foundation NHS Trust where I undertake my clinical work and am also the Director of Research and Development.
My research interest is health services research with a particular emphasis on evaluating complex interventions within urgent and emergency care and using routine patient data to improve urgent and emergency care systems and patient outcomes.
I qualified from the University of London in 1990 and always knew I wanted a career in emergency medicine (EM). However I was never interested in research and always saw myself as a die-hard clinician. I undertook postgraduate examinations before MRCEM existed and as such pursued an early career in surgery, gaining the FRCS in 1995. After this I entered emergency medicine (EM) training and was very fortunate to meet my mentor at an early stage. Jim Wardope (ex-RCEM President and consultant in EM, Sheffield) took an early interest in my career and gently encouraged me to take on some research post-FRCS. Early projects involved trawling through clinical notes and collecting data on patients presenting to the Emergency Department (ED) with chest pain. I remember travelling to the North East where our cardiology collaborators were and the harsh realisation that they were not fulfilling their side of the bargain! The project never got published, although I started to learn new skills and gain an interest in research.
Jim then asked me to consider undertaking a higher degree. Funding was available from the Hillsborough Disaster Appeal Fund for trauma research through a Royal College of Surgeons of England Research Fellowship. The Appeal Fund wanted to fund two researchers in Sheffield and Liverpool. I applied and was appointed to the Sheffield post for 12 months full time research, whilst Simon Carley was appointed to the Liverpool post. At that time in Sheffield we had a thriving trauma psychology service and I was introduced to the head of service and together we planned my project evaluating psychological outcomes amongst trauma patients presenting to ED. I registered for an MD, a decision guided by the time I had available for the research, and secured Jim as a supervisor along with an academic clinical psychologist. My project involved recruiting patients following injury and assessing them for psychological symptoms over time, learning skills in modelling predictors of post-traumatic stress disorder and other traumatic symptoms. Data collection and follow up took longer than anticipated, and so my analysis and write up spilled over into my subsequent full time senior registrar (SpR) training in South Yorkshire. This was extremely hard work and challenging – much of my spare time was taken up with finishing the thesis. It also coincided with sitting and passing FCEM in 2000. I will be eternally grateful to my husband, Jim, and to Graham Turpin (my other supervisor) for their support and encouragement, ensuring I completed and passed the MD in 2001.
Becoming a Consultant
Around the time of completing the thesis and FCEM, Jim started to discuss consultant posts with me and asked if I would be interested in a Senior Clinical Lecturer post linked to the School of Health and Related Research (ScHARR), University of Sheffield. I was delighted that he suggested this, but took some time to consider whether this was the direction of travel I wanted my career to take. However by then I had been seduced by research and found it hard to foresee a career that did not include pursuing my new-found passion. I applied for the Senior Lecturer post – another difficult and challenging process which took a great deal of thought and preparation and for which I took a lot of advice. I was not alone in applying for this position – Steve Goodacre had arrived in Sheffield during the previous year and was also applying, so the pressure was on! I was duly appointed after successfully interviewing and took up post in 2001.
As a newly appointed Senior Clinical Lecturer who had not followed any sort of standard academic career path (such as there was in those days), I had no experience of working in an academic setting, and therefore my learning curve was exceptionally steep! I made lots of mistakes and initially found the academic environment very difficult to adjust to. It felt like academics were all sitting in ivory towers, totally removed from the ‘coal face’, but supposedly delivering ‘relevant’ research to those who were. Having said that I continued to draw on the ongoing support from Jim Wardrope, who was very committed to seeing the role succeed. He was instrumental in helping me with my first large grant application which was a randomised trial of paramedic practitioners managing elderly patients at home. In those days we did not have Clinical Trials Units, and the trial was run from ScHARR with a relatively small but very capable team of researchers, led by me.
Around this time, we also decided we wanted to start a family. I was 35, and had never been particularly interested in children before, but suddenly nature and nurture kicked in! I was fortunate in getting pregnant quickly and was soon off on maternity leave in 2002. However I had also been successful with another large grant and remember trying to get this started whilst also being on maternity leave. We had a beautiful daughter, Katie and started to learn about being a family. I found maternity leave very difficult – I had never had a long period off work before, and also felt under huge pressure to continue establishing my role at ScHARR. I didn’t really thrive, and couldn’t wait to be back at work! Whilst I was on maternity leave, Steve Goodacre was appointed to ScHARR as a Senior Clinical Lecturer, and so establishing an academic emergency medicine group moved closer.
