That “eureka” moment
Julian Halcox is a cardiologist who juggles research and clinical commitments
Julian Halcox is a consultant cardiologist at the University Hospital of Wales and a professor of cardiology at Cardiff University. He leads an active programme in translational vascular research—that is, research that translates basic science into clinical applications—and is director of the All-Wales Cardiovascular Research Network. He is involved in developing local and European guideline production for the prevention and treatment of cardiovascular diseases.
His particular clinical interests are in the investigation, risk assessment, and treatment of patients with arterial disease.
When did you decide you wanted to pursue a career in academic cardiology?
After finishing year 4 of my cardiology specialist registrar training, I went to the National Institutes of Health (NIH) in the United States where I worked in the department of cardiology with an inspirational mentor. Throughout my earlier training, I had planned to follow a career as a cardiologist in a district general hospital. Initially, I saw a research fellowship in America as an opportunity to get out and see some more of the world and to gain experience of working in a different healthcare system. However, after exposure to the amazing academic environment at the NIH where I found the culture of translational cardiovascular research engaging and inspiring—as well as getting some good publications under my belt—it was necessary to re-evaluate my career path!
What is the most demanding part of your job?
Balancing the many demands on your time and energy. As a clinical academic you have many important clinical and teaching commitments as well as the day to day running of your research team and wider collaborative networks. However, if you work hard and try and keep yourself organised everything is possible.
When do you find your job most rewarding?
As a clinician, it’s the personal touches like making correct diagnoses, helping patients understand what’s wrong them, and being able to provide the treatments that will make them feel better and live longer.
From an academic perspective, it’s most rewarding when that “eureka” moment happens: the data come together and you can see your way to a good paper that will make people think differently about physiology or pathophysiology. This has happened on a few occasions, resulting in papers that I am proud of.
Could you give an example of one of those?
One of my best cited papers is from my time at the NIH where my colleagues and I showed that the way the human coronary vascular endothelium responds to pharmacological stimuli (by vasodilatating or vasoconstricting) is a strong predictor of whether people go on to have heart attacks, strokes, or even die.
These data have been confirmed by others and have been fundamental in understanding the impact of the vascular endothelium on the future of our cardiovascular health.
What characteristics does a person need to be successful in academic cardiology?
Cardiology is perhaps not the most intellectually difficult and complex subject, but it’s certainly a competitive specialty, with a lot of highly driven people chasing similar goals. Therefore you have to be not only fairly bright, but also prepared to work extremely hard to make yourself competitive in the field.
What has been the highlight of your career recently?
As far as recent research highlights go, my team and I are coming to the end of a large study working in collaboration with University College London and St George’s Hospital. It’s called the British Regional Heart Study, and it is the culmination of almost four decades of follow-up of several thousand men from all across the United Kingdom. We are looking at the vascular health of those who have survived into their 70s and 80s. This study will provide unprecedented information on the long term determinants of arterial health in later life. Some of these men are likely to have maintained healthy arteries for all that time, perhaps even in the face of exposure to risk factors. We expect the data from our study to have the potential to help identify novel protective factors against degenerative arterial disease, the cause of most heart attacks and strokes.
What advice have you got for any unhealthy students regarding their future cardiovascular health?
Unfortunately, it is well recognised that unhealthy patterns such as not eating well, lack of exercise, and smoking earlier in life are linked strongly to cardiovascular disease, cancers, and diabetes later in life, and that patterns of behaviour laid down in early life are typically maintained or worsened through life. The most important thing to remember is that it’s never too late to change. It is still possible to make a massive difference to your long term risk by making healthy lifestyle changes at any time in life, but the earlier these changes are made the better.Thomas Lemon, fourth year medical student
1University of Cardiff
Correspondence to: LemonTI@cardiff.ac.uk
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2013;21:f214