Interview with Dr. Rebecca Spencer – Guest Lecturer at ICMS 2017

  1. Could you please tell us a little bit about yourself?

I studied medicine at Leeds University in the north of England. I have always been interested in research, so during my medical degree I did an intercalated degree in Clinical Sciences. I stayed in Yorkshire for my Foundation Years (the first 2 years after medical school in the UK system) and started my specialty training in Obstetrics and Gynaecology in 2007. I completed my exams for Membership of the Royal College of Obstetricians and Gynaecologists in 2011 and was honoured to receive the gold medal. With this out of the way I turned my attention back to research and applied for my current post as a Clinical Research Fellow and PhD student at University College London. I am married to an incredibly supportive husband who does most of the childcare for our two children, aged 6 and 2, making it considerably easier for me to pursue the work I love.

  1. Could you please tell us about your research work?

My job as a Clinical Research Fellow is to help set up a phase I/IIa trial of maternal growth factor gene therapy for severe early onset placental insufficiency (see below). This has involved setting up a prospective natural history study of pregnancies where the fetus is found to be very small between 20 and 27 weeks of pregnancy. As part of my PhD I am looking at ultrasound measurements and blood samples taken from these pregnant women to find better ways of predicting which pregnancies will end in stillbirth, which will need very preterm delivery, and which babies are small but will continue to grow. Alongside this I’ve become interested in women’s experiences and attitudes to research during pregnancy. I was involved in setting up an interview study exploring women’s attitudes towards a possible trial of maternal gene therapy and have been awarded a grant to investigate women’s experiences of taking part in our prospective study.

  1. What is the EVERREST Project all about?

We’re trying to develop a new treatment for a pregnancy complication called placental insufficiency. This is when there is a problem with the supply of oxygen and nutrients through the mother’s uterine arteries and across the placenta to the fetus, meaning the baby doesn’t grow properly in the womb. In severe cases the problems with the fetal growth can be apparent in the second trimester. If this happens there is a high risk that the pregnancy will end in stillbirth or the baby will need to be delivered very prematurely. Although other treatments are being tested, at the moment we don’t have a proven way of improving fetal growth inside the womb. In animal studies a gene therapy expressing Vascular Endothelial Growth Factor (VEGF) given into the uterine arteries has been shown to safely increase blood flow to the womb and improve fetal growth. Our trial will see whether this can work in pregnant women.

  1. Why did you get involved in research?

Everything you learn in medical school, from how skeletal muscle works to the best way to treat bowel cancer, comes from research. There’s a lot we know and are able to do but there’s still a lot more work to be done, especially when it comes to pregnancy. There’s a real under-investment by most of the pharmaceutical companies in new treatments for pregnancy complications. This makes it even more important that we work on this as doctors and scientists, to make sure pregnant women in the future get the best possible care.

  1. What do you find most fascinating about your research?

That’s like asking me to choose my favourite child! The best and worst thing about research is that every time you try and answer one question it throws up a whole lot of new really interesting questions that you want to answer next.

  1. What inspired you to become an Obstetrician-Gynecologist?

If you’re going to enjoy your career in medicine I think you need to find a specialty which resonates with you and your personality. Of course it’s fantastic to bring a baby safely into the world and it’s a privilege to support and care for women as they go through life-changing experiences. But for me, on top of that, it felt like the right place to be. Even during my student placements I loved the teamwork of the labour ward, the variety of acute care combined with clinics, medicine combined with surgery, of never knowing what the next day would bring. You might spend an hour talking to a couple with a serious pregnancy complication or the emergency buzzer might go off and you have minutes to deliver a baby. It’s not for everyone but I love it!

  1. What is a typical day of researcher like?

The great thing for me is that there is no such thing as a typical day. Because the focus of my research is clinical I might be recruiting a patient, taking ultrasound measurements and processing their blood samples in the lab, or I might be going to a delivery to collect samples of cord blood and placenta. On other days I could be analysing samples in the lab, taking photos of placental slides, doing statistical modelling of ultrasound data, or teaching students. I also get the chance to attend a lot of national and international meetings and conferences and meet other researchers in my field from across the world.

  1. What was the most memorable moment in your life as a researcher?

Hopefully it has yet to come.

  1. What advice would you give to the young doctors/scientists who aspire to take your career pathway?

I think it’s important to remember that there is no one path you have to take. Some of the best clinical academics I know took very round-about routes to get to where they are now. Don’t be afraid to try. Say yes to opportunities, whether it’s submitting a poster to a conference or presenting at a local meeting, and if you don’t see any opportunities then ask someone. If you can, find someone a bit more senior who is doing the sort of things you would like to do and ask their advice or ask them if they would consider mentoring you.

  1. In your opinion what are the most important qualities that a surgeon and a researcher should have?

Passion, perseverance and having the care of your patients as your first concern. Neither medicine nor research is an easy option, but if it’s what you love then that will keep you going through the hard times

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