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My flexible path into clinical research

Dr Elena Nikiphorou is a consultant rheumatologist at King’s College Hospital and an honorary/adjunct senior lecturer at King’s College London. Elena tells us how she got started in research without following a traditional academic path, the important role of mentoring and shares her advice for would-be researchers at any stage in their career.

How did you get into research?

Although starting on a very clinical path, my interest for clinical research was fuelled during one of my clinical posts as a registrar. This motivated me to pursue an academic career in parallel to my clinical training, also prompting me to undertake short research fellowships in Europe and the US.

I’ve worked on very rich datasets, met great people (clinicians/academics) – some of them have become great mentors to me – and I also made great friendships. I’m originally Greek Cypriot and I got a small scholarship to study medicine at University College London. At the time there was no medical school in Cyprus.   

My first exposure to research, albeit lab-based, was during medical school, through a Wellcome Trust Vacation Scholarship, which helped me realise I was interested in trying to answer questions  we don’t have answers for, but also that I didn’t want to be locked in a lab all the time.

I spent 2 years out of my rheumatology training programme doing an MD research degree at University College Hospital in London and that really consolidated my passion for clinical research. At that point I knew, yes, this is exactly what I’d like to do!

What were the challenges for you?

The problem I had was that there weren’t many research opportunities on my clinical path. I’d never thought of applying at the very start of my career to be an academic fellow, and I had never been in a big academic institution, so I realised I had to figure out ways to make myself competitive with people on a more academic path.

I completed my MD research degree successfully, but there were a lot of hurdles along the way that maybe I would have had a little bit more direction as to how to do things properly if I had been on a more academic path. At the same time, this path made me more proactive and gave me enthusiasm to search for alternative ways to achieve my goal. I’m now a consultant and I feel content that I’ve had a fascinating career in research and clinically so far, despite the hurdles.

Throughout my career I’ve noticed women are often underrepresented in academic medicine. Lack of confidence and self-belief, as well as lack of mentorship, are perhaps only parts of the issue. It might make women more hesitant to pursue an academic career. It would be great to see male colleagues in higher positions reaching out and encouraging women to pursue their academic visions.

Was lack of time an issue too?

It’s a struggle to push research forward, especially as a consultant. I currently work in my clinical role 2 days a week and the rest of the time I devote to research and family. Over the years I’ve spent a lot of my personal time doing research, it’s taken up my evenings and weekends – and it still does. That’s not ideal, but I’m proud of what I’ve achieved; it’s made me more determined. I would encourage others in similar positions to not hold back. 

How has mentoring supported you?

I have had wonderful mentors, who have provided me not just with career advice, but also personal advice, for which I’m so grateful. I found it hard initially to identify academic mentors in the UK, mainly because I was not in academic institutions with the infrastructure that would support this. So, I had to look for support from outside. This was not difficult for me, as I had already started to work with very inspiring people in research across Europe who supported and encouraged me massively to pursue my academic dream. It feels strange to say and admit that, in many ways, I found much more support from outside the UK.

I hope that going forward, and with the support of organisations like the RCP, we can make people feel more supported within the UK. I would love to see this happening, as well as help for young people who want to pursue research despite a very clinical training path to have the mentorship and support that they need, here and now. Otherwise we could lose very talented people who have no choice but to reach out for academic support to countries beyond the UK.

What advice would you give to others on a clinical pathway who want to be more research active?

In a way I’m grateful for facing the hurdles I did, being a very clinical trainee trying to pursue an academic path along the way, as it has made me more motivated and determined to pursue my dream. It has resulted in me meeting and working with people who were not just good at the work they were doing, brilliant clinicians and clinical academics, but also amazing human beings. I’ve made very strong friendships that I will forever cherish.    

My advice for anyone considering research, despite being on a clinical path and without academic institutional support, is to go for it. You might have to work harder to compete against people from academic institutions, but don’t let that stop you. Very few people know how much research they want to do early on in their career, so don’t let being on a more clinical path hold you back.

I feel very proud for being research active without having had much academic support. You don’t have to be in an academic institution to be active in research. Having said that, I think there needs to be more support for people in my situation, especially women, because it means you have to work harder to distinguish yourself from people in well-recognised institutions. Sometimes simply navigating university bureaucracy is difficult; getting research grants without the back up of large academic institutions can be challenging. But certainly not impossible.

The RCP recently published the results of a membership survey showing physicians in rural hospitals, as well as women and BAME physicians, struggle to participate in clinical research. Research for all? An analysis of clinical participation in research outlines these findings and how we want to work with NHS trusts to tackle this unequal access.