How I Survived the NIHR Doctoral Fellowship Application · How I Survived the NIHR Doctoral Fellowship Application. Dr Sohaib Rufai . BMBS BMedSc MRes. ... review, \൷orld class

How I Survived the NIHR Doctoral Fellowship Application

Dr Sohaib Rufai BMBS BMedSc MResNIHR Doctoral Fellow and Specialist Registrar ST4 in Ophthalmology

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Contents

1. My Background2. The Pitch3. The Proposal4. The Interview5. Salvation

2.2 BILLION

PresenterPresentation NotesRight now, there are 2.2 billion people in the world who are blind or visually impaired. Half of these people have reversible blindness, but we aren’t yet good enough at delivering treatment to them. As for the other half, we haven’t yet understood their conditions well enough to develop suitable treatment.

PresenterPresentation NotesWe need to develop better ideas to tackle this problem, but this cannot be achieved by individuals alone. This can only be achieved through advanced technology and collaboration. This was key principle underpinning my NIHR Doctoral Fellowship application.

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Contents


Early Recognition of Raised Intracranial Pressure in Craniosynostosis using

Handheld Optical Coherence Tomography

Dr Sohaib Rufai BMBS BMedSc (Hons)NIHR Academic Clinical Fellow

PresenterPresentation NotesGood morning all and thank you so much for this opportunity, my name is Sohaib Rufai and my presentation is on Early Recognition of Raised Intracranial Pressure in Craniosynostosis using Handheld Optical Coherence Tomography

Images courtesy of GOSH Face Value Appeal: gosh.org

Background:Craniosynostosis

• 1 in 2000 babies1

• Causes ↑ICP in 40-75% -developmental delay, blindness, death2-4

• Surgery has serious complications: stroke, death, need for redo.5,6

References: 1) Cornelissen M, et al. J Craniomaxillofac Surg. 2016;44(9):1273-9. 2) Tamburrini G, et al. Childs Nerv Syst. 2005;21(10):913–921. 3) Thompson D, et al. Plast Reconstr Surg. 2006;118(1):184-92. 4) Renier D, et al. J Neurosurg. 1982;57(3):370-7. 5) Greives MR, et al. Ann Plast Surg. 2016;76(2):211-5. 6) Rodgers W, et al. Plast Reconstr Surg. 2017;140(1):1-134

PresenterPresentation NotesCraniosynostosis is characterised by premature fusion of bones of the skull. It affects 1 in 2000 babies and causes raised intracranial pressure in a substantial proportion, which can cause developmental delay, blindness and death.The only treatment is cranial vault expansion surgery, which is very risky.However, a popular policy around the world is to perform prophylactic surgery for all multi-sutural cases, which may represent unnecessary surgery.

Background:Visual Evoked Potentials (VEP)

• High variability

• Time consuming

• May detect damage after it has occurred

Images source: diopsys.com

PresenterPresentation NotesTo avoid this, Great Ormond Street Hospital risk assess with clinical assessment and Visual Evoked Potentials, which involves measuring the electrical response across the brain in response to light. However, this is a rudimentary test and detects damage after it has already occurred.

Background: Handheld OCT

• Ultra-high resolution 3D eye imagingRapidSafeInfants

• Should recognise ↑ICP earlier

PresenterPresentation NotesOptical Coherence Tomography has revolutionised clinical ophthalmology by providing 3D images of the eye in amazingly minute detail within seconds. This technology has recently been adapted for children through the advent of handheld OCT, which should recognize raised ICP earlier than existing methods.

Project

PresenterPresentation NotesIn this diagnostic cohort study, I will recruit patients from the GOSH craniosynostosis clinic, introduce handheld OCT and compare the diagnostic accuracy of the current care pathway with handheld OCT versus without.

Power: 90 participants

Reference: 7) Patel A, et al. Ophthalmology. 2016;123(10):2147–2. 2017;135(4):320-328.

To demonstrate sensitivity improved by 10%

130 have invasive ICP (gold standard) annually

Recruit 260 patients from clinic 50% need surgery70% handheld OCT success rate7

PresenterPresentation NotesOur sample size calculation demonstrates we need 90 participants to demonstrate an improvement of sensitivity by 10%. GOSH perform gold standard ICP measurements on 130 infants per year. Thus, we will recruit 260 on the basis that half need surgery and handheld OCT should be successful in at least 70%.

Preliminary Data:Cerebral Malaria

Normal ClinicalswellingSubclinical

swellingSignificant correlation

PresenterPresentation NotesOur Leicester Group has preliminary data on chlidren from Malawi with Cerebral Malaria, which also causes raised ICP. This is an OCT scan of a normal optic nerve head. This is a clinically swollen optic nerve head. By contrast, this scan demonstrates subclinical optic nerve head swelling, which is only detectable on OCT but not clinically on ophthalmoscopy. All our ONH parameters demonstrated significant correlation with ICP estimated by lumbar puncture, such as rim volume demonstrated here.

