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Brighton & Sussex Medical School

Inspirational women: Prof Jackie Cassell

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Inspirational women: Prof Jackie Cassell

Prof Jackie Cassell, Head of the Department of Primary Care and Public Health, and Director of Research and Knowledge Exchange at BSMS, reflects on her career to date, discusses the challenges she has faced as a researcher and reveals her career highlight.

I trained in medicine and I was a really awful medical student. I got quite bad grades, though I didn't actually fail anything. I got to the end of medical school and I thought 'I shouldn’t be doing this'.

I am not the kind of person that can do well in medicine and I struggled. So I went and did all of these little part-time jobs such as blood transfusion on the buses, a half-day each week 'special clinic' doctor in Brighton, where I was the only woman at that time, alongside family planning sessions, but all of these jobs were not going anywhere. I also worked at A&E, to fund a second degree in Philosophy at the University of Sussex, trying to work out what on earth I was going to do. Through those jobs I got interested in sexual health, particularly infections, so I did the exams to go and train in genitourinary medicine which is sexual health medicine with HIV and sexually transmitted infections, and managed to get a trainee job. I then got a training fellowship from the Wellcome Trust to work on sexual health in general practice, and that was really difficult, it fell apart. One of the great things about research is that you make a lot of mistakes and you learn from them so I ended up designing about three projects and then doing something that wasn't what I had planned. I realised while I was doing my masters in epidemiology that if I did two extra years I could do public health training and that meant that I could work on whatever I liked. This suited my limited attention span, as I prefer to work on lots of projects and not just one thing. You can do that in general practice and in public health but otherwise you have to stick with what you know, whereas I quite like doing something I don't know much about and can learn.

I joined BSMS in 2006 as a Senior Lecturer in Clinical Epidemiology. I've always been in the Primary Care and Public Health department but I have done various roles over the years. At the moment, I am Director of Research and Knowledge Exchange and also Head of the department.

I didn't always want to work in medicine. I was at an experimental comprehensive school on the Isle of Sheppey in Kent where we had a completely different school system to the rest of the county, and very few of us aimed for university. I thought I was going to go to music college but I then suddenly decided that I wanted to do something more 'useful' when I was in the sixth form. I was quite academic so I thought medicine would be for me. I managed to get an offer to do medicine on the condition that I had to do science three A-levels. I found medical training quite tough. I did the first part of my training in Cambridge and in those days they couldn't teach anatomy. We were given a book which had a few diagrams and a lot of long words and a person to dissect and lectures. The knowledge was all 3D and I'm not a very visual person so it was extremely difficult. Today's brilliant teaching technologies weren't available then, and a lot of us struggled.

In terms of my area of research, my main focus remains sexual health. But the big thing I've got interested in which has been a surprise is scabies in nursing homes. It's a neglected, important and difficult problem which very few people have wanted to work on because there is no money in it and it's not obvious where it sits as a topic. I also love working with my colleague Dr Liz Ford on electronic health records and working with colleagues across the University of Brighton and the University of Sussex on developing methods for gaining public health information in a way that is ethically acceptable.

There are still challenges facing women who work in medicine. I've often been at meetings where men have done 95% of the talking and then congratulated themselves on how everybody has had their say and it doesn't feel like that. I do think it is surprising to what degree there is gender segregation within medicine. For example, sexual health is now almost all women and gay men, although it's probably a fairly extreme example. On the hospital wards when I was a junior, the night nurses were often women with children who would come in and do a night shift then go home for the school run. Medicine hasn't got to grips with rotas to make a variety of jobs female-friendly.

The most challenging thing about being a researcher is that you fail a lot. My former boss, Professor Dame Anne Johnson, said to me: "Jackie, there are not many people that have the tenacity to be in research". Success isn't primarily about being clever but coming back after failure is essential. I've had to change fields and projects and I've had stuff that's been catastrophic and I think the biggest challenge is that when things go wrong, as they do, you have to try to keep your team together and feeling supported at work. I prefer CVs that say things like 'this collapsed and that collapsed and here's how I dealt with it' because that's ultimately how you learn and become a better researcher.

The advice I'd give my younger self is the advice I give the students in induction week; you will probably be retiring in about 50 years if you're lucky and you have good health so you need to give yourself the flexibility in your working life not to get bored. You hear a lot of people wanting to pack up or saying that they're bored, so I think you have to train for something that has enough breadth to keep you engaged and to move sideways.

One of the biggest influences on me was an English Literature academic, Stephen Medcalf, who taught me at the University of Sussex. He saw everything as being connected to everything else across different fields. In terms of direct career mentors my biggest influence was Prof Dame Anne Johnson. She was very inspiring, extremely busy, always doing loads of stuff but she always knew when you really needed her attention for something important. That's something that I've tried to take away as I get busier and have my fingers in too many pies!

My scabies work, with Jo Middleton and Stefania Lanza here at BSMS, has taken 10 years to get to the point of getting a single study done because there wasn't any money in it and nobody believed we could do it. It ended up being published in a really good journal and on the front page. Lots of people have been in touch with us about it, some are the same people who once thought 'why is she doing that and is that a real problem?', so it has been really rewarding. I think I am most proud of this study because it's so important, and it is a study that would not have got done without me making it my mission, so this is my career highlight to date.