Reflections on structured PhD training for general practitioners in Ireland

ew photoEmma Wallace is a Senior Clinical Research fellow in the Health Research Board (HRB) Centre for Primary Care Research at the Royal College of Surgeons in Ireland (RCSI) Medical school

 

This week, the Society of Academic Primary Care (SAPC) conference is being hosted by the Department of General Practice, of the RCSI, in Dublin. As part of the organising committee for the conference I am very much looking forward to welcoming primary care researchers from all over the world to Dublin to partake in what is sure to be a stimulating and diverse programme.  In parallel to the conference, a clinical academic career in Family Medicine/General Practice (GP) meeting will take place to share international experiences and best practice with attendees from Sweden, Canada, the United Kingdom (UK) and Ireland. In anticipation of this meeting, I will share some of my own experiences and reflections as a GP undertaking structured PhD training in Ireland.

An average day working as a GP involves consulting with approximately 30 patients, returning telephone calls, reviewing patient correspondence, writing prescriptions and completing endless paperwork. Working on the clinical front line is fast-paced and, at times, frenetic. When I decided to pursue an academic primary care career and undertake a PhD I assumed my research days would be similar. Instead I found myself with an empty page and a long day ahead, paralysed at times by indecision. Sightings of huge hard bound theses and murmurings of conferring ceremonies seemed aspirational.

Structured PhD training has the great value of adding order to what can feel, overwhelmingly at times, an ambiguous process. I completed the four-year Health Research Board (HRB) funded Structured Population and Health Services Research Education (SPHeRE) programme in Ireland. This interdisciplinary programme comprises of one taught year followed by three years of full-time research. On my first day, a programme schedule and meeting new classmates eased the transition from full-time clinical work to a research environment. My class of 14 included PhD students from pharmacy, social science, policy, psychology and general practice backgrounds.  We quickly found common ground and their peer support was to prove the defining aspect of my time on the programme. As we transitioned from the taught year of the programme to our desks, collected data and grappled with analyses, we depended on each other for advice, mentorship and friendship.

As a GP starting the programme I had less research experience than some of my classmates. This meant that each aspect of my PhD offered new learning opportunities, which really helped keep my focus. My thesis was a prospective cohort study examining predictors of adverse health outcomes in older community-dwelling people. As part of this process I completed a systematic review, conducted primary data collection and completed statistical analyses. This was followed by several months of writing and revising thesis chapters and papers for publication. Finally, following some last minute formatting debacles, my thesis was ready for submission, and subsequently successfully defended.

My PhD programme offered a great opportunity for me to develop both generic and subject-specific research skills, in addition to project management experience. I continued to work clinically as a GP throughout, which I considered essential for maintaining my own professional identity and to keep my research grounded in clinical practice. This definitely was important when presenting my research findings to GP colleagues’ whose interest always centred on the applicability of the research in clinical practice. Balancing these roles was at times challenging, but I think my participation in research benefited my clinical work and vice versa. I was very fortunate to have excellent supervision from two GP academics and one methodologist, whose expertise proved hugely beneficial to me in developing as a researcher.

Overall I look back on my structured PhD training as a formative part of my career to date. I am particularly grateful for the peer support and mentorship the programme facilitated. As I embark on my postdoctoral GP academic career I am confident that I can balance clinical and academic roles effectively.

Editor's note: This is the fourth in a series of 8 blogs about international collaboration in strengthening primary care research, ahead of the #SAPCASM2016 conference in Dublin, Ireland

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