57- Dr Ruth Payne- When flexibility mattered

Dr Ruth Payne has a dual professional identity as a Consultant Microbiologist for the National Health Services (UK) as well as a Senior Clinical Lecturer at the University of Sheffield. Her interest in malaria vaccines may have been the starting point for her research career, but her expertise in vaccines became the corner stone of her ability to contribute to the Covid vaccine development efforts.
 
 Ruth entered the world of research as a doctor following her appointment on a research fellowship position that became her PhD work at the Jenner Institute, University of Oxford (2012 - 2016). Her interest in malaria and vaccine development is anchored in a childhood spent in East Africa and in seeing first-hand the impact of this disease. After her research fellowship/PhD, she went back full time to a clinical role in Nottingham before jumping into a Clinical Academic Lectureship position.
 
 Ruth calls herself “an accidental academic” and admits that it was the inspiring and supportive approach of her academic manager/ PhD supervisor during her research fellowship position and PhD that led her to continue a career that embraced both clinical work and research.

Building a research team is never easy but establishing yourself as a new PI when you work 50% time as a clinician and 50% time in research, and then on top of that a world pandemic is forcing you to stop your research…well that is quite a start when you are a new Principal Investigator.

This challenging period has brought her resilience and connections. During the Covid period, her experience in vaccine development enabled her to get involved in many new vaccine clinical trials projects, that she could never have predicted. It allowed her to jump into new projects and build very close working relationships with many new colleagues. It created opportunities to be involved at a national level in policies related to vaccine development (e.g., UK Clinical Vaccine Network, Covid19 task force of the British Society of Immunology).
 
 Listening to our conversation will prompt your thinking:

·       How embracing the silver lining of the Covid pandemic created more opportunities and exposure than ever

·       How embedding yourself into larger projects creates the economy of scale needed when you get started as a new PI

·       Why keeping lines of communication within your network increases your opportunities

Transcript

Sandrine Soubes: 0:04

Good morning, good afternoon. Good evening, dear listeners. You are on the podcast, research lives and cultures. And today I have with me, Dr. Ruth Payne. Welcome on the show.

Ruth Payne: 0:15

Thanks, Sandrine. So

Sandrine Soubes: 0:18

I'm doing a series of interviews with, um, researchers who are a little bit unusual compared to the type of researchers I've interviewed so far. And Ruth come from a clinical background. So tell us a little bit about yourself. Where do you work? What do you do?

Ruth Payne: 0:37

I am a consultant microbiologist in Sheffield, and also a senior clinical lecturer at the University of Sheffield. And so my time is split 50 percent between academia and between clinical work. And that's across two different sites, um, both within Sheffield. So, yeah, that's a very quick snapshot of my, uh, my working life.

Sandrine Soubes: 1:01

So being both a, a scientist and a doctor, I always think is a little bit greedy. It's wanting a little bit of, of both world, but really how did it all start for you? Because obviously the medical training is, is a really long training and then doing a, you know, a piece of research on top of that, and then shifting onto becoming a clinical academic is a very long journey. So where, where, where, where did this start for you in terms of the, the bug for research?

Ruth Payne: 1:31

Yeah, it's a good question. I, I usually term myself the accidental academic because, um, it wasn't part of my plan. I certainly, I didn't go down that route from medical school. I didn't go into the kind of standard academic, um, clinical fellowship type role. But, um, I, uh, had an interest in infectious diseases and tropical medicine, um, and I ended up doing a master's at the London School of Hygiene and Tropical Medicine, um, early in my kind of registrar training in infectious diseases. And as part of that master's, um, obviously had to do some research background and then a research project. Um, and that was really what kind of sparked an interest. Um, and then A year after that, I had an opportunity to do a research fellow post in Oxford, working at the Jenner Institute developing malaria vaccines, which obviously kind of fitted into my tropical medicine interest. And it was a two year post and I kind of thought, oh, if I'm here for two years and I come out the other end without an MD, people are going to wonder why I haven't got an MD. So I thought, oh, I'd better register for an MD. And then that turned into a PhD. And I was there for four years, um, and, uh, and yeah, and really enjoyed it, and learned a lot, and developed a lot of different skills, um, which meant that when I went back into clinical training, um, I then was interested in becoming a clinical lecturer to kind of allow me to expand that a bit more, develop my independence a bit more. Um, I've moved back, that allowed me to Sheffield, um, as opposed to being in Oxford. Um, and the rest is history, I guess. I've been, I've been doing 50 percent research ever since, and that was, so 2018 is when I started that post.

Sandrine Soubes: 3:18

So we, we certainly have a link, um, in terms of research interest because obviously I did my PhD on malaria and, um, it's really, really long time ago, but that's certainly for me was a really important topic to be working on as, as a PhD student. So I'm interested in a way, I mean, There are many diseases that you could have been working on. What was the trigger? Because that's one of the challenge, you know, as a, as a doctor is that you see, you know, you see lots of different pathologies, lots of disease that you could be working on. And at some point you need to make a choice. So what was the, I don't know, the, the trigger maybe of wanting to work on this in particular.

