Self-Care Tips to Keep You Sane: Podcasts

At the end of January I wrote about the importance of academic self-care for PhD students; I didn’t delve too far into the specifics of what I do in my downtime and a lot of people asked. ‘It’s hard to switch off’ and ‘I find it hard to relax’ were the two phrases I encountered most frequently, so I thought I’d introduce a series of posts that provide more information, and recommendations, on what to do to give yourself a break during the inevitable stressful periods that come with doing a PhD.

This week I’m starting with podcasts. I listen to podcasts daily; they help force my brain to focus on something that isn’t work, and they can be a really good way to spend the time you can easily lose when experiments are running or when you’re walking to/from the office. When looking for a new podcast to listen to I’m always a bit overwhelmed by the amount of choice available, so I’ve narrowed my favourites down to 4, and also given you a list of the 3 that are next on my ‘to listen to’ list.

What? Serial – Season 1
Who? Sarah Koenig, the people from This American Life, and a huge variety of guests linked to the case
What’s it about? Serial started the rise in podcast creation, it’s still the bench-mark for new pods to aim for, and it won a Peabody Award in 2015 for its innovative telling of a long-form non-fiction story. The first season investigated the 1999 murder of Hae Min Lee, an 18-year-old student at Woodlawn High School in Baltimore, Maryland. Her corpse was discovered on February 9th and identified two days later. The case was immediately treated as a homicide. Lee’s ex-boyfriend, Adnan Syed, was arrested on February 28th, and charged with first-degree murder. Syed’s first trial ended in a mistrial, but after a six-week second trial, Syed was found guilty of Lee’s murder on February 25th 2000, and given a life sentence.
A word of caution – don’t get sucked into Serial Season 2; it’s no where near as good as Season 1. Season 3 is coming later this year – fingers crossed it matches up to Season 1.
When? Season 1 aired in 2014 but all episodes are still on iTunes ready for you to binge!
Where can I listen? Listen on iTunes here, or on the podcast website here.

The creators of Serial have just announced a new podcast called S-Town, starting March 28th, which sounds amazing.

What Undisclosed – All seasons are brilliant, but season 1 is my favourite
Who? Season 1 – Rabia Chaudry, Susan Simpson, Colin Miller
What’s it about? Rabia Chaudry was the person who initially alerted Sarah Koenig to Adnan’s case, leading to Serial. After Serial Rabia didn’t feel as though Sarah had done enough digging, she knew there was more, so she got together with Susan Simpson and Colin Miller to take a closer look at the case through Undisclosed. Season 1 is a brilliant podcast for those who’ve just finished Serial Season 1, but Season 2 (Joey Watkins) and Season 3 (Freddie Gray) stand alone. It’s one of the most in-depth podcasts I’ve ever listened to, and I find myself thinking about it for days afterwards.
When? Seasons 1 and 2 are already on iTunes, Season 3 started on March 6th, updating Mondays and Thursdays
Where can I listen? Listen on iTunes here, or on the podcast website here.

What? Don’t Salt My Game
Who? Laura Thomas PhD, plus guests
What’s it about? Laura Thomas is a Registered Nutritionist and Wellness Advocate, she talks to people in wellness, foodies, bloggers, entrepreneurs from cool brands, nutritionists, doctors, and anyone else who is shaking up the wellness world, to find out how they stay on top of their game – and to help you do you, but better. It’s not all headstands and courgette though; she and her guests aren’t afraid to dig deep into the darker side of wellness and will call BS on weird and faddy trend that don’t have any legitimacy or scientific merit.
This is a refreshingly honest pod that focusses on evidence, avoids the usual airy-fairy Insta-nutrition we see from unqualified influencers, and straight up calls out weird stuff like putting coconut oil in everything. I love this podcast, it feels like you’re having a chat with Laura and her guests – you’ll learn a tonne and never feel patronised.
When? New episodes every Friday
Where can I listen? Listen on iTunes here, or on Laura’s website here.

