Research lives and cultures
Research lives and cultures
72- Dr Cariad Evans- Integrating research into your clinical practice
Dr Cariad Evans is a virology consultant for the NHS, as well as an infectious diseases specialist. After a period of working in Africa, Cariad returned to the UK to work as a consultant. A corridor conversation with a senior colleague kick-started her engagement in doing research via an MD. The recent pandemics have been fertile grounds to contribute to research, as well as impact national policy decisions.
Listening to our conversation will prompt your thinking:
- Do you know your motivation and drive to stay involved in research post-PhD or MD once you return to full-time clinical practice or training?
- When looking at different formulas for keeping your research going- full clinical practice with research on the side, part-time clinical and part-time research or any other possible combinations, what feels most manageable, achievable or exciting?
- What is going to fuel your desire and interest to remain research-active: a brilliant collaborative team, the pressure to access research funding to answer challenging questions, a mentor who believes you are bringing a unique set of skills/ expertise and perspective, a topic that you feel passionate about addressing, and/or a drive to create systemic change?
Read the full blog:
https://tesselledevelopment.com/research-lives-and-cultures/cariad-evans
Okay. Let's get started. Welcome on the podcast research lives and cultures. I'm your host, Sandrine Soub. And I have the pleasure to have with me a doctor. Cariad events. Welcome on the show, Cariad.
Cariad Evans:Thank you, Sanjay.
Sandrine Soubes:So I've been doing a number of recordings with doctors who are involved in research in one way or another, and there are great many paths for medical professionals. to be involved in research. And so I'm really interested to hear your own path of being involved, in your own way in the research that you're currently doing. So you're consultant and you
Cariad Evans:that's correct.
Sandrine Soubes:and you work at, Sheffield teaching hospital as a consultant. So Give us a brief overview of your career so far. How did you get to work as a virologist?
Cariad Evans:So as I trained in Sheffield, so I was at medical school in Sheffield. Graduated in Sheffield, and I was involved in at medical school in setting up the Medical Students International Network, which was about connecting medical students globally. And at the time, my particular area of interest was because the HIV pandemic was kind of in its early stages. And so we were doing a lot of work around mother to child transmission, education, health education, testing, counseling. Sexual health in schools and things like that. So I suppose that's where my early virology interest came in. Then I started as a junior doctor in Sheffield and I applied for the infectious diseases job as a house officer. So that was my first rotation. And then completed that, really loved infectious diseases, and then went on to do what was then called my senior house officer rotations here at the Northern General and at the Halamshire Hospital in a variety of specialties. I quickly realized I wanted to go traveling and see the world a bit. So I dressed it up in the guise of education. So I went to do the diploma in tropical medicine down in London. Then worked in East Africa, in Uganda doing general medicine and infectious diseases. Madagascar on a dive project. And,
Sandrine Soubes:sounds incredible.
Cariad Evans:Yeah, so I was working in Madagascar on a dive project and doing sort of basic health care and then came back to Sheffield to carry on my SHO program. And decided then that I did really want to do Infectious Diseases and there was a post advertised for Infectious Diseases and Virology, which was a brand new sort of specialty combined post at the time. There was only one in Sheffield previously, one of my colleagues, Ali. So I spoke to her and she was like, yeah, it's great. It's great training program. Go for it. So that's how I got into ID and Virology. But at that same time, I was approached by one of the infectious diseases consultants to do some research to step out, do an MD for a couple of years, and then I could start the training program later. And it was one of those corridor conversations where you're like, really? Do you mean to talk to me? I've never done research in my life. I'm not, I'm not sure it's really for me. And then I came home and I talked to my partner and he was like, well, what is it in? And I was like, oh, I didn't actually even ask what
Sandrine Soubes:know.
