Academic Clinical Lecturer - Respiratory Medicine

Job role

The post provides the opportunity for higher and advanced sub-specialist specialist training in respiratory medicine alongside research and contribution to teaching in a variety of respiratory subspecialties. This post will be based at Heartlands hospital initially but will rotate to the other University Hospitals Birmingham Foundation Trust sites (generally Queen Elizabeth hospital) according to training needs. Training in clinical trial, systematic review methodology and other aspects of applied health research are available at the Institute of Applied Health Research and opportunities to participate in grant applications and delivery of clinical trials may be possible through the Birmingham Clinical Trials Unit. This rotation therefore provides a unique opportunity for both training and research into all aspects of subspecialty respiratory medicine.

Currently there are 3 respiratory lecturers on the SpR rotation whose research is in a laboratory/translational area. This fourth post allows effective job sharing by having two lecturers job share at each of the Heartlands and Queen Elizabeth sites. The ideal candidate's research should be in applied health or epidemiology.

Academic opportunities in IAHR

Birmingham has a long history of innovation and excellence in respiratory medicine at both the clinical and research level. This has been recognised by the University and as such Respiratory research is an expanding area within the University of Birmingham's research portfolio. The respiratory group within IAHR consists of:

• Professor Peymane Adab, Chair in chronic disease epidemiology and public health
• Professor Kate Jolly, Chair in public health and primary care
• Professor Sheila Greenfield, Chair in medical sociology
• Professor Alice Turner, Chair in respiratory medicine
• Dr Rachel Jordan, Reader in epidemiology and primary care
• Dr Amanda Farley, Lecturer in public health and epidemiology
• Dr Andy Dickens, Postdoctoral research fellow
• Dr Kiran Rai, Postdoctoral research fellow
• Dr Rachel Adams Postdoctoral research fellow

Our Institute offers a clinical lecturer a great opportunity to develop significant applied health research expertise.

The respiratory epidemiology research group in IAHR are involved in a range of research activities both in the UK and internationally. The multidisciplinary team includes researchers with expertise in epidemiology, public health and primary care working with social science and methodological experts focusing on respiratory disease. Specifically, the team have interest in research on screening for undiagnosed COPD, management of early COPD, self-management of chronic disease (mainly COPD), implementation and adaptation of pulmonary rehabilitation programmes in a variety of settings, smoking cessation and prevention, and the effect of chronic lung disease on employment and occupational performance. The team, led by Professor Peymane Adab, have set up two large ongoing cohort studies. These include the Guangzhou Biobank Cohort Study, a population based cohort of 30,000 adults in South China, and the Birmingham COPD cohort; a primary care cohort of around 2000 patients with COPD, recruited from UK primary care. These datasets provide an opportunity for analyses to support a better understanding of risk factors and natural history of COPD.

The Birmingham COPD cohort study is part of the Birmingham Lung Improvement Studies (NIHR Programme grant, 2010-18), including a trial of case-finding for early disease (led by Dr Jordan), with economic modelling to examine the cost-effectiveness of different approaches to future implementation. Ongoing follow up of patients who were identified by case-finding will provide data on patient benefit and outcomes. The team have also undertaken systematic reviews to examine the effectiveness of different case-finding strategies for COPD on disease yield and explored the views of patients and health practitioners on COPD screening.

The team, directed by Dr Rachel Jordan & Professor Adab are also part of an NIHR funded Global Health Research Group focused on early diagnosis and management of COPD, working with researchers in China, Brazil, Macedonia and Georgia.

Dr Jordan, is research chair of the International Primary Care Respiratory Group, offering opportunities for wider research collaboration with respiratory practitioners working in primary care across over 30 countries.

Professor Turner's group have ongoing studies in both COPD and alpha 1 antitrypsin deficiency, examining the efficacy of different models of care (INTEGR-COPD trial), methods of measuring disease progression, the impact of different sub-phenotypes of COPD and the use of NIV. She is also managing 2 large interventional trials in COPD; Colour COPD and Predict and Prevent COPD, both of which aim to enhance patient self-management and recognition of exacerbations. Her group comprises clinical and non-clinical postgraduate students, as well as postgraduate researchers, a trial co-ordinator and data manager.

