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Episode 2 Life as a Pleural Fellow – with Dr David Arnold and Dr Thisarana Wijayaratne
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In this episode, we sit down with David Arnold and Thisarana Wijayaratne, two pleural fellows – one research (now a newly appointed consultant) and one clinical, to hear their first-hand experiences of fellowship training. They share what drew them to the field, how to go about applying for fellowships, and what day-to-day life as a fellow looks like.
Whether you’re a trainee considering applying, a clinician curious about fellowship pathways, or someone interested in the future of pleural practice and research, this conversation offers practical insights and honest reflections from those who have lived the experience.
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Transcript
Introduction to Pleural Fellowship Podcast
00:00:02
Speaker
Welcome to the second episode of the UKPS ss podcast career spotlight series.
00:00:08
Speaker
I'm Benesh, a Plural Research Fellow in Oxford, and I'm joined by my co-host Malvika today. Hi everyone, I'm a Clinical Plural Fellow at Oxford, and my name is Malvika. Our episode is about fellowship experience in plural disease. We're looking at both a research as well as clinical perspective. Our guests today are David Arnold and Sarna Vijayaratne, who have both successfully completed plural fellowship at expert plural centres.
00:00:36
Speaker
We are hoping to hear from them about their career journey, so welcome Dave. ah Would you like to introduce yourselves to our listeners please?
Backgrounds and Fellowship Experiences of Guests
00:00:44
Speaker
Hi, both. Thank you very much for having me on the podcast. Sounds like a great idea.
00:00:49
Speaker
My name is David Arnold. I'm only recently now consultant, senior lecturer, been a consultant from August of last year that completed an NIHR doctoral research fellowship in pleural disease between 2019 to 2022. It was a fantastic experience and yeah really happy to talk to you about it. so My name is Disarana. I'm currently an East Midlands ST6 respiratory trainee, East Midlands South veterinary.
00:01:17
Speaker
I've done a clinical pluralshhip at Glenfield Hospital Leicester between the years of August 2023 to August 2024. I've done a whole year of it and now back into training as an ST6 registrar.
00:01:30
Speaker
So I'm excited to talk about what my experiences were. Great. Thank you very much. So i will ask you, Dave, first, what made you consider Plural as a subspecialty within respiratory medicine? Or did you have any inspiration you want to talk about?
00:01:45
Speaker
i have been doing this for a sort of tediously a long time. I have to go all the way back to that's one I've always had an interest in academia throughout medical school, but like many of us starting F1, didn't really know which clinical area I was interested in.
00:02:00
Speaker
and Did respiratory as a first job in the Bristol Royal Infirmary. And the first time prescribing a laxative and things like that, bit of a buzz. So thought actually respiratory, good department, nice people and nice mix of procedures.
00:02:14
Speaker
I was doing the Academic Foundation program as it was at the time. And one of the registrars said to me, oh there's Nick Maskell up at Southmead. He said he's got a whole ton of pleural fluid in a freezer, which you might be interested in.
00:02:28
Speaker
And it sounded great, you know, so I came up, met with Nick and Professor Ann Miller. Nick had brilliant ideas. It was exactly the sort of thing I was interested in. was good medicine, but also a mix of procedures and also ah specialty that had advanced hugely in the previous sort of decade.
00:02:47
Speaker
And it became really apparent from the first BTS I was invited to that year. That actually is a lovely group of people as well and work really collaboratively together. Then I did the sort of fellowship in this area as well. So that's my that's my story and that's why I became interested in pleural disease in the first place.
Importance and Challenges of NIHR Fellowships
00:03:03
Speaker
Great. I just want to ask a follow-up question on that, that how was your experience applying for these NIHR fellowships? Because they're quite competitive and are they necessary to do a research or a PhD or you can do it without it as well?
00:03:18
Speaker
It's certainly not 100% necessary for you to get an NIHR or MRC fellowship to do plural research. There are plenty of standalone jobs out there where you just apply for a PhD, for a standalone PhD.
00:03:32
Speaker
And often they'll be attached with a research question already in mind. The advantage of doing the doctoral fellowship is that you get to design your own question, you get your own funding, it gives you more freedom.
