Dr. Kim Ozano: Hello listeners and welcome to Connecting Citizens to Science, the

global health podcast that brings together people from across sectors and settings

to explore current debates and real world challenges in health systems research.

This final episode of our miniseries on research capacity strengthening,

we're turning our attention to the PhD.

Not just as a qualification, but as a catalyst for change.

And today we ask what does it take to balance a PhD with the demands

of clinical care and teaching community engagement and management?

And how can embedding a PhD in a programme go beyond just academic outputs, becoming

a tool for learning by doing and leading systems change that is really needed.

We also discuss the advantages of embedding research capacity and skills

early on in your clinical career, and the advantages that that can bring

for maximum impact and sustainability.

Joining us for this conversation are three inspiring clinicians who are also

researchers currently undertaking their PhDs as part of the PACTS programme.

We have Dr. Hezekiah Isa Albarka, who is a senior lecturer at the

University of Abuja, and a haematologist who is currently pursuing his

PhD through the PACTS project.

He is building on a career rooted in both clinical care and sickle cell research.

We also have with us Dr. Mmamulatelo Siame Mumba, who is a paediatrician

and researcher based in Zambia with a focus on tropical paediatrics

and implementation research.

She coordinates research activities across PACT sites and leads the standards

based audit teams as part of her PhD.

Finally we have joining us Dr. Eunice Jeman Ahmad, who is a

haematologist and a PhD student.

Her research focuses on supporting adolescents with sickle cell disease

to transition into adult care, and she plays a key role in both

national training and the Pan-African Sickle Cell Research Consortium.

So, here's the challenge, whether you're a policymaker, a practitioner,

or a researcher, how are you creating the space and support

for embedded learning and capacity strengthening within your programmes?

Is your system set up to value real world problem solving, or

are we still treating research as something separate from practice?

Let's jump into the conversation.

It's so great to have you here today to discuss research capacity

strengthening, and you have a really unique position in that you're all

clinicians and also have a PhD and lots of different responsibilities.

So, perhaps you could tell us a bit about your understanding of

research capacity-strengthening and what you get from your PhD that is

different from your other practice.

Dr. Mmamulatelo Siame Mumba: Hi, my name is Mmamulatelo Siame Mumba.

I do prefer to be called Telo.

I am a paediatrician based in Lusaka, Zambia.

I am working with the Sickle Cell disease and I am now a PhD candidate with

Liverpool School of Tropical Medicine.

So, maybe I can start with a story.

Dr. Kim Ozano: Yeah.

Dr. Mmamulatelo Siame Mumba: My education or my postgraduate studies

to become a paediatrician, I was focused on the clinical work.

I had a lot of fulfilment in the clinical work.

However, I was thrown into the world of research by a certain mentor of mine, and

this research was implementation research.

And I was like, what is this and how will it, help my practice?

I love children.

I wanna be working with them and so on.

But he said something very unique.

He said, when you step out into the world of research, your mind opens up

to so much more that you can do, even as a clinician, should you decide to go

back, you'll find that your practice will be enhanced in everything that you do.

And I was looking at him, I'm like, nah, like what you on about?

And he kept on saying, you have to do your PhD. And that was two years ago.

And, two years after that discussion with him, I had the opportunity now to join

the programme as a PhD student with PACTS.

And during this time I've also had the opportunity to go back to a

bit of clinical practice and boom, exactly what he said has happened

with every time that I'm practicing, I'm looking at the patients I'm

teaching students, postgraduate students, undergraduate students.

I find myself referring back to some of the principles that I've learned.

That I'm learning through my PhD work through that research.

So, I think that story just sums up how that capacity, that research does

impact the work that we do as clinicians.

Dr. Kim Ozano: Thank you very much.

I love that story from, first of all what is this research?

Why do I need it to really understanding in practice.

Has it been the same for you too, Hezekiah?

Dr. Hezekiah Isa Albarka: My name is Hezekiah Isa, I'm an adult

haematologist based in Nigeria.