Professor Kate Jolly's team has also been involved in trials of pulmonary rehabilitation in various populations, and in conjunction with Dr Jordan, in undertaking systematic reviews of self-management interventions for people with COPD.

In addition, the team in IAHR have an interest and expertise in undertaking epidemiological research using secondary data from publicly available datasets, such as the Health Survey for England and the THIN database from GP practices. Several projects using these datasets have already been undertaken and there are additional project ideas that can be pursued.

The Clinical Trials Unit(s) is one of the largest in the UK, housing over 300 researchers and providing access to essential skills (statistics, trial design, randomisation, and outcomes) for trial activity. Mixed methods evaluations of healthcare interventions are also well supported, with many researchers having qualitative research expertise.

Laboratory/translational aspects of respiratory medicine are studied elsewhere in the College (Institute of Inflammation and Aging); staff here include Professor David Thickett (Chair in Respiratory Medicine), Professor Liz Sapey, (Professor of Acute and Respiratory Medicine) and Mr Babu Naidu (Clinician Scientist in Thoracic Surgery).

Main Duties

ACADEMIC

1. Individual and Group Research Projects

• To perform clinical research studies complementing the academic interests of IAHR
• Attendance at research group meetings and the seminar programme at the IAHR is anticipated.

2. Analysis of data from research and subsequent presentation and publication

• To apply statistical methods to analyse scientific study data.
• To prepare study findings in a format appropriate for speech or poster presentation.
• To write research papers based on the findings of the studies performed in a format appropriate for publication in scientific and medical journals.

3.Participate in writing grant and research ethics application

• To prepare applications to the Research Ethics Committee for the approval of proposed studies.
• To prepare grant applications for the funding of proposed future studies, to bodies such as the NIHR, Wellcome Trust and the Medical Research Council.

4. Contribute to undergraduate and post graduate teaching programmes for a variety of courses including the MB ChB, BMedSc and BDS courses. The post holder will be expected to play a role in teaching delivery, but not teaching management 15

CLINICAL

50% w.t.e. as clinical registrar in Respiratory Medicine at a clinical unit.

It is anticipated that the Clinical Lecturer will rotate, probably annually with other Clinical Lecturers in Respiratory Medicine, to provide maximal clinical experience.

Respiratory Medicine at Heartlands hospital

Lecturers here are supervised by Professor Turner. The Respiratory Department now comprises a purpose built unit based on wards 24, 25 and 26, which include 63 beds in total, as well as 4 beds fully equipped, for overnight sleep studies. There is an eleven bedded area equipped for patients requiring assisted ventilation (NIV) and an extensive outpatient NIV service, including a regional neuromuscular disease service, supported by physiotherapists. Within the Department of Infectious diseases there is also access to isolation and cubicle facilities for patients with tuberculosis (or Covid). The respiratory area also houses the Severe and Brittle Asthma Unit (SBAU) and West Midlands Adult Cystic Fibrosis Centre. SBAU serves a population of over 500 asthmatics from across the country and is supported by 5 asthma nurses, a speech therapist, a research fellow and 2 consultant physicians. The CF Centre looks after a pool of approximately 400 adult patients from around the West Midlands region (also some from other regions). It has 20 single rooms for in-patients, 9 outpatient rooms and a clinical room to enable patients to come up to the ward for ad hoc review, or procedures (e.g. long lines fitted). The CF multidisciplinary team currently includes 5 physiotherapists, 5 specialist nurses (2 part time), 4 dieticians, administrator, a part time clinical psychologist and a social worker. Medical staff includes 3 consultant physicians, a specialist registrar and a clinical fellow.

Academic opportunities in Respiratory Medicine at Heartlands

There are a number of senior academically active staff at Heartlands including Professor Fang Gao (University of Birmingham, intensive care), Professor Gavin Perkins (University of Warwick; intensive care), Professor Alice Turner (University of Birmingham; COPD), Mr Babu Naidu (University of Birmingham; thoracic surgery), Dr Adel Mansur (severe asthma, honorary chair at University of Birmingham), Dr Gareth Walters (occupational and interstitial lung disease(ILD)), Dr Rahul Mukherjee (honorary lecturer at University of Birmingham; non-invasive ventilation (NIV)) and. Finally, there are active research collaborations with the department of infectious diseases, especially in tuberculosis (Dr Martin Dedicoat) and viral respiratory infections including Covid (Dr Chris Green).