00:03:46
Speaker
The disadvantage is it is a large amount of work. And so as you say, it's quite competitive. One of the good things about the ECF program, for example, is it gives you a bit of protected time, because I would say it probably takes a good nine months to one year to work up application.
00:04:02
Speaker
With a lot of obviously career uncertainty mixed in with that as well. Perfect. Good. Thank you for that, Dave. And this, what about you? What made you choose plural as a subspecialty?
00:04:15
Speaker
Similar to Dave, I've always wanted to do respiratory. I come from Sri Lanka and probably a bit of inspiration from Lyalka, who was a respiratory physician back home. I used to get exposed to the field. I was exposed as a child stupid to go to his outreach clinics in the rural parts of Sri Lanka. So I knew I wanted to do respiratory.
00:04:33
Speaker
I went to a med school in Bristol, so I met Nick, but obviously as a medical student. And then once I came through Outland Foundation training and for medical training back then, whilst I got into respiratory, I always wanted to do something procedural.
00:04:49
Speaker
i was looking through the different subspecialties within respiratory and plural and interventional, I had a very much of a liking to us from the beginning, from the early years.
00:05:00
Speaker
And I just thought, okay, what are the opportunities I have? And luckily, so I'm an East Midland South trainee. So when I was an ST3 and ST4 year registrar, was in DGHs, in District General Hospitals. Then as an ST5 registrar, I came to Glenfield, which was my first tertiary placary center experience. So when I came, I saw this fellowship.
00:05:22
Speaker
And I managed to reshadow the current fellow at the time. managed to see what they have, what sort of scope is available, what's the job like, how busy it is, what sort of opportunities you get, which kind of gave me a lot of insight into the subspecialty of puerile disease. And I just, the more I found, the more I liked it.
00:05:44
Speaker
And in Glenfield, there's a... bit of an overlap of the fellowship, not just plural, but also intervention. Mostly you do bronchoscopies and evers, which is waterless lankens. So all in all, I was very much interested and I applied for it and i was fortunate enough to um do the job and I really enjoyed my year.
Preparation and Skillset for Pleural Fellowships
00:06:02
Speaker
Perfect. So now that you've mentioned that it was a plural and interventional fellowship and you applied for it, etc., Glenfield is a well-known established centre for interventional, in particular, respiratory ah medicine. And i imagine that the post is very competitive.
00:06:19
Speaker
So how did you prepare for it? You told us that you shadowed, etc. but What else went into preparation to apply for the fellowship itself? The preparation is mainly for the interview.
00:06:31
Speaker
So I was fortunate enough because the current fellow and there was a previous another register who was Hall 67. So they were both mentored me as to how to prepare for the interview, but essentially in a nutshell, if I give yourself advice, it's basically like you just have to know what your skillset is and also being aware of the current advancements in plural diseases, your basic knowledge in plural medicine and also they don't really expect you to be competent with a advanced pluriprocedures like the rachoscopies because the whole point or one of the whole points of doing the fellowship is to make sure that you are you are trained in that but at least some exposure so all in all in terms of and advice that i can give is just
00:07:18
Speaker
read and get updated about the current advancements in pleural disease, your main trials that you need to know, everything that has changed practice, the guidelines and the BDS pleural procedural clinical statement as well.
00:07:32
Speaker
Great. So thank you. That's quite helpful. So I'm going to ask you, Dave, the same question, but probably slightly want to add that I guess the fellowship that you did was probably very competitive as well, I can see. And how did you prepare in particular?
00:07:47
Speaker
Were you working towards it? like Because you're always tall, least what I did, getting in touch with people early. you want to work so that you know what the feel is like, how people before you got the fellowship, so you need to do?
00:08:02
Speaker
some small research like case rap reports or QIPs and stuff preparing towards it or was it a slightly different journey for you? It was tricky. I think the academic route is obviously, he's it is very it's very different and you're slightly beholden to a different master on you because you're not competing with other respiratory physicians. You're competing with anyone across the country who's applying for some sort of research fellowship.
