Download Medicine TMAT ACF job description

ACADEMIC CLINICAL FELLOWSHIP in MEDICINE CT1/CT2
ADDENBROOKE’S HOSPITAL, CAMBRIDGE
(in local Translational Medicine and Therapeutics (TMAT) in
Gastroenterology, Renal Medicine, Rheumatology, Respiratory Medicine,
General Internal Medicine, Acute Internal Medicine, or Haematology).
A Papworth Hospital Respiratory ACF post can be applied for via a
separate application process on Oriel.
This Core Medical Training/TMAT post will be appointed at CT1/CT2 level and provide funding for up
to three years. The principal aim of the ACF scheme is to allow academically gifted clinical trainees
the opportunity for 25% protected research training alongside completion of CMT and during that time
to formulate and submit an application for an externally funded Research training Fellowship (RTF)
(e.g. MRC, Wellcome Trust, BHF). If candidates are unsuccessful in obtaining funding for a RTF/PhD,
they can transfer into non-ACF ST3+ posts and pursue full time clinical sub-specialty training. It is
anticipated that all successful ACFs completing RTFs would be in a strong position to compete for
Clinical Lecturer posts following award of their higher research degree, as per the Integrated
Academic Training programme. This post will attract an NTN(A).
Locality
The Cambridge ACF programme in General Medicine Specialties is based at Addenbrooke’s Hospital,
Cambridge University Hospital NHS Foundation Trust, but includes opportunities to rotate to GIM and
sub-specialty CT1/2 posts at Papworth Hospital, Hinchingbrooke Hospital and the West Suffolk
Hospital.
Aims of the Academic Clinical Fellowship
The main aim of these posts is to allow individuals to be exposed to academic environments and
research techniques that would inform their choice of subsequent full time research training and
provide the senior academic input needed to support the submission of an externally funded RTF. As
such, the research components are not constrained. For example, an individual may wish to
undertake an initial project involving basic molecular and cell biology followed by periods undertaking
translational and/or patient based studies. Alternatively, an individual may be interested in exploring
different research techniques and/or wish to spend their entire research time working in a single
research area. It is anticipated that all Medical ACFs will rotate into research in 3 month blocks
spread throughout the 3 years, with at least one spent working with the proposed supervisor for the
RTF. This would allow time to undertake preliminary studies in support of the RTF and time for
background reading and preparation of a RTF application. These ACFs are intended to support
clinical academics wishing to undertake subsequent sub-specialty training in the above areas.
Clinical component
ACFs would participate in the normal CT1/2 CMT programme for 9 months in each year and rotate
through a balanced set of GIM/sub-specialty CMT training posts. The choice, blend and sequence of
jobs would be overseen by Dr T Burton (ST1/2 CMT Clinical Lead) and Dr A Floto and be designed to
allow exposure to the principal sub-specialist area of interest but also to include a broad portfolio of
jobs capable of delivering CMT, including a 3-6 month placement in a DGH. These posts would be
indistinguishable from the mainstream CT1/2 CMT posts and involve normal pro-rata on-call
commitments, medical take/post take rounds and night cover.
The Clinical Programme Director is Dr Tim Burton
Academic Component
Medical ACFs will rotate into three periods of research (in 3 month blocks) spread over the 3 years,
with at least one period spent working with the proposed supervisor for the anticipated RTF. This
would allow time to undertake preliminary studies in support of the RTF and time for background
reading and preparation of a RTF application. ACFs will also have the opportunity to register for a
taught MPhil in Clinical Science (Translational Medicine and Therapeutics) (usually spread over two
years), and attend relevant scientific talks and meetings during their fellowship.
ACFs are encouraged to explore the possibility of research attachments and subsequent PhD projects
with Principal Investigators (PIs) from the Department of Medicine (www.med.cam.ac.uk), the
Cambridge Institute for Medical Research (www.cimr.cam.ac.uk), the Institute for Metabolic Science
(www.ims.cam.ac.uk), other departments within the Schools of Clinical Medicine
(www.medschl.cam.ac.uk) and Biological Sciences (www.bio.cam.ac.uk) and within affiliated
Institutes such as the MRC Laboratory of Molecular Biology (www2.mrc-lmb.cam.ac.uk), the CRUK
Cambridge Research Institute (www.cambridgecancer.org.uk), The Babraham Institute
(www.babraham.ac.uk) and the Wellcome Trust Sanger Institute (www.sanger.ac.uk). More
information on PIs in Infection/Immunology can be found at Cambridge Immunology
(www.immunology.cam.ac.uk)
and
in
Neuroscience
at
Cambridge
Neuroscience
(www.neuroscience.cam.ac.uk).
The Academic Programme Director is Professor Andres Floto
Details of academic groups in the clinical specialty areas listed:
Gastroenterology
1. Professor Arthur Kaser’s group focuses on mucosal immunology and has a special interest in
inflammatory bowel disease and its related conditions. In particular, they study the biology of the
intestinal epithelium that forms the interface between the body’s most abundant and diverse microbial
habitat and the sterile host environment. They have a special interest in the epithelial endoplasmic
reticulum (ER) stress response, and how genetically or environmentally imposed unresolved ER
stress within the epithelium can lead to inflammatory bowel disease and its sequelae. They also aim to
understand how host genetics and the environment affect the intestinal microbiota, and how the
microbiota in turn affects host physiology.
