Outstanding Early Career Researchers Awards 2024: Meet the winners - Dr Stephen Bradley

The RCGP Scientific Foundation Board (SFB) and the Society for Academic Primary Care (SAPC) are pleased to announce the winners of the 2024 Awards for Outstanding Early Career Researchers. This award recognises the contribution of early career researchers to advancing primary care theory and practice. The winner of the Academic General Practitioner Award is Dr Stephen Bradley, a GP and Academic Clinical Lecturer at the University of Leeds.

This Q&A provides some more information about his research journeys, interests, and advice for primary care researchers.

What is your main area of research interest, and how did this interest develop? 

My research has been on cancer diagnosis. I was very fortunate to be taken on by Professor Richard Neal in 2018 as a research fellow and PhD student as part of the CanTest collaborative, funded by Cancer Research UK. CanTest has come to an end, but being involved was an incredible experience and allowed me to meet, learn from and collaborate with amazing researchers in the UK and worldwide.

Aside from work on cancer diagnosis I am also very interested in issues relating to health policy more generally and how we can improve our research system through increased transparency and by taking action to reduce systemic causes of bias.       

What does your research involve, what challenges presented themselves during the research, and how did you overcome them? 

My PhD research mainly involved using routinely collected data to better understand how well chest X-ray performs in diagnosing lung cancer and on variation between English general practices on how often the test is used. The main challenges have been delays in access to data. My anecdotal experience is that the NHS ethical approval process is now quite efficient, but accessing data is costly and associated with long delays which is compounded by other problems such as staff turnover within organisations that curate data, meaning processes and discussions may need to be repeated and misunderstandings can occur. I've been struck during my research that there is a stark contrast between the ways on-line corporations are able to gain access to intrusive data about our everyday lives for profit, with the great difficulty researchers have in using data for the public good. Aside from being frustrating for individual researchers, If these problems are not addressed It will endanger the UK's aspirations to become a pioneer in utilising health data. 

In terms of overcoming such barriers, I have no particular strategies to offer other than persistence and trying to have other projects lined up to work on during long waits. From a wider system point of view, sensible measures have been suggested to streamline access to data, for example in the Goldacre review. Helping those with influence find the will to tackle these and ensure that UK health research achieves its potential to benefit patients might require more advocacy and collaboration between clinicians, researchers and the public. Politicians and other leaders are unlikely to sort out these problems unless we make them understand what the problem is and why it should be a priority.             

What are your plans for your future academic career, are there any research topics you hope to further explore?

I am continuing to work on lung cancer diagnosis. Alongside one of my PhD supervisors, Prof Mat Callister I am co-leading a feasibility study which will examine using low dose computed tomography instead of chest x-ray to diagnose lung cancer in patients with symptoms. As well as Prof Callister, two of my other PhD supervisors, Prof Richard Neal and Prof Bethany Shinkins are collaborators on that project.

I am very interested in exploring ways to improve diagnosis for other cancers, and have begun thinking particularly about Pancreatic cancer, which like lung cancer often presents late with non-specific outcomes and unfortunately has very poor outcomes. Together with some colleagues, including University of Leeds medical student Amber Johnson we recently published an editorial in the British Journal of General Practice, setting out some ideas around how pancreatic cancer diagnosis might be improved. I'm also interested in exploring whether blood biomarkers could have a role in improving diagnosis of symptomatic lung cancer, and whether their use alongside chest x-ray could prove to be a cost-effective alternative to using computed tomography for patients with common symptoms such as cough that have a low risk of cancer.        

What will the RCGP/SAPC Early Career Award enable you to do?

I hope to use the Early Career Award to travel to Denmark to find out how low dose Computed Tomography has been used there for symptomatic patients and to understand what challenges have been encountered in using that modality compared to chest x-ray. Denmark's health care system has similarities to the UK's, including the role of general practice and the strategy Denmark has adopted is often discussed as a possible model for improvement here, so I hope to gain a better understanding as to what lessons Denmark might have for the NHS. I plan to meet with Prof Henrik Møller, who has great experience in UK as well as Danish health policy (for example he authored an important study on general practice uptake of urgent suspected cancer pathways)  as well as other researchers and policy experts in general practice and cancer.  

What advice do you have for people who want to work in primary care research?

Before getting a paid position in research it is quite common to have to spend quite a bit of your own time (unpaid) gaining experience. This situation means many people with additional responsibilities or who are at particular stages in their life may find it particularly hard to get involved in research. This is a problem, particularly in terms of ensuring diversity of our academics, but the reality for many is that succeeding in research may involve investing a lot of your own time. And there are aspects of research that are tedious. So it Is really important to try to understand whether a career in research will suit you and whether it will be worth all the effort to get there. Clinical careers are already really tough and giving up precious free time should not be undertaken lightly.     

Having said that, I absolutely love my work and every day I feel blessed to have this job. It feels a privilege to spend time on problems that are important, interesting and that allow me to work with brilliant colleagues and friends. I am very indebted to supervisors and mentors who have supported me and have been extremely kind with their time and encouragement. Prof Richard Neal was my main supervisor and always looked out for my interests and development to an extent that I think is rare and special amongst PhD supervisors. Similarly my other supervisors, Prof Bethany Shinkins, Prof Mat Callister and Prof Willie Hamilton were incredibly supportive and generous with their time and expertise. Prof Robbie Foy along with Dr Sarah Alderson gave me my first introduction to primary care research around 10 years ago and I still regularly turn to them for mentorship and advice. 

So, my main advice would be to find people who can help you learn about research and give you the opportunities to launch your career. Showing you can write and express your ideas is really important and can help persuade academics you are worth investing in. The beauty is that even without academic connections or access to data anyone can do this by writing letters to journals, or opinion articles (for example on BMJ Opinion and BJGP Life). 

For GPs another excellent way to 'dip your toe' is by signing up to the Primary Care Academic Collaborative or even by serving as research lead for your practice.