00:08:32
Speaker
And so I think the main thing that we were trying to do is to say my CV is what it is, but the research question is a really important one when you compare it to everybody else who is going to be applying in terms of event mental health or perinatal medicine or whatever else that people might be interested in. I think the advantage of respiratory is often a disease of deprivation in respiratory infection. It's a lot around AMR that you can build on and make the question sound important.
00:09:01
Speaker
And then you've got to make sure when you're applying academically that you're doing it from centers that have got a bit of a track record because often the NIHR, if it is the funder we're talking about, is going to be spending close to half a million pounds on any one of these fellowships. They want to make sure they're getting value for money. They want to make sure their money is safe.
00:09:20
Speaker
And often that means they're going to be looking not only just to the applicant and the question, but also the center you're applying from. and make sure that the mentor supervisor that you've got has he got a track record of hosting PhDs.
00:09:34
Speaker
The question I got at interview was how many PhD students has Nick Maskell? Have they all been successful? And really goes to show that actually they're not just looking at you, they're looking at the entire environment around you. And it's very different, I suppose, to applying for a clinical fellowship where it's a lot more about what he brings to the table.
00:09:54
Speaker
When you apply academically, you're bringing everyone else along with you as well. And when you applied for the Bristol fellowship job on its own, was there any preparation that you did for the interview in particular?
00:10:05
Speaker
for but In terms of, it was funded by the and NIHR ah and then... The fellowship comes with it You just say, I'm going to be doing a PhD, but at the same time, i'm going to be contributing towards the plural service. And suppose if you're bringing your own money and bringing your own salary for three years, unless you're right lease of work, most hospitals are say, yeah, come along. And so the same thing has happened at a consultant level as well.
00:10:29
Speaker
just got a five-year fellowship to do the same thing, but at a consultant level. And whilst you do have to go for a clinical interview to make sure you're going to work well within the department, you're not competing with anyone else.
00:10:41
Speaker
It's you applying for that job. And provided you meet the sort of clinical safety threshold, you're going to get that job because you're bringing your own salary for five years. So it's a very different approach.
00:10:52
Speaker
Perfect, yeah. So of course we know that plural disease is rampant and plural services are always quite busy clinically, quite a heavy work schedule.
Structure and Dynamics of Clinical Fellowships at Oxford
00:11:02
Speaker
So what was the structure of your fellowship then, Thais, and what did you like most about it?
00:11:07
Speaker
It's a busy week that you have and it's mainly plural and interventional. I mean, as interventional, it doesn't stop at thoracoscopy or removing an IPC. You'll also have a bit of lung cancer with bronchoscopies, EVUS, advanced EVUS.
00:11:22
Speaker
And so you have a dedicated procedure list on a Tuesday AM and PM where it's a mixture of bronchoscopies, endobrochial biopsies, endobrochial cryobiopsies, other people started recently, and EBUS and EBUS as well, which we have started recently that started when I was the fellow.
00:11:40
Speaker
And then the Tuesday PM list would be dedicated for theroposcopies. And if there are no theroposcopies that week, then it would get filled by bronchs and EBUSs.
00:11:52
Speaker
You all do attend and see patients once a week in a pleural clinic. And also you get once a week, you get a lung cancer clinic as well. And on top of this, you do get opportunities to do your own projects, development projects, improvement projects.
00:12:09
Speaker
And then also in terms of what I liked about it, I think from what I expected, I managed to gain whatever I wanted, if not more. I've had a good year, had a good productivity in terms of.
00:12:23
Speaker
I managed to five projects which all five I managed to visit at BTS in Winton, Class 10 and it's going to be busier for whoever does it clinically but also to focus on the other projects that you might get.
00:12:38
Speaker
Now I feel more confident in managing rural diseases and I think that's what is needed given the transition train. And just want ask Tiss on that, did you have to cover the respiratory ward or any on-calls as part of it?
00:12:54
Speaker
The good thing about the Glenfield Plural Overtholoship is that no, you are not a part of the alcohol team. So I did not do any alcohols over here. In terms of the ward, you don't do specific ward rounds as such. You're not counted in terms of the ward registrars.