Ruth Payne: 4:03

I think, um, Part of it comes down to, to opportunity and what actually is available, doesn't it, um, in reality for research and having a research fellow post that came up at the right time, um, in an area I was interested in was, was really key to why I ended up doing that. in a way, but actually, you know, malaria is the most common imported tropical medicine into the UK. Um, it's the most widespread and most lethal parasite in the world. Um, so, you know, it deserves special mention and lots of attention, I think. Um, and it's you know, something that you can't help but be familiar with if you've done a Master's in Tropical Medicine. Um, and so, um, so yeah, I think just being interested from a clinical point of view, um, and also my, um, I think the reason I ended up being interested in infectious diseases at all was because my, my childhood was in East Africa. Um, and so I had family members who'd had malaria. I'd seen people already sick with malaria. Um, you know, I knew firsthand, um, how, how deadly a disease it could be. Um, and so, yeah, having an opportunity to actually. Do something to try and, uh, make a difference is, is always the biggest driving factor I think for success in research. You, you need to be interested and you need to care about what you're doing. Um, and so finding something that kind of ticked those boxes was essential for me in terms of getting into and remaining in research because as I say, it wasn't something that I thought I was gonna do from day one.

Sandrine Soubes: 5:36

And how was it? I mean, obviously, if you were doing a master in the School of Tropical Medicine, you know, you're, you're kind of surrounded by people who work on lots of different elements of tropical disease and malaria and so on. But how did you go about choosing who you were working with? Because, you know, the mentors that we have, are very influential in terms of shaping the type of research we can do, the, the, the research culture that we, you know, grow up in, in some ways. So what were, what was the approach that you had in terms of making the choice of who you were going to work with?

Ruth Payne: 6:15

So I think. My master's was a kind of separate thing because obviously that was, it was mostly a taught master's and then I had a research project, and it was with our kind of module lead. So, um, you know, someone I, you know, knew well from doing the master's over the year. And it was in vaccination rates within the Gambia, it wasn't to do with my master's project, it was nothing to do with malaria, but it was to do with vaccines and vaccine uptake. And, yeah, enabled me to go and do research in the Gambia, kind of travel around, see different things, again, exploring and understanding a lot of the important aspects. to a research project and seeing one through from start to finish, which I think, you know, is really key experience as part of that master's, um, you know, learning process. In terms of the PhD, as I say, it was, it was a research fellow position. And I think, you know, the reality is, is that, um, I took it as a job, not as a PhD, um, uh, opportunity initially. And it was really. seeing that it could become something more than just doing a research fellow job. Um, and, and that was actually because the person who ended up being my supervisor, who I didn't know before I started the job, was, was really inspirational and really supportive. And, um, uh, and that absolutely was key to me remaining in research. It wouldn't have worked had I had someone who, who didn't have a really positive attitude and who wasn't really supportive, because I'll be honest, and in my first few months I kind of thought, I've made a mistake, this is, this is boring compared to clinical work, I don't enjoy it, I'm just sat at a desk all day, um, and it took a lot. longer of really understanding and seeing the process and seeing the results of what actually running a clinical trial and see, you know, and seeing the outputs and how exciting that can be and all the different aspects you then get involved in as you become more experienced. Um, and so, yeah, I fully credit having an amazingly supportive supervisor for wanting to stay in, in research and, um, yeah, and still being here today.

Sandrine Soubes: 8:30

So what was, so during the period where you did this project, where you fully, um, Embedded in, in, you know, in a research team or were you still doing some clinical work?'cause obviously, I mean, um, having now discussed with a, a number of clinical academic, it seems that there is, you know, the diversity of of, of spectrum, of activity. People working part-time and or people working full-time. And so in your case, your, the period where you started research, was it, uh, full-time job or did you still do, uh, clinical work alongside that?

Ruth Payne: 9:06

It was a full time job and it was in a different city to where I'd done my clinical training, so I think that also makes quite a big difference in terms of whether you're more likely or not to be drawn back into the clinical world and be tempted to kind of do those additional shifts or whatever it is. It's a lot easier if you're not in the same city and you don't know the clinical team because it, you know, it was within the university rather than the NHS. And so yeah, it was a fully a full time, um, position as a research fellow. I just worked on, um, vaccine trials, um, for a variety, but, but of illnesses, but predominantly malaria. Um, but having said that, you know, I was aware of the need to kind of keep up clinical skills. And so. I, every year I came back to Sheffield and did some locuming, um, usually for a week or two, um, sometimes a bit longer, um, in order to kind of, uh, make sure that I, I kind of still kept in touch with the department, kept in touch with my clinical skills, and, um, uh, and so yeah, that, that's always, you know, I think a bit of a, Um, something you've gotta balance for yourself. And I think it, it w how it works is different for everybody. For me, it was better to date, take some time out and I either took it as annual leave or unpaid leave from my university job to come and, um, do that in, uh, do that kind of locum work in Sheffield when there was, when they needed some help. And I, I had capacity within my role down in, in Oxford, so that

Sandrine Soubes: 10:34

Remind, yeah, reminding yourself what it's like to be a doctor.

Ruth Payne: 10:37

Yeah, exactly. And, and, you know, and I still really enjoyed the clinical work and I knew I didn't want to be, um, a full time academic. I knew I wanted to be a clinician, um, and probably primarily a clinician, actually, you know, my research was very clinical, um, and. Um, and, and the reason I'd gone to Oxford to do research rather than the opportunities that at the time were available in Sheffield was because I wanted to do clinical research and not basic science. I knew that, um, being in a lab all day every day was, wasn't my kind of research. I, I wouldn't thrive on that. Um, so again, it comes back to finding the, the type of research and, uh, that you are interested in because it's the only way you'll sustain. Um, the, the kind of workload and, and demands is, is being interested in what you're doing.

