On overseas opportunities, the woeful Bombers and writing a kick-ass grant.
Daffodils had started to bloom outside Professor Philip Conaghan’s office in Leeds, England, when he spoke to Rheumatology Republic a few weeks ago.
After heading off to the UK as an early-career rheumatologist nearly 25 years ago, the professor has been abroad for the vast majority of his career.
Professor Conaghan is now director of the Leeds Institute of Rheumatic and Musculoskeletal Medicine at the University of Leeds and deputy director of the Leeds National Institute for Health Research Biomedical Research Center. He spoke to Rheumatology Republic about his career and passion for research, tips for young rheumatologists and the footy.
Where does your spark for rheumatology come from?
I think it’s ultimately, “Can I make a difference?” I’m now, perhaps more than ever, interested in making a difference to treatments for people before I retire. We’ve got big drives here on equity, diversity and inclusivity in our research team and a big drive looking at underserved communities. There’s still much to be done there. There’s never a reason to stop.
Being increasingly involved in osteoarthritis pathogenesis and intervention studies remains my passion; to improve treatments for common problems and the commonest of them all is osteoarthritis. Currently, our treatments haven’t changed in 50 to 100 years. And it would be very good to be part of developing something new.
Why did you go overseas originally?
At that time there weren’t many groups doing clinical rheumatology research in Australia and few with enough critical mass to be able to run lots of different trials. When I arrived in the UK the research group I was with started using MRI in a study. This was of great interest to me. They also started to get me involved in international groups involved in imaging and that allowed me to play in both rheumatoid arthritis and osteoarthritis studies. When I started to look for job opportunities back in Australia there were few opportunities, and they didn’t offer the same sort of critical mass of researchers or access to research funds.
What are the most exciting discoveries you’ve made in your research?
An early career highlight was the understanding of subclinical inflammation in rheumatoid arthritis using imaging. Understanding that there was no discrepancy between inflammation and damage and that clinical assessment was actually quite poor. That was the reason people had differing views of how severe rheumatoid arthritis was.
Then, being part of the OMERACT and then co-leader of a good group of international people who brought standardisation to outcome measurement and MRI clinical trials. Then subsequently being the inaugural chair of EULAR’s imaging group and bringing in recommendations for the use of imaging in clinical practice. And recently, work on osteoarthritis structure and where the pain comes from is starting to bear fruit.
The difference in career and research opportunities between Australia and the UK were quite obvious a couple of decades ago. Does being overseas still hold an advantage?
I think so. My impression is there’s still a bit more research funding around over here. I know that recently it’s been a particular bugbear for Australian medical scientists and clinician researchers that the pool of money is so limited.
The other difference I suspect is the tyranny of distance. We’ve got more cross-Europe collaborations and just bigger populations. Small things like time zones for meetings also still adversely affect Australian involvement in things. I’m always saying to industry collaborators, “no, no, we can get a time where we can get the Australians on as well!”.
I don’t think anybody has any negativity about the quality of the Australian product. It’s just ease of accessibility over here and the sheer number of people that you’ve got to recruit from. That being said, Australia actually has done very well recruiting in rheumatology and some of the private trials groups have done extremely well.
Any advice for rheumatologists considering a new placement?
I always suggest to people that a year or two interstate or overseas is generally a good experience. And sometimes we don’t do that because we think it’s going to stop progression up the research ladder or whatever. But I think generally you gain from the experience working in other environments and with senior people. I was lucky to work with a lot of smart people here and, you know, some of it rubs off eventually!
Any advice for early career rheumos?
Learning to play the grant writing game early in your career is incredibly important. You can get experience by reviewing the grants of others and working with people who are writing grants. If you look at the strong rheumatology groups in Australia, they’ve all done well on the grants front. Also, find a mentor early on in your career; somebody quite senior who will just give you good advice. Just go and have a chat with them about the future and what’s out there. Getting that sort of advice early in career is golden.
I was going to ask if working abroad has changed you at all but that’s hard to say because you’ve lived there for so long. You’ve almost ‘grown up’ in the UK.
Yes, to some extent. I’m in Australia a couple of times a year so it’s hard to separate that out. I still watch AFL football on the weekend.
Who’s your team?
Essendon.
How they going?
Terribly. They’re at the bottom of the ladder. This week is the first week and it was a disastrous opening game. I was born and bred in the shade of Essendon’s ground so they were always going to be my team. My office still has plenty of Essendon football club paraphernalia around.
Do you think you’ll come back to Australia?
Just at present I’m about to lead a much bigger, expanded Biomedical Research Center here. That would commit me to the UK for at least another few years. If I went back to Australia now it would have to be for something that would help build Australian research capability, to try and keep us international players. I guess that type of job would be limited and few but I always have a dream.
Then you could go to Essendon matches.
Exactly! I’ve kept my MCG membership up but it might take a few years for the Bombers to be competitive. That’s my worry.
Editorial update, 13 April: Professor Conaghan can revel in Essendon’s rise from bottom of the ladder – they’re now third from the bottom.