00:13:10
Speaker
So the plural ward, which is ward 29 on the Plural Lung Cancer Ward has their own registrars and you do not get counted in the headcount. However, if there is a patient related query, like if somebody needs an IPC or there's a patient with an IPC related query, then you might get to go and review.
00:13:30
Speaker
But that's not a major part of your job plan. Okay, good. So Dave, same question to you. So what was the structure of your fellowship? And what do you like the most about? it looks like you like most of it already, but...
00:13:45
Speaker
What was the bit that you really want to talk about? and sounds like it just went quite a bit harder than I did, but I suppose what did we do? was doing the fellowship at the same time as some great colleagues, Steve Walker, Tanisha DiFonseca, Anna Bibbia and Rahul. And you can split the time, we split the time between us.
00:14:03
Speaker
So in general, we probably did a one in three. And in the week you were clinical, you were doing but a plural clinic, a couple of heart patients and procedure list. holding the phone but for tricky pleural cases. It wasn't the fact that if the pneumothorax came into ED, you were expected to go down.
00:14:22
Speaker
Nick and Millie have always been very keen that we stay in contact with the pleural service, with the clinical service, because that's where a lot of the research is happening. You can't completely absolve yourself of that because actually we're picking up a huge number of our patients, but they got pneumothorax, pleural infection, malignant coerfusion from actually being integrated within the clinical service.
00:14:41
Speaker
And so, you know, a one in three, it wasn't too bad. And it gives you the other the two weeks to then do your PhD at the same time, which is which was great. And I think the setup works really nicely. It's going to be vastly different across the country, obviously, depending on the sort of service they run and the number of other people doing the same thing as you. But that's how we did it in Bristol.
00:15:03
Speaker
it works It works really nicely. The thing is, the priority is always the patient, isn't it? and And with pleural disease, the patients who were following up for cancer at the very early stage of their cancer diagnosis, you can't just see patients one one week and then completely drop the clinical until you come back three weeks later.
00:15:21
Speaker
So you've always got to keep an eye on it. And that's the one thing I found slightly challenging was, you know, you can't switch off from your NHS emails as much as you might like to because you're trying to get PhD done.
00:15:31
Speaker
Thanks so much for that, Dave. Thanks for sharing the structure of your respective fellowships. And and since currently I'm doing a clinical fellowship at Oxford, actually. And just for the listeners and just generally speaking, yes, the clinical plural fellowship at Oxford is quite busy as well. We tend to do two intervention lists, which is basically a mix of all sorts,
00:15:56
Speaker
essentially thoracoscopies, image-guided biopsies, your aspirations, your chest strains, etc. And then we tend to do two plural clinics a week and we participate much like yourself this in a weekly long MDT as well as a separate plural MDT of our own.
00:16:13
Speaker
And of course, there is, i think, similar to what Dave said about holding the plural bleep. So we're not, like you were saying, Dave, we're not called for a green pneumothorax down in ED or whatever.
00:16:24
Speaker
But we do get a fair few referrals for advice, et cetera. And it it does get quite busy. But at the same time, quite an enriching experience, actually, in terms of getting that clinical exposure. We are expected to take decisions, really. And of course, we always have.
00:16:42
Speaker
Naj and Rob around for advice, etc. But we tend to try to take those decisions as as independently as we can. But yeah, that's it's quite a bit similar to the clinical structure, the structure of the clinical fellowship in Glenfield.
00:16:57
Speaker
And I think Beanish can tell us a bit more about the research fellowship bits, actually.
Research Fellowships: Independence and Development
00:17:03
Speaker
Yeah, so the research fellowship here is completely separate to the clinical fellowship. So how it works in Oxford is that you apply for a clinical fellowship.
00:17:12
Speaker
And almost all of us have come through that route, that while you heat it, you develop ah research project with Naj and Rob while you are working as a clinical fellow, but then you develop that. Either you apply for a fellowship application or you just continue to stay on to do your own thing.