The Research & Development department is actively promoting research activity; a purpose built research department (MIDRU) provides clinical trials facilities and a dedicated respiratory research unit equipped with airway inflammation assessment tools. The Heartlands site also has some research lab infrastructure which is soon to be upgraded to include full cell culture facilities. Heartlands has active research projects in the areas of CF, difficult asthma, sleep medicine, thoracic surgery, acute lung injury, occupational lung disease, interstitial lung disease and COPD. All lecturers will participate in supporting ongoing trials at the site when placed there.

The post holder will also be expected to participate in the postgraduate and undergraduate teaching programmes and will have some responsibility for the education of junior medical staff.

Clinical training Opportunities at Heartlands Hospital

The respiratory department at Heartlands Hospital offers extensive sub-specialty clinical experience available to trainees in thoracic surgery, CF (dedicated 3 month attachment), bronchiectasis, difficult asthma, sleep medicine and NIV (dedicated 3 month attachment), lung cancer, intensive care (dedicated 3 month placement), infectious disease, immunodeficiency as well as in occupational medicine. Trainees are encouraged to undertake at least 2 specialist modules (protected time 0.5 days/week for 10 weeks each) in addition to their usual training, and to participate regularly in national and departmental audits.

Respiratory Medicine at Queen Elizabeth hospital (QEHB)

Lecturers at this site are supervised by Prof Thickett, and rotate between the two Lecturer slots ~every 3 months. Consultant staff, who all have specialist interests include Prof Elizabeth Sapey (acute respiratory diseases), Dr I Woolhouse (lung cancer), Dr R Thompson (Lung Transplantation), Dr S Gompertz (COPD), Dr Shyam Madathil (sleep), Dr Anita Sullivan (community COPD/ bronchiectasis), Lt Colonel Duncan Wilson (asthma), Lt Col Andrew Johnston (respiratory / ITU), Dr Mike Berry (acute medicine). Dr Ben Sutton (interventional bronchoscopy) and Dr Syed Huq (home ventilation).

QEHB is both a busy district general and tertiary care hospital. The 4 Respiratory teams are 'on take' for unselected emergencies on either a day shift or a night shift and this translates to about 1 in 12 for whole time staff and 1 in 24 for academic staff. We have the second largest lung function unit in the UK lead by Dr Brendan Cooper (Consultant Clinical Scientist). The physiology facility provides a full range of lung function including antigen challenge, impedance oscillometry and full cardio pulmonary exercise testing. National training programmes and practical courses are regularly delivered with input from all medical and physiological staff.

Academic opportunities in respiratory medicine at QEHB

The research programme is based predominantly in the Centre for Translational Inflammation Research. In addition, there is a Wellcome funded Clinical Research Facility, and the Institute of Translational medicine hosts research offices and the Trust R&D department. There is opportunity, therefore, to undertake research from very basic to clinical level, and many opportunities to collaborate with all major specialities including the Departments of Hepatology, Gastroenterology, Renal Medicine and Rheumatology. A contribution to clinical trial activity is also expected when placed at this site.

Clinical training opportunities at QEHB

Sub-speciality training in lung transplantation, interventional bronchoscopy, alpha 1 antitrypsin deficiency, acute lung injury, lung cancer, COPD and bronchiectasis are possible at QEHB. Intensive care placements also occur in similar fashion to Heartlands hospital.

Person Specification

Essential

• Full General Medical Council registration
• Membership of Royal College of Physicians, or equivalent
• SPR in respiratory medicine
• Postgraduate (MBBS) research experience in clinical respiratory medicine
• Knowledge of research methodology, statistics and trial design
• Peer reviewed research publications as first author.
• Experience in teaching undergraduate students
• Minimum of 1 years' experience in respiratory medicine either clinically or in a clinically focussed research environment

Desirable

• Higher degree (MD/PhD)
• Knowledge of the appropriate use of radiation in clinical research
• Experience of laboratory science e.g. flow cytometrym, cell culture, PCR
• Publications in high impact journals
• Formal teaching qualification