Sandrine Soubes: 11:26

Yeah, and I suppose that's a really important part because also the, um, the perception in a way, how we, um, the, the, the judgment or the value that we assign to different type of research is something that often we're a little bit I'm scared of talking and, you know, what is the value of basic research? What is the value of clinical research? And in a way, depending on the environment where you are at, at the time, you know, it can influence the decisions that you made and, and not necessarily positively and, and in a way, having yourself a sense of that's how I want to contribute. That's what matters to me. is really important instead of being influenced what, you know, the environment is telling you is the, you know, the, the best thing to do, actually. So no, that, that, that's what matters to me.

Ruth Payne: 12:16

yeah, 100%. Yeah, I think you're right. And I definitely have felt that that, you know, running clinical trials and that kind of clinical research is not as, it doesn't feel as highly regarded as, you know, discovering a new molecule or a new drug compound or whatever it might be. In terms of the kudos, but, but actually, you know, we know from the last few years what an impact successfully run clinical trials can have in terms of, you know, vaccine production and testing and, you know, saving lives. So I think, you know, had it, had I not had those skills and that experience, I wouldn't have been in the place I was. To be able to kind of take on clinical trial work in vaccines rapidly here in Sheffield at a time when we were looking for, or people were looking for, for PIs across the country, uh, in order to do so.

Sandrine Soubes: 13:15

So, so at the end of your PhD, then what was the, if you take this step back, what was the mechanism for you then to jump into, um, you know, a position where you could do both? Because again, and that's something, you know, through the, some of discussion we're having at the moment in how do we support. Uh, clinical PhD, you know, make that transition if they wish to, to carry on, you know, doing research while they're going back to their, to their clinical practice. So in your case, what was needed along the way in order for you to carry on?

Ruth Payne: 13:52

Um, so I went back into full-time clinical training after my PhD. Um, and actually that was in Nottingham. I didn't get a job in Sheffield. Uh, so things don't always go to plan. Um, but uh, that was actually a really valuable clinical experience. Um, and. You know, and I really appreciate the time I had there and the opportunities that kind of provided which were, you know, are always going to be a bit different. And I fully support working in different places. I think it's you gain something so much from working in different institutions and seeing how places work. But like I said, I'd stayed in touch with Sheffield throughout my PhD time. They knew I was interested in clinical research. They knew that, you know. that I wanted Sheffield. And so I think it is about, you know, maintaining those connections and lines of communication, because it meant that, you know, they, when they were putting in bids for the NIHR um, clinical academic training pathways in Sheffield, they knew they'd have someone who would apply for the job if they had an infectious diseases option. Um, and and it was really having those conversations and um, Being aware of the timelines and when things were coming up. Um, and then, um, you know, again, in, in all honesty, I didn't think I'd get the job as in the first year I kind of expected it to take two rounds of applications, but I thought I'll put an application in. I'll go through the process. I'll learn and I'll be ready for next year because, you know, I knew there may be stronger candidates than me, um, especially if they were local to Sheffield. And I, and I current I know, and I hadn't been for several years. Um. But, but as you know, fortune had it. I, um, you know, I interviewed well and, and got the, the, the post, um, as a academic clinical lecturer. Um, and, and so it, you know, I, I was fortunate'cause that's a funded scheme through the NIHR. Um, you're then supernumerary and to the, to the trust. And so, um, it, it's a, you know, you're a bonus doctor for the 50% of the time that you are around, but it gives you 50% time to do. um, clinical research and really start to develop those, um, you know, your own niche, I think, within an area. And that was important for me because I'd very much been part of a big research team in Oxford and I hadn't had to do anything on my own. Um, and the ACL post was the first time that I kind of had to think up my own project, design my own project. Um, you know, It was, it was still done in collaboration with the team in Oxford, because I had that really good relationship with them and I still do, I still collaborate and work with them closely. But it was my own project and I got my own funding for it through the Academy of Medical Sciences. And, and so, yeah, that was, that was quite a big transition, um, in terms of, yeah, everything kind of being my responsibility. I no longer had a team, it was just me. Um, and, you know, as you'll know, because I've, because of how we've, um, set things up in Sheffield, uh, it, it was a big learning curve, um, and something that I'm hopeful that we can try and improve for, for future. clinicians coming through, um, through their PGRs and, um, or through their PGR time and, uh, and also through their clinical lecturer time, because there are definitely skills that you need to develop, um, in that kind of transition.

Sandrine Soubes: 17:27

so, so in the scheme that you applied, basically, it was a type of fellowship where you, you straight away has a position within the NHS because it's again, among some of the discussions I've had with, uh, clinical, PGR students, this thing of, you know, how do I negotiate two position, you know, with, with the hospital and then with the, you know, with the university and, and people being very confused of, you know, if I want to do research, but you know, I don't have a position, a clinical position, how does this work? So in your case, it was something that was combined

Ruth Payne: 18:03

Yeah, so clinical lecturer positions are kind of pre specified before the interview as to which clinical domain will host them, and my job, it's not. quite that specific, but mine could have gone to someone in infectious diseases, or it could have gone to someone in cardiology. Those were the two options for the post I applied for, um, and depending on what the person applying for wanted to do. But yes, it was identified and there would be space, um, created. And I was still a trainee at this point, so this wasn't a consultant post, this was, um, a trainee post. I still had about three years left of training to do at the time. So, um, Yeah, so it, it allowed me, uh, you can, there are a maximum of four years long, um, but it means you, within that time, you effectively get two years of research time, um, and two years of your training time, and then you make up the rest of your training time at the end. But, but again, that's, that can be flexible and, and, um, depending on the kind of projects that you've got and the funding that you've got, you know, I, I stayed as 50 50 even beyond the, um, the end of my NIHR award because I had enough funding to, to kind of fund my time, um, and, and, yeah, and, and again, and, and bring my CCT date forward because I'd, I'd, I'd gained enough clinical experience by kind of front loading my, my clinical time, um.

