A career combining general practice and research

Andrew Wales with his cat

I never had a grand plan for my career and, having explored pathology and microbiology earlier in my career, I have subsequently been able to mesh general practice with research and writing in these fields.

My clinical interests finally settled on small animal general practice, with an interest in orthopaedic surgery. In common with many general practitioners, I find the balance between focus and variety rewarding, if occasionally frustrating.

But research has enabled me to add an extra dimension to my career, one that allows me a sustained focus on detail and the chance to take a longer view of things than clinical practice usually permits. And, of course, skills, insights and knowledge gained in one field can help in another.

Recently I have been collaborating on a project developing a microbial reality simulator for veterinary practice training (‘AMRSim’) that involves close observation of animal and staff movements, plus their interactions, around veterinary surgery premises. The aim ultimately is to develop and evaluate digital educational tools to illustrate bacterial transfer and distribution, and thus to assist practical strategies that can help reduce the spread of antimicrobial resistance.

The research is done in collaboration with a design team from the Glasgow School of Art, with behavioural psychologists, and with a clinical partner of the University of Surrey’s vet school – a truly multidisciplinary team, working on a One Health issue.

"A veterinary degree can provide an excellent platform from which to build such a hybrid career, especially with current opportunities for remote and flexible working"

In drawing up the research proposal, one of my tasks was to look closely at the evidence for the benefits of antibiotic use during and after veterinary surgical procedures, particularly in orthopaedics.

Although it was relevant to my own clinical practice, I would probably not have found the space or motivation to do this were it not for the project.

Perhaps unsurprisingly the waters are a little muddy, but there have been some well-considered recent studies performed in specialist orthopaedic facilities that compare outcomes with and without antibiotics given after surgery. Interestingly, the study that I perceived to be of highest quality found no benefit to the use of postoperative antibiotics for clean implant surgeries.

While I have not commonly used postoperative antibiotics for soft tissue surgery, it is only in the light of this research reading that I have now found the evidence and the confidence to follow suit for my orthopaedic procedures, with pleasing results.

An allied benefit of this decision has been the extra impetus it has provided our clinical team for maintaining excellent standards of surgical asepsis.

Thus, tangible and sometimes unforeseen cross-fertilisation can occur between therapeutic and research activities, and from my perspective the involvement of general practitioners in research has much to recommend it. A veterinary degree can provide an excellent platform from which to build such a hybrid career, especially with current opportunities for remote and flexible working. 

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