What? Missing Richard Simmons
Who? Dan Taberski and whoever he can rope in to speak to him
What’s it about? On February 15, 2014, fitness guru Richard Simmons disappeared. He stopped teaching his regular exercise class at Slimmons, cut off his closest friends, and removed himself from the public eye after decades as one of the most accessible celebrities in the world. Nobody has heard from him – and no one knows why he left. Filmmaker Dan Taberski was a Slimmons regular and a friend of Richard’s. Missing Richard Simmons is Dan’s search for Richard – and the deeper he digs, the stranger it gets.
The thing I really love about this podcast is that everyone has a different theory of what’s happened/is happening. Amanda Hess reported in The New York Times that this is a ‘morally suspect podcast’ – others think Taberski is genuinely worried about his friend and is doing everything he can to find him. I’m not sure where I sit, I just really hope that at some point we get an updated episode with an appearance from Richard Simmons himself.
When? New episodes every Wednesday
Where can I listen? Listen on iTunes here, or on the podcast website here.

Podcasts on my ‘to listen to’ list:

  • My Dad Wrote a Porno – I’ve heard a lot about this podcast, everyone I’ve spoken to about it says it’s absolutely hilarious, but then they blush a little and the topic moves on..
  • The 45th – hosted by Rabia Chaudry (Undisclosed), and featuring Susan Simpson and Sarah Basha, this is a recently developed podcast that examines developments from the White House that are worth a second look.
  • The Minimalists – After watching the Minimalism film – a ‘documentary about the important things’ I’m really intrigued by this, it’s next on my list once Missing Richard Simmons finishes next week.

Are you an avid podcast listener, are there pods I’ve skipped entirely? Leave a comment or Tweet me your recommendations!

Women in STEM: Events, Challenges – and Why?

I haven’t touched on any political or religious topics on this blog, I haven’t spoken about money or what I think of Donald Trump, and largely I think people believe that feminism belongs in that same pile of topics you-just-don’t-talk-about. I don’t agree.

Feminism is important, and the process of explaining my views, beliefs and actions to help support other women, especially in the scientific community, is necessary. So this week’s blog post is going to be a bit of a brain dump of thoughts inspired by events and conversations over the past week – the week of International Women’s Day. I hope it ends up being a cohesive piece about why supporting women in STEM subjects (Science, Technology, Engineering and Mathematics) is a positive and useful thing to do, rather than the feminist rant that’s in my head.

Let’s start with some nice news:

This week I was told I’ve been accepted to take part in Soapbox Science‘s Edinburgh event this July. In their own words: “Soapbox Science is a novel public outreach platform for promoting women scientists and the science they do. Our events transform public areas into an arena for public learning and scientific debate; they follow the format of London Hyde Park’s Speaker’s Corner, which is historically an arena for public debate. With Soapbox Science, we want to make sure that everyone has the opportunity to enjoy, learn from, heckle, question, probe, interact with and be inspired by some of our leading scientists. No middle man, no powerpoint slide, no amphitheater – just remarkable women in science who are there to amaze you with their latest discoveries, and to answer the science questions you have been burning to ask.

I’m going to be talking about clinical trials – why take part in a trial, how participation might be beneficial, and what happens if not enough people take part in clinical trials. It’s not designed to be a propaganda piece, or a talk to try and get people to take part in trials; just an opportunity for me to talk about the work I do and the reasons why I think it’s important, and a chance for members of the public to ask questions and take part in a discussion. There’ll be 11 other women scientists there talking about their own work, and I’m really looking forward to learning about what they do too.

And an online engagement activity for women in STEM:

This month, The STEM Squad are running a photo a day challenge on Instagram – take a look at their Instagram account here. In their own words, they are “An inclusive community of femme-identifying STEM professionals and enthusiasts“. The challenge involves people posting a photograph each day for the whole of March (including #WEARESTEMSQUAD), with the aim of showing the many sides of women in STEM. As I write this it’s currently day 10 and I’ve managed to keep up, I’ve really enjoyed seeing everyone’s posts and following what they get up to each day. It’s so cool to see what every does, how different each career is, and what we all like to do outside of the labs/offices/fields that we’re in day-to-day.

The themes covered in the Instagram challenge are in the picture above, so take a look at the hashtag and join in if you haven’t already!

I was talking to a friend earlier on in the week about the Soapbox Science event and The STEM Squad challenge, and she (very innocently) said, ‘Why is it just for women though? That seems a bit unfair.’