Cariad Evans:was in. He said, well, why don't we go back and see properly and find out a bit more about it. So I did. And essentially, it was very clinically based research, and I, I thought our research department at the time was very molecular, very much on a cellular level, whereas this opportunity was with patients, recruiting patients recruiting healthy volunteers and inoculating them with an alive bacteria, a friendly bacteria related to the bacteria that causes meningitis, and Neisseria meningitidis. So it was using Neisseria lactamica, and I thought, Oh, I could probably do that. I think I could talk to people. I think I could recruit people. I think I could, you know, learn the immunology and think about and identify the bacteria and do the cultures and things like that. So I went for it. And I did an MD and I had a brilliant time, really, really enjoyed my research. I was I was lucky it worked. It took a while to work.
Sandrine Soubes:Can I check with you Kayad? So when you say an MD, basically it's a period where you are still paid as a doctor, but you're given leave from your clinical practice, huh?
Cariad Evans:yeah, so I had two years out from my clinical practice. It was funded by the charity, Meningitis UK, that, yes, funded my salary for two years to do, to do the MD. so yeah, so I did the two years, but then it was very much a defined two years, and then I had to go back into clinical practice, into infectious diseases and virology training. So I, so to finish the md I had to write it up in my spare time. My. Dad was really sick at the time. I had a toddler at home. Um, so was extremely difficult and it took a long time, but I did finally get the papers published and, and submit my thesis and managed to complete my MD. So after that, I then sort of just threw myself into my specialist training in ID and virology and what Essentially happened was a series of extraordinary opportunities Because of being a virologist It does tend to lend itself to large outbreaks and pandemic responses
Sandrine Soubes:Well, yeah. Okay.
Cariad Evans:So within two months of me starting in virology as a brand new registrar, we had the swine flu pandemic. Um,
Sandrine Soubes:I remember I was already in the UK when this happened. Yeah.
Cariad Evans:yeah, yeah, so, so it went from sort of me going, Oh gosh, virology is a little bit dull. I'm just sitting at a desk all day, not seeing patients anymore. Am I really going to enjoy this? to just an extraordinary experience of kind of setting up the testing in our lab, designing a new assay, getting diagnostics out there for our patients and for our staff and being part of that big kind of outbreak response. So on the back of that I realized how important rapid testing at the front door was for flu and in a pandemic and I took the opportunity to do some work with a new diagnostics company for a rapid molecular point of care test that gave me a result for 15 minutes and this was quite unheard of to have a molecular rapid point of care at the time. So that's when my research knowledge was super helpful because I just thought I know how to, to write an application. I know some places that I could approach for some funding. I know, I kind of knew how to get some small grants from like the British Infection Association was who we approached at that time to get some time for staff to step out and deliver the research and do the work and for me to be able to do that. sort of supervise that and participate in that sort of a role because that was the only real capacity because I couldn't get more time out and I needed to carry on my clinical training but I, I knew I could help do the protocols and do the supervision
Sandrine Soubes:What's interesting to me is that in a way it's a, this chance encounter with a senior, consultant who basically triggered. A past that maybe you may not have considered before. what do you feel this person so in you in terms of suggesting that you get involved in this, was it because it was just like a passing comment or, was it somebody who was mentoring you? Because often we are given opportunities by others where they see something in us that we're not even aware of ourselves.
Cariad Evans:Yeah. No, I asked him later in life. so I think it was, it's like you say, the thing, the qualities you don't see in yourself. So I didn't see that actually I'm, I'm quite organized. And he knew I was a doer that I would deliver on the project aspects about sort of communication, relaying information. He kind of seen how I could speak to patients and thought it should be good at communicating research information, patient information for consent and to enroll people into the study because it was quite complex with it being a live bacteria. we joke about the fact that I would then speak to everyone in the field about what they've done and what they've published on. And he was like, you're not supposed to be quite so open and collaborative But I think that's a, it's a good skill, isn't it, to kind of be able to reach out to others. So I think it was some of those. that he saw, that I suppose I'd always had preconceived ideas that researchers had to be uh, much more kind of detailed, focused, thinking I don't know, sort of a, I suppose I had a bit of an old school Kind of image of older consultants that I'd seen, older male consultants that were working all the time and all hours and the weekends and just writing grant proposals in there. And it was all about the publications and the impact factor and these things. These drivers that I couldn't really quite relate to, whereas he made me realize that you could do research in quite a different way. And that your research could be much more about kind of clinical impact and translated onto the clinical side. It didn't have to be in the laboratory and down at a very molecular level. So I suppose that's, that's what he made me see and helped me believe in myself that I could do
Sandrine Soubes:What do you think was really significant in these two years, doing DMD? Because when you've never been involved in research and been thrown at the deep end of, understanding, the, protocols and, ethical practices to do with research and so on. What did really support you in that period of doing, a piece of work, to actually deliver a thesis and some publication. what really helped you in that period?
