How the Associate PI Scheme provides invaluable experience and opportunities

Krishnaraj Rathod, a consultant cardiologist at Barts Health NHS Trust, took part in the NIHR Associate Principal Investigator (PI) Scheme.

The Associate PI Scheme is a six month in-work training opportunity, providing practical experience for healthcare professionals starting their research career.

Here, he shares his career journey and tells how the scheme benefited him as an early-career researcher - even helping him secure his latest job.

As an interventional cardiologist, I’m interested in what we can do to improve the lives of patients with heart conditions through practical procedures.

But even before I qualified as a cardiologist, I was always interested in research - I always wanted it to be part of whatever I ended up doing.

I started out, as part of my intercalated degree in Medical Science at Queen Mary, University of London medical school, doing discovery science research, in which I was carrying research in the basic science labs. I was inspired by Professor Amrita Ahluwalia, who was my supervisor at the time and has subsequently become my mentor through my discovery science research journey. However, I wasn’t particularly orientated towards clinical research at that time.

I did research all through my foundation years as a doctor before I got a position as a cardiology registrar. This was largely observational research with Dr Dan Jones and Dr Andrew Wragg – but nothing like a big clinical trial.

I also completed a PhD with Professor Ahluwalia and Professor Anthony Mathur, who motivated me to continue with my ambition into academic cardiology. Coming towards the end of my cardiology training, I really wanted to develop a clinical trial research portfolio.

I first heard about the NIHR Associate PI Scheme in a webinar about the RECOVERY COVID trial. I thought ‘this [scheme] is exactly what I want to do.’

There were a couple of studies that Barts Health was running that I thought might be suitable. I managed to get in touch with the local PI and the national Chief Investigator of one of them and managed to get it registered on the NIHR portfolio, so I could use that study for the scheme.

The first study, iCorMicA, involved recruitment of patients who had angina (chest pain) due to a problem with the small arteries that supply the heart. The study is aiming to look at whether guideline-based stratified medicine approach is achievable and whether patients feel better after these treatments are implemented.

“After speaking to the NIHR, they told me I could do a second study as part of the scheme if I wanted to - so I chose the CHIP BCIS3 study.

This study is looking at whether a small heart pump device, inserted through an artery in the leg, is beneficial for patients with a weak heart who are undergoing stent procedures. In these, stents (which are like scaffolds) are used to stretch open a narrowed blood vessel around the heart, to treat people who have conditions such as angina or have suffered a heart attack.

Even though I’ve completed my time with the scheme now, I’m still involved with recruitment, follow-ups, screening patients, inserting devices and so on, which is a very rewarding part of my job. Partly as a result of undertaking the scheme, I’ve been able to develop a good relationship with the trust’s research team. They now often come to me to help with setting up new studies and I am more involved in recruitment for other studies as well.

I would like to become a PI on clinical trials in the near future and I think being part of the Associate PI Scheme has helped a lot with that - it’s made sure I’m up-to-date with my Good Clinical Practice (GCP) training, understand various governance aspects of running a clinical trial and so on.

It may have been that if I did not do the scheme, I might have got a similar job, but with less involvement in clinical trials. So it’s really made a difference in terms of getting to the next stage of my career. I’m now considering applying for an intermediate or advanced research fellowship, which would be suitable for an early career researcher like me.

It’s very easy to apply for the scheme and anyone can apply, whatever your clinical background. The scheme is open to any health and care professional willing to make a significant contribution to the conduct and delivery of a study at a local level over a period of six months.

I would recommend this scheme to anyone who is interested in considering taking a larger role in clinical trials. Even if they are not planning to become a dedicated trials researcher in the future, this scheme definitely provides invaluable experience and an opportunity to develop skills that can be incorporated in other career paths within the healthcare system.

• To find out more about the scheme, take a look at the NIHR Associate PI scheme webpage.