00:17:29
Speaker
So i I don't have a dedicated NHR MRC fellowship, but I'm doing my own PhD or my own research idea based on, of course, other funding pots, which, of course, once you are In Oxford, you would know, your negotiat you negotiate, you talk to a large about that. And so you just can develop that idea yourself. But then we are not asked to cover clinical service, but we do attend pro-MDTs. We do cover gaps in when the clinical fellows are away or short on the ground floor.
00:17:59
Speaker
So we do sometimes list as a senior supervision and also clinics just to keep up with our clinical skills as well. But that's not a requirement of our fellowship.
00:18:11
Speaker
There's more like us just wanting to be involved. But also just want to say from the clinical fellowship perspective, we do cover respiratory wards. every few weeks for one week as a respiratory reg and also on-calls as well, which are respiratory on-calls, which is on-site within till 10 p.m. I think, then off-site from home and also cover GIM nights as well, what but a bit few and far between. So that's just to give a whole structure of how this fellowship works in Oxford.
00:18:42
Speaker
Yeah, sure. Coming back to Thys and it'll be interesting to hear from a clinical animal research perspective about the pros and cons, really, of the fellowship structure or if there could be something additional.
Evaluating Fellowship Structures: Pros and Cons
00:18:56
Speaker
So, Willem, shall we start with you, Thys? What do you think could have been added on to your fellowship structure which would have made it more helpful or better, if there is anything?
00:19:07
Speaker
that's a bit of a difficult question to answer. Because think the program is very structured. Obviously, they've done it for many years. yeah Even though it sounds very clinical, 80 to 90% will be clinical.
00:19:20
Speaker
You do get the opportunity to go get involved with my descent and basic studies. In all three of you will be a aware that Glenfield has been taking part in a lot of plural studies. And as the fellow, you get first-hand experience in terms of Identify patients, randomization, and they can be put in their trials, etc. So you do get that sort of research side as well. And also in the projects that you do get to do, depending on what they are and how they're themed, you do get the research side of things, even though they are not at a PhD level.
00:19:56
Speaker
I'm a very clinical person and I don't mind doing a little bit of research, but certainly i can't see myself doing a PhD. So for me, like this very much, but also there was a bit of research, which research is very important. these is ah it's The clinical research side of things is interesting in this job.
00:20:16
Speaker
I can't really think of anything that could have been made better. And the the overall, the fellowship is very well supported. You work with the Dr. Hanshul and he's very supportive. And if he's not at all, there are a number of other consultants who are happy to troubleshoot.
00:20:34
Speaker
Perfect. That sounds great. And what about you, Dave? What do you think? I think the the only issue is that, especially with plural, it's quite a practical specialty.
00:20:47
Speaker
When you're doing a PhD, you're torn in two different directions between the technical and the academic. And if you're only doing a procedure list, let's say one in one in three, one in two, one in four, then you're probably not going to get as much exposure to procedures as you would doing a clinical fellowship or even as one of the clinical registrars on the board.
00:21:10
Speaker
And for me, I would have liked to done more procedures during my PhD with the knowledge that actually that probably would have pulled me away from the academics. So you can never win, can you?
00:21:22
Speaker
I think, especially when you're doing a plural PhD and you're going into it, probably ask the question, how many proceduralists are I going to be doing? How many hotcakes are you going to be doing? Is that going to be enough to keep up my skills?
00:21:32
Speaker
I think that's a very fair point that you, what type of outcome you want, you just try to join that type of fellowship program because that's what should be the aim that what I'm going to get out of it. And if you want to be purely clinical, I think having a clinical route would probably suit you better with some peppering of research projects here and there. But if you want to be a clinical academic, and I think that comes with that trade-off that you have some time taken away for research, which is necessary.
00:22:00
Speaker
Just because you guys have been successfully through the journey, want to that if someone is interested in doing Proval Fellowship, either clinical or research based, do you recommend about getting in touch with people sooner, networking, and how early do you think they need to start?
Networking and Preparation Advice for Aspiring Fellows
00:22:20
Speaker
ah working towards it because training is now only four years, you have very little time and in lots of competition for these fellowship opportunities. So maybe, Dave, I can start with you first.
