Feature: Opinion – "Clinicians need to be scientists too"

16 November 2012. By Robert MacLaren, Professor of Ophthalmology, University of Oxford

A clinician with a scientific understanding of a disease is in a very powerful position to develop an effective treatment for it. To do this, of course, they need the financial support to run a laboratory. However, as they look into the problem in detail, it is easy to lose sight of the big picture: where is the research going? How might it eventually be translated into a treatment?

Advice is best given by someone who has been down the same path before. For me, that person was Professor Peng Tee Khaw FMedSci. We met thanks to the Academy of Medical Sciences mentoring scheme, which pairs up clinical lecturers and clinician scientist fellows with one of the Academy's 1000 Fellows.

Professor Khaw's direction and guidance helped me focus my scientific thinking onto my clinical area - retinal degeneration. He reminded me that scientific achievements should not let me lose sight of my principal role as a clinician, which is to develop new treatments for the benefit of patients.

When developing a new scientific discovery as a treatment, it is essential to consider things from the clinical trials perspective as early as possible. In gene therapy, for instance, you need to think about the timing of interventions and also the potential pitfalls of complex surgery.

One also needs to be aware that human retinal diseases are genetically much more diverse than the typical 'knockout' mouse models used in the laboratory. From the start, your experiments must be guided by knowledge of exactly how the treatment might eventually be applied, and to whom.

The National Health Service is an excellent platform for clinical research, something that has undoubtedly helped our multi-centre UK trial become the first in the world to use gene replacement to target directly the retina's photoreceptor cells. The NHS research networks are underpinned by scientific funding (provided by the Wellcome Trust and others) that supports clinical researchers at early stages in their careers. This environment sets British clinicians firmly on the path of discovery in a way not seen in many other developed countries.

Consultants need to know that it is not enough just to apply established treatments to diseases - we also need to develop new treatments for the diseases that are currently incurable.

In my view, the concept of clinician scientist should overlap with the ideals of any NHS consultant. While few will have their own laboratories, all will have access to patients who may benefit from new treatments, and a consultant engaged in basic science will be in the best position to develop the trials that will, hopefully, lead to treatment.

This feature also appears in issue 72 of ‘Wellcome News’.

• Interested in being mentored? Contact mentoring@acmedsci.ac.uk or see the Academy of Medical Sciences website for a booklet and video on the Academy of Medical Sciences scheme.

Image: Professor Robert MacLaren.