Progressing in my career
Since then I have continued to gradually develop my career, applying for and gaining promotion to Reader (2007) and then to a Chair in 2010 – the first female in Emergency Medicine in the UK to achieve this.
These promotions were punctuated by another period of maternity leave when we had Georgina in 2006 – I enjoyed this time off much more as I felt much more secure in my career and able to take time out without feeling too guilty. I have always worked full time – partly by choice, but also because I have two jobs and find it difficult to tick all the boxes and work part-time. However the one great thing about academic life is its flexibility. As an employer, universities support achieving a sustainable work-life balance, caring responsibilities and working from home policies. Whilst I have never worked from home much, the flexibility to nip out and pick kids up from school etc. has been hugely beneficial.
Steve and I were joined by Fiona Lecky in 2015 as a third Chair in Emergency Medicine. From this point we established our CURE group (Centre for Urgent and Emergency Care Research) in ScHARR, from where we each pursue our own areas of research interest, and are fortunate to work with a highly skilled group of researchers.
In the United Kingdom (UK), as academic staff progress they can apply for promotions which carry different titles. Some Universities have individual nuances in how these different roles are named but in general, positions progress from Lecturer to Senior Lecturer, Reader and then Professor. In some Universities, the title of Senior Lecturer is awarded for contributions to teaching whereas Reader is reserved for those involved in research, in others Reader is a more senior position. People who are then promoted to the role of Professor are said to have a ‘chair’ in their chosen subject. These can be established chairs, which are associated with the University and may be recruited to when someone leaves or retires, or personal chairs which are created specifically for that individual.
Things I have learnt that I would like to pass on:
- The clinical work always comes second. As a clinical academic, my career lives and dies by my academic success. Maybe it’s me, but early on, I had to accept research was my priority – it is why I was appointed. As such, my clinical development has been slower. I had to make choices about what I would do – for example, I do not work enough clinical hours to competently and confidently manage an acute airway or practice ultrasound to a high standard – these were areas I did not train in as an SpR and therefore came to late. Over time, I have learned to swallow my pride and worry less about asking for help or advice.
- Academic environment is crucial. I was sceptical about a joint appointment with ScHARR. This was more borne out of ignorance, and I was quickly proven wrong. ScHARR is a thriving community of academics and educators of which I am proud to be part. The ability to have statisticians, modellers, qualitative researchers and access to excellent undergraduate and postgraduate students is what has driven the success of my own career and that of our CURE group.
- Career paths. I did not take a formal career path into clinical academia, but then again, there was no such thing when I trained. As such it was probably easier to gain entry with relatively limited experience. Now, the National Institute for Health Research (NIHR) have developed training paths and this is by far the smoothest route into such a career. However, it is not finite, and there are opportunities to enter the NIHR path at different stages, and also to developing a non-standard academic career path. In the end I would say the essential elements to developing your academic career are academic mentorship; gaining a higher degree; determination and hard work.
- Grants and Publications. It is never too early to start writing small grant applications and papers. The sooner you start the better – not only for the experience you gain, but in order to understand the importance of accepting failure! You will fail more than you succeed in applying for grants, and your paper will rarely get into the journal you think it worthy of. This should never ever discourage you! Each failure is an opportunity to learn and gain more experience. It does not get easier to accept the disappointments, but it is something I have learned to live with.
- Conferences. Go to them, submit abstracts and learn how to present well. I started going to international conferences very early in my career and travelled a lot presenting small bits of research. I had a fantastic time and started to meet people with similar interests, learn about research in the field and gradually improved my presentation skills.
- Support. You cannot do this alone – find a good mentor who takes an interest in you, guides you and supports you. I have been very fortunate in my early career to have this with Jim Wardrope. I now try to do this for others. I have also been immensely grateful and fortunate to have unending support from my husband who has shown unwavering belief in me, and has made sacrifices himself to support me.
- Hard work. It is! However, much of medicine is hard work, regardless of what you do. I do not regret for one second what I chose to do. I have always loved it and gained a huge amount of personal and professional satisfaction from my work. I would recommend it to any trainee. In the end it is the long game you are working for – the hard work and sacrifice in your early career will pay off and is definitely worth the effort. I can now pick and choose a bit more what I do and where I go as a consequence.