Sandrine Soubes: 19:28

So, I mean, I mean, one of the great challenge at that stage is really the, you know, the building of your own niche. Because obviously, you know, you, like you described earlier, you, you, you were working in a, in, in a larger group and then suddenly you're on your own in Sheffield, you know, your main collaborators are down in Oxford. Even though, you know, you may maintain, you know, close collaboration, but there is still a moment where suddenly it's you and, and, and your laptop and, and having to decide actually, what am I going to work on? So can you take us through, I don't know, some of the thinking that you had at the time and some of what was needed for you to, to build a sense, okay, I know what I want to do, I know what I'm doing, and I'm going to, kind of surround myself by the right people, you know, locally to be able to not just be on my own. How did you approach that?

Ruth Payne: 20:28

Um, yeah, it's a good question. I think. So the important thing was, is that although I did my research fellow post in Oxford, um, and my PhD work was done in Oxford, it was actually through the University of Sheffield. So I'd maintained links with the University of Sheffield all the way through, obviously,'cause I was doing my PhD here. I, um, and through the process met, um, Lynn, who was my, uh, examiner at my confirmation review, and then she was one of my examiners for my, um. for my, for my viva. Um, and I knew that she worked, uh, with neutrophils and macrophages and that kind of innate immune system. I knew that was a strong area of research in Sheffield. Um, and I knew that it was something that we didn't do anything to look at, um, in Oxford in terms of vaccine response, but actually, you know, we, we were collecting all this data in terms of safety and in terms of the reactogenicity of vaccines. So, you know, people were having fevers or they were getting a lot of systemic symptoms. associated with vaccination, um, and we, we use adjuvants that are there, that are designed specifically to kind of, um, activate the innate immune system that, that's literally what they do, but we don't, we weren't measuring anything in terms of what that was actually happening. So, so that was really where I saw a niche because I thought, you know, we're doing these trials, we're kind of collecting a lot of data anyway, and we're not collecting samples at the right times, but actually could I add that into a project? And actually, you know, for me in terms of an ACL project, given that, you know, if you're, you're kind of first pots of money are unlikely to be massive. If you can find a project that you can kind of, like, tag something onto that's running back, that's running in a kind of already funded way, um, it's much more likely to be, you know, you can get something much bigger out of that than, um, than trying to set up your own project from scratch. I was never going to have enough funding to set up my own vaccine trial and do that. Um, analysis by collecting my own samples, but I could do it in collaboration with a team that I knew really well, who knew me really well, um, and who kind of had faith that, that my question was a worth asking and worth exploring. Um, and so that was really how I kind of came to my. Niche as it were in term. And, and, and it linked back to Sheffield because as I say, that was an area that they, um, already had a strong research background in. And so I could get advice locally about, um, you know, which cell populations it would be sensible to look at. And, and I had support in putting my application together. Um, and, and, you know, and, and yeah, and being able to kind of discuss time points or watch assay, which assays would, would maybe be sensible to look at, learn some new skills. you know, like starting to do a bit of flow cytometry that I've never done before. And, and so yeah, really kind of taking those opportunities to develop and to do something new. Um, yeah, which, which kind of seemed to work well.

Sandrine Soubes: 23:29

I mean, it's a really, really critical point because in a way there is, if you have very, very ambitious project as your starting point for your niche, Yeah, you may not get enough funding to actually start anywhere and, and starting. And I suppose for, you know, people who will be listening to this interview, this idea of starting small and building and getting the preliminary data and, and maintaining these relationships that you, that you need, where you can't often, there is a. You know, we have often conversation about, you know, developing your research independence. And actually, in reality, what it looks like to develop independence is actually meant mostly, it's about maintaining this close working relationship with people in different places to be able to do the

Ruth Payne: 24:16

Absolutely. Yeah. And, and really strengthening some of those, um, networks and relationships that you've kind of peripherally known, um, through different opportunities at work, but actually when you're kind of then in a different position and on your own. Um, suddenly, you know, those relationships can change quite a lot because you can provide, you know, opportunities and, um, oversight or, or something or projects that you wouldn't have been able to when you're part of a different team. So, yeah, I think building on those opportunities and, um, you know, my, my kind of approach to things was really to, uh, to try and say yes to quite a lot at the start in terms of op, you know, in terms of, um, funding potential and, um. the opportunity for different projects that might come in because you know that not all of them are going to come to fruition. And so you can't put all of your eggs in one basket and you need to kind of have a plan B and a plan C. Um, you know, and, and, and, yeah, and that's, that's just the way in research, I think. You, you know, you can't just go down, down one route and assume it's all going to be okay. You know, mine would have been a disaster like for many people because of COVID happening when it did. Um, and stopping the trials I was working on and, um, but the opportunities came because of my background and because of my, um, my experience in, in running vaccine trials to then go into something else and take up opportunities that arose because of the pandemic and because of the need to, to roll out large vaccine trials across the country and, and obviously globally.

