Clinical academic training

HCRI hosts a range of clinical academic trainees at various different stages, for shorter or longer term placements. NIHR Academic Clinical Fellowships are specialty training posts that incorporate academic training. These Academic Clinical Fellows (ACFs) spend 75% of their time undertaking specialist clinical training and 25% undertaking research or educationalist training.

NIHR ACF posts are only available to medically qualified candidates and are aimed at those who, at the early stages of their specialty training, show outstanding potential for a career in academic medicine or dentistry. The duration of an ACF is usually for a maximum of 3 years (4 years for GPs). During this time, alongside clinical training, ACFs will be able to develop their academic skills and be supported in preparing an application for a Research Training Fellowship (to undertake a higher research degree) or an application for a place on an educational programme (leading to a higher degree). HCRI has been supporting Emergency Medicine ACFs for a number of years, we have also had ACFs from Intensive Care Medicine.

NIHR ACF posts are recruited and managed regionally. In the North West you can apply via Health Education England’s Website.

Clinicians can also undertake academic training earlier in their career via Specialist Foundation Programmes (SFP) (formerly Academic Foundation Programmes). HCRI has also hosted those undertaking SFPs for their research block.

If you are an aspiring Academic Clinical Fellow, or planning a Specialist Foundation Programme, and you are interested in working with HCRI, then please contact hcri@manchester.ac.uk.

Alumni

Since the HCRI was established, it has hosted and supported many clinical academic trainees in academic foundation programmes, academic clinical fellowships and academic clinical lecturers – several of whom continue their work at the Institute. Below is a selection of the work that some of our alumni undertook during their time at the HCRI along with their contact details if you would like to know more.

Dr Hassaan Afzal, Emergency Medicine

"I worked at HCRI as part of my Academic Clinical Fellowship in Emergency Medicine, supervised by Professor Anthony Redmond. HCRI, as a World Health Organization (WHO) Collaborating Center, was asked to develop a research program for Attacks on Healthcare in emergency regions: a phenomenon gaining more attention in recent years, and one the WHO wished to know the impact of. As research on the topic was rudimentary, I first conducted a scoping review to understand what is known of the impacts of attacks on healthcare.

I reviewed 223 documents and was able to categorise the impacts into 15 themes. I also highlighted shortcomings in the available data, including the lack of a systematic data collection process, poor probing into secondary impacts, and the failure to distinguish the impact on public health from conflict itself. This work led on to a Delphi study to describe all the impacts of attacks on healthcare. Using a panel of 17 experts on the topic, and a three-round process, the study produced a list of 222 data items that describe the full range of consequences from attacks on healthcare. Both papers have been published and contributed to HCRI's successful application to Department for International Development for a £2.5million grant to further research the impacts of attacks on healthcare.

During my time at HCRI I was also invited by the WHO Attacks on Healthcare team to their headquarters in Geneva to work as an advisor for the development of their Surveillance System. This system creates a standardised approach to the collection of data on attacks on healthcare globally. My roles included revising their methodology on data collection, providing support to country offices for data collection, analysing attacks data and rolling out the Surveillance System. We officially launched the system in January 2019, and is currently operating in 12 conflict-afflicted countries."

1. Afzal MH, Jafar AJ. A scoping review of the wider and long-term impacts of attacks on healthcare in conflict zones. Medicine, conflict and survival. 2019 Jan 2;35(1):43-64. https://doi.org/10.1080/13623699.2019.1589687

2. Afzal MH, Jafar AJ. Attacks on healthcare: what information is needed to understand their impact?–a Delphi study. Medicine, Conflict and Survival. 2020 Apr 2;36(2):137-61. https://doi.org/10.1080/13623699.2020.1745999

Contact at hassaan.afzal@manchester.ac.uk

Dr Mina Naguib, Emergency Medicine

"My time at the HCRI was spent focussed on forced migration: specifically looking at the delivery of healthcare to forced migrants whilst in transit using an interdisciplinary approach with particular reference to EU borders and transit. During this period I worked as a ship doctor for Sea-Watch in the central Mediterranean, and have since worked with Médecins Sans Frontières in Palestine, Iraq, and Belarus, where I continue to write critically on humanitarianism with reference to forced migration for the operational reflection unit. I am also an active medicolegal report writer for Freedom From Torture.

