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Dr Rebecca D’Cruz on the Turner-Warwick lecturers

In this blog, Dr Rebecca D’Cruz – 2020 Turner-Warwick lecturer for London – speaks about what she gained from the scheme and her unique experiences with research during the COVID-19 pandemic.

My involvement in the Turner-Warwick lecturer scheme was prompted by my research supervisors emailing me a link to the upcoming round of applications. I perused the RCP website and read about the outstanding and innovative work being undertaken by medical trainees from across the UK.

I must admit that I felt wholly underqualified to submit my research for such a prestigious award. But after some gentle encouragement from my colleagues, I submitted my abstract and was astonished to discover that I had been selected to deliver a Turner-Warwick lecture for the London region.

After the initial excitement, nervous apprehension set in as I realised that I needed to speak coherently and engage with a wide general medical audience about my area of interest. How to make it interesting and relevant? How to maintain enthusiasm on the online platform (as face-to-face lectures were suspended due to the pandemic)? What questions might I be asked about my research?

As some background, I am a respiratory registrar and took time out of my training to undertake a period of research. Prior to this, I had very little experience of academic medicine, having unsuccessfully applied to academic training programmes at both foundation and specialty levels. After my early years of training and the intense clinical workload this involved, I decided to contact a range of experts in my areas of interest (COPD and ventilation) to enquire about research opportunities. I was shocked when several replied and asked to meet.

I met with Professor Nick Hart and Dr Paddy Murphy at the Lane Fox unit at St Thomas’ Hospital, which is a tertiary centre for ventilation and weaning. They described several projects they hoped to develop and encouraged me to apply for funding from the National Institute for Health Research to support this. I was fortunate to be awarded sequential fellowships (a 1-year clinical research fellowship and a 3-year doctoral research fellowship), through which I was able to develop myself as a health researcher and undertake my clinical trials on respiratory physiology and hospital readmission prevention for COPD patients recovering from a severe exacerbation.

The COVID-19 pandemic unfortunately coincided with the early recruitment phase of my feasibility randomised clinical trial. Non-COVID research was suspended at Guy’s and St Thomas’ NHS Foundation Trust, and so I requested that I be redeployed within the critical care services to support the clinical teams.

I submitted my application to the Turner-Warwick lectures in the summer of 2020, hoping that I could share the background to my research and some of the fascinating data I had collected, although my hopes were not high, given the limited number of patients I had so far recruited.

I was honoured when my award was confirmed, and it was a privilege to meet Sir Andrew Goddard, RCP president, and the late Professor Donal O'Donoghue (the then RCP registrar) and discuss my subjects of interest, albeit virtually. I later delivered my online lecture, chaired by a previous consultant colleague with whom I had worked at Northwick Park Hospital, Dr Jacob de Wolff.

My research involved the application of high-flow therapy in a home setting to patients recovering from COPD exacerbations. This form of respiratory support has been increasingly used among general medical, respiratory and critical care teams in recent years, and much more so since the pandemic onset.

I wanted to use my lecture to teach the audience about the physiological effects of high-flow therapy on the respiratory system, highlight evidence-based clinical applications, discuss aerosolisation of respiratory particles (which had been an important discussion point during the peaks of the pandemic) and present my own study data.

Delivering my Turner-Warwick lecture was a unique opportunity to speak to a diverse audience about my specialist area.

It made me consider how to adapt my lecturing methods in order to engage a non-specialist audience and make my talk as clinically relevant as possible. It improved my confidence in public speaking as, at this point, I had limited experience in speaking at conferences. It also helped me to extend my professional networks, as I was able to meet other trainees both within and outside of respiratory medicine and hear about their work.

After presenting my lecture, I continued to balance clinical redeployment and my academic commitments. I engaged with COVID-19 research by supporting data collection for multicentre observational trials that were being undertaken within the trust as well as undertaken my own observational study on clinical and physiological outcomes following severe COVID-19 pneumonia.

I closed recruitment to my clinical trials in spring 2021, submitted my thesis in September 2021 and was awarded my PhD in January 2022. I have now returned to my full-time clinical role as a respiratory registrar and am thoroughly enjoying being part of the dynamic respiratory multidisciplinary team again. I am in my final months of training and am excited to be exploring opportunities to develop myself as a COPD and ventilation specialist and to deliver clinical research that can improve outcomes for patients.