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Tuesday, 19 September 2017

A NIHR In-Practice Fellowship: Growing evidence-base for self-harm in primary care

Wtitten by Dr Faraz Mughal | | @PCSciences | @farazhmughal

As a GP and Royal College of General Practitioners (RCGP) Clinical Fellow for Children and Young People’s  Mental Health, I was delighted when I heard the news that my NIHR (National Institute for Health Research) In-Practice Fellowship application was successful. The fellowship will not only allow me to develop research skills and evolve as a clinical academic, but will also allow me to further understand self-harm within primary care, a subject which personally, really troubles me. 

But what is an In-Practice fellowship?

More often than not, General Practitioners will go through their training and have little to no involvement with research. This isn’t to say we have no interest in it, on the contrary, we often come across conditions that need further research to better inform practice, but we often don’t know how  to contribute.

In short, the fellowship offers an academic training opportunity to fully qualified General Practitioners who may have already spent  time in NHS practice or fresh from general practice training, but have had little formal academic training so far. Training opportunities are flexible, however provide structured supervision within a research setting to ensure attainment of academic goals and will often include the completion of a Master’s degree. 

What will I be doing?

My fellowship will lead to the completion of an MPhil, which will be supervised by Professor Carolyn Chew-Graham and Dr Lisa Dikomitis.  I will spend part of my time developing my research skills, completing two studies within the Mental Health Research Programme of  Keele University’s Research Institute for Primary Care and Health Sciences. I will spend the rest of my time continuing with my clinical commitments as a practising GP.

The first study is a systematic meta-synthesis of qualitative studies of primary care practitioner attitudes and knowledge of self-harm in young people. The second will be a qualitative study, where I will be interviewing young people between the ages of 16 and 25 about their experiences of self-harm, help seeking behaviour, and their access to care with a general practice focus. 

Why self-harm?

I developed an interest in self-harm in young people early in my career as a GP. Being a young person today, is very different to what it was like 20 or 30 years ago, and the accumulation of stressors on these young people may result to the feeling of wanting to self-harm, or indeed carry out the act of self-harm. However, even as a GP, I still find it difficult to fathom what inflicting (or wanting to inflict) pain onto one’s self could be like.

We are seeing more and more cases of self-harm within primary care, and I hope that the research conducted through this fellowship will be beneficial to the small but growing self-harm evidence-base in primary care, and form the basis for further research.  

Tips for a successful application

Because of the great opportunities that these fellowships offer, competition is often fierce where applicants must be able to demonstrate that they have an outstanding potential for development as a clinical academic in research, or research linked to medical education.

The selection process is intense, so if you’re considering applying for an In-Practice Fellowship my tips for writing a successful application would be; 

Gain some research skills

Even if it’s self-funded, gaining research skills will give you some extra weight in your application, and help you through the fellowship process. I’ve conducted some previous research during my training and in the early years of becoming a GP (unfunded), which resulted in a few research publications on tobacco and medical education  and non-research peer reviewed publications. I also had the opportunity to present at international and national conferences. 

Find a mentor

Finding a mentor to guide you through this process is invaluable. The RCGP and the Society for Academic Primary Care both offer mentorship opportunity that are definitely worth considering. 

Take your time

Take the time to focus on your research question, identify a suitable supervisory team, and plan your application. A mentor once advised me not to rush into applying and to ensure you apply at the right moment, and in hindsight, this was crucial advice for me. 

I am thoroughly looking forward to beginning my fellowship later this year, and starting my journey into clinical academia. It will give me the opportunity to learn from a team of experts from one of the top Primary Care Research Institutes in the UK and I know the experience will be invaluable as a practising GP. 

More information about these fellowships can be found on the NIHR website

About the author


Dr Mughal is a salaried General Practitioner (GP) based in Birmingham, who after completing his GP training through the North Birmingham Vocational Training Scheme in 2015, was appointed as a Royal College of General Practitioners (RCGP) Clinical Fellow in Children and Young People in Mental Health. Here Faraz contributes to the growing mental health work of the college – an enduring clinical priority until 2019. You can browse the RCGP mental health toolkit for primary care staff online

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