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How to Complete a PhD in the Medical and Clinical Sciences

Edited by

Ashton Barnett‐Vanes

St George’s, University of London and Imperial College London, UK

Rachel Allen

Reader in Immunology of Infection and Head of Graduate School
St George’s, University of London, UK

 

 

 

 

 

 

 

 

 

 

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List of contributors

Kyrillos N Adesina‐Georgiadis DIC PhD
Honorary Research Associate
Imperial College London
UK

Rachel Allen DPhil
Reader in Immunology of Infection and Head of Graduate School
St George’s, University of London
UK

Ashton Barnett‐Vanes BSc PhD
MB‐PhD Candidate
St George’s, University of London and Imperial College London
UK

Adel Benlahrech PhD
Post‐doctoral researcher
University of Oxford
UK

Manu Chhabra MBBChir PhD
Doctor
National University Hospital, Singapore and University of Cambridge
Singapore, UK

Timothy M Cox FMedSci
Emeritus Professor of Medicine and Director of Research
University of Cambridge
UK

Fiona Cunningham BSc PhD
Professor of Pharmacology
Royal Veterinary College
UK

Henry D.I. De 'Ath PhD MRCS
Surgical Registrar and Honorary Clinical Lecturer
Wessex Deanery and Queen Mary, University of London
UK

Michael Dustin PhD
Professor of Immunology
University of Oxford
UK

Jonathan Elliott PhD MRCVS
Professor of Veterinary Clinical Pharmacology and
Vice Principal for Research and Innovation
Royal Veterinary College
UK

Kate Gowers PhD
Research Associate
University College London
UK

E. Allison Green BSc PhD FHEA
Senior Lecturer
University of York
UK

Ming He MBBS MRCS PhD
Surgical Research Fellow
Imperial College London and King's College Hospital
UK

Rebecca Ingram PhD PGCHET
Lecturer
Queen's University Belfast
UK

Laura Lambert MA PhD
Post‐doctoral researcher
Imperial College London
UK

Paul Langford BSc PhD
Professor of Paediatric Infectious Diseases
Imperial College London
UK

Jonathan C.H. Lau BSc MSc
MB‐PhD Candidate
University of Cambridge and University College London
UK

Fiona Reid BSc MSc
Senior Lecturer in Statistics
King's College London and St George's, University of London
UK

David Salman MBBS MCRP
Wellcome Trust Clinical Research Training Fellow
Imperial College London
UK

Célia A. Soares MD
MD‐PhD Candidate
School of Health Sciences, University of Minho
Portugal

John Tregoning MA PhD
Senior Lecturer
Imperial College London
UK

Fiona Tomley BSc PhD
Professor of Experimental Parasitology
Royal Veterinary College
UK

Kristien Verheyen PhD MRCVS
Senior Lecturer in Clinical Epidemiology and Head of Graduate School
Royal Veterinary College
UK

Andrew John Walley MA DPhil
Senior Lecturer in Human Genomics
St George's, University of London
UK

About the editors

Dr Ashton Barnett‐Vanes is an MB‐PhD Candidate based in London. He completed his medical and clinical science years at St George’s, University of London where he was awarded the William Brown and Devitt‐Pendlebury Exhibition. In 2012, he graduated with First Class Honours in his intercalated BSc and in 2015 completed his PhD in War Injuries, both at Imperial College London. In 2016, he was a British Council Scholar at Tsinghua University, Beijing. He is the recipient of a Foulkes Foundation Fellowship. Read more at www.howtophd.com @HowtoPhD

Dr Rachel Allen is a Reader in Immunology of Infection at St George’s, University of London. She obtained her DPhil in Immunology at the Weatherall Institute of Molecular Medicine in Oxford and was awarded a Beit Memorial Fellowship to continue her postdoctoral studies at Cambridge University. In addition to her research activities (including PhD supervision) since joining St George’s in 2007, Rachel has acted as Associate Dean for Research Degrees and was appointed Head of the Graduate School in 2014.

Foreword

Episodic evolution of health care within the modern state and explosive progress in science have had transformative effects on medicine; but human nature has changed little and people still fall ill! While many formerly intractable diseases can now be treated or prevented, it is a striking fact that nearly all therapeutic advances have been developed and introduced by scientifically minded researchers and doctors. The distinctive mind‐set of those who materially advance understanding or introduce successful cures, is usually characterised as that most favourable for scientific thinking: insatiable curiosity; strong ideals; an often irritating and a sceptical mistrust of hand‐me‐down explanations of natural phenomena – and distaste for rote learning.