Cariad Evans:I think I had a, that we were in a really good research group. We were very supportive to one another. So things I didn't understand or know or was familiar with, someone in the group would know. Everyone did help one another quite a lot. That made a massive difference. I think he can be quite, can be quite isolating doing research and. I think if things aren't working out very well as well, to have that self drive, that motivation can be difficult. And we, we looked out for one another quite a lot. Yeah, I had a really good group of colleagues in the group, so that supported me a lot. I think having a really good supervisor who believes in you um, and is very available to bounce ideas off of it, or, you know, if something's not working out, that they're, they're quite present to work through those issues. And I think as a clinician, you're used to firefighting all the time, like every day, something's happened, something's gone wrong, you're having to readjust your day, reschedule, replan, rethink, reorganize your expectations or what you're able to deliver, or particularly how to prioritize to get everything done. And I think those skills did me very well given the type of projects that I had and the time constraints I had. So that didn't really throw me and I found that quite easy to re jiggle things around when things didn't quite work out or when participants couldn't come when you needed them to and you had to have all of that sort of flexibility
Sandrine Soubes:so then if we go back to that period where, you know, okay, you had done a project for UMD and in a way it's like, okay, that's, don't understand, not exactly, but there is a new epidemic appearing and it feels like, and you use the term extraordinary, circumstances, you know, opportunity. So what was really important for you to kind of set the path of being able to do research, research that interests you, that has kind of clinical implication, but in a way that other people do the research and you become the research leader who set the path for others, set the goals, set the direction. How did this transition happen and also access funding to pay people to do the work?
Cariad Evans:so I tried a lot of experience and tried lots of different pathways. So the one was with the respiratory flu point of care work. And that was through the British Infection Society and the Healthcare Infection Societies and small grants and things like that. So that you can then get. staff, because the main thing I found is getting someone to do the work and getting money for the staff. So they were good research pots to get that. I managed to, I would do in my spare time mostly to write the protocols and write the applications. Then I did quite a lot of PPE research. So to do that, I affiliated myself with the health and safety executive who are based over at Buxton. And they have a brilliant research team, so they could run a lot of the research, but I could give in the clinical input and the clinical knowledge and kind of interpretation. So again, they had that support. the staffing base. And they have some of their own local funding. So I could just then give him my expertise, but again, that was mostly in my spare time. Then as time has gone on, there have been. So out of the PPE work, I was then involved in some national guidance around high consequence infectious diseases and PPE which has led to us setting up a training program to train staff in HCID PPE and a big educational program at the Sims suite. And so we've got a large grant with MPS now to look at the impact of the training on healthcare workers and the outcome of the training and using this unique simulation tool. So again, it was sort of knowing where kind of research money can sit in different pots for different opportunities and, and trying to get people who were like me before who were registrars or junior doctors or junior nurses, as is the case with all the PPE work some dedicated paid for time for them to deliver the research. And as I've done it in my spare time, then as a, as a consultant then the COVID pandemic happened and then we managed to actually get some dedicated money for our clinical time so that we could have one additional PA in my job plan for a year to kind of recognize how much time is spent on research. And again, I've sort of affiliated myself then with the University of Sheffield to do the sequencing work and lots of genomics work that came out of the pandemic that needed a clinical lab and needed clinical samples and isolates to, to get across to the university. But the main body of the work could then run through the university, so that the staffing and the, and the workload was placed over
Sandrine Soubes:When you think about various sort of funding streams that you've had, who was kind of your team? It's, it's kind of an evolving team of nursing, collaborators. How do you find these? Because it's almost like there is nothing that is set in stone. And I mean, mostly in research, most teams are very transient, How have you found that, you may have funding for six months on something and 12 months on something else in a way of retaining, the expertise that people have to be able to move project forward, from a small pilot projects to something else.