I'm currently doing my PhD in global health, which is

embedded in the PACTS project.

I consider the PhD programme a necessity.

It's a very important programme that one needs because my

background is basically clinical.

Even though I did a postgraduate training and did a project at the

end of it, the research component, it was not very extensive.

If you are in academia, I'm also a lecturer, I train medical

students and conduct research.

One of the things that will impact more on your career is a PhD

programme because it opens up your mind and makes you think critically.

You analyse problems, it enhances your capacity to think critically and how to

solve problems and so on and so forth.

So, it is a very important programme that is very essential for any academic.

Dr. Kim Ozano: Excellent.

I love this link to solving problems.

So, we've heard in our previous episode that, clinicians are often

faced with problems, but maybe don't think about the solutions so much.

Have you found it's really affected your practice as well Eunice?

Dr. Eunice Agyeman Ahmed: Yes.

I was also drawn so much into clinical practice and more like shying away from

research as much as I could because it was a bit of like a daunting area to go to.

But each and every day that I practice, I realised that there was this gap

that needed to be filled, and the only thing that could fill it was research.

So, I didn't have a choice.

I just had to open up and then embrace research because it brings

much more to my practice than just rendering a service to the patient.

And it also helps you reach out more to the world rather than just

reaching out to your patients.

Dr. Kim Ozano: So, it connects you to more of the wider global health.

Dr. Eunice Agyeman Ahmed: Exactly.

Dr. Kim Ozano: And is that useful?

Dr. Eunice Agyeman Ahmed: Yes.

It's very useful.

Dr. Kim Ozano: In what way?

Dr. Eunice Agyeman Ahmed: So, for my professional growth you can

network to other people who are also interested in the things that you do.

That's one of the benefits to me as an individual, and of course there's also

a benefit to the patient because if you are linking whatever knowledge that

you would use to impact them, you are linking it not just with what you know,

but with what others can also input.

Dr. Hezekiah Isa Albarka: Most of the time we compartmentalise the clinical

disciplines, but they are actually related to each other to enrich practice.

So, for example, I can tell you that when some colleagues hear that as

a haematologist, I'm doing a PhD in global health, they'll be surprised.

They will say, 'Ah, what is a haematologist doing in global

health, leave that to the public health physicians or specialists?'.

It has really opened my eyes because as a clinician that is just seeing

patients in the ward and in a clinic, you are really limited when the patients

come to you, that is when you see them.

But sometimes, it really involves going out there to reach out to the

patients, and it also involves really making sure that the patients also

participate in their own management.

It is a patient-centred management.

That is what makes it so beautiful, and it has a lot of impact on both

the practitioner and the patients.

Dr. Mmamulatelo Siame Mumba: By taking the principles up and learning in

terms of implementation research in global health, we are able to spot

the problems more clearly than most of our other colleagues . And we're able

to harness some of the things we've learned to bring up the solutions.

So, I have a few mentees, that I speak about some of the things I'm learning

and there are clinical meetings that bring together the consultants, the

postgraduate students, the junior resident medical officers, and in those platforms,

there are presentations of clinical cases within the hospital, certain departments

will bring forth presentations.

So, in those discussions, I have learned even with the mentees, to just

ask them, what can we do about it?

What resources can we use to bridge those gaps to solve the problems.

And using those approaches, a lot of them are opening up and they're actually

saying, oh, we can actually do this.

So, I am part of the haematology, the paediatric haematology unit,

which looks at sickle cell disease.

Other conditions are haemophilia and aplastic anaemias and

some leukaemias as well.

So, when I have a new set of registrars, I tell them, look for

a problem that you can find on the ward and let's solve it together.

We don't need any funds.

You don't need money.

You can actually think about changing the system.

So, that's some of the impact.

Also they're now having interest as well.

So, I have some of them asking me, I also want to know what you can do,

and even speaking to the heads of institutions as well, there are what

we call quality improvement committees that look at various aspects of the

hospital beyond the clinical area.