2. Dr Miles Parkes’ interest is the molecular genetics of Crohn’s disease and ulcerative colitis. Our IBD
repository consists of >3000 DNA samples recruited from patients across Eastern England, intestinal
biopsies from >400 IBD cases plus serum and stool samples. Current interests include fine mapping
of the 99 confirmed IBD susceptibility loci identified to date - using sequencing and array-based
technologies together with expression and functional studies; correlation of association signals with
immediate clinical end-points such as drug response and need for surgery in IBD; investigation of
differential methylation in colonoscopic biopsies from IBD cases and controls; and participation in both
investigator-led and commercial trials of new therapies in IBD. His group works closely with colleagues
at the Wellcome Trust Sanger Institute, with members of the UK and international IBD genetics
research consortia, chaired by MP, and with the Wellcome Trust Case Control Consortium.
Renal medicine
Research in the Division of Renal Medicine is focused on immunity and inflammation in both basic
science and clinical settings
1. Professor Ken Smith's group is based in the CIMR and works on how defective regulation of the
immune system (in particular of B cells and plasma cells) can lead to autoimmune disease such as
lupus and why the genetic defects underlying this dysregulation are common in normal populations.
This has led to work examining how genetic predisposition to autoimmunity influences the risk of
infections such as malaria. Menna Clatworthy is studying how defects in lymphatic development might
be involved in autoimmunity. Much attention is focused on "inhibitory receptors", the cell surface
molecules that as brakes on the immune system and on the new area of micro-RNA control of gene
expression. The Cambridge Hinxton Centre for Translational Research in Autoimmune Disease
(CHiC TRIAD), coordinated by Professor Smith, is a collaboration between the laboratory in the CIMR
(led by Smith and Paul Lyons), the vasculitis and Lupus Clinic (see below) and the European
Bioinformatics Institute at Hinxton. It is studying patients with autoimmune disease and with renal
transplants to understand pathological mechanisms and is defining biomarkers to guide
immunosuppressive therapy
2. Dr David Jayne runs the Vasculitis and Lupus Clinic and coordinates multi-centre trials in vasculitis
and SLE. These have focused on the evaluation of newer agents and the optimisation of conventional
therapies. He co-ordinates the European Vasculitis Study Group which performs clinical trials and
long-term evaluation of vasculitis patients. He is a visiting Professor of Chiba University, Japan and
has conducted studies with the Japanese Ministry of Health on vasculitis.
3. Dr John Bradley's group is studying the pathways involved in signaling by TNF receptor family
members in endothelial cells and their relevance to renal inflammation and transplant rejection. He
also coordinates the Yale Cambridge Cardiovascular Research Initiative. There are also links with the
Department of Medical Genetics (Fiona Karet and Richard Sandford's groups) and Surgery (the
Transplantation programme headed by Andrew Bradley)
Rheumatology
Prof J.S.H Gaston, Dr Frances Hall, Dr Robert Busch
The Division of Rheumatology is interested in the immunologic mechanisms which are responsible for
the major forms of inflammatory arthritis, including rheumatoid arthritis, connective tissue diseases
(e.g. SLE, scleroderma) and spondyloarthritis. These diseases not only have involvement of joints, but
are also systemic disorders with significant implications for other organs including lungs, kidneys and
eyes. In particular, a high risk of cardio-and cerebrovascular complications has been noted in these
diseases, likely related to chronic uncontrolled inflammation persisting over many years.
Our work consists of laboratory studies of the phenotype, function, and dynamics of different
molecules and cells in the immune system, particularly various subsets of T lymphocytes, but also B
cells and antigen presenting cells such as the dendritic cell. With regard to T cells, we are interested in
their specificity (the antigens they recognize), their cytokine and cell surface receptor expression, and
how they interact and are influenced by antigen presenting cells. With regard to molecular
mechanisms, we are interested in antigen presentation by class I and class II molecules of the major
histocompatibility complex, links between cellular stress and innate immune activation, and
mechanisms of autoimmune damage to blood vessels. We are looking for specific features which
would result in the development and persistence of immunopathology
All current techniques in immunology are used in this research including multicolour flow cytometry,
confocal microscopy, T cell cloning, gene transfection and transcriptional profiling. Emerging
techniques, such as stable isotope labelling of macromolecules to probe dynamic immune processes,
are being introduced. We investigate cohorts of patients with different forms of arthritis, and the
Department of Rheumatology is active in clinical trials particularly of "biologic" drugs, i.e. those which
target specific components of the immune system using antibodies or soluble receptor constructs.
Haematology
There are exceptionally strong links between the Addenbrooke’s Department of Haematology and the
University of Cambridge Department of Haematology, with Professor Tony Green acting as chairman
of the former and head of the latter.