Cariad Evans:Yeah, it's quite challenging. We've found, so I think Because I'm now mainly based in laboratory medicine. So our colleagues in the lab are biomedical scientists by background and training. And they have brilliant brains and minds and are keen for lots of research opportunities and they also have to do MSCs and other projects through their pathways for their training. So I found that supporting BMS staff and working with BMS staff is a really nice. of one, expanding their knowledge and background of more clinical research, but two, them achieving their requirements for their training. But three, their colleagues that are there with me in the department for a long time. So a lot of those skills from different projects or knowledge from different projects, then become interchangeable when we try and do get involved in different things.
Sandrine Soubes:Can I double check with you? Are these people who are on sort of technical training programs within the NHS, people who work in laboratories for the NHS, usually for diagnostic, but are also involved in sort of uh, side research projects to develop protocols and so on. Okay.
Cariad Evans:Yeah, exactly. And then the, the other arm has really been sort of trainees in infectious diseases and virology. Not all trainees have wanted to follow an academic ACF pathway but have been really keen and interested in doing some research. So it's really suited them if I can support them in and out of program research for six months or a year. And again, you kind of, you know, through their training and their interests, what their skills are and how you can support them and how certain projects will suit their characteristics and their their kind of future interests. And then I think the nursing is the other side. So the nursing on the infectious diseases unit, I've worked with them for a very long time through my training. And they often don't get much opportunity to do research outside of the clinical research facility and doing a specific, you know, research nurse training post. So again, I've just quite liked to try and get like the MPS grant that we've got, we can have some admin time and some nursing time from laboratory medicine and infectious diseases. So individuals who are already working on those projects with me who have an interest in it and now getting some recognized dedicated time and further experience in that, which I think, I think is really important to help. That's been my ethos is that you you try and give opportunities to people who are full time NHS employees with some additional time in research to try and really integrate clinical research into the NHS. Because I think if we keep, I think it's very important to have the clinical research facility and dedicated, you know, research roles and areas. But I think if we can integrate it even more or expand people's knowledge and experience within it further, then we can get more people involved in Mm
Sandrine Soubes:So it's interesting because in a way, the early years of your involvement in research, and maybe still now, really a lot of it is not fully integrated in term of the time allocated. It's very much because you want to do it and you do it on the side, you know, in the evening and the weekend. And in a way it's almost feel like, you know, it's a passion project. It's an interest. But at the same time, it's additional work that's not necessarily recognized. So in your case, I don't know whether it was a formal decision or decision you could make, but why not shift into this dual identity of the clinical academic and consultant like so some people choose to go, so in your case, staying with a full consultant role, And accepting that the research is the thing that you do on the side.
Cariad Evans:Yeah, it's a good question. I think it's I suppose I kind of, it's how you identify yourself, isn't it? And I suppose identify myself predominantly as a clinician who, who, who does a bit of research out of opportunity when she can. But I started to realize that that's not how I'm actually perceived by many, and because of what I've done, like you're right, I could probably quite clearly describe myself as having an academic arm to my work as well as a clinical arm. So why isn't that academic arm formally in the university? As I said, I've had the research PA for, for a year, so sort of moving a bit towards having that more recognized and also having my role within the NHS and then lab medicine more recognized as a research lead in our department and someone who oversees our local clinical research. I suppose the thing that's always kind of put me off, if I'm really honest, is the pressure of getting grants and funding and money in. And I've found it less pressure to be able to then follow projects that you're passionate about and interested in for, for clinical care and clinical impact, which aren't really, I suppose, Looked upon by the university or other research targets and goals and measures in, in the way that they probably wouldn't reach many of the kind of standards and expectations that are required at the university. So I suppose that's been something that has probably put me off a bit.
