3 February 2016

Part 4. The four seasons of a clinical academic without borders

Franco Cappuccio, Professor of Cardiovascular Medicine & Epidemiology, concludes his journey through the ‘four seasons’ of his career to date as a clinical academic which we hope will inspire and delight you and hopefully encourage some of you to follow suit in this challenging but fulfilling medical career path.

Part 4. The Harvest Season (2005-2015)

Thank you for enduring reading this blog. We have come to the good harvest of formidable seeding seasons. I decided to accept new challenges by moving to Warwick in 2005 to take an Endowed Chair in Cardiovascular Medicine & Epidemiology (Inaugural Lecture). The mandate was clear: to improve the research profile of the new Medical School in my areas of research and, at the same time, to establish a teaching and research programme in sleep medicine. This section shows how, from an initial narrow research interest, I became involved in a variety of fields and made global impacts.
Sleep, Health & Society Programme
OUP Book 2010
Over the last ten years our group, with the tireless support of my closest collaborator, Michelle Miller, established a reputable research programme and a new teaching module in sleep medicine.

The work has led to many publications of high impact, a teaching module attended by just under 100 MB ChB students, many directly engaging in sleep research, and the publication of a textbook. We became an immediate target of interest for media outlets which allowed us to expand our dissemination and impact activities towards lay audiences.

World Health Organization Collaborating Centre
My interest in salt and cardiovascular disease developed into the need to engage with policy makers to make sure that we could influence them (governments too!) to develop comprehensive action plans for a population reduction in salt consumption to prevent cardiovascular disease.

I acted as a Technical Advisor to the World Health Organization to develop global recommendations and we continued the production of research evidence. In 2008, I became the Head of the University of Warwick’s first Collaborating Centre, which has since been at the forefront of the development and implementation of global policies across several continents.

At the same time, our Centre contributed to the development of national guidelines through the National Institute for Health and Care Excellence (NICE). Furthermore, our group has been the first in the world to demonstrate the presence of social inequalities in salt consumption both in Britain and in other countries in Europe, calling for the modifications of health policies aiming at narrowing the social gap.
European Society of Hypertension Centre of Excellence
Notwithstanding the significant shift of interest and activities towards epidemiology, public health and policy, I always kept a firm grip with patients, people and clinical activities, Hypertension and Cardiovascular Medicine being my focus.

In 2008, the European Society of Hypertension awarded our group at University Hospitals Coventry & Warwickshire NHS Trust the status of Centre of Excellence, an important international recognition for a newly established specialist service. As I hinted in Part 2, the level of expertise I accumulated during the Season of Growth has also allowed me to serve for many years in the Executive Committee of the British Hypertension Society as Treasurer, Executive member, Vice-President (and … in due course ... President), training doctors and allied professionals in hypertension.

These rewards, alongside the daily manifestations of satisfaction, respect and gratitude of my patients, have reinforced in me the belief that I have served them well over the years and have fulfilled the Hippocratic Oath.
Additional benefits of a clinical academic career
Prof D Singer (Deputy-Director) and
Prof G McInnes (BHS President)
at the ESH CoE launch in 2008
I want to finish by honestly acknowledging the additional opportunities this job as given me over the years, that is, meeting very interesting people, visiting the world and being known. Beyond meeting Her Majesty The Queen, I attend regular meetings at the House of Commons and the House of Lords to act as an advocate for policy changes in nutrition. I have dined in the presence of Royals (memorable a banquet in the presence of King Juan Carlos I of Spain and a similar experience with the Sultan of Brunei) and I have met politicians and ministerial representatives from several countries.

I touched all continents in my travels, including the unforgettable experience of co-ordinating a five-year population-based programme of salt reduction in rural Ghana. All these visits have not only given me the opportunity to interact with colleagues from all over the world in enriching and stimulating scientific discussions, but they have been a constant open window on different cultures, the necessary yeast of progress and innovation.

"A pinch too far"
One of the important aspect of medicine and research is to pass on the information about your research to audiences other than your peers. To communicate and disseminate knowledge to wider audiences are essential skills not taught at medical schools. As part of my clinical academic work I was fortunate to receive professional media training that proved extremely useful. Over the years I was able to create media interest in what I was doing and managed to convey concisely and effectively the implications of our results (press releases and videos/podcasts). One recent memorable event is the Cookery Session at the Festival of Imagination at the University of Warwick last October

Choosing a clinical academic route is tough and courageous, and the path is not free from uncertainties, hurdles and traps. However, I hope my journey shall be an inspiration for some of you to follow this path with enthusiasm and belief. Have a great career and enjoy every moment of it.

Career learning points:

  • Good seeding leads to good harvest.
  • It takes time to make a difference.
  • Science and research have rules, but innovation does not always follow a straight line.
  • There are no valuable personal achievements without good work.
  • The life of a clinical academic is always fulfilling in the end.

What did my research show about salt?

  • Population evidence in salt consumption is cheap, feasible, achievable, effective and equitable - it is a preventive imperative.
  • Population reduction in salt consumption is the best buy for a public health system (second only to tobacco control) - is it an economic imperative.
  • Effective policy options always involve political choices - it is a political imperative.
  • Every country in the world is going to take action to reduce dietary salt consumption to prevent CVD and to reduce its global burden.

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