It could be infection prevention, it could be the pharmacy unit and

so on that form these committees.

So, we've been speaking to the the head of the institution.

To see how we can use some of the principles within implementation

research to embed in those particular units as well.

Those are some of the ripple effects that I feel are very important on our end.

I think the other thing we've noticed, in our low and middle income settings,

when we want to apply for grants, I think what we found anecdotal in the past and

from what our mentors have really spoken about is we need the PhD certificate or

programme to be able to speak, and to be able to have that that setting or that

force of nature when we are out there.

I think it's something we need to think about in the global health setting, some

may not have that certificate as PhD, but they have that expertise and worth.

Dr. Kim Ozano: Eunice, what has it meant for you, the capacity

strengthening through the PhD and the path that you're looking towards?

Dr. Eunice Agyeman Ahmed: As has been said problem solving.

Basically implementation science is about closing the gap between what we know or

what we already know, what is evidence based and then what has to be done.

Having that capacity strengthening in implementation science will

help you be able to solve problems.

So, you identify a problem in your space of work and then you

begin to think, what can I do?

Because you most likely know what will work, but what is

preventing it from working?

So, you begin to pull resources that are available to you to be able to

close that gap and solve problems.

Dr. Kim Ozano: You've used the term open your eyes a few times.

It sounds like it's affected some of the values in your ways of working

as well, but balancing a PhD against your other work, how has that been?

Dr. Hezekiah Isa Albarka: That is really a good question because the way we are

trained as clinicians is like, even though at the specialist level, you are

supposed to be involved in some level of research and to be on top of your game,

especially if you are in the university system, of course you need to be updating

your knowledge and do some research.

But doing a PhD programme in the means of clinical practice is tough, because

you have the patients to attend to, and then you have the residents to

train and medical students to teach, and then the research work itself.

My PhD research topic is in a different setting in terms of

the study sites and location.

My research participants are not the patients I'm dealing with.

They're in another setting.

Where I collect data is outside the hospital.

So, to really balance that in terms of time, it is a big issue.

You just have to create the time, prioritise... work outside work hours in

the evenings and right into the night.

So, it requires a lot of commitment and energy.

That it is worthwhile and it's it really fulfilling.

Even with these challenges, I think it should be part of the training

and the experience that one is expecting to gain from this programme.

We see this type of commitment in our mentors, they really work hard.

This experience that we are currently undergoing in terms of the time

management, in terms of energy and discipline we need, I think it

is also part of it because beyond the PhD, we are also hopefully

going to step into their shoes.

Dr. Kim Ozano: So, it sounds like during your clinical training you weren't fully

aware of the importance of research and how it could affect your practice.

Do you think that embedding discussions about research and strengthening

capacity for research earlier on would've been beneficial or does

it have to come at the right time?

Dr. Mmamulatelo Siame Mumba: With our programme or postgraduate studies,

yes, we do have a research component, but I think there's so much focus

on the clinical aspect and there's not so much focus on the research.

So, there are two things.

So, one thing is the, it's heavily clinical.

So, more emphasis is placed on do you know the conditions that you

are managing more than your thesis or what research are you doing?

Alright.

So, over time the institutions have been trying to strengthen that

component, but it's been very difficult.

So, the second thing, aside from knowing the clinical side is, there's just

no manpower there, there are no people to work if you're not going to work.

Because our postgraduate studies as clinicians is largely based

on practice as you learn.

So you are on the ward, you are seeing patients, and you're also reading

around the patients you're seeing to gain the expertise that you need as

a paediatrician or even my colleagues here as haematologist as well.

So, that is where the focus is, but you are practically part of the institution

as someone who's working there, meaning if you're not there and you say, oh,

let me go and focus on reading, there's no one who's going to see the patient

that you're supposed to be seeing to gain the experience that you need.

So, there's that vicious cycle that sort of happens, that you have to be there to

see the patients, to read on the patients.

Then what time do you then have to do the other things?