Sandrine Soubes:That's fair enough. and how do you feel that your involvement in research has enabled you to be recognized, valued in the way that, your career is in the NHS, is progressing. Cause again, if it's not part of the job, you don't get necessarily recognized, but how do you feel? It's not part of your job title, but you actually do research.
Cariad Evans:Yeah, so I suppose there's two things there isn't there is about recognition is about there's recognition by your colleagues and the people in the department for work you do isn't there and then there's a sort of formal or financial recognition. By my colleagues and what I do, I think the biggest thing that research gave me. was prior to the pandemic, there was an opportunity to be on a committee called Nerve Tank, which is a new and emerging respiratory virus task advisory group, which is a subcommittee in government just below SAGE. Then the COVID pandemic happened, so it's supposed to be like two meetings a year, and then the COVID pandemic
Sandrine Soubes:Yeah.
Cariad Evans:it was like, a meeting every day for about two years. It's the most insane thing I think I've ever done in my life for the hardest thing I've ever done. But the, but the, the point of the story is, is that they needed a clinical. viral address. They needed someone who was on the ground and knew what was happening in the NHS, and they needed someone who could assimilate data and emerging papers and information really, really quickly, and, and help interpret that into clinical impact, patient care, infection control. And I realized that all my experience to date had given me those skills and that I did, I was able to do that. And as a result of that, I ended up on multiple government subcommittees. And. And so therefore there was very much the professional recognition. So that made me from, by my peers locally, but also nationally get quite connected within the community professionally. So I think I've always felt quite happy that people know that I've had that role. I still have that role. And therefore that is, that is a personal recognition and a professional recognition. I think for the The, the formal time recognition. I think that is a real issue for NHS staff. I think encouraging more research PAs and us being able to apply and have those in our job plans is really, really important. I think we have to end the era of doing it in your spare time and doing it out of goodwill and professional interest. And I think particularly when it's, impacting on clinical care and clinical guidelines and policy, which most of my work has done. I think probably organizations could recognize that more formally and should recognize that more formally. And, and I think, If there is the ability to financially recognize it, then that would be the best because to formally have it in your job plan. But I think also within titles and just hierarchy and structure and organization within the NHS, it would be better to have more people identified as research leads or coordinators or this from, from a clinical perspective. Even if it's just a title, but at least it then does recognise the participation that you're making. Because at the moment we don't even really recognise that very
Sandrine Soubes:How do you feel with the seniority that you have, feel able to influence the culture of the NHS? Obviously it's a monster of an organization but we are all influencing, at our own level. At the moment in the research sphere in the UK, there are loads and loads of conversation on research culture and a lot of funding has been put in addressing that. doing research in a clinical context, I don't know whether the conversation on research culture are seeping in or are influencing the conversation. But how do you feel that with your own role, you are able to influence. something to do with, organization, culture, research, culture, or whether it feels like it's so big to tackle that that's not where you put your energy.
Cariad Evans:I think it's, it's on an institutional level, it's big and difficult to put your energy into that. I think I've seen the culture change a lot through my time, so it was definitely very much a kind of older male led area when I first started. I, I remember going to a like a women in research day down at the Welcome in London 15 years ago, there was just one woman who was
Sandrine Soubes:Oh God.