Sandrine Soubes: 25:58

And I mean, one of the things that you're describing is this idea of flexibility is that it's been key, and especially in the context that you were in starting just at, you know, in a moment where the pandemic completely, you know, shaken, has shaken, you know, the way that research could be conducted and where energy. Um, needed to be put. how was the, you know, the, the COVID pandemic actually redesigned the way that you're working or redesigned the type of work that you're doing?

Ruth Payne: 26:33

Um, it's become much more broad, I would say. Um, I have a lot of projects now, but I have a lot of clinical trials. A lot of them have been COVID related, um, either vaccine trials or monoclonal antibody, um, you know, trials for people who don't mount vaccine responses. Um, it's, it's changed in terms of my involvement at a kind of more national level in, um, in terms of, you know, um, the, so being part of the UK. clinical vaccine network and on the steering committee for that and, um, getting involved, uh, in the COVID 19 task force with the British Society of Immunology. So these amazing opportunities came up, um, which again were just, I think, being in the right place at the right time and having a certain type of knowledge that kind of was a, was a bit different to what other people could bring to the table in those groups and being confident enough to to say actually, I do have something to add, and, um, you know, it's easy to kind of discount yourself as, particularly at the time, you know, I was still a registrar, I was still a trainee, and it feels odd to be in a group of professors when you're the only, almost the only doctor in the, in the room. But actually, you know, you soon learn that that there are things that you, you know, because you're on the ground and you're either running the trials or you're on the ward and seeing the patients, um, which a lot of people in research are slightly removed from. Um, so I think, you know, it's seeing the value of what you can bring to a table, what you can bring to a project, um, and how that and the different opportunities that even, you know, something as awful as a pandemic and the chaos that that brought in can provide. If I looked at it specifically from my ACL point, project point of view, it was a complete disaster. I still haven't analysed the data. The trials had to stop. I completely had to change the project. And, you know, I feel like, and I haven't, I haven't published anything from that, that project yet, um, but, but it will come and, you know, and I, I'm, I'm comfortable with that. Um, but yes, like from a, from a kind of. my primary research that I went into my ACL and had time to do and, you know, it was all nicely structured and laid out. Uh, that, that completely went to pot and my, most of my ACL research time suddenly got taken up by running other people's vaccine trials. Um, which, you know, it's, it's not my primary, it's not my primary project. I don't get any kind of first or last author kudos for it. Um, and so it kind of shifts the kind of, dynamic, I guess, or the, yeah, the capacity with what you have to do everything else.

Sandrine Soubes: 29:19

Do you think that it's shifted your way of thinking about your own project? do you have a sense that all of these experiences actually, they make you a very different, you know, clinical academic researcher than maybe if, you know, your experience of COVID and all these things have not happened?

Ruth Payne: 29:37

yeah, I mean, like I say, you know, huge opportunity came out of it. I think, I think in terms of actually doing clinical research in Sheffield, which had been one of the big aims of my clinical lecture position and on top of my, my research grant with the Academy, I was co applicant with a, with Oxford for a phase one study with the MRC and, and we got awarded that during those, those years. Um, and so, you know, again, that was, that, that was part of this kind of building independence and building opportunity because it enabled me to get a research fellow. Um, it was bringing a clinical trial to Sheffield that was a phase one vaccine trial, but, you know, I think, That would have been a very different journey, um, had we not had this up, this process of essentially all other clinical research stopping and us going in, you know, there were two of us that were PIs on all of the COVID vaccine studies in Sheffield, um, in the research facility. So we got to know the clinical research teams within the trust. really well, um, and, and built really good relationships with them. And so now bringing in new trials and new research is just a really different experience because I know exactly who to go to for things. And, and I know, I know who to talk to. I know, um, what can be done, what can't be done. And I can be realistic about, yeah, the kind of research we can do. Um, And I think it's just, it's, it's smoothed out other opportunities and, um, and, and we've just got such good working relationships and built up, you know, built up a whole vaccine team, which, you know, would never have happened had I just been running this one small, um, malaria vaccine trial, um, on behalf of Oxford, essentially. Um, Even if it did have, you know, even if it wasn't something that enabled a kind of research project for me, which, you know, is the other kind of key thing I think is, is finding if you're, if you are going to collaborate and you are going to run other people's trials, like having opportunities to get your own project and as part of that, that you can publish on, I think is, is really key. And that's the opportunity that that afforded.

Sandrine Soubes: 31:57

Yeah. Can I ask you, so, I mean, as part of some of the discussion that we've initiated with, uh, early career, uh, clinical academic, one of the thing that, uh, comes over and over and over is the one of wellbeing of, you know, this idea of, you know, balance within our lives. So how are you managing that? And I use the term managing, and there is a term that, you know, when, when I run a workshop, I can't stand the term time management because I think it's completely useless because we don't manage time. Time is time. But In a way, in the context of, you know, when you started your lectureship and in the context of, you know, all the, you know, the, the complexity of your task as, you know, as having this, you know, dual professional identity, how do you cope, survive, thrive, put boundaries? Limits, you know, and, and one of the things that you said earlier is that early on, you know, you took loads of opportunities and, and how has this evolved? How do you manage? Because from the outside, from my, from my side, I, I marvel at the ability to, to do that, but we are human. So you have your strategy. What, what is your strategy of, of being able to do it?

