Academic Anaesthesia

Academic training in Anaesthesia.

Anaesthesia offers a wide range of research opportunities, investigating the diverse fields of pain medicine, critical care and anaesthesia and perioperative medicine.  Some example research studies are shown below to give an indication of the diversity of projects currently being undertaken.

 

Some anaesthesia specific advice for trainees can be found from the National Institute of Academic Anaesthesia (NIAA).  More generic advice on integrated clinical training can be found on the National Institute for Health Research website (NIHR training programmes)

 

Introduction to research

The UDA runs an annual course on scientific methods and research, (Scientific Methods and Research Techniques –SMART) which provides a three day introduction to research methods in Anaesthesia 

 

Formal research training pathways

Entry to an academic program can occur at a number of stages during specialty training in anaesthesia.

 

  1. Academic clinical fellowship.These posts are advertised on a national basis annually, for entry at ST3 following completion of core training and are open to any eligible applicant in the UK.These allow 25% research time and are generally aimed at trainees wishing to gain research experience and pilot data prior to applying for a research training fellowship (i.e. PhD funding).These posts run for up to three years, or until research training fellowship is achieved.Details can be found

    here

     

    Presently the East of England has 1 ACF in Intensive Care and 2 in Anaesthesia, all hosted by the University of Cambridge Division of Anaesthesia (UDA)

     

  2. ‘University Division of Anaesthesia’ (UDA) year. For post-fellowship trainees already holding an NTN in the East of England, an opportunity exists to spend one year of higher training based in the UDA, where clinical duties are limited to a maximum of one day a week and on-calls.  The majority of the time is spent obtaining research training and undertaking a research project.  This year can either act as a stand alone year, providing an in-depth insight into research methods and academic skills, and/or providing time for collection of pilot data to support a a Research Training Fellowship application.  More details of this scheme and how to apply can be found here (UDA attachment)

     

  3. Research Training Fellowship.These are funded by a variety of bodies, including charities, the National Institute of Academic Anaesthesia (NIAA) and research councils (e.g. Medical Research Council).To apply for these you will need to identify a supervisor, project and sponsoring academic institution (usually the University of Cambridge or one of its affiliated institutes), and your proposed supervisor will help draft an application.

     

    The Wellcome Trust funds 7 PhD studentships for clinicians of all specialties, 5 based at the University of Cambridge and 2 at the Sanger Institute (WT/Cambridge PhD scheme)

     

    Research Training Fellowships require some pilot data, and although time in an ACF or UDA post are not essential acquire such data, these periods of dedicated research time greatly assist in obtaining such pilot data as well as gaining key research skills.

     

    Applications from suitably qualified candidates from any training scheme in the UK, to undertake anaesthetic related PhDs at Cambridge are welcomed.

     

    4) Academic Clinical Lectureship (ACL).  These are post-doctoral posts taken up for the later years of clinical training (appointed to in years ST5 and above) which allow 50% research time to develop academic skills and obtain post-doctoral funding, alongside completion of higher and advanced specialist training.  These are advertised by the Universities, and can be held for up to 4 years. NIHR Clinical Lectureships.

    The expectation is that trainees who obtain one of these posts will use them as a foundation to apply for an Intermediate Fellowship or Clinician Scientist grant from the MRC, Wellcome Trust, NIHR or other funding bodies.  The UDA currently hosts two ACLs in Anaesthesia and one in Intensive Care Medicine.

     

    Current research in the UDA.

    The full portfolio of research in the UDA is available on the Division website (http://anaesthetics.medschl.cam.ac.uk/).  The following sections provide examples of research projects currently undertaken by trainees at different levels, ranging from ACF training, grant funded research for short projects or longer periods, and an ACL trainee.

     

    Tom Bashford is an Academic Clinical Fellow Anaesthesia, based in the UDA whose interests are in the organisation and delivery of care in resource poor settings.  He us currently developing a PhD project with the Healthcare Design Group (https://www-edc.eng.cam.ac.uk/research/healthcaredesign) to look at the rational design of anaesthetic care in low-income settings.The project involves working with existing health research teams to investigate how a design research methodology can be used to inform parallel improvements in anaesthetic provision, simultaneously across all aspects of a developing health system.

     

    Sarah Chetcuti is a NIAA Research Fellow in Anaesthesia who is working on imaging excitotoxic neuronal cell death after traumatic brain injury. Glutamate mediated activation of the N-methyl-D-aspartate (NMDA) receptor is associated with excitotoxic neuronal death. However, clinical trials of NMDA receptor antagonists have not shown any benefit, probably due to our poor understanding of the temporal and spatial profile of such metabolic derangements following TBI. This project is a pilot study using positron emission tomography and a novel tracer (18F-GE-179) which selectively binds to the active state of the NMDA receptor, with the aim of understanding the temporal profile of NMDA receptor activation and compare this with clinical microdialysis monitoring of glutamate levels.

     

    Lara Prisco – Clinical Fellow in Anaesthesia, Funded by ESICM Levi-Montalcini Award for Biomedical Sciences 2015: Early electroencephalographic abnormalities and dysautoregulation in traumatic brain injury: associations and causative links.

    This study will investigate the temporal relationship between cerebrovascular autoregulation abnormalities and electroencephalography activity in traumatic brain injured patients admitted to ICU with epileptiform discharges, non-convulsive seizures and status epilepticus as well as the effects of potential treatments restoring brain cerebrovascular reactivity, brain oxygenation and depression of ictal activity.  We aim to investigate these hypotheses through correlation of the electroencephalography pathological features described with time-locked time-series of brain tissue oxygenation, near infrared spectroscopy, intracranial pressure, cerebral perfusion pressure and cerebrovascular auto-regulation metrics as well as intermittent microdialysis samples.

     

     

    Andrew Conway Morris is an Academic Clinical Lecturer in Anaesthesia and StR Anaesthesia and Intensive Care.  He undertook his doctoral and early post-doctoral training in Edinburgh, before relocating to Cambridge.  His interests are in the immuno-biology of critical illness, specifically focusing on impairments in immune cell function and the role this plays in nosocomial infections.  He is supported by grants from the European Society of Intensive Care Medicine and the Academy of Medical Sciences, and collaborates with investigators in Edinburgh, Newcastle and London on a range of related projects.

     

     

    Further advice

    For advice on undertaking academic training in anaesthesia, pain and critical care please contact Prof Menon or any of the senior researchers in the UDA (contact details on http://anaesthetics.medschl.cam.ac.uk/)

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