1. Description and strengths of the specialty specific programme; please highlight research track record including any markers of esteem:
Dementia research within the department of Psychiatry at Oxford has expanded considerably over the past year, commensurate with the national and international priority being given to this syndrome. Building on the strong base in Old Age Psychiatry established by Klaus Ebmeier, the specialty has increased in size and scope with the recruitment of Simon Lovestone, Noel Buckley and John Gallacher and their associated teams. Lovestone and Gallacher alone lead international research programmes representing more than £200m in funding and all three new recruits are world leaders in molecular mechanisms and drug discovery (Lovestone and Buckley), in clinical studies and biomarkers (Lovestone) and in epidemiology and longitudinal cohorts (Gallacher). Lovestone has extensive experience in training and development of clinical trainees in his previous role at the Institute of Psychiatry, including two receiving higher degrees, one an international training fellowship (IPA), three having been appointed to senior academic positions and others now in consultant roles. Further trainees would join the programme established at Oxford by Ebmeier, which has seen three ACFs pass through training, one being selected “Royal College of Psychiatry Core Trainee of the Year 2011”. Nine further ACFs and two CLs have been appointed to the department and are currently in training.
2. Description of the research component of the specialty specific programme:
The research programme proposed would build on the UK Dementias Platform (UKDP) and the European Medical Information Framework (EMIF), both of which are repurposing established cohorts and routine clinical data for dementia research and are led by Gallacher and Lovestone from Oxford. The UKDP brings together more than 20 research cohorts and is establishing a national access to medical records for research to enable dementia outcome data to be ascertained from routine care data. Led by Oxford, this infrastructure is already complete in Oxford, Cambridge and West, North and South London including more than one million patient records in mental health. EMIF accesses up to 50k research participant datasets and more than 50 million routine care records across Europe. These data provide an unparalleled opportunity for trainees to drive discrete research programmes of clinical relevance, learning in the process some of the techniques of Big Data including complex analytics such as machine learning and natural language processing as well as the governance of data from legislation and regulation through data security and privacy. An example of a current programme of research is one seeking to determine the inflammatory environmental factors including both disease and anti-inflammatory drugs and their genomic modifiers. This gene x environment study, triangulating routine care datasets on millions of participants and research datasets on tens of thousands, has the potential to identify specific inflammatory pathways for disease modification therapeutics. This and similar programmes interrogating, for example, cardiovascular influences on disease, would be ideal research programmes for clinical trainees to hone research skills and experiences.
3. Description of the clinical component of the specialty specific programme:
The general adult and old age psychiatry advanced training programme supports training for 25 whole time equivalent advanced trainees – with a larger number of approved posts to select from. Clinical placements in Oxford Health and Berkshire NHS Foundation Trusts are rated highly in the GMC trainee survey, particularly for its year-long clinical and more continuous educational supervision. There are ten posts with advanced old age psychiatry trainers that trainees may choose. Dementia care is integrated across all NHS trusts in the area, with common triage and joint recruitment into studies from memory clinics via DeNDRoN. CL clinical training will occupy 50% of the total time with the remainder dedicated to research. This will be offered in the most appropriate way for the trainee’s research, en bloc or as regular time away from clinical duties.
4. Description of how the post complements the proposed 2015 specialty spread for the posts allocated by formula:
This post builds on the established academic training posts in the department and will be complementary to these and other academic training posts in associated departments such as Neurology, Adult Psychiatry or General Practice.
5. Suitability of the Institution to host posts within this specialty:
The strong growth in dementia research with two chairs held by Old Age Psychiatry and with further professorial appointments in molecular neuroscience and cognitive psychology over the past year make Oxford an ideal setting for higher academic training.
6. Description of any innovative / interdisciplinary / new research approaches in this area:
Oxford is the lead site for many national and international dementia programmes and the infrastructure to support this research includes a clinical research facility, world-class neuroimaging and electrophysiology, the national lead site for clinical informatics in dementia and the growing Big Data Institute. The cross-departmental grouping of OxDARE and the BRC theme in cognitive health provide outstanding opportunities for interdisciplinary research. In particular, with the Big Data Institute and the lead for national clinical informatics in dementia research, Oxford can provide opportunities for research in this innovative discipline that has the potential to be truly transformative in both research and clinical arenas.
Key staff involved:
- Academic Lead (University) for the IAT Programme: Professor C.W. Pugh, Director of OUCAGS and Professor of Renal Medicine, The Henry Wellcome Building for Molecular Physiology, University of Oxford, Roosevelt Drive, Headington, Oxford OX3 7BN
- Academic Supervisors (University): Professor K P Ebmeier, Foundation Professor of Old Age Psychiatry (University of Oxford), University Department, Warneford Hospital, Oxford OX3 7JX, Telephone: 01865 226469, Email: email@example.com. / Professor S Lovestone, Professor of Translational Neuroscience, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, Tel: +44 (0) 1865 223910; Email: firstname.lastname@example.org
- Education Supervisor (Trust): Will be appointed for the duration of the Clinical Lecturer’s tenure in the Programme by TPD from list of 10 Psychiatrists of Old Age. All are approved Educational Supervisors of the Oxford School of Psychiatry.
- Clinical Supervisor(s): Will be appointed for each year of Clinical Placement in consultation with the Academic Supervisor, Programme TPD and Clinical Lecturer from the list of 10 Psychiatrists of Old Age. All are approved Clinical Supervisors of the Oxford School of Psychiatry.
- Oxfdord Deanery Training Programme Director: Dr Susan Shaw Consultant Psychiatrist and Honorary Senior Clinical Lecturer, Lead TPD for GA/OA Advanced Trainees, Oxford Health NHS Foundation Trust, City Central CMHT, Mental Health Division, Warneford Hospital,