Reflections from a rainy Manchester University (many of you will grow to love this!)

As many new trainees will have just completed or shortly be starting their first stint at their respective universities, Ang Davies, a senior lecturer on the clinical bioinformatics teaching pathway, takes a look at that pathway and how clinical bioinformatics as a profession has developed over the past 7 years. From the first year of training where the entire profession was practically founded, to the breakthrough that is routine genomic testing across England, who better to reflect on that journey than someone who helped pave the way?

Suddenly autumn is upon us, the hot sunny days in Manchester are long forgotten (or were pretty much non-existent!) and we’re welcoming our seventh intake of STP trainees to the Clinical Bioinformatics Masters programme. This time for Andy Brass and I, we’re taking a back seat and we’ve handed over the reins to the very capable leadership of Andrew Devereau. Andrew has many years of leading training and education in clinical bioinformatics and more recently has worked for a number of years at Genomics England. 

Speaking for myself I have loved every minute of this journey, it’s honestly been a privilege to lead a programme where our students are so self-motivated and have worked alongside us to co-create a programme to meet the needs of a rapidly evolving area. So how has genomics changed and the clinical bioinformatics developed over this time? Seven years ago it’s hard to imagine that there were virtually no clinical bioinformaticians and there was no training programme in existence. The rapid pace of change in clinical genomics has largely been driven by the adoption of next generation sequencing technologies. Previously most molecular diagnoses in clinical genomics were made by Sanger sequencing of individual genes and other techniques such as array comparative genomic hybridisation, now through the launch of the new Genomic Laboratory Hubs whole genome sequencing is being offered as a clinical service to patients. Genomics is no longer constrained to the speciality of Clinical Genomics but has been adopted by cardiology, ophthalmology, oncology and many more areas. 

Building Teams 

The first intake or two of the programme were the trailblazers, often being one of two (or even sometimes a team of one) bioinformatician in their laboratory. From our perspective, this probably meant that our roles transcended the academic/workplace much more than in other healthcare science professions. This also gave us insights into the needs of the workplace and the ways in which the services were developing. The learning curve for these first handfuls of trainees was immense, and was a real test of resilience, being thrown in at the deep end developing bioinformatic workflows from scratch, building unix environments and also developing the infrastructure to run all of this software on. Several years on and it’s great to now keep in touch with many ex-trainees as they become training officers and project supervisors and even lecturers on the programme (please chat to us!). The teams of one or two are now 5 or 6 in some laboratories, allowing bioinformaticians to specialise a little more than in the early days, but key to the success of these developing teams will be the communication skills and the broader team working with other clinical scientist colleagues and clinicians. 

To the future…

Earlier this year the Topol Review was launched, an independent review led by an American cardiologist, with an active interest in the adoption of digital technologies in healthcare. Within the review they set out through various specialist working groups to make a series of recommendations that transcends the healthcare workforce in relation to the integration of digital technologies into routine healthcare. One key recommendation was the expansion and development of clinical bioinformatics as a profession, which is timely given the concurrent decision by the National School to prioritise the review of the clinical bioinformatics curriculum. 

So how do we future proof the profession, we probably wouldn’t have guessed seven years ago that whole genome sequencing would be so rapidly adopted in molecular diagnostics. What are the knowledge, skills and behaviours that are required by clinical bioinformaticians? Certainly, we have had many conversations with our student reps, current and past students who have suggested that general data science skills need to be much stronger, including data visualisation and statistics. Many clinical bioinformaticians are leading software development projects, so much more of the technical skills to assist here would also be welcomed and certainly, some machine learning would also be valuable. We’ve spoken of the expansion of the profession and the need to grow teams so this will require strong leaders and communicators. Other skills such as writing business cases and potentially working much more interdisciplinary and working more closely with industry partners may be required to procure services and co-develop software and workflows. 

Be Bold and Gatecrash Politely! 

This year I’ve had some fantastic opportunities such as being invited to be a panel member at the Chief Scientific Officers (CSO) annual conference, present at the NHS Expo and work with the newly recruited Topol Fellows. At all of these varied events, I have been proud to discuss the work of our Clinical Bioinformatics trainees and what they have achieved, particularly in their research projects, which are of outstanding quality year on year. In July I attended the International Society of Computational Biology conference in Basel, speaking to many colleagues who lead bioinformatics education and training from across the globe it became very clear that there was a lack of awareness of this very applied field of bioinformatics and the fact that there is even a small but community of Clinical Bioinformaticians in the UK seemed a revelation. 

I am really pleased to see that this blog is so strongly supported by Adriana and Jes – they have done a fantastic job, but their training is coming to an end and I am sure they will be looking towards others to follow in their footsteps and take a lead role in its publication. With so much interest in the profession currently my advice to anyone starting out on their healthcare science career is to “be bold and gate-crash politely” a great phrase I heard at the CSO conference. Get involved – write about your work, in this blog or in journals, contribute to the creation of new guidelines and policy, seek out new opportunities and electives that will help to broaden your scope and expertise. Some great advice I got from a colleague at Manchester some years ago is to embrace a “buy one get one free” approach in your work for example consider using your assessments to fulfil competencies, consider writing posters that might be submitted to multiple conferences, write your dissertation in a publication format so that it can be easily adapted for journal submission. 

Finally create your own communities of practice – the teams are growing but clinical bioinformatics is still a fledgling profession, talk to your peers and develop networks – there’s certainly lots of time whilst at Manchester for both in-class (and out of class!) socialising – make the most of this intense but unique opportunity to develop your networks. 

Good luck on your journey over these next three years, it will undoubtedly be intense, hard and demanding but will lead you into a career that is expanding, valued and at the cutting edge of healthcare science.

Author: Jes

I am a trainee clinical bioinformatician working at the Royal Devon and Exeter NHS Foundation Trust. I am passionate about increasing awareness and discussion about healthcare science and particularly the routes into the field.

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