My initial response was to be a bit stroppy – why does every event that involves only women get the whole ‘why not men?’ argument thrown back at it, why can’t we just do stuff as a group of women supporting each other?! The more I thought about it, the more I calmed down. Maybe women in STEM get this weird backlash because people don’t understand the point of why we’re doing these events, these public engagement activities and challenges online. I figured this was a good place to talk about it (Twitter was out because of that time I tweeted about a BBC Three documentary called Men At War and got trolled for at least a fortnight ).

Women are not represented equally in the STEM workforce, in fact the percentage of women in science professional occupations dropped from 50% in 2015 to 41% in 2016. That gives a slightly skewed picture though; 41% isn’t so bad, right? Perhaps, but that 41% isn’t consistent across the board:

  • Only 18% of people in ICT professional occupations are women
  • Only 8% of people in Engineering professional occupations are women
  • Only 14% of people in management positions in Science, Engineering and Technology are women

Being a woman in STEM is not easy – personally I’ve people who are shocked when I say I’m doing a PhD, ‘but you’re blonde!’ like, really? I’m pretty sure that my hair colour has no relationship with my intelligence (feel free to correct me with a methodologically-outstanding randomised trial). Largely though, I haven’t experienced any sort of discrimination at all, just a whole host of supportive and brilliant colleagues with a view weird comments thrown in.

For others though, being a woman in STEM is really tough, and the comments and discrimination women receive puts them off being in STEM altogether, there’s a genuine gender wage gap, and there’s even research to show that women who work in male-dominated workplaces experience heighted levels of interpersonal, workplace stressors.

It’s important to even this gender imbalance out and create equal opportunities for both men and women. Doing events and drawing attention to the problem is one way to try and push that process forward. Creating a positive and welcoming environment for people to learn, ask questions, and actually see what women in STEM look like (see also #actuallivingscientist and #dresslikeawoman), can make a real difference for the next generation of STEM workers.

#365papers February Update

In my first post on this blog, I set myself 3 PhD-related goals for 2017. One of those goals was to read more widely, and more frequently, and I decided that doing the #365papers challenge would be a good way to do that.

Here’s my February update. I found this month a big more difficult than last month – time just seemed to go much faster so and I was missing days quite regularly, meaning I was reading 4 or 5 papers at a time in order to keep up.

February’s reading:

  1. Making doubt generative: rethinking the role of doubt in the research process
  2. Chocolate bar as an incentive did not increase response rate among physiotherapists: a randomised controlled trial
  3. Presenting the results of Cochrane systematic consumer audience: a qualitative study
  4. User experiences of evidence-based online resources for health professionals: User testing of The Cochrane Library
  5. User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews
  6. RevManHAL: towards automatic text generation in systematic reviews
  7. Developing a survey of barriers and facilitators to recruitment in randomised controlled trials
  8. Enhancing the reporting of implementation research
  9. Making mindset matter
  10. Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial
  11. Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention
  12. Staff experiences of closing out a clinical trial involving withdrawal of treatment: qualitative study
  13. A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable
  14. Cohort profile: the Scottish Research register SHARE. A register of people interested in research participation linked to NHS data sets
  15. Understanding pragmatism and PRECIS-2
  16. Sex can affect participation, engagement, and adherence in trials
  17. Communicating with participants during the conduct of multi-center clinical trials
  18. Models and impact of patient and public involvement in studies carried out by the Medical Research Council Clinical Trials Unit at University College London: findings from ten case studies
  19. Decision aids for randomised controlled trials: a qualitative exploration of stakeholders’ views
  20. Participant retention practices in longitudinal clinical research studies with high retention rates
  21. Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned
  22. Publishing protocols for trials of complex interventions before trial completion – potential pitfalls, solutions and the need for public debate
  23. Design of case report forms based on a public metadata registry: re-use of data elements to improve compatibility of data
  24. Understanding variations in patient screening and recruitment in a multicenter pilot randomised controlled trial: a vignette-based study
  25. Risk of selection bias in randomised trials: further insight
  26. Assessment of clinical trial participant patient satisfaction: a call to action
  27. Stakeholders’ views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs
  28. Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study

Are any of you attempting to read #365papers this year? If you have any papers you’d recommend I read please leave them in a comment below.

