Luke Devey has joined the GSK Esprit R&D Programme as a Director of Translational Medicine. He completed his medical training at the University of Oxford and worked in Oxford, Newcastle and Edinburgh before going on to do an MRC-funded PhD at the University of Birmingham. In 2008 he was awarded an Academy of Medical Sciences/The Health Foundation Clinician Scientist Fellowship, which he undertook alongside training in transplantation and general surgery in Edinburgh.
Working as a doctor in any specialty, it soon becomes clear that medicine is imperfect, and unable to offer good treatments for a great many patients. I have always wanted medicine to think of itself as a ‘technology industry’, using creative research and development (R&D) to seek solutions to the problems of today to shape a better tomorrow.
Until now, my work as a clinical academic has been either at the laboratory bench or at the clinical coalface. As I approached the end of my clinical training and my Clinician Scientist Fellowship, I started to think about what my next move should be. The default position was to continue in clinical academia – very much a known entity. But part of me wanted to explore other opportunities to maximize the translational impact of my work, and I had come to realise that the critical steps on the long path (it takes 15 yrs and 1$bn to make a new medicine) between bench and bedside are most often taken in industry.
Before I could consider working in pharma, I needed to answer a lot of thorny questions in my own mind. Was pharma ethical? Was I ‘selling out’? Would the science be worthwhile? Was this a smart career move for a clinical academic? Was there opportunity for progression? What would I learn in industry? And, finally, were there going to be credible outputs from my work? In other words, all of the same questions anyone who has been embedded in the National Health Service (NHS) and university sector for their whole careers would pose.
Amongst my public sector peers, perceptions of the pharmaceutical industry have been tainted by allegations of drug mis-selling and misrepresentation of trial data. On the other hand, I found Sir Andrew Witty’s announcement of phase III results for a novel RTS-S malaria vaccine in 2011, and novel business models to make it available to patients in the developing world compelling. The power of ‘big pharma’ to choose to eradicate 10 neglected tropical diseases seemed both awe-inspiring and to reflect a growing understanding of pharma’s wider responsibilities to society. Finally, the push for open data from the ‘All Trials’ campaign promised that the altruism of clinical trial participants to be rewarded with benefit for all. How could I judge whether GlaxoSmithKline (GSK) was ‘bad pharma’ or ‘good pharma’? I needed to go beyond the media reports and seek answers from the people actually working there.
When I made my first exploratory visit to GSK R&D, the first thing that struck me was the talent and enthusiasm of the people I met. These were highly respected individuals who had made significant contributions to their fields in biomedicine, and were easily recognisable in academia. Though no secrets could be divulged, it was clear that they found pharma to be a fertile ground in which to develop their ideas. They also enthused about the very high standard of the work they were able to do, driven by the need to create robust pre-clinical data which inspired the confidence required for investment in costly late phase drug development. Publication wasn’t a problem; they were conducting well-funded, high quality studies using novel compounds, and as a result, were fully expecting to produce high impact papers. Crucially, their outputs weren’t just papers and grants but real medicines for real patients.
These initial meetings made an impact on me – the GSK Esprit programme was clearly a very exciting opportunity which I felt compelled to grasp. But in order to safeguard my career as a clinical academic, I would need to convince my clinical and academic mentors. Though I approached early discussions with some trepidation, I was pleasantly surprised by the level of flexibility I encountered, with most objections melting away when I was able to describe the level of the work I would be doing, and the calibre of the people I would be working with. By being open and negotiating with my funders, my University and the Esprit Programme, it has been possible to establish a ‘landing pad’ back in surgery and the University in three years, should I wish to use it. A large part of maintaining that open door meant working out what I would offer the public sector in three years’ time with the benefit of my private sector experience.
This opportunity marks a new era of support for collaboration between university, NHS and industrial sectors. New initiatives from the MRC and the Wellcome Trust, are supporting movement of researchers between industry and academia during their careers, while academies and learned societies are investing resources for early career researchers to better understand the interface between industry, academia and the NHS. For example, the Academy of Medical Sciences has recently partnered with GSK to provide mentoring and career development support to postdoctoral clinical research fellows seconded to GSK’s Academic Unit in Cambridge. Quid pro quo, industry is increasingly looking to externalise Research and Development, to share data and co-develop molecules with academics.
Being a GSK veteran of some three weeks’ experience(!) I can now report that it is a very enjoyable place to be. I have rarely experienced a more stimulating flow of fascinating ideas or climbed a steeper learning curve. I am working on a number of familiar immunological pathways I have studied before, but using them to make real medicines for real patients. It feels healthy to be exposed to different ways of working, particularly the relentless clinical focus of the work – abandoning ideas which are interesting but not going to create new treatments, and the way that projects are taken forward in collaborative teams as opposed to individuals working alone at the bench.
In the end I knew I had to leave my comfort zone to explore how else I could make a difference to patients and, so far, I’m glad I have.
Information on the Academy’s mentoring and career support is available at www.acmedsci.ac.uk/mentoring.