PersonNIHR Academic Clinical Fellow

MRes and handheld OCT training

7 International/national prizes

15 Publications

20 International/national presentations

National/local media impact

PresenterPresentation NotesI am most fortunate to have been awarded an NIHR Academic Clinical Fellowship, which has included the MRes degree, specialised HH-OCT training and substantial research output, including best presentation at ARVO – the world’s biggest vision meeting.

Progression

NIHR DF

Systematic Review

World Class OCT

Expertise

Project Management

and PPI

PhD

Research Outputs

NIHR ACL

NIHR DF

PresenterPresentation NotesThis NIHR Doctoral Fellowship would equip me with a wide range of research skills and experience including systematic review, world class OCT expertise, project management and PPI, my PhD degree and research outputs leading to new guidelines, which will help me become an independent NIHR ACL.

Training Plan

SYSTEMATIC REVIEW

DATA ANALYSIS KNOWLEDGE EXCHANGE

CLINICAL (20%)

PresenterPresentation NotesI have devised my training plan with four key components fulfilled by rigorous internal training and prestigious external courses and placements, notably an overseas visit to Harvard to learn about their applications of paediatric OCT and other advanced technology.

Collaboration

OCT ExpertiseI Gottlob, FA Proudlock

Clinical ExpertiseR Bowman, NUO Jeelani

Statistical ExpertiseC Bunce

Image source: le.ac.uk Image source: glassdoor.co.ukImage source: gosh.com.kw

PresenterPresentation NotesThis is an ideal collaboration with fantastic support. Leicester is a world leader in paediatric OCT, GOSH has the largest craniofacial unit in the UK and I have statistical support from Dr Catey Bunce at King’s who is an expert ophthalmic statistician.

Training

Expert Advisory Group

Press Teams & Charities

Social Media

Patient and Public Involvement

PresenterPresentation NotesI will undertake PPI training and establish an Expert Advisory group including patients and families to inform and steer my study. I will also work with press teams, charities and social media to engage patients and the public and stimulate valuable discussion.

ImpactWorld’s first study of its kind

New knowledge – broadly applicable

Prevent disability and vision loss

Economic benefits

Future: New guidelines

Future: Artificial Intelligence

Thank you for listening!

Image courtesy of GOSH Face Value Appeal: gosh.org

PresenterPresentation NotesThis is the world’s first study of its kind that will improve neuroscientific understanding and prevent disability and vision loss, fulfilling the aim of the World Health Organisation Vision 2020 initiative and producing economic benefits. Future directions for this research include new guidelines and the application of artificial intelligence. Thank you for listening.

Contents


PresenterPresentation NotesToday, I’d like to talk to you about Handheld OCT, particularly the research I’ve been conducting using this advanced technology.

Where to start?Where to start

https://www.nihr.ac.uk/documents/guidance-notes-nihr-fellowships-doctoral-and-advanced-round-3/22463

https://www.nihr.ac.uk/documents/guidance-notes-nihr-fellowships-doctoral-and-advanced-round-3/22463

https://www.rds-eastmidlands.nihr.ac.uk/

https://www.rds-eastmidlands.nihr.ac.uk/

Stage 1Application Summary Information

Applicant CV

Applicant Research Background

Plain English Summary of Research

Scientific Abstract- 500 word limit

Detailed Research Plan – 5000 word limit

Stage 2 PPI

Management and Governance

Detailed Budget

Proposal tips

START EARLY (6-12 MONTHS)

SEEK SUPPORT EARLY

USE BOLD TEXT FOR EMPHASIS

DON’T NEGLECT THE TRAINING PLAN

Contents


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Anticipate interview topics

• Project• Person, inc. future career• Place• PPI• Ethics• Training/supervision

Top tips for interview

Take deep breaths before you go in

Wear something that makes you feel confident

At least three mock interviews, ideally with repeat panelist(s)

Make final slide of pitch impressive, as it will probably be left up

Contents


You’re in!!!Well done : )

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2009 2019

Thank you for listening!

Dr Sohaib Rufai BMBS BMedSc MResNIHR Doctoral Fellow and Specialist Registrar ST4 in Ophthalmology

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dailymail.co.uk

Slide Number 1ContentsContents2.2 BILLIONSlide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10ContentsEarly Recognition of Raised Intracranial Pressure in Craniosynostosis using Handheld Optical Coherence TomographyBackground: CraniosynostosisBackground:�Visual Evoked Potentials (VEP)Background: Handheld OCTProjectPower: 90 participantsPreliminary Data:�Cerebral MalariaPersonProgressionTraining PlanCollaborationSlide Number 23ImpactContentsWhere to start?Slide Number 27Slide Number 28Slide Number 29Slide Number 30Stage 1Stage 2Proposal tipsSlide Number 34ContentsSlide Number 36Slide Number 37Slide Number 38Anticipate interview topicsTop tips for interviewContentsSlide Number 42You’re in!!!Slide Number 44Slide Number 45Slide Number 46Slide Number 47Slide Number 48Slide Number 49

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How I Survived the NIHR Doctoral Fellowship Application · How I Survived the NIHR Doctoral Fellowship Application. Dr Sohaib Rufai . BMBS BMedSc MRes. ... review, \൷orld class