So, I think putting more emphasis would be lovely in terms of the research

part and I think we have been working with the University of Zambia, where

the most of the postgraduate studies are done, and where I am seated.

So, we've been working with institutions to see how much more can we improve this?

And one of the things is what we've learned in research...

My focus is on participatory design or participatory approach to help

healthcare, healthcare workers translate guidelines into practice.

So, in my reading around participatory approaches and participatory design,

I spoke to the department head and I said, we need to speak to the

postgraduate students themselves.

How do they want the support that they need for their research, and it came

up that they start to learn about the research a bit later on in their years.

So, they want it done early.

So, I think that was quite interesting as well.

Those are the two things that are really hindered that embedding of research

early on in the postgraduate studies.

Dr. Kim Ozano: It sounds like institutionally you're on the cusp

of changing the culture, and that there's a real thirst to bring in

the idea of research and research capacity strengthening earlier

into the training programme.

And also, maybe to carve out some space so that you can do a PhD alongside

your clinical work, but then this is challenged by the availability of

people to to see patients as well, which is difficult for the institutions

and for the individuals as well.

So, I think we could talk all day, but we've come to the point in our

podcast where we like to ask your one piece of advice for anyone who wants to

strengthen their capacity for research.

So, what would be your one piece of advice?

Eunice, we'll start with you.

Dr. Eunice Agyeman Ahmed: Okay.

Okay.

What I would say is you cannot do without research, let's

not put research in a box.

Yeah.

Where you feel okay, I'll go for it when I need it.

It's something that you need in your practice.

It has to work hand in hand with your clinical practice and without that,

it'll be almost impossible to get the best that you might be looking for.

Dr. Kim Ozano: Excellent piece of advice.

It's not additional, its core to what you do.

Yeah.

Wonderful.

Dr. Eunice Agyeman Ahmed: Yeah.

Dr. Hezekiah Isa Albarka: The emphasis, just like we said earlier,

is on training clinicians and specialists for patient's care with

just a little research component.

Whereas in the university systems, there are well developed systems for research

in the PhD programmes, so if there could be some interface between these

colleges that are involved in training clinicians at specialist level with the

university systems, this will be good so that as one is undergoing clinical

training as a specialist, one will also be heavily involved in research work,

and at the end of the day, you are coming out with a PhD and also, very good and

solid clinical knowledge and skills.

Dr. Kim Ozano: I think you've just designed a whole system right there.

You can go back and implement that entirely, but I think

it's an excellent point.

Working across institutions to maximise the capacities and bring those skills

together, I think is a great suggestion.

Thank you very much.

Telo.

Take us home with one final piece of advice

Dr. Mmamulatelo Siame Mumba: Go big or go home!

Nice.

So I just tell anyone that I talk to, go for it.

Look for the opportunities and everything else will fall into place.

And the second thing is find a mentor.

I think just find a mentor, someone you can run to and help you.

By the way, you can actually have more than one mentor that can take you up

in various aspects of your career, your personal development and growth.

Dr. Kim Ozano: Look for a mentor and go big or go home.

I think that's an excellent way to end our podcast.

Thank you for joining us today.

It has been an absolute pleasure talking to you.

Well, listeners, that's it for this episode and our miniseries on

research capacity strengthening.

I've certainly learned a lot and I hope you have too, and importantly

that these conversations have sparked ideas, reflections, and new ways of

thinking that you can apply in your work.

But the conversation doesn't stop here.

In our upcoming series, we'll be shifting focus to gender justice and backlash,

exploring how power, resistance and social norms are shaping not just

health systems, but the wider structures that impact our lives from climate and

economics to migration and care, because as we keep hearing across all of these

episodes, nothing happens in isolation.

So, here's your next challenge.

In the face of growing gender backlash, how are these forces reshaping your work,

your context, your policies, and more importantly, how are you responding?

Those episodes are coming soon, so if you haven't already, make sure

you like, subscribe, and follow Connecting Citizens to Science on

your favourite podcast platform.

You won't wanna miss out on what's coming next.