Working life: Clinical Fellow in Psychiatry Dr Emmert Roberts
Career in brief:
- Medical school at the University of Oxford
- Academic foundation doctor for two years at the Bristol Royal Infirmary
- Clinical Research Fellow at the Mid-Atlantic Wellness Institute, Bermuda
- Research Fellow at the National Clinical Guideline Centre, London
- Academic Clinical Fellow and Speciality Training (currently year 4) in General Adult Psychiatry at the Maudsley Hospital, London
Addiction is an area where you can offer genuinely holistic care to patients. Patients with addiction disorders are often marginalised by society and within the health service. Being able to give good quality care to people who would otherwise struggle to access it is exceptionally rewarding. Patient care includes on-site sexual health, drug, alcohol and medical services.
At the moment I dedicate three days a week to clinical time and two days to research but when my MRC Addiction Research Clinical Fellowship starts I’ll be able to dedicate more time to research. Working at a national specialist service at the Maudsley Hospital, I see patients with depression and bipolar disorder whose treatment hasn’t worked.
We’re an outpatient service and see patients from all over the UK. We provide recommendations on their treatment and are also involved in clinical trials. We’re currently evaluating whether the intranasal drug esketamine – a component of the general anaesthetic ketamine – can help patients with depression who haven’t responded to other treatments.
My main research focus is alcohol-use disorders. I’m looking at how services, the patients who use them, and staff working in hospital departments, have been affected by changes to the commissioning of services over recent years in England.
I’ve enjoyed all of my training but I’d recommend taking time out from the constant conveyor belt of medical training. It makes for a more varied career and gives you an excellent sense of job perspective. It also provides you with some interesting stories to reel off in interviews and over dinner. Once I had to find a temporary home for 20 exotic parrots – it’s the kind of thing they don’t teach you at medical school.
When I was an academic foundation doctor, I spent four months researching stigma towards mental illness at the Mid-Atlantic Wellness Institute in Bermuda. I looked at attitudes towards mental illness in the island’s newspaper media. Despite improving trends across the rest of the world, we found that mental illness reporting in Bermuda showed a worrying tendency towards using a negative tone, with many articles relating to violent crime. We talked with the island’s media to develop a dialogue to change this for the better.
During a year out of medical training I worked at the National Clinical Guideline Centre. This involved working on two National Institute of Health and Care Excellence (NICE) guidelines, in osteoarthritis and acute heart failure. I also advised a NICE technology appraisal in hepatitis C. By judging the quality of evidence available I helped make national recommendations on treatment strategies.
In this role I learnt the fundamentals of systematic review. This is a skill useful to any clinical researcher to assess bias in research and combine data to inform evidence based-treatment recommendations. I’d recommend this experience to other clinicians, not least as I’d never worked in an office before.
I then worked for a year in one of the poorest mental health trusts in the country, at St Ann’s Hospital in Haringey. We struggled daily with a lack of available hospital beds and scarce resources in a London borough with a high burden of mental ill health. Through this experience I became interested in the way services are commissioned and how that can directly affect patients.
The skills I consider most valuable are time management and planning. The ability to not check my email when I’m on holiday is also very important!
My career advice is to approach everybody. Email them. Meet them for a coffee. Nothing bad will happen. People are overwhelmingly very pleased to talk to, mentor and advise early-career-stage clinicians and researchers. These conversations have been where some of my most exciting collaborations have been born.
The MRC Addiction Research Clinical training scheme is giving me the chance to develop skills in research methods in epidemiology and develop contacts within addiction sciences to further my career. The scheme includes a funded MSc in Epidemiology, which I’m due to begin in August 2017, followed by a PhD. I’ll look at whether access to specialist care for people with alcohol problems affects the likelihood of being hospitalised, or of suffering harm related to drinking alcohol.
Think about a career in addiction. It’s a vast speciality that includes epidemiology, clinical research, neuroimaging and a whole smorgasbord of exciting projects. It often slips people’s minds but in my opinion it’s the most rewarding and challenging speciality.
Find out more about the MRC Addiction Research Clinical training scheme: www.imperial.ac.uk/medicine/mrc-addiction-research-clinical-training