The First Year of My PhD: Advice For New Starts

A few weeks ago I was asked to give a short talk at one of the University of Aberdeen’s Postgraduate Research Student Induction sessions entitled ‘The First Year of My PhD’. It’s a short session for new postgraduate researcher students across all disciplines within the university, with the aim of demonstrating how varied PhD experiences are, as well as sharing a few helpful hints and tips on what new starts should expect over the course of their first year of study. It takes  place next Tuesday so I figured this was a good time to get my thoughts in order. Hopefully some of you will find this useful – if you have any burning questions please let me know so that I can add answers in to my talk too!

So, a few things I learned during my first year of the PhD:

Getting your head around the project takes time
PhD advertisements usually include a basic outline of what your Supervisors see you doing, but the project should be yours. You’ll be the one ranting to your best friend at 10pm because your approvals haven’t come back and you need to get started with data collection – so it’s useful if you feel a sense of ownership over the project. Spend the first few weeks, if not months, getting to grips with what the project looks like; where it fits in with the current literature, and what you need to do to get it going. At the beginning I wrote a PhD protocol. It wasn’t anything formal, but it forced me to look at the big picture.

Building brownie points is really important
A PhD is a big coordinated effort with you at the core doing the majority of the work. For example, for my systematic review (protocol here) I wanted to do abstract screening, full text assessment, data extraction and risk of bias assessment all in duplicate. That’s a huge amount of work for one person, so finding someone to be my second was sometimes tricky. Of course Supervisors always offer to help, but they’ve got enough going on and it’s a good idea to get other researchers involved too. In come the banked brownie points! Offer to help out on other projects, do some abstract screening for another student, or write up minutes of meetings – integrate yourself into your team and you’ll find it much easier to ask for help when you need it later down the line.

Don’t be intimidated by the phrase ‘you’re doing a PhD’
Just after I started the PhD I was in the pub with some friends, someone asked what I did and I told them I had just started a PhD. They acted like I’d just told them I’d won the Nobel Prize for Chemistry – ‘Woah, you must be so clever!’ – this was coming from a qualified paramedic, i.e. someone who regularly saves lives. In comparison to my office-based daily activities of reading, writing and interviewing that seems a bit crazy to me. I thought about it for too long and started to doubt whether I was good enough to do a PhD – maybe I wasn’t clever enough? A word of advice, a PhD is more about resilience than intelligence, so just keep going and don’t fall into the trap of being intimidated by the process. More about so-called Imposter Syndrome here.

Little victories will keep you motivated
Some parts of the PhD take a really long time – I’ve currently been working on my systematic review for 15 months and I’ve only just got to the interpretation bit (i.e. the fun bit). It’s important to set yourself realistic goals over the course of the PhD so that you stay motivated throughout. I’m someone who write lists for everything, so each morning I write a list of things I want to do that day, and as a rule I don’t leave the office until that list is complete. These daily lists keep me on track and feeling like I have a purpose, even when the projects are long and can sometimes feel never-ending.

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Manage the expectations of the people around you
I have a few friends who are also doing PhDs, but the majority of the people around me have no idea what I do each day – sometimes my Mum genuinely asks me if I’m going to school that day (Yes, really. I’m 25 and she still calls it school.). Anyway, there will be times throughout your PhD where you have a bit of a meltdown – this undergraduate dissertation hand-in day multiplied by at least a hundred. Explain to your friends/family/partner/dog etc that you’ll probably be a bit of a nightmare to be around every now and again for the next 3 years or so – do this at the beginning of the process and they’re much less likely to want to smother you when you wake them up at 3am because you’ve lost your USB stick. (Disclaimer: They might still want to smother you, but at least you’ve warned them early on in the process and you can use the phrase ‘I told you I’d be a nightmare’).

What advice would you pass on to new PhD students? Leave a comment and share your experiences!

A Trip to Oslo, Norway – February 2017

Travelling is something that I’ve always loved; I get itchy when I don’t have a trip booked – whether that’s to a new city, country or continent. I enjoy exploring new places and new cultures, and I knew that I’d like to take as many opportunities to travel from the day I started my PhD. I’ve always been clear with my Supervisor that travel is on my agenda, so both he and I can keep an eye out for opportunities/conferences etc further afield.