Cariad Evans:mostly talking. I was like, oh my goodness. And she was, you know, extremely affluent from London, who had a nanny to look after her children. And, And, you know, everything she sort of described, she's a formidable, amazing woman who achieved a lot. But I just couldn't relate to her on any level because I just thought, you're just not me and that's not how I'm going to live my life. So if that's what research looks like, it's not going to be for me. So I think that's the way you influence culture is to be, try and be a leader in your area, even if it is in a small area that I'm influencing in infectious diseases and virology, but to my trainees and everyone coming through, And like I said with the nurses and the biomedical scientists, that's how to change cultures to give everyone those opportunities. Let everyone see that it can, it can look different doing a bit of time and research. It's just as valuable to do some time and research as in my opinion, as it is of doing a PhD or an MD. Let's not get into that ridiculous world of mine's better than so I just try and change culture that way, really and kind of make people realize that you can have a family, you can have a clinical job, you can still do research and be quite active and that your research can have a big clinical impact on patient care. So yeah, I think I try to influence it in my smaller sphere. As it were, rather than on a more institutional level, though I have done quite a few talks recently. There's obviously a bit of momentum at the moment. So International Women's Day, they had quite a few inspiring talks and leadership talks. So I was invited to do that. And I've done a couple of other regional talks at research days trying to share my experience. So yeah.
Sandrine Soubes:When you think about the way that you've balanced, your clinical practice and the research side of what you want to do, how have you built the balance that is necessary of what kind of balance to have a normal life on the side. So how did you set up in the way that you organize yourself or the support that you access or, mentors who gave you some good ideas? How have you managed it in a way that's worked for you?
Cariad Evans:Yeah. So I think so, so it's changed over the years, waxed and waned a lot. So I think it's important to recognize where you are in life and what time you have and resilience you can give to it. So I've definitely been at stages in my life when I have quite happily worked. Evenings or when I've been on call at the weekends, I've kind of, you know, done the clinical work and then there's been some downtime with the on call and that's where how I've always put my research time, writing time, reading time into those quieter downtimes when I've still been at work. I have been through phases where it's been. It's definitely been too present at home and too intrusive on my family life. So we've had to be really strict about it. I've had to accept that. I think if I could go back to my former self, my earlier younger self, I would say be really patient. I think I had quite high expectations of translating research into guidelines and national guidelines and, and national practice change. And I now accept that can take nearly 10 years. And that's like, Yeah I think it's accepting that it's always there, it's always on the to do list, it's always going to take time, so by staying late, by working crazy hours, doesn't doesn't necessarily make it stop or finish or go away because if it's something that you are always interested in and will always want to do, then you're, even if that project finishes, you'll just move on to the next. So I've tried to be quite strict with myself and say, you know, you're just doing these hours, you're just going to work on it for this time, carving out some dedicated time as well, because I found. It takes quite a while when you're in clinical to then get your head into research or reading or writing. So I've tried to have dedicated time when I can then just be much more productive because I've got a bigger block of time to spend on something rather than doing lots of little bits and feels like you keep going back to the beginning a little bit or not moving on a huge amount. So those are probably the, the tips I would say and I think just, yeah, find mentors that have got a good work life balance around it and chat to them about how they do it. And think about, just be a bit strategic in how you're productive. Cause some people are really productive early in the morning or late at night or in big chunks or in short snippets. One of my professors, she was really productive on trains. So she, yeah, so she would, whenever she'd go, like, you know, pre Zoom days, she would put meetings in London and she would know on the way down, on the way back, she'd just be on fire with, like, thoughts and ideas because she'd be out of the office, she'd have lots of brain space. She would, you know, really prioritize those times. So, yeah, just think about what what works for you. Don't be rigid and be very patient.
Sandrine Soubes:in so many of the conversation that I've had in the last year with clinical PGR or, early career clinical academics, the thing about the boundaries is something that, comes up a lot in the conversation in terms of the boundaries between home, and work of course is always a challenge, but also the boundary between different element of your job. When you're a clinician, there is always more that you can do often people will say, well, you know, I put the time in my diary and then something comes up and, and then the three hours that I had dedicated for that writing just disappears. What's been the motivation element that's allowed you to really maintain the momentum through these boundaries.
