Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why should I be an academic pathologist ? Phil Quirke Royal College of Pathologists YCR Centenary Professor of Pathology University of Leeds

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Contents Why do research Careers –Academic clinical fellows –Clinical lecturers Future

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why do research? You can make a difference –Prevent a disease –Cure it –Reduce its effects

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why Service career –Reports 2,000 surgicals a year –35 year career –70,000 patients –50 colorectal cancers a year :1,750 –GI biopsies: 17,500 each Variable private practice Increasing management interference Decreasing independence Increasing commercialisation –USA, Australia, SERCO…….

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Academic impact - Research Research Helicobacter pylori observation 50% of the worlds population? –Duodenal ulcer – 4 x10 6 Gastric ulcer Gastric cancer Gastric lymphoma Warren 2005

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Leeds - Research Bowel cancer 1.2M worldwide –Observations on surgery Total mesorectal Excision Abdominoperineal excision Colon cancer –Screening –Implementation –Change –Flexisigmoidoscopy

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Leeds research Can we prevent bowel cancer ? Abnormal microbiome Faecal transplants?

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Academic impact - Teaching Teaching –Undergraduates Influence 230 students per year 8,050 doctors over 35 years Create the next generation of pathologists –Postgraduates FRCPath –10 years training committee 300 PhD’s/ MD’s –40

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why? Patient benefit Excitement Challenges Independence Consultant for 35 years Technology changes Cutting edge Self interest - jobs Self confidence Self satisfaction

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why? Variety Influence policy Change practice Travel Opportunities Reward –Building your own team –Seeing the success of others –Following their achievements –Pay progression/patent/startups/consultancies

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Lecturing/training/influencing

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Why do research? The thrill of discovery You work in a worldwide community Similar aims Competition/friendship

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Academic careers Never a better time Major shortage Ageing population Council Heads of Medical schools –Worst Pathology/Anaesthetics 5x the chance of holding a Platinum award International market Freedom to explore your ideas

NIHR Trainees Coordinating Centre Integrated Clinical Academic Training Pathway

NIHR Trainees Coordinating Centre NIHR Academic Clinical Fellowships Academic and clinical training For entrants to Specialist Training 25% is academic component Support in making application for training fellowship or educational programme leading to higher degree Up to 3 years (4 for GPs) All ACFs except medical education are run-through 250 posts each year £4,500 over 3 years to fund research training and conferences

NIHR Trainees Coordinating Centre OpensCloses ACFsRound 1Early NovemberEnd January ACFsRound 2Early FebruaryEnd March (following year) ACF Recruitment Timetable

NIHR Trainees Coordinating Centre NIHR Clinical Lectureships Academic and clinical training for those with a higher degree Available to qualified GPs and GDPs with higher degree 50% is academic component Support in making application for Clinician Scientist Scheme or similar Up to 4 years End point marked by CCT and substantial piece of post-doctoral research or educational work 100 posts each year £1000 for travel per year

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Pathways Service Consultant ST1 ST2 ST3 ST4 ST5 Consultant Academic and service ST1-3 / Academic Clinical Fellow Out of programme experience PhD/MD Lecturer Senior Lecturer Reader Professor

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Out of programme experience 3 years funded by fellowship –NIHR –MRC –CRUK/ARC/BHF –College –PhD/Publications –Presentations

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Senior positions Senior Lecturer 5 years Reader 2-3 years Professor – established Chair/personal Chair – career position

Leeds Institute of Molecular Medicine Pathology and Tumour Biology What happens All –Understand the literature –Undertake a research project –Present their work at national meetings Some –Publish papers –MD/PhD –Awarded grants –International meetings –Specialist reputation Few –Professional academic –Own research programme –International reputation Fewer –Head academic grouping within University

Leeds Institute of Molecular Medicine Pathology and Tumour Biology What is the connection between Black and Decker and Pathologists Information What do we do?

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Threats

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Opportunities Digital world 3D and digital pathology Integration of genotype and phenotype Stratified/personalised medicine

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Opportunities – Digital pathology Integration of the microscope and computer Efficiency Breaks the limitations of the microscope Anytime/anywhere International opinions Learning/teaching/quality

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Stratified/personalised medicine Prognosis – aggressive/benign outcomes –Her-2 amplification –Mismatch repair Prediction – which drugs –Her-2 breast and gastric cancers –Ki ras EGFr antibodies –Focus 4 Toxicity –DPD deficiency –UGT1A1

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Future medicine Whole genome Now £ years £500 Association of genotype with phenotype Deep sequencing for rare events Copy number variation

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Next generation sequencing TPD52 Copy number variation In house 1-50 Fluidigm 144 Haloplex 4,000 Mutation detection

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Maldi-Tof imaging Protein visualisation without antibodies 30um resolution EGFR Amphiregulin Epiregulin

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Leeds

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Programme LURE iBSc aFY2 ACF Clinical lecturers ACF position to be advertised November start August 2013 Lecturer position

Leeds Institute of Molecular Medicine Pathology and Tumour Biology Questions?