CL in General Surgery
Dr Simon Knight (2014)
Pathway to a Clinical Lecturership
I did my undergraduate medical training in Cambridge and during my time there I took my part II in neurophysiology. My dissertation work involved laboratory experiments characterising the responses of human cone photoreceptors, and this got me interested in the academic side of medicine.
I knew my interest lay in a career in surgery, and I went on to complete my basic medical and surgical training in Cambridge and Nottingham. I then moved to Oxford to take up a clinical research fellow post in the Oxford Transplant Centre, supervised by Sir Peter Morris. I was attracted to transplant surgery by its unique blend of technical surgical skill, intensive medicine, nephrology, pharmacology and immunology.
Working with Sir Peter at the Centre for Evidence in Transplantation (CET), I developed skills in systematic review and meta-analysis, producing my MChir thesis on the optimisation of immunosuppressive medication in transplant recipients.
On returning to higher surgical training, I carried on my work with the CET, taking on the role of deputy director and supervising a number of ACF trainees in successful systematic review projects. I was keen to secure an NIHR Clinical Lecturer (CL) post to protect some time for this ongoing work and expand my skill set.
What does the work involve?
I still work closely with the CET in producing systematic reviews and meta-analyses, and have developed skills in literature search, critical appraisal and the statistics of meta-analysis, including network meta-analysis. Most of my systematic review work now involves supervising ACF and DPhil students who come to us looking for projects to fit into their limited academic time.
As a natural extension to my interest in evidence-based transplant surgery, I have become more involved in clinical trial design during my CL post. I am an investigator on the COPE organ preservation trials, looking at normothermic ex-vivo liver perfusion, and am also developing grant applications for other large RCTs. My interest in trial methodology has also led me to develop a project to define core outcome sets that should be reported in clinical trials of solid organ transplantation.
I also have an interest in patient and public involvement in research and clinical trials, and am leading the James Lind Alliance Priorities Setting Partnership in Kidney Transplantation. This involves working with both patients and professionals to define and prioritise future topics for transplant research.
I have not found protecting my research time during my remaining clinical training as difficult as I perhaps thought I would. Due to the ongoing nature of many of my projects, splitting my time into 6-month blocks would simply not work. Fortunately, the transplant rota is such that I am able to split my time to alternate weeks of clinical and academic work, which I think has benefitted both.
Having originally completed my medical training in Cambridge, it was a difficult decision to move to “the dark side”! However, the Oxford Transplant Centre is well recognised, and has ample clinical training opportunities and excellent academic opportunities. I have been very lucky in finding extremely supportive mentors who have really helped me to develop both my clinical and academic careers.