Cariad Evans:I suppose. The main drivers are to, so when I'm at home and I'm with my daughter and my husband, that's that's, nothing sort of comes into that zone. So that's probably one of my, my main drivers is that there's a deadline or picker, you know, an end of school or something. And that's, that's my time when I will go home, definitely 100 percent switch off until she's in bed or there's some quiet time later on, and then I might revisit something. So that's a big motivator for me around boundaries. The other things I do is I think clinically there's always a phone call, there's always someone at the door, there's always an email, isn't there? As you said. I don't open my emails when I'm going to just sit down and work on some research work. Because otherwise stuff will just ping in and completely distract me. I try and put something on my office door that I'm in a meeting or something like that. So I kind of try to be quite strict about those sorts of things. if it's something I can't avoid, then I just prioritize in my diary. I always prioritize quite far in advance in my diary so that I know that I've got that time carved out and therefore I just block it so that nothing else can kind of go in. So those are probably some of my main strategies.
Sandrine Soubes:It's interesting because, often people know about these strategies and do not implement them. When you think about, core driver that you have to actually do the research? What do you feel is the core value or the core driver that's given you, the energy to carry on?
Cariad Evans:Probably because All of the projects I've chosen to participate in, I feel quite passionately and strongly that they will make a clinical difference to staff or patients, or both, ideally. So that is my core driver, is that it will make a systems improvement or a clinical care improvement. A lot of my work is probably more systems improvement. So like the point of care, the pathway of a patient through an organization, the, you know, the overriding effect that has on patient flow, on infection control, on outbreaks, on risk to others. So I, I quite like that sort of bigger picture impact of what I do and the PPE stuff again is rather, I know that, you know, it's once in a blue moon and it's rare that high consequence infectious disease comes in, but if it does, it paralyzes and shuts down the A& E department and the consequence of that to the rest of patient care is massive. Whereas doing some simple, system change and education and training of that pathway for that patient to go through means your A& E will stay running and there won't be a huge consequence. And I think again, that was a lot of all the policy work and guidelines stuff that I've done is, it's, It does focus on the same. So I think my driver is about improving kind of NHS systems and patient care, and that's what keeps you going. And then that means when you see these opportunities, you think to yourself, Oh, I can see how that would fit. I can see what the potential of that looks like. So that gives me the real drive to then get, just get the evidence and the structure and a process to demonstrate and prove that concept.
Sandrine Soubes:of the things that we often discuss with people that are, getting involved in research and sort of transitioning from working on a project somebody's designed to building their own, research sphere is, this concept of research niche how do you feel that yours has evolved?
Cariad Evans:I suppose my, my niche, is around outbreaks, pandemics and preparedness. I think that's my, probably my niche and my focus. I think it's probably fair to say I'm within that mostly respiratory viruses and I think therefore how that's. changed over time has been, well, the common denominator over time is that all of my research opportunities have come from large outbreaks or from pandemics. And I think then you just build on each experience and each knowledge to then look at what are the new research opportunities or the new ways of handling this next new threat outbreak or pandemic. So I suppose that's, that's the kind of more niche area that I'm into. And it is the preparedness and the operational side of it. And that whole impact on patient care that's the main driver.
Sandrine Soubes:If you reflect on what's really hindered or, really supported evolution of your research activities. what do you think that they are?
