December 13, 2017 | Gaurav S. Gulsin, BSc, MBChB, MRCP
International

An abundance of research opportunities are available to cardiology FITs seeking to engage in postgraduate research in the U.K. Once enrolled into a cardiology specialty training program, FITs in the U.K. are expected to gain a postgraduate research-based PhD or MD prior to completion of residency. Completion of a postgraduate degree enhances FITs' skills across several domains and are usually desired prior to applying for sub-specialty fellowships.

Skills enhanced by undertaking a postgraduate research-based degree include:

• Critical thinking and appraisal
• Research methodology and design
• Presenting and writing skills
• Applying for research funding
• Translation of research into clinical practice
• Development of new science and technology
• Delivery of excellence in clinical education
• Supports a well-trained and professional clinician
• Medical leadership

Entry points into academic cardiology in the U.K.

For U.K.-based FITs, there are several routes to attaining a postgraduate degree. Quite often, FITs will find research opportunities in their own institution, by word-of-mouth or through local advertisements. Alternatively, FITs may choose to undertake their research in another institution in the U.K., where available projects align with their interests. These may be advertised in publications such as the British Medical Journal or online via the British Cardiovascular Society and British Junior Cardiologists' Association websites. Applications are competitive and highly sought after. A wealth of opportunities in academic cardiology are also available to international FITs wishing to undertake research in the U.K. Not only does this provide outstanding research exposure in an entirely new health service, but also gives FITs the chance to experience our tourist attractions and the wonderful culture. International FITs make valuable contributions to research and are regarded as desirable additions to the workforce in the U.K. cardiology community.

For U.K. FITs who are committed to a career in academic cardiology, a paired clinical and academic training program is also offered. This program permits FITs dedicated time for undertaking research in parallel to their clinical training. Typically, these posts will encourage time for a doctoral degree and lead to postdoctoral research opportunities and lectureships. Again, the posts are extremely competitive and usually require some level of prior research experience (i.e., undergraduate science degree, previous research placements, etc.)

My own experience as an academic cardiologist in the U.K.

Postgraduate clinical training in the U.K. has a different structure than the U.S. and other countries. This difference is well described in a recent ACC FIT article, Cardiology Training 'Across the Pond', by Amardeep Dastidar, MBBS. Having always been an aspiring academic cardiologist, my training has followed the paired clinical and academic training pathway described in the article. I undertook a National Institute for Health Research Academic Clinical Fellowship (NIHR ACF) in cardiology at the University of Leicester, and then secured a British Heart Foundation (BHF) Clinical Research Training Fellowship, which is my route to obtaining a research-based PhD. Clinical academic training in the U.K. is both challenging and rewarding. I am required to obtain all the clinical competencies necessary for completion of cardiology training. Additional time, free from clinical work, is allotted for me to meet my academic commitments. I work in the Department of Cardiovascular Imaging at the University of Leicester, which is led by Professor Gerry McCann, professor of cardiovascular imaging.

My NIHR ACF was a three-year program of integrated clinical and academic training. Two years were reserved for clinical training in general internal medicine, identical to that required of all FITs in the U.K. The additional year was reserved purely for research and research training. I developed an interest in pathophysiology, diagnosis and management of diabetic heart disease. In particular, I am interested in using multiparametric cardiac magnetic resonance imaging to identify the prevalence and determinants of subclinical cardiac dysfunction in adults with type 2 diabetes. To this aim, I undertook two retrospective studies in diabetes and heart failure, respectively. These studies laid the foundation for me to prepare a successful BHF Clinical Research Training Fellowship funding application. I also completed an MRes in Medical Research Skills, which was a requirement of the NIHR ACF. In one year, I learned numerous clinical and applied cardiac MRI research techniques, developed a better understanding of basic research principles and gained first-hand experience in preparing a research funding application. These skills will undoubtedly serve me well in my future as an academic cardiologist.

I am now in the first six months of my BHF fellowship, which primarily involves undertaking a prospective study aiming to identify the prevalence and determinants of subclinical cardiac dysfunction in adults with type 2 diabetes, using cardiac magnetic resonance imaging. My responsibilities have ranged from preparing research protocols, ethics applications and all the other documents needed to begin a research study, to the day-to-day running of a trial, all whilst undertaking the required research training delivered by my institution to prepare me to be an independent researcher in the future. I have already enjoyed great success in my research, delivering several presentations of my work at national and international conferences, as well as publishing a number of research articles, which I hope will provide a valued contribution to our field. Following my PhD, I hope to secure a Senior Lecturer and clinical cardiologist post, eventually to lead my own research group. Ultimately, I aim to produce research that offers patients with diabetes better cardiovascular health.

This article was authored by Gaurav S. Gulsin, BSc(Hons), MBChB(Hons), MRCP(UK), a Fellow in Training (FIT) at the University of Leicester in the United Kingdom.