So far the travel aspect of my PhD hasn’t been super exciting – I’ve spent a lot of time in various cities around the UK, but no where further. That’s been fine with me though, I’ve used my holidays to explore different places instead, so far travelling to: Denmark, Thailand, Iceland and Austria. PhD-wise though, at the beginning of this month I was given the opportunity to travel to Oslo, Norway for a few days – hoorah!

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If you’ve never been to Oslo, I would really recommend that you do. I was a bit nervous before I went because I have never travelled to a non-English speaking country alone before, it turns out Norway is not exactly non-English speaking! The country is essentially bilingual; every time I asked if someone spoke English I was greeted with the response, “of course I do, how can I help?”. Travelling around Oslo was also incredibly simple, the metro system, buses and trams all seemed to work seamlessly. They were always on time, super clean, and very easy to navigate.

Aside from the practicalities of getting around, Oslo is such a cool place to be. After 3 days of meetings and work-related activity, my boyfriend flew out so that we could spend some time exploring Oslo together. We had such a good time! Earlier in the week everyone had been saying how awful the weather was, it was -4 degrees C and snowing on and off, but compared to Aberdeen which is often grey and rainy, the snow was a welcome change.

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So, why did I go out to Oslo in the first place? The trip was part of a project funded by a grant we received from the Chief Scientist Office (CSO) of Scotland last year. The project is the core of my PhD work, and aims to find out how trial teams are currently doing trial recruitment, what sort of evidence researchers need to design effective trial recruitment strategies, and how that evidence should be presented to them.

I met with colleagues at the Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), and the Norwegian Knowledge Centre for the Health Services (Kunnskapssenteret), to talk about trial recruitment experiences and issues, and tools and resources that might help. The individuals I spoke to were all hugely welcoming, helpful and enthusiastic about my work – I came home feeling excited to get back to my desk and get my teeth into this PhD again. Since I came back on February 6th I’ve Skyped with a few more members of the team out in Oslo, and again they’ve been brilliant! Over the next few weeks I hope to continue to collaborate and build relationships with the team, particularly at the Norwegian Knowledge Centre for the Health Services; my research and interests align with the team there most closely.

If you’re in the process of PhD study, I’d really recommend that you try to integrate some travel into your work. Personally I think it helps with motivation and enthusiasm for your own work, but more importantly it undoubtedly strengthens the work you’re doing. Speaking with new people gives new insights into the work you’re doing, can make you think differently about the way you conduct your research, and ultimately ensures that the results of the work you’re doing have a greater impact on the research community around you.

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#365papers January Update

In my first post on this blog, I set myself 3 PhD-related goals for 2017. One of those goals was to read more widely, and more frequently, and I decided that doing the #365papers challenge would be a good way to do that.

Here’s my first update, covering the month of January. Overall, I’ve found this a really good month for reading – I tended to skip a few days and then do an afternoon of reading to catch up. At first I felt a bit guilty about that; I wasn’t reading every day, but I’ve found this works for me. I think I get more out of the papers if I have a longer period of time to sit down and really unpick the work, I get into some sort of rhythm and then the time seems to be spent more productively.

My reading list started out with a few pretty general papers; I was looking for papers covering clinical trial recruitment in a broad way so that I could then move on to reading quirkier, small scale primary research. I’ve kept a log of everything that I’ve read so far, including brief notes and any points that I want to come back to – e.g. comments on style of writing or presentation methods that I like and want to bring into my own work, as well as any critique of the methods used.

January’s reading:

  1. Current challenges in clinical trial patient recruitment and enrolment
  2. The recruitment of patients into clinical trials
  3. Seminars may increase recruitment to randomised controlled trials: lessons learned from WISDOM
  4. Barriers to clinical trial recruitment in head and neck cancer
  5. Re: Haddad et al. Barriers to clinical trial recruitment in head and neck cancer
  6. Trials and tribulations: obstacles to clinical trial recruitment
  7. What difference does patient and public involvement make and what are its pathways to impact? Qualitative study of patients and researchers from a cohort of randomised clinical trials
  8. Using qualitative research methods to improve recruitment to randomised controlled trials: The Quartet study
  9. Optimising recruitment and informed consent in randomised controlled trials: the development and implementation of the Quintet Recruitment Intervention (QRI)
  10. A survey of facilitators and barriers to recruitment to the MAGNETIC trial
  11. Using Facebook ads with traditional paper mailings to recruit adolescent girls for a clinical trial
  12. An embedded randomised controlled trial of a Teaser Campaign to optimise recruitment in primary care
  13. “You need to be a good listener”: Recruiters’ use of relational communication behaviors to enhance clinical trial and research study accrual
  14. Improving recruitment in clinical trials: why eligible participants decline
  15. Women’s reasons for participation in a clinical trial for menstrual pain: a qualitative study
  16. Challenges in recruitment and retention of clinical trial subjects
  17. Using Facebook to recruit college-age men for a human papillomavirus vaccine trial
  18. Culturally competent strategies for recruitment and retention of African-American populations into clinical trials
  19. Recruitment challenges in a diabetes prevention trial in a low- and middle-income setting
  20. Recruiting to clinical trials on the telephone – a randomised controlled trial
  21. Recruitment strategies and challenges in a large intervention trial: Systolic blood pressure intervention trial
  22. Examination of participant flow in the CONSORT diagram can improve the understanding of the generalizability of study results
  23. Research START: A multimethod study of barriers and accelerators of recruiting research participants
  24. Projection of participant recruitment to primary care research: a qualitative study
  25. Training recruiters to randomised trials to facilitate recruitment and informed consent by exploring patients’ treatment preferences
  26. Using a business model approach and marketing techniques for recruitment to clinical trials
  27. The experience of adolescents participating in a randomised clinical trial in the field of mental health: a qualitative study
  28. What are the roles and valued attributes of a Trial Steering Committee? Ethnographic study of eight clinical trials facing challenges
  29. The role of therapeutic optimism in recruitment to a clinical trial in a peripartum setting: balancing hope and uncertainty
  30. ‘The trial is owned by the team, not by an individual’: a qualitative study exploring the role of teamwork in recruitment to randomised controlled trials in surgical oncology
  31. Recruiting and consenting into a peripartum trial in an emergency setting: a qualitative study of the experiences and views of women and healthcare professionals

Are any of you attempting to read #365papers this year? How’re you finding it so far?

Academic Self-Care for PhD Students: Why & How?

January is always a weird month for me; everyone’s trying to get back into a routine with work, attempting to maintain resolutions to go to the gym regularly and eat healthily, and the weather is dark and gloomy – especially in Aberdeen. This week has been particularly tough for me, I’m lacking in motivation and it’s been a week where prioritising self-care has kept me working. A few weeks ago, Olivia Kirtley shared a thread on Twitter about mental health issues, career pressures and academia. The hashtag #AcademicSelfCare has also taken off into a little online community. So, this week I’m talking about academic self care in relation to PhD students specifically, covering my tips and when you should be prioritising yourself over your work.

fullsizerender-1Taking the weekend off doesn’t work. Many people shift their focus to self-care at the weekends; they ‘allow’ themselves a lie in, they see friends and they spend time doing things they enjoy. This never works. Book-ending your week with good stuff means the working week becomes a prime opportunity for burnout.


Self-care needs to become an integral part of our daily lives
. Whether that means doing something small each day, or doing something a bit more substantial when you need a break.

Here are a few ideas of what I do to keep myself happy when I’m feeling stressed or under pressure:

Take a break and talk about it. I know lots of PhD students that don’t take lunch breaks; we grab a sandwich in between meetings, often eating at our desks. Taking time away from my desk to eat lunch and go for a walk helps me de-stress, and when I get back to my desk I’m then much more productive. It’s also a good idea to talk to other PhD students about how you’re feeling – if you’re feeling stressed, you can bet they know how you feel! Take time out to go for a coffee; realising that you’re not alone and asking for help can really take the weight off your shoulders.

Take advantage of your freedom. Like a lot of PhD students, I manage my own time. I’m rarely seen at my desk before 9am and if it’s raining and I don’t want to walk to work I won’t be at my desk at all. I work from home a lot, especially when I’m having a tough week. This week I worked from home 1 day out of 5, another day I left the office early to go to the gym before it got busy, and another I didn’t get to my desk until 11am. All of the work I wanted to get done, still got done.

Say no. This one’s tricky. We know it’s important to get involved with multiple different projects, we’re looking for opportunities to publish and doing all we can to increase the chances of getting a job once the PhD is complete. If you say yes to every opportunity you’re given, you’ll likely burnout after a few months. Think strategically, and say yes only to the things that fit your research interests, your time scales, and that involve people you enjoy working with.

