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  • Why a particular testing strategy is employed for that disease Risk calculations/Conferences of professional bodies/New technologies Clinical Pathology Accreditation
  • Sanger sequencing Sizing PCRs (deletions/insertions) Multiplex ligation probe amplification (dosage) Southern blotting (large expansions/insertions/duplications) Clonal sequencing (everything) Oligonucleotide ligation assay (single nucleotide changes)
  • Focuses on the outcome of bloodstream infections – over five sites C diff study – four sites
  • Published February 2010

Clinical science 2011 Clinical science 2011 Presentation Transcript

  • A Clinical Scientist in 2011
    • Claire Bosomworth
    • Research and Development
    • Microbiology
    • Leeds General Infirmary
  • How it all started
    • BSc (hons) Medical Genetics
    • Trainee Clinical Scientist position in Molecular Genetics St James’ University Hospital
  • What you had to do then (2005)
    • 2003 Government White Paper – Our Inheritance, Our Future
    • Apply through central recruitment agency
    • Two routes:
      • 4 year training program for graduates
      • 6 year training program for post doctorates
    • Certificate of Competence
    • ACS Certificate of Attainment
    • Registration with the Health Professions Council
  • Molecular Genetics
    • Study of gene structure and function
    • Inherited disorders
    • Three sections
      • Prenatal diagnosis
      • Carrier testing
      • Diagnostic – confirmation of a clinical diagnosis
  • The training
    • Cover core diseases tested for in the laboratory
      • Mode of transmission
      • Phenotype/genotype
      • Testing strategy and reporting
      • Clinic attendance
    • Standard operating procedures
    • Audit
    • CPA inspection
    • Courses/conferences
    - 1 - 2 + 1 I II
  • The portfolio/assessment
  • Post competence – a typical day
    • ~75% - diagnostic testing
    • 2/3 diseases
    • Set up testing
    • Supervision of technicians
    • Analysis of data
    • Report writing
    • Liaising with clinicians/external labs
  • Techniques employed within the laboratory
    • Sanger sequencing
    • Sizing PCRs
    • Multiplex ligation probe amplification (MLPA)
    • Southern blotting
    • Oligonucleotide ligation assay (OLA)
    • Clonal sequencing
  • Data kindly provided by Ian Berry
  • Interpretation
    • Literature search
    • Bioinformatics
    • Disease specific databases
    • Synonymous/non-synonymous
    • Change at protein level
    • Protein prediction software
    • Sequence alignments
    • Training and scientific knowledge
  • Assay development
    • Malignant hyperthermia
    • ARMS vs. sequencing
    • UKGTN
    In line with other testing procedures Gel based Technical support Cheap More expertise Quick Sequencing ARMS
  • Duty Scientist
    • Gatekeeping of all samples received
    • Extraction/storage/rejection
    • Work closely with extraction technician
    • Deal with enquiries
    • Sign off all samples – contract/billing
    • Sending
  • What happened next
    • Completed (almost) four year training contract in Molecular Genetics
    • July 2009 - Swine flu
    • Virology laboratory Leeds General Infirmary
    • Set up respiratory virus testing laboratory
    • Registration with HPC
    • March 2010 – Moved to R&D within Microbiology
  • What I do now
    • Currently employed to work on a bloodstream infection trial
    • Implementation of new identification systems for bloodstream infections
    • Help in the laboratory with Clostridium difficile research
    • Developing an in-house PCR for C. difficile
  • Molecular genetics vs. Microbiology
    • Diagnostic
      • Data analysis
      • Lab work
      • Duty Scientist
    • Service development
    • Day to day work – Clinical Scientists/Technicians
    • All one lab
    • Fewer samples
    • TAT 3 – 40 days
    • Research
    • Service development
    • Clinical trials
    • Day to day work – Biomedical Scientists
    • Lab split into distinct sections
    • More samples
    • TAT much shorter
  • What would you have to do now?
    • Modernising Scientific Careers: The UK Way Forward
    Taken from: http://www.dh.gov.uk/
  • MSC framework Taken from DH –The UK way forwards
  • STP training Taken from DH –The UK way forwards
  • Payscales Taken from http://www.rcn.org.uk
  • Tips
    • Work experience
    • News
    • New developments
    • Remember what you did in your degree
    • Research the company
  • Dates to remember
    • Feb 2011 – NHS careers will publish training posts
    • No applications accepted before 24 th Feb
    • Advertised in New Scientist and NHS jobs
    • Closing date 13 th March
    • Employment will start October 2011
  • Useful websites
    • Association of Clinical Scientists
      • http://www.assclinsci.org/acsHome.aspx
    • NHS careers website
      • http://www.nhscareers.nhs.uk
    • Department of Health
      • http://www.dh.gov.uk
    • Health Professions Council
      • http://www.hpc-uk.org/
    • British Society for Human Genetics
      • http://www.bshg.org.uk/
    • Association for Clinical Biochemistry
      • http://www.acb.org.uk/
    • PHG foundation
      • http://www.phgfoundation.org