Cariad Evans:So support is definitely colleagues. It's all about who you work with. And colleagues who believe in you, colleagues who mentor to you, colleagues who you just really trust and work really well with. So everything out of the pandemic the colleagues of mine at the university. That I worked with, you know, they, I trust them a hundred percent and they made everything happen. I, I just knew that I could just send them loads of respiratory samples and I, they know how to interact with me. They know how crit, how little time I had, how insane things were from a clinical virology perspective. They know how to quick assets, quick discussion, quick. Clinical slant and then I completely implicitly trust them to then translate that into the research sphere, the genomics, the sequencing, the whatever it was at the time. So it's, it's all about your team and it's all about having a really healthy, collaborative environment around you. I think that's, The absolute main reason I'm where I am today. I've never very fortunately experienced any real sort of negative or difficult or, you know, uncollaborative behavior or exclusive behavior or anything like that. I think the main challenges I found as an, as an NHS physician working in research is, it's just the time for a lot of the paperwork and that, that, that practical, the practical aspects. So we have a research coordinator in that medicine and he's a phenomenal person who dates back to, he was doing research when I was doing my MD from Lila. So we get on really well, but he, again, he just gets. how to review the protocols, how to do all the submissions or to do the IRAs, the ethics, all the processes that if I didn't have him, they, I find them as quite large barriers. To research from a clinical perspective because they just require so much of your time and energy to, to fill in and bureaucracy and paperwork.
Sandrine Soubes:Yeah. Paperwork. Yeah. That's not the most fun, but it's an, it's necessary thing. so I'm going to just ask, two final questions you were to do it all over again, what advice would you give to your younger self? And you sort of mentioned patience, but what else?
Cariad Evans:I think. Probably to believe in myself a bit more. I think I think at the time when I was starting, and I hope people listen to this or, you know, start to realize that being active in research can, can take on all different forms and shapes and sizes. And you don't have to be a conventional academic, you know, grant funded, huge input, output individual to, to be respected and be active in research. I think I would say that to myself a bit more because I think I, I've still, yeah, I don't think I really recognize that all of those projects and bits that I was doing, it's come up in appraisals because You rarely know what other consultant colleagues are doing or what they're involved with. And so it's only really in your appraisal. Does someone objectively look at what you've called service valuations or something and gone, These aren't really, these are way beyond. You're doing really active, you know, quite meaningful work regularly and doing loads of projects beyond Um, you never really know that or get that feedback, I think in, in the NHS anyway, because we've, as we've said, we don't recognize it. So in our titles, we don't really measure it, which has its pros and cons, but I would go back to myself and I would say, have a bit more, a bit more self belief in what you've done. And maybe talk a bit more about you being research active and having the opportunity Recognizing that aspect to your work
Sandrine Soubes:So my final question is about joy. When you think about research and joy, what gives you the biggest joy in being involved in research?
Cariad Evans:Biggest joy? When it works? when you, well, when you can make change because, because of the research you've done, that's the biggest joy. So, so when we did, going back to the flu point of care, it was so powerful how rapid results. meant that you could, patients got treatment so much earlier, how we isolated them, the PPE, their length of stay in hospital was significantly reduced, their whole patient journey was altered and that was joyful because sometimes the joy is sapped by the cost and the business case and they're trying to prove that your idea is the right idea. And it can be really difficult to make change in the NHS, because it's such a big beast. So when you do a piece of work that's, that you, that you, it is just so brilliantly evidence based. It then just opens doors and you can change patient care really quickly. That's, that's probably joyful.
Sandrine Soubes:I'm daring a final, final question. I promise this is the last one. do you think is next big step in terms of your own research leadership? What is the next big thing that you feel that that's really what I want to contribute towards?
Cariad Evans:I think probably the, the grant that we've got at the moment for the PPE work, I think I would like to be able to demonstrate the, the impact that PPE training can have. does have on patient care. I think we're very PPE fatigued on the back of the pandemic. I think we've gone in a complete opposite direction from wanting to put it all on when the pandemic first started and it being everyone needs it and we need everything and the best of it and now just no thought, no consideration, no idea when to use it or how to use it appropriately. I would love there to be a new era Where we really recognize the role of it and how it can protect health care workers and how it can therefore then improve patient care and infection control. So trying to do that thread of work and translate that into some really good established clinical practice would be really nice.
Sandrine Soubes:Well, I wish you the best of luck with this work. Thank you, Gaia. It's been really a pleasure talking to you. Really much appreciated.
Cariad Evans:It's nice to reflect on things.
Sandrine Soubes:Thank you. Cheers. Bye. Bye. Bye