Ruth Payne: 33:16

Um, I think a lot of it comes down to how you work. And I don't think everyone can do the same. You know, I don't think everyone can do the same kind of thing. I have a brain that likes to be in four different places at the same time. So for me actually multitasking. actually works well for me because I like thinking about different things at the same time. And so having multiple projects on at the same time doesn't stress me out. It's something that works better for my brain. I'm not very good at the hyper focus approach. So I think you're recognizing that we're different and that what works for someone will be completely stressful and not work for somebody else. Um, but actually, you know, someone's seemingly slightly chaotic approach to things may just be the way that they're wired and, uh, you know, and I've had, I've kind of had to just learn that about myself and accept it and think it's not actually a bad thing. It enables me to do lots of different things. I think I'm probably, I'm guilty still of taking on too many things. Um, I'm not very good at saying no. Um, I've got better than I used to be. And I, and I. And I definitely now take on things that IC uh, uh, make sure I care about. Um, and, you know, and part of that, you know, I'm, I'm very early on in my kind of, um, senior lecturer position. You know, I, I only became a consultant, um, in 2022, so I'm less than two years in as a kind of, uh, post CCT. Um, and I'm aware that I've probably taken on roles that are usually done by more senior people. But again, the thing about, um, academic training is that it takes a really long time. So although I'm junior in terms of my appointment, you know, I've I've been a doctor for nearly 20 years. I don't feel very junior and I, I'm aware that I've got a lot of experience and I'm near to the experience of a lot of the trainees. So, so the things I've taken on, in addition, I kind of have been to do with that transition between, um, clinical work and, um, and academic training, which, you know, I felt wasn't being addressed particularly in the, in the region. Um, and, you know, we've developed a role of, um, these support champions, uh, for the region. There were two of us, we're the only ones in the country at the moment for that specifically focus on academic trainees. Um, and we've got funding to run workshops, um, and, you know, you're very, uh, kindly part of that, uh, for us because it's, it's about trying to find the things that I think. Make, um, you know, if you can find the things that people generally and frequently find more stressful about that experience of being a clinical academic, then I think the well being becomes easier to manage because you're not struggling with everything and you can kind of, you know, I've been really keen to try and develop a lot more kind of peer network than I had going through that process. Um, and, you know, people being able to share those experiences. You know, you know that we met through me doing the Academy of Medical Sciences Women in Leadership course. And that was so key to my kind of, to my well being because I met all these other amazing women who had exactly the same fears and, you know, were kind of very, vocalizing all the things I'd kind of thought and all the kind of negative aspects of what we kind of tell ourselves. And you suddenly realize that this is just completely universal. And actually, once you know that, it becomes so much easier to think, Oh, actually, maybe I'm okay, because I'm not a complete failure. And I'm not like, the worst creature that's ever walked the planet.

Sandrine Soubes: 37:02

yeah, giving yourself less of a

Ruth Payne: 37:04

Exactly, exactly. And but yeah, in terms of in terms of time, I also got a lot stricter, um, during, for, for personal reasons during the kind of, um, last few years of, uh, of trying to keep work at work, um, and recognizing how important it was to have downtime and not work every weekend and every evening, which it's, it's easy to kind of eat into that time. But, um, but I realized that that was, you know, that's a way to burn out, uh, sooner rather than later. So, so I'm quite, I'm quite firm in terms of, how often I'll work out of hours. Um, you know, because also, you know, I'm clinical, so I also have to do clinical out of hours work and that already eats into enough of my evenings and weekends. Um, so I don't do a huge amount of additional stuff. Um, And that means I'm slower, um, than I used to be. I'm not as productive as I used to be. For me, that's the balance, um, and I'll take that balance, um, because it means that I, I'm here. Um, and I'm functional and I'm, and I'm not overwhelmed, um. most of the time. Um, but yeah, and it's recognizing the things that actually give you energy and make you feel better. And for me, you know, it's being outside, it's exercising. If I can get enough of that into my week, then I'm probably okay. Um, so it, you know, it's, it's managing you and knowing yourself, knowing what, um, what you need in order to kind of feel like things are okay.

Sandrine Soubes: 38:38

And I think that some, it's something that, uh, people need to hear is that in a way, all the choices that we make, you know, in terms of the opportunities and the boundaries. Everything has an impact. Everything has got consequences. And in a way, it's like, what kind of impact do you want your choices to have on your life? And if it's actually my well being is the way I can be my best as a clinician and as a researcher, then these boundaries are absolutely critical.

Ruth Payne: 39:07

And I think it's, you know, again, it comes down to. what you want, in your career and what you want your balance of clinical and academic work to be. And, you know, I've got colleagues who'd much rather spend the majority of their time in academia, and are much less interested in, in clinical time and they're split. It's different to mine. I primarily became a clinician and like I said at the start, I didn't intend to become an academic and I, I really enjoy my clinical work. I enjoy working with my clinical team. And also seeing the opportunities that might come there were so many opportunities for research within the, the NHS side that don't, that get missed because there's, there's a kind of lack of time and capacity to even think about that within where they're 100 percent clinical. So actually, you know, it gives you a very different scope to be able to kind of maybe think about things differently. I knew from the outset that I, I wanted a 50, 50 role. it's affected the kind of route I've gone down in reality, to me, it comes down to actually what, what I enjoy about my role and my job. And I genuinely enjoy both, and I don't want to give up one or the other,

Sandrine Soubes: 40:20

I was talking to somebody about the UKRI future leader fellowship. It's the type of founder who is very keen to get people probably from the clinic or people from industry being funded. But again, if your desire and your motivation is actually, I want to have both. I don't just want to have the research. Then, then sticking, say, well, okay, the fellowship route maybe is not the right one for me. Or maybe I've got to negotiate with UKRI and say, okay, how, how is the deal for people working in the clinic? In terms of the funding and, and in a way, and I suppose that's where the impact at a national level, you know, at a national level matter is that in a way you are now in a position where you can have conversation with funders, say, actually, if you want clinicians to get involved, maybe the split in terms of the research doesn't quite work from our side, so changing the practices that allow clinicians to work is, is an, I think is an important, an important piece of work in terms of shaping the research

Ruth Payne: 41:27

yeah. And, and, you know, to be fair, there are some funders who, who have gone that way, and then there are opportunities now that are, that do allow a kind of 50 50 split a lot more.

