Why all doctors should be involved in researchBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i164 (Published 23 February 2016) Cite this as: BMJ 2016;352:i164
Neena Modi tells Hannah Jacob about her career in research and why this is a fundamental part of every doctor’s job
Neena Modi is president of the Royal College of Paediatrics and Child Health and professor of neonatal medicine at Imperial College, London. She is a practising clinician and academic lead of a neonatal research programme focusing on nutritional and other perinatal determinants of lifelong metabolic health. After a period as vice president for science and research at the college, she was elected president in April 2015.
How did you become interested in research?
I realised that what I was being taught during my training was wrong, and my very enlightened consultant challenged me to design a trial to back my contention. There were no training posts in neonatal medicine when I started my paediatric training, but there were lots of opportunities to learn and undertake research because the rate of change was so great. That was really exciting.
Which research projects are you most proud of? Which do you think has had the biggest impact?
We did a series of studies to develop methods for measuring body water compartments in extremely preterm babies and to describe the postnatal alterations in fluid balance. We also tested the hypothesis that immediate sodium supplementation in babies with respiratory distress syndrome was harmful. That was a big achievement.
Most recently we have identified possible biological mechanisms that underpin the epidemiological associations between early onset of features of the metabolic syndrome and being born extremely preterm. That is of real interest as we learn more about the long term effects of extremely preterm birth.
How have you coped with the inevitable setbacks of a career in clinical research?
Real life is about being refused things and carrying on anyway, so I have developed resilience. There was no academic training route when I started out, so I have had to forge my own way. People will always tell you that it cannot be done. You have to pursue the things you are passionate about.
Do you have any advice for junior doctors interested in doing research?
Work out what interests you, and then find the person who is going to help you do it. Being approached by an enthusiastic junior doctor is always well received, and once you have found the right senior person they can support you in achieving your goals. Do not lose heart if you don’t get an academic training post as they are not the only way into research. Some of the best research students I have worked with have not come through the standard path.
What would you say to doctors who have no interest in doing research?
I would argue that they may not be thinking broadly enough about what research actually is. Every clinician is responsible for evaluating their own practice, and to do that in a robust and meaningful way you need to use the tools of research. We all need to be able to critically review research done by others. For example, the guidelines used in everyday clinical practice are based on meta-analyses and systematic reviews. So I think all doctors need to be involved in research in some way, and that may be different for different people.
How can undertaking research help doctors in their careers?
It’s not just a help, it’s essential. There are few absolutes in science, and without inquiring minds medicine will stand still. Participation in research enables doctors to evaluate their practice objectively and to be involved in advancing their discipline. You can learn so many skills that make you a better clinician around appraising the evidence and thinking critically about a situation.
What are the benefits and downsides of doing research—both on a personal and professional level?
The benefits come from knowing you are contributing to the science of medicine as well as the art, and are able to question, evaluate, and test different approaches objectively. Everyone has a role in supporting research—many will contribute, and some will be research leaders.
As for downsides, life has ups and downs, and research is no different. You have to not be too disheartened when a grant application gets rejected. When you want to achieve something, you have to keep speaking to the powers that be until you find someone who can be an advocate.
How do you juggle the research, clinical, and leadership aspects of your working life?
It is a balance that is evolving all the time and that provides me with a huge stimulus. Every time I have been presented with an opportunity I have had to evaluate its potential effect on the other components of my work. I always say yes to the things that interest me and follow my muse. We are very privileged as doctors to have such a range of tremendous opportunities available to us.
Do you have a particular philosophy that has guided you in your career?
When life offers you an opportunity, do not turn it down. I believe you must do what grabs your interest, and if you are still doing it years later you know you made the right decision. When you lose the excitement, it is time for a change. The future lies with junior doctors, and you can be a part of shaping it in the way you think is right.
Is there anything you would do differently if you had your career again?
I would have much greater confidence to fight for something I believed in.
Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I am the academic officer for the Paediatric Educators Special Interest Group of the Royal College of Paediatrics and Child Health.