8 minute read
Mind the gap - women in research
By Dr Melissa Maguire
Dr Melissa Maguire is a Consultant Neurologist at Leeds Teaching Hospitals and NIHR Specialty lead in Neurological Disorders for Yorkshire & Humber. She holds the honorary title of Clinical Associate Professor in Neurology at the University of Leeds.
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The gender gap in research
Women make up around three quarters of the NHS workforce and represent over half of all medical school graduates. Yet women account for just one third of UK researchers working within the medical field. This disproportionate gender pattern of researchers is seen globally and exists across other research areas including science, technology, engineering and mathematics (STEM). So why does this gender gap exist? And how can we address the imbalance?
A survey conducted by the Royal College of Physicians in 2020 reported that women members and fellows particularly those working less than full time and those working within non-university hospital settings participated in research in disproportionately lower numbers than men (a 12% gap). This was not for a lack of interest however, with more than one third not research active expressing a desire to participate. This suggests an untapped research potential. Many stated that a lack of time, inflexible job planning and perceived lack of skills and supportive culture in their organisation were key challenges. Women were also less likely to report formal academic training, a completed higher degree and university funded time at new consultant level. This suggests divergence potentially occurring during training. These factors are likely to explain why fewer women go on to attain senior leadership roles in research. For example, only 11% of professorial roles are held by women in UK Medical Schools despite a steady increase in the number of women and graduate students entering Medicine. This remains an ongoing concern since the importance (and lack of) inspirational role models and mentors are critical in supporting and developing women in research.
12 ‘One third of women surveyed expressed interest in research and represent an untapped research potential’ (RCP: Research for all, 2020)
My research pathway
My own research pathway began in the North West in 2004. I scrambled into a research job in Liverpool having failed to secure a training number in Neurology through my lack of a completed higher degree. At the time I had not intended to divert from clinical training yet what seemed like an uncertain off road step actually turned out to be the most important and career defining three years I have ever worked. I cut my teeth in epilepsy, acquired a bunch of new analytical skills and became part of a supportive clinical research network. The friends and mentors I made during my higher research degree continue to influence my research pathway and career today. The vast majority however were men! Experience of research opportunity during higher training in Newcastle was quite mixed given competing demands on time to supervisors, it did require a certain level of enthusiasm from me to ensure I remained ‘research active’ and up to date within my field. Actively seeking out opportunities as a trainee goes a long way with busy consultants and once people are aware of your interest, I found more and more academic opportunities opening up to me.
The best part of being a Consultant Neurologist at Leeds Teaching Hospitals has been joining like-minded women peers and mentors who have a passion for research and have set out to raise the academic bar in Neurology. In 2011, I joined a research team conducting a handful of research studies in multiple sclerosis with a single research nurse. Fast forward a decade and we now have a portfolio of over 20 studies in the fields of epilepsy, multiple sclerosis, movement disorders and headache, a research team of seven, competitive doctorate fellowships and the first Professor of Neurology, who yes, is a woman!
One of the key aspects for me in taking part in research is being able to contribute in a meaningful way to improving patient care and being at the forefront of new treatments and innovations in epilepsy. I find the intellectual stimulation appealing and it brings variety to what can sometimes feel like a monotonous clinical job. Approaching research as a newly appointed consultant can be daunting and some may question whether they have the appropriate skill sets and knowledge. The National Institute of Health Research (NIHR) clinical network has been fundamental in providing opportunities to early career researchers. There are MRC-NIHR academic research partnerships that can fund dedicated research time, skills workshops and network opportunities to participate in clinical trials. When I started out at Leeds, I took on a phase four portfolio epilepsy study to gain
some experience. Gradually over the years I increased the complexity of work to include earlier phase studies and commercial studies. This I found not only embeds you into the local network but opens up a whole host of partnership opportunities and expertise to collaborate with on your own homegrown research projects.
In 2017 I received the title of Honorary Clinical Associate Professor in Neurology from the University of Leeds (UoL). With three years of funded time supported by the Leeds Hospital Charity, this post has enabled me to develop novel avenues of epilepsy research at UoL with academics; a subject area previously devoid of any research activity. I now supervise higher degree research fellowships exploring clinical and biological factors in brain tumour related epilepsy and have forged links with a MedTech company to examine the clinical utility of long term subcutaneous EEG in patients considered for epilepsy surgery. As a full time NHS consultant and leading a busy epilepsy service, it has allowed me to identify gaps in patient care where translational research might benefit. Sometimes the translational impact is not
always recognised within academia and it takes an experienced clinician to guide the study design and ideas.
Closing the gap
It is widely recognised across different organisations that more needs to be done to investigate gender inequalities and understand the barriers to medical research participation of women. The Athena Swan Charter introduced in 2005 has been an important step in ensuring academic institutions promote gender equality and tackle behaviours and cultures that detract from collegiality of study environments for people of all genders. In the NHS, women clinicians are more likely to work less-thanfull-time (LTFT) with this strongly correlating with lower formal employment in research roles. Another area where women report barriers is a lack of knowledge or skills suggesting they feel less confident or find it harder to access appropriate training. NHS trusts need to ensure flexibility in job planning to protect time for clinical research including research delivery within direct clinical care programmed activities. NIHR networks need to support NHS trusts in enhancing capacity and capability of women researchers who represent an untapped research potential. NIHR have partnered with the Royal College of Physicians in designing a postgraduate certificate focused on the practical elements of clinical research. This qualification will form part of the new NIHRAoMRC Clinician Researcher Credentials Framework, which provides a range of practical, Master’s level clinician researcher development programmes aimed at experienced clinicians who are new to research.
Finally, in a 2021 publication, the BMA Women in Academic Medicine (WAM) Group shared their successes and challenges in the research world. Their stories are really inspiring and a common theme in their success was the presence along the way of supportive mentors. Having a community of practice for women in research where all are welcome should be a key development aim. By providing research mentorship we can help to inspire, support and develop the next generation of women researchers, something I am passionate to make happen.
Conclusions
I hope that my story provides at least some inspiration to female trainees and new female consultants coming through who may not wish to be fulltime academics but want to develop an academic branch to their NHS job role. With a flexible, supportive work environment, protected research time together with positive enthusiasm, it is possible for all women working within the NHS to get involved in research. This can only benefit professionals and patient care in the long run.
Meet our people – Nick Devereux
What is your role at the Trust and how did you get into it?
I’m a Registered Nursing Associate, currently working in Urology Theatres at SJUH.
When I initially joined LTHT I worked as a Clinical Support Worker on J83 and was encouraged by one of the ward sisters to apply for the nursing associate apprenticeship. I spent my two year apprenticeship working on an acute surgical ward before making the decision to transfer to theatres so I could focus on developing my clinical skills as a newly qualified.
Tell us something about your role that people find surprising.
How much variety there is in the nursing associate role! There are a lot of different routes the role can take. I know people who work in adult nursing, children’s nursing, learning disabilities, mental health, community and education so there are plenty of opportunities as the role becomes more recognised.
What do you find most rewarding about your role and would you recommend it as a career?
What I find most rewarding is having a role that I feel makes a difference. I loved being able to care for my patients in a way that made an inpatient stay a little bit brighter and in my new role I’ve got so much to learn it’s a whole new challenge for me.