Sandrine Soubes: 41:36

Can I ask you, if, if you were going to, you know, to, to explain, to boil down, you know, why really you want both, because, you know, if again, from the outside, I say, okay, gosh, how do you make your life really difficult? You have, you know, to, to. part time job, which together are actually two full time jobs. So why really bother? Why does it matter so much to have both?

Ruth Payne: 42:03

Yeah. I mean, some days I do ask myself the same question, but, um, I think ultimately. Like, I, I'm someone who likes to know why things happen. I like to understand, I like to dig down, and I think research ultimately is what gives you the opportunity to do that. To me, it just, it sparks interest. It gives lots of different opportunities. It enables me to meet some really interesting people, to really understand things in a different way. And that keeps it exciting. And I think, and also being able to kind of, see others come through the pathway as well and help shape their experience of it has been, has been really valuable. And, you know, again, I always have a bee in my bonnet about trying to make things better in that regard as well. So, for our PGRs and for our clinical academic trainees, I want their experience to be even better than mine and I don't want the attrition rates that we see in research because, you know, so much goes into really promising and keen individuals. And then, and because it is hard, I think it doesn't necessarily sometimes need to be as hard as it's made. And I think that, that to me is, you know, it's trying to find the balance that, that doesn't absolutely burn you out and doesn't overwhelm you, but that's enough to satisfy that curiosity, gives you something meaningful to do, allow you to kind of feel not completely incompetent at your clinical role. but still produce and contribute to something on a bigger scale. And to me that, that's where things probably need to shift slightly because I think the, the expectations. are kind of starting to shift at a lower level in terms of, the projects that are put forward for PhDs and now that there's much more rigor in terms of making sure that they're achievable within the funded time. there's a, there's a lot of attention being paid to being realistic at that kind of earlier level, but we need to continue that up the chain and be realistic about what people can achieve at every level. if we want them to remain healthy individuals and, and not spend their entire lives at work.

Sandrine Soubes: 44:18

One of the final question that I like to ask is about the, promotion criteria, that are within the university system, where really were designed based on people working fulltime within a lectureship, position and having that dual role. Okay. You work part-time and you have. the added complexity of, being a clinician. So how, how do you feel that the promotion criteria that currently exists, how does this impact you in terms of the choices that you make, or do you completely ignore them and just do what, what you feel? And then eventually you will look at them. Do you look at them? Does it shape the decisions that you make or not at all?

Ruth Payne: 45:02

I have to admit, currently, not really because, you know, as I said, I've only, I'm less than two years into this role. Um, and so I don't see myself going for a promotion anytime soon. Um, but I'm aware that, you know, compared to Um, compared to the kind of criteria, you know, there are things I would struggle on, I think, and, but equally, you know, I think there is some movement in terms of recognizing some of those other skills that are, that are important. Offered and developed. Um, and I know that within Sheffield within the kind of one university type approach. There's quite a lot of work being done to kind of look at some of those, um, attributes that maybe aren't seen as valuable, but really do. are essential in order to, to kind of run a, um, run a department successfully and, and for, for people to thrive. You know, and my, the reality is that my, in, within my role, um, I, I have three and a half PAs, which is less than two days of research time because I have a PA a week that's doing the support champion thing, which is trying to oversee, um, academic, you know, trainees returning to training, clinical training across the whole region. And I also am one of the deputy academic training program directors within the university. Again, trying to, you know, trying to contribute towards the clinical academic training pathway. Now, the reality of that is that I haven't got 50 percent of time to do research. I've got less than two days a week to do research. Um, and, you know, on top of that, you know, you have your, your teaching and your

Sandrine Soubes: 46:50

Supervision and

Ruth Payne: 46:51

of a PhD student and of our trial fellows and, um, you know, and for clinical trials to oversee and run. So, you know, what's the reality of how, how much I can achieve in that time? Um, it's, it isn't going to be what counts towards the university metrics in the same way. Um, uh, but the things I've chosen to do are things that I believe in and I think are really important. And I think, um, you know, I want to see improvement and changing. Um, and to me that, that actually currently matters more. Um, And

Sandrine Soubes: 47:33

yeah. And in, in a way that's the, that's how, that's where you influence changes within the institution in term of making people aware of different types of researchers, different, you know, those who are working as clinical academic researcher, their path is very different. So it's almost like the promotion for those needs to be different within the institutional

Ruth Payne: 47:58

Yes.

Sandrine Soubes: 47:59

Because their role, their role is very different. And in a way, the work that you're doing in supporting the early career clinical academic is part of that leadership and citizenship element that is so important in building, you know, a positive research culture. And that's, that's really a massive contribution.