Alongside my humanitarian research I collaborated with other Manchester based clinical academics in Emergency Medicine at the outset of the COVID-19 pandemic, participating in what began as weekly critically appraised rapid literature reviews to filter relevant clinical insights from the volume of literature produced. This evolved into the Royal College of Emergency Medicine COVID-19 CPD team. We have since published our methodology, and now have a regular slot in the Emergency Medicine Journal which rotates through academic centres internationally."

1.Reynard, C., Darbyshire, D., Prager, G., Jafar, A., Naguib, M., Oliver, G., van den Berg, P., Body, R., Ambroziak, H., & Carley, S. (2021). Systematic literature search, review and dissemination methodology for the COVID-19 pandemic. BMJ Simulation & Technology Enhanced Learning, bmjstel-2020-000817.

2.Jaffar AJN, Darbyshire D, Prager G, Reynard C, Naguib MP. EMJ COVID-19 monthly top five. Emerg Med J. 2021 Jan;38(1):73-75. doi: 10.1136/emermed-2020-210979. Epub 2020 Dec 18. PMID: 33355245.http://dx.doi.org/10.1136/emermed-2020-210979

3.Reynard C, Prager G, Oliver G, Jafar AJN, Naquib M, Body R, Carley SD. Journal update monthly top five. Emerg Med J. 2021 Nov;38(11):858-859. doi: 10.1136/emermed-2021-212053. PMID: 34686540.http://dx.doi.org/10.1136/emermed-2021-212053

4.Reynard C, van den Berg P, Oliver G, Naguib MP, Sammut-Powell C, McMillan B, Heagerty A, Body R. The prognostic value of emergency department measured hypertension: A systematic review and meta-analysis. Acad Emerg Med. 2021 Sep 22. PMID: 34553441.https://doi.org/10.1111/acem.14324

Contact naguibmp@gmail.com

Dr Govind Oliver, Emergency Medicine

British Red Cross and HCRI Research Fellowship (2015-2016)

"Working alongside Professor Tony Redmond and Dr Darren Walter, I researched the preventability of pre-hospital deaths from trauma with specific focus on those who die prior to arrival at hospital and are not included on the Trauma Audit Research Network. I worked closely with Her Majesties Coroners for Manchester and Cheshire and was granted permission to review cases of pre-hospital death under their jurisdiction. I studied the inquest for each death and in particular the medical cause of death and pattern of injury at autopsy. Using historical methodology, we performed a direct historical comparison to Prof. Redmond’s earlier work to assess what had changed in two decades.

We performed a second analysis using contemporary methodology to analyse the survivability of injuries and whether any there were any potential avenues to improve outcomes. This work highlighted key areas for improvement and led to three peer reviewed publications in high impact factor emergency medicine journals. In addition to being presented at one national and two international conferences, this work led to a national campaign #DontsStopAt999 with media coverage and a parliamentary launch through our study funders the British Red Cross."

Oliver GJ, Walter DP, Redmond AD. Are prehospital deaths from trauma and accidental injury preventable? A direct historical comparison to assess what has changed in two decades. Injury. 2017 May;48(5):978-984. PMID: 28363752

Oliver GJ, Walter DP, Redmond AD. Prehospital deaths from trauma: Are injuries survivable and do bystanders help? Injury. 2017 May;48(5):985-991. PMID: 28262281

Oliver GJ, Walter DP. A Call for Consensus on Methodology and Terminology to Improve Comparability in the Study of Preventable Prehospital Trauma Deaths: A Systematic Literature Review. Acad Emerg Med. 2016 Apr;23(4):503-10. PMID: 26844807

Contact govind.oliver@mft.nhs.uk

Dr Michael Pallot, Anaesthetics

"Having undertaken an intercalated MA at the HCRI during my undergraduate medical training, I was fortunate enough to complete a four month research block in 2019 as part of an academic foundation programme (now known as specialist foundation programme), working with Dr Amy Hughes and Professor Bertrand Taithe.