“But I don’t have time to do any of this stuff!”

Everyone has time to say no. Everyone has time to make themselves a cup of tea and eat their lunch without scrolling through their inbox. It’s about getting into a routine of small things; at first you’ll find that you need to ‘make’ time to do these things, but after a few weeks they’ll come naturally. After that it’s important to recognise the days when you need to turn your alarm off to catch up on sleep, the times that you just leave your desk and go easy on yourself.

Self-care is a process that requires effort, but in the long-term you’ll find it helps you avoid burnout and unnecessary stress, and you’ll enjoy your work much more.

What do you do when in need of some #AcademicSelfCare? Let me know on Twitter.

Doing a PhD in Health Services Research

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As last week’s post explained, my PhD is in the field of Health Services Research and looks at the process of participant recruitment to clinical trials. My undergraduate degree was based in lab science, and as far as I know I’m the only person from my graduating cohort to leave the lab but remain in academic science. I tend to get a lot of questions about what I do now that I don’t work in a lab anymore, so this week I wanted to take some time to explain what it’s like to do a PhD in this field; the questions I get and how it’s changed the way I look at science more generally.

Why did you decide to leave ‘proper’ science?
This is one of the best things to ask me if you want to see me bite my tongue so much that it bleeds. I’m still struggling to work out whether ‘proper’ science is intended to suggest that health services research isn’t worthwhile, or if my questioner simply isn’t aware that science can, and does, take place outside of a laboratory. I’m hoping it’s the latter.

I decided to leave lab science because I didn’t feel like the work I was doing was close enough to patients. To be clear, I’m not saying lab science is not a useful or worthwhile career path, just that I work best when I’m not too many steps away from the end result.

How do interviews help your work, surely you want data and evidence?
Yes, this a real question that someone asked me a few months ago.

To explain a bit of the background – undergraduate lab science degrees don’t pay much wpid-photo-aug-12-2013-805-pmattention to qualitative research whatsoever, or at least mine didn’t. I think in first year the words ‘qualitative data’ were mentioned once, and only when explaining that everything we would do going forward would involve the opposite. The PhD very quickly taught me that evidence comes in all shapes and sizes, and interviewing people to find out about their experiences and views on specific topics is just as useful as percentages and p values – it just depends on what you want to know.

We don’t know lots of things, and the NHS isn’t always right
I’m showing my naivety here so bear with me. Before starting PhD study, I thought that if something – whether that’s a type of surgery or a new drug – is put into practice within the NHS, then there was good equality evidence to support that decision. Turns out, I was wrong. I won’t say much more on this – Margaret McCartney’s books are a good starting point if you want to find out more.

Science in the media
The biggest change I’ve noticed in myself since starting the PhD is the way I consume media reporting of scientific stories. Previously I would be cautious of ‘bad science’, understanding that some news outlets will happily sensationalise content to improve readership figures. Now though, I find myself reading stories and picking holes in them as I am reading – thinking ‘well that’s not true because…’ or ‘the data you’ve provided does not show that result…’. I’ve stopped reading health/medicine stories on certain websites, and now stick to a few that I feel comfortable relying on. Vox and The Conversation are now my go-to news sites, and I try to follow specific reporters on Twitter too. I’d recommend both Julia Belluz and Kathryn Schulz, I saw Julia give a talk at last year’s Evidence Live conference and it was clear she really cares about accurate reporting – you can see her talk on YouTube here.

Healthcare’s Dirty Little Secret: Results From Many Clinical Trials Remain Unreliable

I wrote this article along with my PhD Supervisors, Prof Shaun Treweek and Dr Katie Gillies at the University of Aberdeen. We originally published this work on The Conversation in October 2016, and I’ve republished it here under Creative Commons licence 4.0 as I think it gives a good background to the topics and issues that my PhD is based on.


Clinical trials have been the gold standard of scientific testing ever since the Scottish naval surgeon Dr James Lind conducted the first while trying to conquer scurvy in 1747. They attract tens of billions of dollars of annual investment and researchers have published almost a million trials to date according to the most complete register, with 25,000 more each year.