00:22:31
Speaker
Start now, I think is the thing, because I've just come from a meeting with ah an f one Who just mentioned on the ward, oh yeah, I'm quite keen on respiratory and I really like academia. I'm thinking about applying for an ACF at some point.
00:22:42
Speaker
You need to be telling us, so you need to be saying, I'm here, I'm coming. Because what you don't realize when you're a bit more junior, you're thinking, you're looking up at these jobs thinking, well, they're really hard to get. I'll get to them when I'm getting them.
00:22:54
Speaker
All you don't realize is people looking down, the maskals, the rackwins, they're looking down thinking, who there who's coming up for these jobs? I need to justify to the university. I need to justify to the trust that you've got someone in mind because otherwise we're losing it to obstetrics. We're losing it into the mental health people.
00:23:10
Speaker
And so you've got to let people know. And if I've learned anything from doing a sort of PhD and working with good people around me is i always was slightly fearful about sending that email. Just send it. The worst thing that can happen is they don't reply.
00:23:25
Speaker
Who cares? And if they didn't reply, they probably weren't even worth talking to in the first place. so And so I would just send it to the most important person at the top. And actually, you'd be surprised that in the majority of the time, they are waiting for emails from people like you.
00:23:40
Speaker
They really want to hear from young, aspiring academics or clinicians who want to do the job and get in contact with them early. Because it's pointless coming to them a week before the interview saying,
00:23:52
Speaker
I'm interested in this. How can I buff my CV in? It needs to be two years before so that we're actually perfectly aligned. And the optimum thing, obviously, in any academic role is that you're a shoo-in for the job before you even walk in the door. You know, the job has been designed for you.
00:24:07
Speaker
That's position A1, isn't it? And that is possible if you talk to the right people at the top early on. Yeah, no, absolutely. I think, Dave, that's really good advice and I think very true and accurate as well. sure I'm sure our listeners will find that very helpful. Thank you for that.
00:24:22
Speaker
What about you, Thys? What would you recommend in terms of someone aspiring to do a clinical plural fellowship? What sort of networking opportunities should they look out for? What kind of things should they do?
00:24:34
Speaker
The way that Glenfield plural fellowship works is that what normally goes around November, just before the winter BTS. And that's an opportunity to go and meet Dr. Panchal, who's the supervisor of the fellowship in Hinamiri.
00:24:49
Speaker
Who's to winter BTS, going and introducing you and just showing your interest would be beneficial and some people are thinking doing a fellowship is going to be a break. And with the clinical fellowship, I should say that it's definitely not. Because I remember when I, before I started, people were like, oh, you're going to have a very true idea because I'm not an uncle or brother.
00:25:11
Speaker
But in fact, you do have a busy year and you you have to be mentally prepared to do a lot of work. And also that basic knowledge of pleural diseases, there are lots of resources that you can read and whether it's the anatomy, whether it's the physiology of pleural diseases, whatever.
00:25:29
Speaker
That always helps. So make sure preparation from that side is beneficial as well. Great. Okay. I think I just want to add that's brilliant. It's also like looking at the job description of the fellowship that you want to apply. Maybe looking at it a year in advance, for example, that you know that this is where I want to go Well, I have a couple of options. Try to look at the job description of the post and try to align yourself as much as you can with it. If you probably want to be in an academic center,
00:25:59
Speaker
Then try to do some projects that can just really uplift your CV in plural. Kind of small things, but at least to show that you have been, you have a trajectory right that rather than a spike that came immediately just trying to apply for the job.
00:26:13
Speaker
And the same for clinical, as you say, Zahana, that if this is the job description, it's a busy hospital, a busy trust, lots of clinical cases that you have to deal on your own, then just brushing up on those skills to the point that you can safely manage, I think is very important from my experience.
Future Prospects for Pleural Fellowship Trainees
00:26:32
Speaker
I think the last question you're going to ask is about, is probably a bit more controversial question. So I'll start with you, Dave. What's the future of post-fellowship trainees and consultants looking like? Because criticism is that there are limited centers and everybody wants to do plural.
