I am a Clinical Associate Professor and Honorary Consultant Gastroenterologist. I’m based in the Nottingham Digestive Diseases Centre, which is part of the National Institute for Health Research (NIHR) Biomedical Research Centre in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and the University of Nottingham.

Having completed my clinical gastroenterology training as an NIHR clinical lecturer, I wanted to continue to pursue a career in academic medicine. I therefore applied for an Anne McLaren Fellowship, which I felt would enable me to ring fence a considerable portion of my time in research, whilst also fulfilling my role as a Consultant Gastroenterologist. 

I was initially attracted to Nottingham as a clinical trainee as it enjoys an excellent national and international reputation in academic gastroenterology. We are fortunate to be funded by a prestigious £23.6m NIHR-Nottingham Biomedical Research Centre for early translational research. I strongly believed that continuing my research studies as an Anne McLaren Fellow (AMF) in Nottingham would be highly advantageous and give me the best chance of succeeding in my research goals.

Since been awarded an AMF, it’s been non-stop, with lots of international travel and excellent networking opportunities. I feel that the University is really invested in its fellows, for example cross-faculty events provide helpful advice on funding and building one’s profile. Of course, it’s not without it challenges. As a clinical academic, I’ve found it necessary to revise my job plan to balance my research and clinical commitments. Fortunately, as a Consultant, there is flexibility in the way we work and so it has been possible to make changes when necessary. 

My research focuses on the gut pathogen commonly referred to as C. diff (Clostridioides difficile). C. difficile infection is the leading worldwide infective cause of antibiotic-associated diarrhoea in hospitalised and community populations. Sometimes the disease can be mild and resolves but in a proportion of patients, the disease can lead to a severe colitis and even death. Normally, the millions of bacteria in our guts prevent disease-causing bacteria like C. difficile from causing a problem. However, antibiotics can damage these protective defences, allowing C. difficile to move in, grow and produce harmful toxins, which can damage the lining of the bowel and thus cause symptoms. My research focuses on how the immune system and microbiome (microbes within the intestine) behaves during and after infection, to try to detect new ways of fighting the bug. One of the best aspects of my research is being able work to with international collaborators who share my keen interest in this bacterium. My AMF project has allowed me to travel to Central India to study for the first time the burden of C. difficile infection in highly divergent urban and rural hunter gatherer populations. My team is using new molecular fingerprinting methods, such as whole genome sequencing to study C. difficile strains and the composition of the gut microbiome in fine detail. 

I’ve always been interested in gut pathogens and how clever they are in evading the body’s host defences. I particularly enjoyed immunology and microbiology components of the medical school curriculum, and later pursued a BSc during my clinical studies. I later gravitated towards speciality training in gastroenterology following my postgraduate examinations. Working as a gastroenterology trainee, I realised that gut pathogens were a major challenge and how rewarding it would be to study them in greater detail and to ultimately take what I was learning in the lab to the patient’s bedside.

My AMF research studies will provide much needed epidemiological information on the burden of C. difficile infection in Central India, which can then be crucially used to inform infection prevention and control policies at a regional and national level. My lab studies will help provide mechanistic insight on how the bacterium impacts upon the human immune system and gut microbiome, which many eventually lead to the development of more efficacious and cost-effective treatments for C. difficile infection.

I’m hoping to tackle the major global challenge of antimicrobial resistance accelerated by the overuse of antibiotics by increasing awareness of infections such as C. difficile, a neglected pathogen in Central India. Through the generation of high-dimensional molecular data sets, my team and I hope to be able fundamentally advance our understanding of C. difficile pathogenesis, and, in so doing, inform new treatment strategies.

I would say that my greatest achievement so far is being appointed a Clinical Associate Professor and Consultant Gastroenterologist at Nottingham University Hospitals NHS Trust. The journey has been long and demanding but worth it.

Alongside my supportive family, I have received excellent support and guidance from my colleagues in the School of Medicine as well as internal and external mentors, the latter via the Academy of Medical Sciences mentorship scheme. Although it takes a lot of self-determination and hard work, having a trusted network of helpful colleagues has really helped propel me to my current position, to whom I am eternally grateful. 

It’s important to plan ahead at an early stage. Speak to senior academics in your chosen field or speciality to understand more about the career transitions and hurdles that will need to be overcome. Don’t be shy about seeking out the best labs and people who you feel you will learn the most from. Remember to be adaptable and expect the unexpected. Have in mind that you are going to fail at times but be constructive and learn from these situations. The key to succeeding is always perseverance in my book.

There are many advantages to being based here, including excellent opportunities to carry out transdisciplinary research, working in cutting-edge laboratory facilities with internationally renowned experts at the forefront of their fields, and fantastic support for early career researchers, particularly in relation to accessing funding opportunities, advising/supporting grant applications and in the provision of career advice.

With the assistance of a UoN Research Priority Area grant, we are implementing a new molecular diagnostic (multiplex PCR) platform that will allow us to determine more broadly the aetiologic causes of infectious diarrhoea in Central India. This system will allow us to detect pathogens in stool samples in a shorter time frame, which means we can accurately prescribe the most appropriate antibiotic and ultimately improve patient outcomes. We will collect DNA and RNA from all faecal samples, which we will biobank for downstream studies, in an effort to discover biomarkers of infection.