The University department contains 7 Professors (AR Green, AJ Warren, R Read, JP Allain, W
Ouwehand, B Göttgens and J Huntingdon), 2 Readers (H Lee and L Williamson,) and 2 Senior
Lecturer (B Huntly and C Ghaevert) and one intermediate Wellcome Fellow (Dr M Chapman), has an
annual research spend of £3-4M, and in the last 5 years has had numerous publications in highranking journals (including Nature, Nature Genetics, Science, EMBO J, PNAS, Lancet, NEJM and
Blood).The major research interests of the department are:
1.Stem cell and leukaemia biology
This focuses on the transcriptional regulation of haematopoietic stem cells and pathogenesis of
myeloid leukaemias that arise from such stem cells. Research groups are situated in the Cambridge
Institute for Medical Research (CIMR) and MRC laboratory of Molecular Biology. Major thrusts include
the pathogenesis of bone marrow failure syndromes (Professor Warren), the transcriptional regulation
of haematopoietic stem cells (Prof Göttgens, University Reader), development of haematopoietic stem
cells (Dr Ottersbach, LLR Fellowship), the biology of leukaemia stem cells (Dr Huntly, University
Senior Lecturer) and the molecular pathogenesis of myeloproliferative disorders (Professor Green).
2.Thrombosis/haemostasis and structural medicine
This focuses on structural approaches to a number of clinically important molecules with research
groups based in the CIMR. Prof Huntingdon is studying the mechanisms that control the behaviour of
coagulation proteins and other serpins. The group of Professor Read (Wellcome Trust Principal
Fellow) works on extending the power and scope of methods used in protein crystallography and has
particular interest in the mechanism of action of bacterial toxins.
3.Transfusion medicine
Research groups are based in the NHS Blood and Transplant building. This houses a GMP facility,
stem cell processing and stem cell research laboratories together with groups working on platelet
immuno-biology and functional genomics (Prof Ouwehand), the use of antibody engineering to
generate novel and clinically useful monoclonal antibodies (Prof Ouwehand) and the study of
megakaryocyte biology (Prof Ouwehand and C Ghaevert). There is also a Clinical Studies Unit in
conjunction with the MRC Clinical Trials Unit.
The main sources of departmental research funding are Wellcome Trust, MRC and Leukaemia
Research Fund. In addition the Department has recently been re-awarded a $6M Centre Grant from
the US Leukemia and Lymphoma Society, the only Centre Grant to be awarded outside the US.
Respiratory Medicine
The Respiratory Medicine Division has four main areas of research: Inflammatory cell signalling, the
structure and function of alpha1-antitrypsin and related serpins, the genetic and molecular basis of
pulmonary hypertension and the immunopathology of allergic diseases.
1. Professor Chilvers' interests relate to the intracellular mechanisms regulating NADPH oxidase
function in neutrophils and the regulation of neutrophil survival by hypoxia and inflammatory cytokines.
Translational studies also include the use of radiolabelled autologous white cells to examine neutrophil
kinetics in vivo.
2. Professor Morrell's group is studying the functional consequences of mutations in the bone
morphogenetic type II receptor (BMPR-II), which underlie many cases of primary pulmonary
hypertension. The group is also focusing on cell growth pathways regulated by hypoxia as these are
likely to be important in the pathogenesis of pulmonary hypertension secondary to chronic lung
disease.
3. Professor Floto’s group is focused on understanding the interaction between bacteria (particularly
mycobacteria) and the host immune system; the regulation and dysregulation of antigen processing
innate immune response to bacteria; how antigen processing is controlled by macrophages and
dendritic cells and how it may be dysregulated in autoimmune disease and subverted by
mycobacterial infection. He is Research Director of the Cambridge Centre for Lung Infection,
Papworth Hospital, studying the pathogenesis and treatment of bronchiectasis, fungal and
mycobacterial lung infections.
4. Dr Marciniak’s group is studying the cellular consequences of endoplasmic reticulum stress; in
particular its effects on tissue growth and cell survival. In doing so, they hope to identify targets for the
development of novel therapies.
5. Dr Nathan’s group is interested in dissecting the molecular mechanisms underpinning the ubiquitinproteasome system and how they might be dysregulated in lung disease and potentially exploited
therapeutically.
6. Dr Ewan's research interests are in the clinical and biochemical aspects of allergic disease and
novel approaches to desensitization.
The Respiratory Medicine Division has a strong commitment to research training as indicated by our
current compliment of 7 MRC/Wellcome Trust Clinical RTFs, one Wellcome Trust Career
Development Fellowship and an ALTA training award. Since 2001 19 students have completed a
PhD. The theme has important links with many of the clinical Respiratory Units at Papworth Hospital,
which has nationally recognized expertise in the areas of pulmonary vascular diseases, cystic fibrosis,
lung defence, thoracic oncology, ventilatory failure/sleep medicine, and lung transplantation.
For further information please contact:
The ACF Programme contact – Professor Andres Floto [email protected]
For further information please visit NIHR TCC website
For email enquiries - Health Education East of England