00:26:50
Speaker
And the plural centers already have established consultants and systems in place. So what is going to be the future like for all of these new plural fellows who are going through the system that...
00:27:04
Speaker
Would they be getting any plural sentence job in the end or is it even worth doing a fellowship if they can't practice that? If I answer it from more academic slang, would that be okay?
00:27:15
Speaker
think in the sort of current political climate, very hard to be an NHS consultant with a research interest. I think everybody's PAs are being squeezed and the concept of having a few research PAs to do some research in your area is is becoming rarer and rarer. So actually it's becoming important to have a research interest early and to try and get academic jobs.
00:27:41
Speaker
On the flip side of that, challenging because actually the universities have got less and less money. What's my advice to people? If you do a research post, and that's probably going to be an MD or a PhD in pleural disease, then really your next step needs to be thinking, right, I want to get an academic clinical lecture post.
00:27:59
Speaker
So these are funded by the and NIHR and some universities offer core funding, ah ACL posts as well. And I don't really see any disadvantage and I should absolutely desperate to become a consultant. What they do is they double the time remaining in your trading. So I had a year and a half less, so that became three years.
00:28:18
Speaker
And for one of the half of those years, I've just got academic time. So you can finish off the projects, your PhD, develop your next application. As I said before, the next step is a fellowship and those things take a long time to work out.
00:28:32
Speaker
I don't see a disadvantage in doing an ACL job and it positions you nicely within good supportive departments. And once you're in the door, you're in the door. Before Tis talks about the sort of clinical side of things, I don't think it'd be, it's hardly a disaster to do a plural fellowship and then not to get a plural job at the end of it. You're always going to be in demand if you can do plural procedures.
00:28:52
Speaker
Great. Thank you. And Tis, you want to add from your perspective? I think fellowships are going to be that crucial thing with the transition training. So previously, we were able to see that lung transplant, CF, sleep, and pulmonary hypertension, they were the beginning of fellowships now.
00:29:12
Speaker
And blood and lung cancer, they were dealt with in the five-year training program. But with the transition, you start seeing technical fellowships coming. And I think if you want to aspire to yourself as working in a tertiary centre where you have all yeah all these resources, I think your fellowship is becoming crucial if you're standing yourself ahead of other candidates who may not have it to say that I've done this year, is my skill set and I'm ready to start the job.
00:29:42
Speaker
Compared to somebody who said, oh, I've done the standard four or five year program and this is what I've done. Because there's so much that you can achieve from that one year. And whenever there's a need, I think it should be relatively easy to get what you want.
00:29:57
Speaker
It may not be the same place that you want to ideally where, but I would encourage anyone who wants to do plural to do a fellowship rather than not doing them because there's lack of trouble being divided. I personally did not think about these things when I did the fellowship because all of these things can change in a few years.
00:30:19
Speaker
Yeah, great. I think we need to have this optimism, isn't it? That there's going to be a dream job sitting somewhere, or even if it's not a dream job, you make it a dream job and make it happen. And I guess I just want to close with it in a way that what I feel like in a training program, pretty much everything is dictated for you, the hospital you have to go to which shifts you want to But in a fellowship, you're running the service, you learn those managerial skills, which the training doesn't really offer anything.
00:30:47
Speaker
And I think when you become a consultant, that wherever you are, you know how to run a service and you can develop a service or can expand it as you feel like based on the opportunity. So these are really crucial skills as well.
Conclusion and Final Thoughts on Pleural Fellowships
00:31:00
Speaker
Absolutely. Absolutely. I completely agree, Benesh. Going through the clinical fellowship at the minute, yes. Definitely lots more skills that you acquire that you wouldn't normally get when you're in that protected bubble as a trainee. So definitely, I think listening to you, Dave, and this and you, Beanish, as well, I think all of us would agree that plural fellowship is a good idea.
00:31:21
Speaker
and I think that's pretty much all the questions that we had. You guys, thank you so much for sharing your experiences, your career journeys, and for talking to our listeners and hopefully they've all found it's quite helpful. Thank you. Thank you everybody, that's great.