Ruth Payne: 48:19

I mean, I hope so, for sure. Um, yeah, it would be nice if that was the case, but I think the other thing is that, um, you know, taking those opportunities, um, again, means that now there are a lot more people in the department who know who I am, than it would have been just through my PhD in ACL where I was really, you know, the PhD I wasn't even in Sheffield, nobody knew who I was. In my ACL post, I was working on my own project with Oxford, you know, probably about three people knew who I was, um, but now a lot of people within the department know who I am because of the work that I'm doing with the PGRs and because of the work I'm doing, um, you know, on the in the clinical academic training, um, group. So that, that, that also has, you know, alters opportunities and alters conversations and puts you into, um, yeah, it just puts you in place.

Sandrine Soubes: 49:14

you you create visibility. I mean, you create visibility for yourself and, and who you are as, you know, as, as a researcher and and, and a clinician

Ruth Payne: 49:22

Yeah, but it's also

Sandrine Soubes: 49:24

as within other, within other conversations. And,

Ruth Payne: 49:27

but, and also, you know, it means that you are just more likely to have more conversations with different people and it's those kind of, it's so often those chance conversations where you, where you end up talking about your research and your projects and someone goes, Oh, I'm interested in that, you know, how about, you know, would you be interested in doing this together? You know, it's, it's really, you know, actually getting to know people, um, yeah. Within your, within your own institution, sometimes can be as hard as getting to, or even harder than getting to know people in others, because you have these kind of pre defined networks, um, within your research area. But actually, you could be missing the fact that someone who could be instrumental in, in working with you and, and, on, and, you know, developing another project is just down the corridor, you just, you just never met them. And actually increasing visibility and increasing contact and increasing, um, Yeah, those opportunities for conversations, I think, is not to be, um, underestimated.

Sandrine Soubes: 50:27

I couldn't agree more with you on that. So to, to sort of finish off our conversation, I'll be interested in you reflecting on, you know, if you had to do it all again. Would you choose differently, or what would you tell your younger self? To, in a way make the journey maybe lighter or easier. I don't know what would be the right term, but something that, you know, with the wisdom that you have now, what you, what would you tell to yourself, you know, a few years back?

Ruth Payne: 51:02

Yeah, I think, um, it's a difficult one, because You know, you end up where you are because of the way things go and that doesn't necessarily mean that it's because they went right. A lot of the time it's because of things that go wrong. Um, I think in an ideal world, I'd maybe have done, um, a bit more like lab experience and, um, and really gotten to grips with more, uh, with being more comfortable independently and in that aspect during my PhD. Um. You know, I did some lab work, but it was, you know, it was kind of quite structured and not, you know, it was a couple of techniques that I, you know, I did lots of times. But I think in terms of that, then designing new experiments and design, you know, I've had to go on this massively steep learning curve as a clinical lecturer. When you suddenly are not, you don't have 100 percent research time and, um, you're not a student anymore, um, and you're, you know, in your, um, and it all falls down to you and your project, um, which is, it's possible, but it was, it was, it was stressful. And I think, yeah, having had a, if I'd had a bit more grounding in that aspect. Um, having said that, you know, I wasn't really interested in basic science and lab time. The reality is that if you want to do. immunology based projects, you kind of need that background a bit. So I think that's probably the only thing I'd really change. Um, I think everything else has kind of worked the way it has for a reason, but I think that would have made my transition a lot easier. Um, and, and, you know, and hopefully then would have made. this stage of trying to get things done and again, develop new, um, proposals and projects and, um, experiments easier than it, than it is, because I kind of feel like I'm still doing a whole lot of learning, um, thing.

Sandrine Soubes: 53:11

Some of the practical elements. Yeah. You could, you know, Ruth, you could always do a summer project as a, you know, as a helper of a PhD student in the research. I'm sure they'll welcome you. I'm sure you. work very hard.

Ruth Payne: 53:23

if I only had the time, Sandrine.

Sandrine Soubes: 53:26

I know, I know. So, to finish off, Ruth, what gives you joy in research,

Ruth Payne: 53:33

it's, it's seeing, um, seeing the difference that things may, you know, can be made. Um, and usually that takes a long time to see the outcome of your research. But, um, you know, I think, like I alluded to earlier. Sometimes you get things, you see things really quickly and, um, the COVID vaccines were a really good example of like a very rapid results, and that that made you feel like all of those ridiculous hours and ridiculously hard work was really worth it because actually, within a few months, people's lives are being saved because of something that you've been part of, and, and, and that that really did bring a, you know, a lot of joy and a lot of pride. It's, you know, that you can actually make a big difference by, um, the work that we do. Um, even if you're just a small cog in a massive machine, um, the machine needs all the cogs. So, um, you know, it's, it's fine to just be a part of the story. Um, but, but yeah, it, it, it's, it's amazing to see, um, when it goes, when it goes right and, um, uh, and you, yeah, you get such a good result.

Sandrine Soubes: 54:48

Well, that, that certainly was a bit of an extraordinary period. And I can understand that having been part of that is quite, uh, you know, it's quite rewarding, you know, through the work that was done, people were able to go back to normal lives. Which at the time, you know, we, we didn't know what normal life

Ruth Payne: 55:08

Yeah, absolutely. Yeah. Yeah.

Sandrine Soubes: 55:12

Okay. Well, Ruth, thank you so, so much for this conversation today. I'm sure that what you've shared, with me in this conversation, we will be really of great value to others. So thank you.

Ruth Payne: 55:23

Well, thank you.