A wide-ranging discussion spanned his early career, time in clinical medicine, missed opportunities and the pivot to becoming a public figure as the pandemic reached the UK, not to mention his advice for the young scientists in the audience at the Science Museum on November 29 2022. He fielded questions from AMI President Brendan Gilmore, Jacob Hamilton, Hannah Trivett and Anete Salmane.
The video of the Q&A session can be viewed on The Microbiologist here. The full transcript of the Q&A is posted as follows:
Brendan Gilmore: So I have the honour of asking the first question. I’m not an early career scientist, as you can tell.
So my question is this, maybe you could relate to us your experience of the pivot that you had to make from being an academic researcher to dealing with the pandemic. How did that play out for you?
So the question was about the pivot from being an academic to doing what happened during the pandemic.
For me, that was always easy because my academic research has always been really around policy-related questions rather than kind of deep science.
And because I’d been to the pharmaceutical industry, I’d been to the World Health Organization, I’d been to the public health agencies and also done academia, I had quite a lot to draw on, and in many ways for me it was the kind of best of times and the worst of times.
I wouldn’t have wished it on anybody, I wouldn’t have wished it on myself, frankly, but if I could have planned a career, which I didn’t, that had skill sets from different areas that I could draw down on for that job then yes, in a way it was perfect because they all just kind of came together at the right time.
Hannah Trivett: My name’s Hannah, I’m a university student at the University of Liverpool and in my third year of my PhD.
So you initially trained as a physician at Nottingham, but your experience is far reaching, including industry, academia and the civil service. What made you direct your career away from being at the bedside in medicine towards a career in research?
It was a desperately, desperately difficult choice and for those of you who know Nottingham, perhaps some of you will remember Professor Richard Madely, who was my mentor when I was a medical student, and I did my third year intercalated BSC in epidemiology. And I really got the bug at that point for epidemiological research and publishing stuff.
So I managed to get three papers out of this pretty terrible BSc thesis and a couple of conference presentations, but I kind of got the bug for doing that, and I said to Richard just after I’d qualified,I think I might want to do public health long term.
And he said, Well, do you enjoy being a doctor? Do you enjoy clinical medicine? I said, yes. He said, well, go away, I don’t want to see you for five years. Go and get clinical medicine out of your system. And so I did.
I did five years of jobs where they were still 120 hours a week, and it did largely kind of get it out my system, but it had to be got out of the system, there’s no question.
And that made it a bit easier to then switch over and do other things but I did keep on seeing patients in the emergency room. I did a day a week until 1997, which wouldn’t be allowed these days, but it was in those days.
And yeah, I miss patients to this day and, you know, I don’t rule out going back to the emergency room at some point because I quite like stitching faces and tendons and things.
Anete Salmane: Hello, my name is Anete. I’m from University College of London and I’m a lab co-ordinator there. And I wanted to ask, just following on this question, as you’ve had a career path into academia that’s maybe a little bit less typical, what would be your advice for many of us in the audience who are more the early career stages, what would be your advice about the next steps we should take in our careers?
So I’ve got advice for you there. The first thing is that opportunities in life that you get presented with and the ones you never take are the ones you most regret in the end.
At the age of 18, having just slithered into medical school with a D in chemistry and E in mathematics - it does get better - an A in biology and A in physics. But it was one of what was called a near-miss offer. I felt very unworthy to get to medical school.
And then this letter arrived in the post and it said, Sir, you are to report for your French Army National Service to Perpignan. This is your recruitment number, this is the date, and you will be there.
And of course, foolishly, at the age of 18, I did not go, so I was a deserter. I couldn’t go to France for a few years, so I was a deserter from the French army, and I didn’t do my French national service.
But I wish I had. I desperately, desperately wish I had. And I can’t get that back. I just can’t get that back. Whatever I want to do now, it’s too late.
But, knowing what I know now, I could have rung Nottingham and said, Can I just defer my place for two years because I want to do the French army? And they would have said, yeah, fine, because people do defer places.
So I missed out on that because I missed an opportunity, so always take opportunities when they come along.
And then the other thing is to take time to work out what you are good at, because we’re all good at different things and I took a lot of time to work that out and it wasn’t actually anything I was good at - it was translating between disciplines.
So, you know, talking microbiology to the public health lot, talking public health to the microbiology lot, talking academic stuff to the pharma industry lot, talking public health policy to the pharmacy lot, and then finally, when the vaccine taskforce came along, talking what it is to work in the vaccine industry to the civil service lot.
So for me it was a discovery that it was translation of work interfaces. It may not be for you and it could be - it could be lots of things, but just take your time. You’re going to be working a long while and you’ve got plenty of time to work out what it is that makes you tick.
Jacob Hamilton: Hello, I’ll ask you your last question. I’m Jacob, I’ve just finished my PhD and I now work in global animal health in the Department for Environment, Food and Rural Affairs - so I made that transition to the civil service as well. So this question becomes relevant for that.
I can imagine that straddling the line between public health official and spokesperson for the UK government felt quite precarious at times. How did it feel stepping into the world of policy makers in that sort of public, public way?
Well, the answer to that’s really easy. It is a strange world and it takes time to get used to it, so it was just as well I’d had a couple of years of being DCMO before the pandemic happened, so I kind of worked on my bearings and worked all that out.
But the thing you have to remember is that advisors, including scientists, advise. Ministers decide. And it’s your job to work for whoever that lot out there vote for.It doesn’t matter who they are or what their beliefs are politically, if they’re voted into power in this country, in a democratic society, then it is our job to serve them and work for them.
And what matters then is giving them good advice, giving them complete advice and not obfuscating anything, because then you’re not culpable in a bad decision that could still be a bad decision. Sometimes there is, but you’re not culpable in that bad decision if you’ve given very straight, honest advice. So I think that’s really important.
And there is this very subtle point where part of the answer is science and part of the answer is politics. Then you’ve got to spot where the barrier is and stop at the barrier. So, for example, compulsory vaccination of health care workers. Okay, I can say very clearly that the evidence from the US is very clear that where a hospital has mandated and enforced vaccination of health care workers in a situation where uptake has been 60 or 70%, it’s gone right up to 99%.
That’s not an opinion on whether anyone should do that. That is the science on the studies that actually if mandation is formally implemented and enforced, with the consequences that go with that, then it does actually work, and that’s just science.
Whether the UK should go down that road or not and think about the enforcement is not science, that’s politics. And so you have to find that mark, go up to it and be very clear and don’t get pushed over it.
It doesn’t always work, but most of the time if you remind yourself that that’s what you want to do, then you can at least draw some kind of line. That’s my advice.
Brendan Gilmore: Thanks very much, Professor Van-Tam, and our early career scientist panelists. I think you’ll agree that they were excellent, as always, and maybe give them a round of applause. Jacob, Hannah and Anete.