Today’s research climate presents myriad challenges and opportunities for the next cadre of researchers. Doctors Ashton Barnett‐Vanes and Rachel Allen bring a complementary perspective to this field: intimately familiar with the demands, conflicts and practicalities of the clinical research universe, their scientific perspectives are broad and their experiences deep; their advice is realistic. Here they have collected a set of frank chapters from like‐minded authors that offer an excellent conspectus of the opportunities, pitfalls and sheer diversity of activities that make up the fascinating science that clinical undergraduates, graduates in medicine and allied clinical sciences are eligible to pursue.

The path of the clinical investigator has been well trodden throughout history. Nonetheless, all that we know and apply now for the relief of human suffering has depended on understanding gained by a relatively few great experimenters from the past. To meet its societal obligations, contemporary medicine remains dependent on the engagement of imaginative scientists and clinicians who can make and introduce discoveries into clinical practice and public health. Proportionately, these people are likely to be ever fewer representatives of our profession: for those launching themselves onto this path with research formalised into PhD programmes, I commend this intriguing and helpful collection. Direct, informative, practical: it is, above all, encouraging!

Timothy M Cox, FMedSci
Emeritus Professor of Medicine and Director of Research
Founding Director, MB‐PhD programme
University of Cambridge, UK

Preface

Deciding and embarking upon a 3–4‐year period of exploration is easy to be excited about. But with exploration comes uncertainty: will I get enough data? What will my lab group be like? Will I make a scientific break‐through and/or find a cure? Could I inundate PubMed?

As a PhD student in a world class research institute, I both witnessed and experienced the great spectrum of outcomes that greet those undertaking a PhD. From the student with enough data to write their thesis in the first year, to the student starting their final year without any convincing results.

This book is written for current and prospective PhD students in the medical and clinical sciences. It seeks, through concise chapters, to help provide a framework and guidance for students of all training backgrounds (scientific or clinical) to complete their PhD and move on. It cannot be understated how far‐fetched the phrase ‘complete and move on’ can seem to most PhD students at one time or another. But, out of darkness cometh light. We hope this book will help illuminate that path.

Dr Ashton Barnett‐Vanes

Committing several years of your life to a single piece of work is a major decision. Nobody will ever undertake the same PhD project in the same way as you, so it will be a step into the unknown. This book is intended to help you steer yourself to one known outcome – the award of a Doctoral degree.

As a PhD student, then supervisor, then Head of Graduate School I’ve seen that, despite the unique nature of each PhD, there are many common experiences for PhD students. This book combines the advice of PhD students and academics on how to navigate the various stages of the degree; how to prepare, what to expect and what to do when some‐ (or every‐) thing seems to be going wrong. We hope that this will prepare you for every stage of your PhD, saving the surprises for your research.

Dr Rachel Allen

Acknowledgements

I thank my co‐editor Rachel Allen for her unwavering support for this book and its aims; Dr George Hall and Dr Suman Rice for helpful discussions and advice during the genesis of this project; James Watson, our commissioning editor at Wiley, for his support from the beginning of this book and Loan Nguyen, Yogalakshmi Mohanakrishnan, Lynette Woodward, Rajitha Selvarajan and Thaatcher Missier Glen at Wiley for their advice and assistance throughout the production and editing process. My thanks to students and colleagues who wittingly or otherwise gave me inspiration for this project. Finally, I owe a debt of gratitude to friends and family whose patience and generosity enabled me to take this book to completion.

Dr Ashton Barnett‐Vanes

I’d like to thank all the authors who contributed to this book, for their enthusiasm and insights into the PhD experience – it’s been a great opportunity for us to learn from each other. In particular, I’d like to express thanks to my co‐editor Ashton, who conceived the original idea for this book and acted as motivator‐in‐chief to keep the project on course.

Dr Rachel Allen

Chapter 1
Introduction

Ashton Barnett‐Vanes1 and Rachel Allen2

1 MB‐PhD Candidate, St George’s, University of London and Imperial College London, UK

2 Reader in Immunology of Infection and Head of Graduate School, St George’s, University of London, UK

A PhD

Well done on picking up (and ideally purchasing!) this book. If you’re considering or about to embark on a PhD in the clinical and medical sciences, or related life/natural science disciplines, this might be one of the last scientific books you purchase. That’s not because it’s so good as to end all others, or that it’s so outrageously bad you go off books altogether; but because PhDs are about new knowledge, books are about old knowledge – with new diagrams. That said, why is this book worth reading? Well, before we get to that, it’s worth first laying out the PhD landscape that awaits you.