Clinical trials break down into two categories: trials to ensure a treatment is fit for human use and trials to compare different existing treatments to find the most effective. The first category is funded by medical companies and mainly happens in private laboratories.

The second category is at least as important, routinely informing decisions by governments, healthcare providers and patients everywhere. It tends to take place in universities. The outlay is smaller, but hardly pocket change. For example, the National Institute of Health Research, which coordinates and funds NHS research in England, spent £74m on trials in 2014/15 alone.

Yet there is a big problem with these publicly funded trials that few will be aware of: a substantial number, perhaps almost half, produce results that are statistically uncertain. If that sounds shocking, it should do. A large amount of information about the effectiveness of treatments could be incorrect. How can this be right and what are we doing about it?

The participation problem

Clinical trials examine the effects of a drug or treatment on a suitable sample of people over an appropriate time. These effects are compared with a second set of people – the “control group” – which thinks it is receiving the same treatment but is usually taking a placebo or alternative treatment. Participants are assigned to groups at random, hence we talk about randomised controlled trials.

If there are too few participants in a trial, researchers may not be able to declare a result with certainty even if a difference is detected. Before a trial begins, it is their job to calculate the appropriate sample size using data on the minimum clinically important difference and the variation on the outcome being measured in the population being studied. They publish this along with the trial results to enable any statisticians to check their calculations.

Early-stage trials have fewer recruitment problems. Very early studies involve animals and later stages pay people well to take part and don’t need large numbers. For trials into the effectiveness of treatments, it’s more difficult both to recruit and retain people. You need many more of them and they usually have to commit to longer periods. It would be a bad use of public money to pay so many people large sums, not to mention the ethical questions around coercion.

To give one example, the Add-Aspirin trial was launched earlier this year in the UK to investigate whether aspirin can stop certain common cancers from returning after treatment. It is seeking 11,000 patients from the UK and India. Supposing it only recruits 8,000, the findings might end up being wrong. The trouble is that some of these studies are still treated as definitive despite there being too few participants to be that certain.

Image credit: wavebreakmedia
Image credit: wavebreakmedia

One large study looked at trials between 1994 and 2002 funded by two of the UK’s largest funding bodies and found that fewer than a third (31%) recruited the numbers they were seeking. Slightly over half (53%) were given an extension of time or money but still 80% never hit their target. In a follow-up of the same two funders’ activities between 2002 and 2008, 55% of the trials recruited to target. The remainder were given extensions but recruitment remained inadequate for about half.

The improvement between these studies is probably due to the UK’s Clinical Trials Units and research networks, which were introduced to improve overall trial quality by providing expertise. Even so, almost half of UK trials still appear to struggle with recruitment. Worse, the UK is a world leader in trial expertise. Elsewhere the chances of finding trial teams not following best practice are much higher.

The way forward

There is remarkably little evidence about how to do recruitment well. The only practical intervention with compelling evidence of benefit is from a forthcoming paper that shows that telephoning people who don’t respond to postal invitations, which leads to about a 6% increase in recruitment.

A couple of other interventions work but have substantial downsides, such as letting recruits know whether they’re in the control group or the main test group. Since this means dispensing with the whole idea of blind testing, a cornerstone of most clinical trials, it is arguably not worth it.

Many researchers believe the solution is to embed recruitment studies into trials to improve how we identify, approach and discuss participation with people. But with funding bodies already stretched, they focus on funding projects whose results could quickly be integrated into clinical care. Studying recruitment methodology may have huge potential but is one step removed from clinical care, so doesn’t fall into that category.

Others are working on projects to share evidence about how to recruit more effectively with trial teams more widely. For example, we are working with colleagues in Ireland and elsewhere to link research into what causes recruitment problems to new interventions designed to help.

Meanwhile, a team at the University of Bristol has developed an approach that turned recruitment completely around in some trials by basically talking to research teams to figure out potential problems. This is extremely promising but would require a sea change in researcher practice to improve results across the board.

And here we hit the underlying problem: solving recruitment doesn’t seem to be a high priority in policy terms. The UK is at the vanguard but it is slow progress. We would probably do more to improve health by funding no new treatment evaluations for a year and putting all the funding into methods research instead. Until we get to grips with this problem, we can’t be confident about much of the data that researchers are giving us. The sooner that moves to the top of the agenda, the better.