My project discussed human factors approaches to error reduction in UK healthcare, and how it has been incorporated in training and everyday practice. Drawing parallels between the creation of Pre-hospital Emergency Medicine as an independent subspecialty and the WHO Emergency Medical Teams initiative, I explored what benefits a human factors approach to error reduction may have to the provision of medical care in the humanitarian context.

Since then I have been working in Salford Royal Intensive Care and for Canterbury District Health Board in New Zealand before recently started anaesthetic training in Swansea."

Contact: Michael.pallot@doctors.org.uk

Dr Gabrielle Prager, Emergency Medicine

During my ACF, at my time at HCRI, I had the opportunity to work with a number of colleagues across a variety of projects. I worked with Dr Louise Tomkow on a qualitative project examining the experiences of clinicians providing primary care in multiple occupancy asylum seeker accommodation during COVID-19 as well as Dr Anisa Jafar on using Global Emergency Medicine Literature Review (GEMLR) as a proxy to examine emergency medicine global health engagement. I collaborated with Dr Mark Tan fellow ACF on a systematic review of reviews on Healthcare Resilience. 

I was an editorial member of the RCEM COVID-19 CPD team, initially a collaboration of academic emergency medicine colleagues producing weekly rapid COVID-19 literature reviews, and became a monthly offering in the Emergency Medicine Journal, which I now organise. I was also a core member of the team developing the Global Emergency Care Collaborative (GECCo), which I continue to be a part of.

I am currently completing my PhD at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

 

1. Tomkow L, Prager G, Worthing K, Farrington R. In critique of moral resilience: UK healthcare professionals' experiences working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic. J Med Ethics. 2023 Dec 14;50(1):33-38. doi: 10.1136/jme-2022-108632. PMID: 37169547.

2. Tomkow L, Prager G, Drinkwater J, Morris RL, Farrington R. 'That's how we got around it': a qualitative exploration of healthcare professionals' experiences of care provision for asylum applicants' with limited English proficiency in UK contingency accommodation. BMJ Open. 2023 Nov 23;13(11):e074824. doi: 10.1136/bmjopen-2023-074824. PMID: 37996230; PMCID: PMC10668227.

3. Jafar AJN, Prager G, Ingham JF, Jones P, Kennedy H, Ingram C, Ndiaye H. Emergency medicine engagement in global health: what does 10 years of the global emergency medicine literature review tell us? Eur J Emerg Med. 2023 Aug 1;30(4):287-291. doi: 10.1097/MEJ.0000000000001029. Epub 2023 Jun 27. PMID: 37387630.

4. Tan MZY, Prager G, McClelland A, Dark P. Healthcare resilience: a meta-narrative systematic review and synthesis of reviews. BMJ Open. 2023 Sep 20;13(9):e072136. doi: 10.1136/bmjopen-2023-072136. PMID: 37730383; PMCID: PMC10514640.

5. Reynard C, Darbyshire D, Prager G, Jafar AJN, Naguib M, Oliver G, van den Berg P, Body R, Ambroziak H, Carley S. Systematic literature search, review and dissemination methodology for the COVID-19 pandemic. BMJ Simul Technol Enhanc Learn. 2021 Jun 8;7(6):524-527. doi: 10.1136/bmjstel-2020-000817. PMID: 35520975; PMCID: PMC8189824.

6. Prager G, Oliver G, Darbyshire D, Jafar AJN, Body R, Carley SD, Reynard C. Journal Update. Emerg Med J. 2021 Sep;38(9):734-736. doi: 10.1136/emermed-2021-211890. PMID: 34413136; PMCID: PMC8380876.

