Page 12 - ANZCP Gazette November 2021

CLINICAL PERFUSION AND A PART-TIME PHD
Flinders Medical Centre, SA
‘A Doctor of Philosophy – a postgraduate academic degree awarded to a candidate who has submitted a thesis based on extensive and original research in their chosen field’ – something I never thought I could achieve, but I finally did in January 2020, twenty years after I completed my honours degree.
Many colleagues have asked how I went about achieving my part-time PhD while continuing with a clinical load, so I thought I’d share my story in the hopes of inspiring some of you to take the plunge and explore a higher degree.
I completed a Bachelor of Science with Honours in 1999. In 2000 I was employed as a trainee perfusionist at Flinders Medical Centre. In 2004, after completing the Structured Course in Clinical Perfusion (SCiCP), I moved to the Royal Adelaide Hospital completing my certification exams. During my time at the RAH, I was exposure to a varied and challenging clinical load. In 2011, I volunteered for my first Open Heart International trip to Fiji. The trip gave me a huge amount of confidence and I realised just how much I had learned about perfusion.
While I enjoyed the clinical load and the challenges it presented, I felt I needed to extend myself beyond the clinical aspect of our profession and with my desire to constantly learn, I decided to explore the option of a PhD. In 2012, I returned to the Flinders Medical Centre, and Rob Baker’s well establish research group, to commence the search for a supervisor and a research project.
I found Jonathan Gleadle, a consultant nephrologist in the renal unit and Professor of Medicine at Flinders University. Jonathan Gleadle’s research interests included the regulation of gene expression and microRNAs (miRNAs) by oxygen and its implication for renal disease focussing on cellular physiology and ischaemic disease. In 2012, oxygen delivery and goal directed perfusion were very much at the forefront of acute kidney injury (AKI) research with the association between oxygen delivery during CPB and the development of postoperative AKI being explored. I had found the gap – could I correlate oxygen delivery and ischaemia with a molecular marker of hypoxia measured during CPB? Jonathan introduced me to Associate Professor Michael Michael from the Flinders Cancer Centre for Innovation, and he became a co-supervisor. I had found my three supervisors: Jonathan Gleadle expert in the kidney, Rob Baker the expert in perfusion research and Michael Michael the molecular biology expert.
The specific aims of my thesis were to successfully isolate and measure circulating and urinary miRNAs (such as miRNAs associated with hypoxia and haemolysis) to gain a greater understanding of the molecular response to CPB, and to elucidate the molecular mechanisms involved in the development of AKI following CPB (potentially identifying a predictive marker of AKI during cardiac surgery). (see figure for summary of major findings).
After six years of laboratory-based research, years of spending my weekends writing, a reduction in income and a year
to collate chapters and finish my 100,000 word thesis, I submitted my thesis titled ‘MicroRNA levels, hypoxia and cardiopulmonary bypass in the development of acute kidney injury’ for examination in October 2019. Dr Raymond Wong, perfusionist and editor of JECT and Professor Jeremiah Brown, professor of cardiovascular epidemiology and biomedical informatics research at Dartmouth, were chosen as my examiners. After eight weeks to examine my thesis and with only minor amendments to make, I submitted my completed thesis in January 2020. My degree was conferred in April 2020, however my graduation ceremony was postponed due to COVID. In May 2021 I was able to celebrate my graduation and it was an emotional moment when I was introduced on stage as Doctor Annette Mazzone.
They say to achieve a PhD you need 10% intelligence and 90% persistence.
My advice is
1. Chose a topic you are interested in and are passionate about.Especially with a part-time PhD – you need to maintain focus and interest over a number of years.
2. Branch out of the perfusion bubble, research local universities and see what other people are researching – most people do not know our profession exists, let alone the research possibilities of a unique cohort of patients undergoing cardiopulmonary bypass.
3. Find the right supervisors and have regular meetings.
4. Seek support from perfusion and wider cardiothoracic surgical unit colleagues.
5. Seek support from family and friends – it’s an emotional roller coaster!
6. Be prepared for it to take up and enormous amount of your time.
7. No matter how huge and overwhelming the process is – break it into small manageable tasks
8. Don’t give up!
I look forward to the future of perfusion and the possibilities it holds. I am privileged to now be the supervisor of FMC newest trainees – Aidan Singh Howard who joined the team in March 2021 and Jessica Betts soon to be joining the team. I hope that I can be a good mentor to them, passing on my clinical knowledge but also a passion for research and the opportunities that exist. I’ve also enjoyed serving on the ABCP and am excited as we move to a Masters level qualification for our future perfusion trainees.
I encourage all my perfusion colleagues, no matter how long you have been practising as a perfusionist, if research interests you to pursue further studies. We are a small profession, but are experts in our field. Don’t be afraid to branch out and try something new – after 20 years I’ve proved it’s never too late!
Annette Mazzone PhD, CCP FANZCP
9 NOVEMBER 2021 | www.anzcp.org