Real-life story - Helen A Brough
Find out more about the real-life story of a clinical lecturer in paediatric allergy and clinical immunology
There is a lot you can do for atopic children to improve their quality of life. I found working in a field with close links between academia and clinicians stimulating and exciting.
I was impressed with people that I met in the paediatric allergy field. They were all open minded, research orientated, approachable people. Also I liked the idea of a specialty where you still are dealing with multiple organ systems. Thus you can be a specialist in allergy but also deals with almost every organ system as allergy can affect the lungs (asthma), nose/eyes (rhinitis), skin (eczema) and gut (eosinophilic gut problems).
I enjoyed the specialty immediately and had a steep learning curve as there is very little paediatric allergy training in undergraduate medicine.
I first decided I wanted to be a paediatrician when I worked in A&E and preferred covering paediatric A&E than adult A&E. I then decided to get into paediatric allergy when I attended an Allergy Academy course and heard leading allergists speak about their field and got to speak to many of them myself.
I initially wanted to be an adult Gastroenterologist but then decided to become a paediatrician. However now I am able to do a lot of gastroenterology within allergy and run a joint Allergy/Gastroenterology clinic which is very enjoyable.
To be a GRID trainee in Paediatric Allergy and Clinical Immunology you need to show an interest by having attended paediatric allergy clinics. It is also useful to have some paediatric immunology experience. A research interest is also important and there are two Allergy MSc courses at the University of Southampton and Imperial which I would highly recommend. The Allergy Academy also runs practical courses throughout the year at St. Thomas’ Hospital if you want to get an insight (like I did).
Once you are a BSACI member then you can attend regional training days 2-3 times a year for free (you can pay to go if you are not a member) and the BSACI conference which is excellent. Also join the BPAIIG (British Paediatric Allergy Immunology and Infectious Diseases Group) which allows you to attend their regional modules twice a year.
There are a number of joint clinics that run in our department that ensure the close clinical and research collaboration between allergy and various other specialties:
- joint allergy and gastroentrology clinics
- joint allergy and respiratory clinics
- joint allergy and dermatology clinics
- joint allergy and ENT clinics
In allergy you work closely with the nurses and dieticians and thus have a multidisciplinary approach which is very rewarding.
My clinical working hours whilst in training are the usual 9am-5pm with general paediatric on calls. However as a consultant I may or may not have to cover general paediatrics. Given my academic slant this does take up a lot more time but is very flexible so I can usually go to any training day I wish to attend and then catch up on research work on other days. Thus I would say that they can certainly be sociable and family friendly however research can be all consuming!
My typical day would be a 9am start for clinic which runs till 1pm. I would see between 6-8 patients and spend about 30 minutes with each patient. In between patients I will be authorising clinic letters and responding to patient queries. I am likely to recruit a patient to one of my or somebody else’s research project during clinic. We then have a lunch time meeting to discuss patients and have presentations from one of our team or a pharmaceutical company which sponsors lunch. I then go to the lab and either process research blood samples sent across or work on research admin/grant writing/report writing/data analysis. I spend quite a lot of time on paperwork for research. I go home between 5-8pm depending on what I would like to do as I can always continue working from home on my research projects.
Other days may consist of giving lectures or attending courses, meeting with people in the lab to help with the research I am doing or with collaborators. I also cover A&E from 5-9pm once every 2-3 weeks and cover the paediatric ward 3 weekends every 6 months (part-time general paediatric on calls).
I get 34 days leave per year.
Outside of work I enjoy travelling and sport. I enjoy my research too which is good as I spend a lot of time on it!
In training to be a paediatric allergist and clinical immunologist you still train as a general paediatrician, thus it is possible that you could do a variety of consultant positions. I am in an academic post thus I could go for a senior lecturer position or tertiary paediatric allergist consultant position. However I could still be a general paediatrician with an interest in allergy if I chose to do this.
Research has already provided big opportunities in allergy such as immunotherapy for hay-fever which is now readily available in clinical practice. Management of asthma and eczema has also significantly improved due to research in this field. In the next 5-10 years we will hopefully be able to offer desensitisation to foods in food allergic individuals and we are also evaluating prevention of food allergy.
I have been the Trainee Representative for the British Society of Allergy and Clinical Immunology for the last 2 years. I set-up a Food allergy Interest Group to promote translational research in Food allergy in our clinical/research department. I have worked closely with the Charity Action Medical Research who has funded part of my PhD project and I presented some of this charity funded research at the House of Lords. I have set up new services including the Joint Allergy and Respiratory clinic and the home food introduction, baked cow’s milk and baked egg desensitization programmes in our department. I have also published articles in the field of allergy and am in my penultimate PhD year. I have assisted in guideline development for the World Allergy Organisation cow’s milk allergy guideline and for local guidelines and audit in venom and nut allergy. I have worked with the charities Action Against Allergy and the Anaphylaxis Campaign doing seminars for parents of allergic children.