Callanan R, Deasy C, Slowey J, O' Brien R, Dunphy M, Dasari K, Brennan T, Walsh S, Gilmartin S, O' Sullivan I, Prager G. EMJ COVID-19 monthly top five. Emerg Med J. 2021 Jul;38(7):558-560. doi: 10.1136/emermed-2021-211704. Epub 2021 Jun 8. PMID: 34103381.

 

Contact at lgprager@doctors.org.uk

Dr Mark ZY Tan, Anaesthetics and Intensive Care Medicine

My research interests span complex systems, health services, medical humanities, and critical care. During the integrated clinical academic training, I undertook a systematic review of reviews on healthcare resilience. At a time when healthcare organisations and systems were being challenged due to the COVID19 pandemic, I was keen to take an interdisciplinary, cross-sectoral and multi-level approach. For this, I worked under the supervision of Prof Paul Dark and Dr Andrew McClelland and with fellow ACF Dr Gabrielle Prager. Several papers have been published from the results of this project. It has been presented at various meetings and has won several awards including the Association of Northwest ICU’s trainee prize (2nd place) and the Manchester Foundation Trust’s Trainee Conference prize (1st place). This project was part of a larger ESRC-funded joint project between HCRI and Alliance Manchester Business School on Recovery, Renewal, and Resilience. I’m currently looking into integrated care systems through the lens of ICU survivors, hoping to better understand interorganisational relationships and coordination of care for complex patients.

Alongside my academic interests, I am also a multi-award-winning writer and a broadcaster with BBC Radio 4. Many of my works are aimed at a general audience and explore dilemmas of modern medicine, particularly focused around ICU care, survivorship and the dying process. I am currently also working on a book exploring these themes within frames of art, culture and history. My clinical special interest is Point-of-Care Ultrasound (POCUS). I regularly teach on courses and train others in several ultrasound modalities. The NW ICU logbook I created has been downloaded over 3000 times across more than 30 countries during the first 3 years of its launch. 

1. Brunswicker A, Tan MZY, Garner M, et al. A realist (re)view on surgical lung biopsy in interstitial lung disease: who, how, when and at what risk? Shanghai Chest 2022;6 doi: https://dx.doi.org/10.21037/shc-22-28 [dx.doi.org] 

2. Wickham AJ, Highton DT, Clark S, et al. Treatment threshold for intra-operative hypotension in clinical practice—a prospective cohort study in older patients in the UK. Anaesthesia 2022;77(2):153-63. doi: https://doi.org/10.1111/anae.15535 [doi.org]

3. Tan, Mark Z. Y. Resilience Is a Dirty Word: Misunderstood, and How We Can Truly Build It. Critical Care 26, no. 1 (2022/06/08 2022): 168. https://doi.org/10.1186/s13054-022-04040-x [doi.org] 

4. Tan, Mark Z. Y. Critical but Stable—Critical Care Communication in the Covid-19 Pandemic**. Intensive Care Medicine  (2022/03/28 2022). https://doi.org/10.1007/s00134-022-06675-4 [doi.org] 

5. Tan, Mark Z. Y. A Resilient Death: Gross Oxymoron or Realistic Utopia?. Journal of the Intensive Care Society 0, no. 0 (2022): 17511437221142252. https://doi.org/10.1177/17511437221142252 [doi.org] 

6. Tan, Mark Z. Y. Gymnopédie: Music in the Icu. Intensive Care Medicine 49, no. 2 (2023/02/01 2023): 267-68. https://doi.org/10.1007/s00134-022-06935-3 [doi.org] 

7. Julian, Peter, and Tan MZY. Learning to Clap: A Post-Covid19 Recovery Story. Journal of the Intensive Care Society 0, no. 0 (2023): 17511437231186691. https://doi.org/10.1177/17511437231186691 [doi.org] 

 

Contact at mark.tan.zy@gmail.com