Clinical science 2011

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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

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

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