The road less travelled: clinical academic training in SRH by Dr Neha Pathak

Posted 18 Mar 2019

Date: 18 Mar 2019

Author: Dr Neha Pathak

“Two roads diverged in a wood, and I— I took the one less travelled by, and that has made all the difference.” – Robert Frost. Dr Neha Pathak is a CSRH trainee currently out of programme on a Wellcome Trust Doctoral Training Fellowship investigating the sexual and reproductive health of migrants. She takes us through the highs and lows of training as a clinical academic, and why the road less travelled is the road for her (and maybe you!).

Only 5% of consultants are clinical academics and only 28% of clinical academics are women. In CSRH which is already a small specialty, the road can feel even less travelled (here’s a helpful roadmap to navigate it) and yet for some reason I keep plodding merrily along it! I love it! Here’s my top reasons why:

1. There is no such thing as an average day

One day I might be in gynae or sexual health clinic, another I might be writing papers or debugging statistical code to analyse big data, and another I might be brainstorming with refugees and migrants to ensure my research takes a direction that is actually useful to them. This diversity means I am constantly engaging different parts of my brain, learning new skills and am never bored. I feel that I give more of myself to my patients and constantly feel happy and excited to be in clinic because it almost feels like a treat! The variety also means that I have acquired a breadth of knowledge, expertise and confidence to be able to share what I learn with the public - speaking on an episode dedicated to sexual health on The Food Medic podcast (a nutrition health influencer) was definitely a highlight.

2. It’s constantly inspiring

I have been blown away by the people I meet as a clinical academic. For example, a few years ago I did some research on domestic violence and abuse in sexual health settings. As a result, I went as an intern to the WHO internship and eventually delivered the WHO global train the trainers on violence against women and girls (VAWG). Every day my passion was reignited: I listened wide-eyed to stories of the struggles behind the first research showing VAWG is a public health issue; I was moved to tears watching representatives from every country commit to the global plan of action on violence; I have seen people from the poorest of settings work tirelessly to address VAWG and still keep smiling.

3. SRH desperately needs us

“Research is vital in providing the new knowledge needed to improve health outcomes and reduce inequalities. Research is even more important when resources are under pressure – it identifies new ways of preventing, diagnosing and treating disease.” (White Paper on NHS in England. Equity and Excellence: Liberating the NHS).

SRH is often the first to suffer from health inequalities and stripped resources. As a clinical academic, you are uniquely placed to take real-life problems from the clinic to research and back into service development. I investigated HPV self-sampling after diagnosing a few too many late stage cervical cancers and worked on domestic violence and abuse enquiry after feeling frustrated at the healthcare response. More recent clinical work with migrants has meant I am now completing a PhD on migrant SRH and hopefully the questions are useful because they will be informed by my clinical experience. Our specialty needs our frustrations to drive it forward and develop evidence that enables best possible care for all.

So, what are the cons?

First of all, it seems obvious but it’s hard work. You are essentially embarking on two careers which requires time, effort and planning. Second of all, for every ten projects you start, only two might work out. Resilience and passion for your area of research are key as you need to enjoy the journey, which may well be peppered with failures, not just the achievements at the end. Thirdly, research is slow. It can take years before an idea is transformed into evidence that eventually impacts clinical practice. As a clinician entering the work of academia, you can bring action-focused energy that can help accelerate this, but the importance of slowing down to work with and involve others as well as pacing yourself to avoid burnout is not to be underestimated. The best advice I have been given is this African proverb: “If you want to go fast, go alone. If you want to go far, go together.”

Despite these challenges, I feel incredibly lucky to have a job that inspires me and teaches me to think and act differently. I feel pumped every morning to tackle the day, indulge many of my passions and use parts of my brain that I didn’t know existed. I am the eternal student and I love it, but, more importantly, I know that training academically is giving me a broader perspective to hopefully be a more patient and thoughtful clinician.

Everyone’s path is different but I thoroughly recommend veering off to find the right one for you. If anyone wants to learn more about forging your own path as a clinical academic, have a read of this and also feel free to drop me a line anytime ☺ I’m also using my PhD time to develop a programme of public engagement on sex and relationships education - you can follow my instagram @thesexualhealthdoc for progress updates on this.