A large amount of UK research is publicly funded. You know the drill – law abiding citizens work and pay taxes, which are then distributed around our economy. Now, as well as subsidising first class seats on empty trains, some of this money goes into big productive industries, including science. Medical research charities are another major source of science funding, along with the pharmaceutical industry and related enterprises. In the UK, about 1.5% of GDP is invested in research and development(1); the two largest of these funders of scientific/medical research – the Medical Research Council and the Wellcome Trust – collectively spend just over £1 billion per year. That’s a lot of money, enough to buy 167 000 hip replacements, 22 000 teachers or four (Challenger) battle tanks(2). This money filters down a scientific waterfall and finds its way into universities, research institutes, laboratory groups, and occasionally PhD student bar tabs – sorry, projects. At any one time, there are around 30 000 PhD students in: medicine and dentistry, subjects allied to medicine, biological sciences and veterinary science(3); which to give you a sense of scale is about the same population as Gibraltar…

To wrap this up, it’s worth knowing that each PhD student is quite an investment. A three‐year stipend will reach around £45 000; a consumables budget could easily reach £30 000, not to mention those tuition fees. In short, each PhD student costs around £100 000, that’s £2.7 Billion of coinage going into one cohort of PhD students, lots of which comes from the public and charitable sectors; moreover, this cost can be significantly higher when considering clinical trainees undertaking a PhD. There’s also the time invested in the enterprise by your supervisors, and their equivalent salary costs. While 3 or 4 years sounds like a long time (and it kind of is!), this is comparatively short compared to other countries. For example, PhDs in the United States can sometimes double that duration. So, if we’re going to keep ‘our’ PhDs comparatively shorter, safeguard their international prestige, ensure they’re value for money – and actually have a good chance of discovering something; it’s vital that projects are conducted efficiently and effectively from the get go. That’s where this book comes in.

Perspective

Research is exciting. The focus and expertise you can acquire on a specific area is quite incredible, at times even alarming. On this relatively solitary journey, it’s easy to feel you’re in the know, and everyone else isn’t, but keep perspective. Check the illustrations below for what we’re getting at, courtesy of Matt Might(4).

Imagine this circle represents the boundaries of human knowledge, everything we know is contained within it.

Illustration of a circle.

Figure 1.1

Courtesy of Dr Matt Might

The circles represent different levels of human knowledge, the inner circle is what we learn in primary school, they expand into secondary school and begin to reach out as Bachelors, Masters and eventually PhDs – the latter furrowing at the edges of human understanding.

Illustration of a circle consisting of 3 concentric circles with point touching the outer circle; and a dashed box enclosing the portion where the point touches the outer circle.

Figure 1.2

Here’s what your PhD looks like to you, as you push against the wall of current knowledge.

Illustration of a semi-ellipse touching a quarter circle.

Figure 1.3

Eventually you’ll make your mark, and push that boundary forwards – expanding human knowledge.

Illustration of a semi-ellipse with protrusion on the tip touching a quarter circle.

Figure 1.4

Here’s how it looks to you up close as the researcher.

Illustration of a quarter portion of 2 concentric circles.

Figure 1.5

But remember, this is how it looks to everyone else.

Illustration of a circle with protrusion depicted by arrow as Ph.D.

Figure 1.6

Why a book? How to use it

There are ample books to help students get through their undergraduate studies; get a ‘First’ or write a good Master’s thesis and so on. But oddly, when it comes to the highest degree on offer in the UK, books offering guidance on PhDs are all too often generic, with some even as long as a doctoral thesis! Of course, you should receive a student handbook from your university, but these are seldom an inspiring read or source of friendly advice. This book addresses these shortcomings three‐fold. First, it’s aimed at a much narrower audience, focusing on medical and clinical science PhDs, and related biomedical and life‐science disciplines. Second, it is direct and concise; PhD students can often be overwhelmed by the amount of literature reading they need to do, a guide book should be there to support not supplant. Third, this book combines the perspectives of current or recent PhD graduates with those of senior researchers, from both scientific and clinical backgrounds. We hope that this will give you an insight into academic’s expectations, while avoiding the potential for a ‘how it was in my day’ bias.

So, without further ado, welcome, happy reading and good luck!

References

  1. http://ec.europa.eu/eurostat/statistics‐explained/index.php/Europe_2020_indicators_‐_research_and_development
  2. www.bbc.co.uk/news/magazine‐32309311
  3. https://www.hesa.ac.uk/stats
  4. The Illustrated Guide to a PhDhttp://matt.might.net/articles/phd‐school‐in‐pictures/